Well I just got back from my intake appt. I guess I have anxiety and clinical depression and fear of public places.... I'm not sure why I have it now and didn't have it before the accident. They think the depression is due to my limitations physically from the injury. So they are going to do some cognitive therapy. I asked them why I have it now and didn't before and they said when you get a head injury all the stuff can bubble up from underneath the surface... I'm not so sure on that one but we'll see... Has anyone else had this happen to them?

I think it's normal to be depressed when your home recovering for five months plus..... So I'm at a loss. Any outside thoughts on this?

My head is pounding from being there so long..grrrr..

I can understand the fear of public places. The overwhelming visual and auditory stimulation makes the public places problematic up to the point of being terrifying.

I hope they don't try to do immersion therapy to help you overcome this.

Many with anxiety will respond to therapy because their anxiety is thought oriented. PCS anxiety can be both thought oriented and purely physiological. It will take a different approach to deal with the physiological caused anxiety.

Have you been trying to go out with ear plugs in your ears? This can help with the auditory issues. Also, wear sun glasses and even a wide brimmed hat to help bright lights and other visual stimulation.

I can understand your head ache. The waiting room, front office chatter and such can be draining on the brain.

Try to take a nap if you can.

My best to you.

I had very little depression before my injury and zero anxiety. Post-injury, I have full blown GAD (Generalized Anxiety Disorder) with massive anxiety and panic attacks and moderate depression. So I think it's normal to have these problems after a brain injury.

Thanks for your input!! Sometimes I question myself with all these different dx getting thrown my way. They kept asking me, "why cant you work?" I'm like hello, Head Injury.

They did say that they didn't think that I was being managed properly because of the amount of pain/headaches I get. I tried to explain I didn't want to be on painkillers everyday. I dont think that is good for my recovery.

They're going to speak with my MD's to try and come up with a plan. Gulp.....

I do get down but being in pain for so long is draining as I'm sure you all know.

I'm not sure if I should call my MD and ask him to prescribe something else...I'll wait and see I guess..

The difficult part sometimes isn't just the depression, but also the motivation to do things. I was depressed about a month ago for a few weeks and came out of it by watching funny television. My therapist suggested "Party Down" if you have Netflix. It will get you howling with laughter.

I've opted not to go to the pain medication unless it's really, really bad. There are things you can actually do to get your spirits up. Even try Tai Chi. I've done a couple of sessions of that through a DVD and it's worked wonders on my mood.

I must say, staying calm is also the hardest thing to do. There's more effort required and you have to be extremely self-aware to have to cope with all the different environmental stresses. Ease yourself in, living with your condition and making those allowances. Look for ways to gauge yourself on occasion then try moving forward with each symptom.

My theory is that we ALL have primitive emotions such as anxiety and fear, but normally don't "feel" these things due to balancing factors in the cortex regions of the brain.

Primitive emotions are stored in the more primitive areas of the brain located near the center of the skull, and thus more protected from physical trauma. These raw emotions are not undesirable per se, as they conferred adaptive value to a developing species (translation: fear and anger kept us alive long enough to propagate).

In TBI, more advanced areas of the brain (i.e. closer to the surface) are damaged, wiping out more advanced cognitive processes that normally balance the primitive drives. Courage, for example, is a higher form of cognition, and balances the fear drive.

You DID have anxiety and fear of public communication before your injury, as we all do. You simple kept these feelings under such efficient control that you didn't even realize you had them. That's what they meant by "bubbling up". These feelings are literally accreting from deeper parts of the brain, with nothing to stop them.

Your brain injury robbed you of your power to control primitive emotions, and you must now find other ways to compensate. Some of the ways suggested are good- Tai chi, laughter. I have found very good benefits from martial arts type stuff, and meditation (and have some theories on that as well).

The way my neurologist/psychiatrist/research scientist put it is this.

The concussed or injured brain, once it has reached the critical mass of severity of injury, loses its ability to filter stimulation and the many environmental factors we constantly live with. When this filter (or system that give us the ability to ignore inconsequential issues or issues that we have developed a tolerance for) fails to work, it allows information to make it to cognitive (conscious) and even sub-conscious thought.

The brain has a limited band width for information processing. The injured brain has even less due to inefficiencies of the biochemical and physiological systems.

If the healthy brain were an 8 lane highway, the injured brain is reduced to 4 lanes with occasional reconstruction zones. When the information is flying down the road at 60 mph on 8 lanes, it does fine. When the on-ramp metering lights are on, even rush hour traffic can keep up to an limited extent.

The injured brain is like rush hour but the on-ramp meter lights are not working (filtering) As cars (sensory stimuli) increase and flow onto the highway, traffic starts to get crowded. But, the cars are still trying to go 60 mph. Eventually, the road narrows to 4 lanes and cars (sensory information) start to collide. Now, we have a 150 car fender bender pile-up. Brain overload and crash into a full blown anxiety attack or shut down.

To correct this, the traffic has to be slowed at the on-ramp ( environmental stimuli, sounds and lights etc.) and the pile-up of dented cars need a traffic free environment to get untangled and moving ( refocus in a quiet place) or towed away ( a nap).

My doctor did some diagnostic work with a qEEG. He could observe as my brain's auditory filtering and processing center tried to pass everything I heard to be processed and forwarded to the frontal areas. Unfortunately, that first step of directing the auditory information gets stuck with a single lane where there normally should be 4 lanes. (25% processing power).

As such, it crashes and lets all of the auditory information flow unregulated and unformatted to the frontal area. Now, the frontal area is still working at full power ( mine is processing at up to 10 times normal power by my doctor's observations). Now, my brain is going full speed trying to decipher piles of shredded and cross-cut documents. As the saying goes, Garbage in, garbage out. A likely uncontrolled outburst or a total crash/pile-up.

The only solution for me is to physically limit the amount of sensory information allowed in. I do this by controlling my environment and being ready to exit an environment that gets beyond my ability to moderate.

With 10 years of practice with failures and successes and a prior 30 years of a less intense need to limit stress but still a need to limit stressors, I can lead a decent life. I had to move away from too busy and chaotic California and find a place in suburban and rural Idaho.

My 2 day visit to California last weekend was all I could handle. Same goes for visits to see my grandkids in Seattle.

Hope this helps people understand.

My best to you all and to all a Good Night.

Mark: The way your Dr.'s put it is really perfect.

xxxxcrystalxxxx: Try to find a therapist who specializes in brain injury, or who knows how to deal with people who are dealing with major health issues. TBI is even a way to filter therapists who specialize in treating people with it on Psychology Today when looking for a therapist on their website.

The first therapist I had had no clue, but it helped me just to talk to someone for an hour every week.

I never really needed therapy before the injury I got either, although I did have PTSD, I managed it just fine on my own. After I acquired the injury, I couldn't handle stimulation and I couldn't be aware of my own surroundings which made me super scared! Because I already had PTSD...

Now I have a therapist I love and I see her once a week and she totally understands what I'm going through. But not because she specializes in tbi, because the therapists in my area that do are way over-booked (but maybe you can find one or at least get on a waiting list to see one), but she understands major health issues and knows what it's like to have an immediate life style change and a sudden change in personal ability which is frustrating and depressing for anyone who has to deal with that sort of thing.