Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 01-17-2013, 02:33 PM #1
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Default Panic Attacks and Insomnia

Why do we get anxiety, panic attacks and insomnia? I also have noticed I have a lack of motivation, is this normal?

I feel like I am not myself when I have these problems. Insomnia is the biggest letdown out of all of them. Something is just strange with me and most of the time, I need someone to get through my days. Should I seek treatment again?
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College Student in Information Technology and avid PC Gamer, hit the back of my head against a bunk bed and went unconscious for 3 minutes back in 10-28-2012.

Symptoms: Occipital Neuralgia.
2 MRI's and CT normal.

Currently going through Paxil withdrawals, and psych has me on L-Theanine, Benadryl for zaps, and Lemon Balm. It has eased it by a bit, so I am continuing the treatment till 1 month from now.

Made a 98% recovery on April 8, 2013 with only symptoms of pinched nerves/Occipital Neuralgia in the head and is being treated with injections and physical therapy.

Was experiencing:
Migraines, Headaches, Nausea and Vomiting, Panic Attacks and Anxiety, Depression, Major Insomnia, Brain Fog, Tinnitus, Lethargy, Loss of appetite, Major Heart Palpitations, Occipital Neuralgia has eased a bit.

Vitamins and Medicines: , L-Theanine, Omega 3 Super DHA 900mg, Stress B-Complex Extra Strength, Potassium Gluconate 1000mg, Magnesium Malate 1250mg, Vitamin D3 2000 IU, Methylcobalamin B-12 5000 mcg, Vitamin C 500mg, Lemon Balm.

Things that helped me: My Vitamin Regimen, Medication, Earplugs (Love these!), Nature Sounds, Hydrotherapy, Neck Pillow with Heat, Heating Pads, Resting, Being Outside!
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Old 01-17-2013, 06:19 PM #2
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Quote:
Originally Posted by Consider View Post
Why do we get anxiety, panic attacks and insomnia? I also have noticed I have a lack of motivation, is this normal?

I feel like I am not myself when I have these problems. Insomnia is the biggest letdown out of all of them. Something is just strange with me and most of the time, I need someone to get through my days. Should I seek treatment again?
Consider: you are very early into your situation. Sadly, you are experiencing things that are all "normal" in the processing by your brain while it sorts out what is going on with itself.

It was injured, badly enough to need a period of time to have to itself to recover and find a new balance. During which time, you will be affected with the effects it suffers through the reorganization, if it gets the chance it wants to reorganize.

That is why you hear folks here stating : Rest, back off and give Rest a chance.

How much rest is not something anyone can say offhand. That is why being under the care of someone who is very attentive to the Concussion and mTBI, and the sequellae is very important throughout the initial and continual process until you reach some recovery, before further therapies are even planned.

You should still be under a neurologist's care, with regular revisits through this initial phase (especially with new symptoms occuring), and discussing possible future plans of therapies and/or evaluations.
Or a very good Primary Care Practitioner with very good experience with concussion/mTBI patient care.
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Old 01-17-2013, 08:34 PM #3
Mark in Idaho Mark in Idaho is offline
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I disagree with Concussion. There are very few PCP's and Neuro's who will understand your struggles. A Physiatrist (Physical Medicine and Rehabilitation) is sometimes a good find, if you can find a good one. The problem you risk with frequent doctors visits is being labeled a hypochondriac, somatoform disorder, and other negative labels. Over-medication is also a common problem.

Anxiety/panic attacks are usually caused by an overload of stimuli. Too much noise, voices and visual stimuli overwhelms the brains ability to process so it kicks into 'fight or flight' mode. This speeds up processing causing the anxiety attack. The injured brain has much less tolerance for this fight or flight mode so it tends to crash hard. The solution to this is to learn the triggers and how to moderate them. Some environments are simply not tolerable.

One problem with audio stimulation is related to being unable to identify the sound and the source of the sound. That dripping faucet or item blowing in the wind and banging against the building are common examples.

The concussed brain often can only process one channel of stimulation at a time. Sometimes, it will help to close your eyes to reduce the visual channel.

Unfortunately, few doctors will help you with these issues other than try to medicate you. The common anxiety meds are benzos like Xanax, Valium, Klonopin, and Ativan. They are not good for maintenance. Some need them for critical times. I find I do well with beta-blockers like propanolol. They have less side-effects and quicker action times with no CSF residue.

I bet everybody here has struggled with anxiety as some time during their concussion recovery.
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Old 01-17-2013, 09:03 PM #4
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I agree with Mark. To date I have seen two nuerologists, two pcps, a orthopedic spine surgeon, psychologists, and physical therapists. Most at best are skeptical of what I was trying to describe. In my opinion mTBI or concussion is not well understood in the medical society. Yes there are those rare few doctors who really help you.

My long term pcp helped me. It had more to do with the extreme change I went thru and he recognized that. It was over two or three visits unrelated to my concussion that he wittnessed this difference. Finally after 4 months and noticing that I was not getting the medical care I needed he stepped in. Prior to that he would counsel me to trust the nuero and just talk to him. I am so thankful for his intervention it made all the difference.

I know your struggles and how awful this injury is. I still struggle and believe it will affect me all the rest of my life. I have learned I am different but I am still able to contribute. My family and immediate co-workers have been great support. At first it was a struggle to find any joy in the day. Especially in the early months when the pain was the worst. With time and focus I practised celebrating any small joy until with alot of time I recovered to the point that the anxiety subsided and the pain is much reduced.

