I think the challenge about anxiety is complex. Doctors see patients come in complaining about PCS and manifesting anxiety and the docs want to treat the anxiety. They usually do not have any treatments for the other PCS symptoms. They usually do not directly connect the struggle with anxiety with the injury. I doubt they really understand that concussions create/increase the physiological cause of anxiety.

The PCS subject has a similar dilemma. Their anxiety can be overwhelming and self-perpetuating. The 'when is this going to be over?' anxiety often rules the days. They are left to their own devices to sort out physiological vs psychological anxiety. They are rarely given tools (counseling, etc) to lower their own psychological anxiety levels let alone being told that some of the anxiety is directly due to their injury.

Learning to accept PCS symptoms as real and ongoing, at least for the time being, can help. The moment by moment 'when is this going to be over?' is counter productive. Many on NT appear to track their symptoms by the hour. This is not helpful. We need to let go of those micro-tracking of symptoms and try to look at a longer term analysis. Hopefully, this will lessen anxiety levels.

So, if we can reduce the psychological component of anxiety, we give our brains a better opportunity to heal from the physiological component of anxiety. For some of us, that physiological component of anxiety will be with us for a long time, for some, even permanently.

It is a big struggle with no simple or quick cure.

I'm new to this site as of today. I had a bicycle accident exactly 6 weeks ago. Broke my hand, my ankle and worst of all learned that I had a concussion. The concussion stuff didn't hit me until approximately 5 days later. Headaches and naseau are pretty much gone but will this anxiety ever go away. Scares the heck out of me. One day I think I'm recovering then all the sudden, bam, major panic attacks. I never had anything like this. Neurologist put me on Effexor and then moved me to Zoloft which made me feel like my heart was going to explode. I finally went to my general practitioner who told me to stop taking it. I felt better for a day. Almost normal then bam, last night I had a major anxiety attack for no reason. Is this ever going to end? I can't live like this. Currently taking Ativan but only a .5 milligrams. Any help or recommendations? I want my normal