Find the best doctor you can. I have heard more good reports here from those have seen physiatrist than any other dr. so that is an excellent piece of advice.

Best of luck.
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To see the divine in the moment.
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Old 01-18-2013, 02:46 PM #5
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Quote:
Originally Posted by Mark in Idaho View Post
I bet everybody here has struggled with anxiety as some time during their concussion recovery.
I'm still struggling, depression too. My doctor prescribed Cypralex.
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Old 01-18-2013, 02:51 PM #6
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I am a emotional wreck....ALL over the place as well!!!
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What Happened: In 2011 I was in a MVA
.


Symptoms: Physical: I am always cold in any season!!I cannot tolerate anything pressure on my head(sun glasses,hats)longer then a hour,Lock jaw/Displaced TMJ, Dropsey, Hands go numb, Arms go numb, back of head numb (when asleep),Muscle spasms in face & upper body,migraines, concentration headaches, dizziness, nausea, neck and back trauma (from accident), tinnitus, extreme light sensitivity, noise sensitivity, EXTREME fatigue, impaired vestibular system, balance off, Pupils NEVER equal, disrupted sleep cycles,speech problems.

Cognitive: Cognitive Behavior, Brain fog, impulsivity, speech problems, word finding problems, slowed processing speeds, impaired visual memory, impaired complex attention

Emotional: Unable to handle stress or overstimulation without getting extremely irritable or angry, easily overstimulated, MAJOR depression, major anxiety, Panic attacks

Treatment so far: Treatment for PCS,PTSD,Depression & panic,Vestibular therapy, Physical therapy, Vitamin Schedule,Walking,No Dairy, No eggs, No caffeine, No artificial coloring, Sleep with 2 pillows, Very little sugars consumed, Eat healthy,No alcohol, Medications, limit stress and overstimulation.

~*~Learn to treasure yourself and your Divinity. Be willing to accept yourself completely. Be yourself, be graceful, be kind, be wild, be weird ... be true to yourself~*~
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Old 01-18-2013, 06:59 PM #7
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Dear Consider,
Valid points have been made but I must add......

Insomnia I believe in this instance to be caused by the subconscious becoming aware of an unresolved issue. Normally when we have a problem, the brain breaks it down into small pieces , disects it and resolves. Due to brain trauma you are temporarily not able to do this.
Your accident has changed your life so rapidly that your body cannot keep up.

So at night when you should be calm enough to sleep your brain is screaming at you that something is wrong but you in your conscious mind do not know what and so every time you close your eyes where your subconscious should take over and work in the form of relax and dreams, it too is full of anxiety and unresolved issues. There you get insomnia.

Anxiety is a physical reaction caused by the body becoming overloaded and not breaking down problems faster than the problems are compacting. This also causes depression.

Panick attacks are part of fight or flight. Your body believes because it has entered a temporary situation that is new, that it must be wrong. ie hit head, new symptoms that are not resolving quickly and so the body believes it is better off dead.

So you get palpitations, shortness of breath, sweating, shaking and the brain goes into overdrive and really believes you are dying.

The best way to deal with a panick attack is to let it happen. Remember it cannot kill you. Some people however have been known to to go onto develop a heart problems based on not dealing well with constant panick attacks.

In your case you will probably benefit well from councilling. This speaking therapy will aid your brain, teaching it to learn how to break down your problems again and prevent them from compacting, causing anxiety, panick attacks and insomnia.

Good luck.
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I am a 36 yr old female who has played football, as a hobby, for 13 yrs. In July 2012, during a game I was slammed to the floor by two angry guys who hit into me so hard that one of them broke their ribs.
This knocked me back onto hard ground leaving me unconscious. I awoke to chronic head and neck pain, sickness and the inability to see or balance.
The paramedics made me walk to the ambulance, instead of placing me on a spinal board, where I was taken to the ER. I was hospitalised with suspected brain hemorrhage for 1 week, then on complete bed rest for 1 month, in a wheelchair for 2 months.

I have been left with PCS, moderate constant head pain, little short term memory, no memory of the accident, balance and sight problems, depression and exhaustion.
The worst problem is collapsing regularly. This has finally been diagnosed as Hemiplegic Migraines , these cause my brain to regularly shut down when I am tired and I then feel the full effects of a stroke (without the bleed on the brain!!) of which the symptoms last 2-4 days.
I have had 6 CT's, 2 MRI's and am under 3 specialists.

I believe everyday is one more towards improvement. Mainly I believe in the power of acceptance not the weakness of complacency or resignation.
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Old 01-19-2013, 02:31 PM #8
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Been there with the first concussion and back there now. It's such a difficult thing to go through. Your "flight or fight" response is switched to "on" all of the time. It caused me a myriad of unpleasant (that's putting it mildly) symptoms, including insomnia, anxiety, depression, racing heart, no appetite, feeling disconnected, etc....the list goes on. It did get better over time after my first concussion, however, it was a slow process for me. I now find myself back in the same space and am trying to roll with it, but it's tough.

Remember you aren't alone in this!
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.


PCS "survivor" - first concussion 10/2010 with PCS for nearly a year. Hit back of head on a shelf. Symptoms were head and neck pain, vertigo, nausea, lethargy, anxiety & depression. Experienced greatest amount of recovery between 9-12 months, with the following year being much, much better
.


2nd concussion 12/2012 - hit front left forehead on wooden edge of couch. Currently dealing with a return of PCS symptoms including headache, nausea, vertigo, brain fog, and lethargy.
.


~ just trying to take it one day at a time
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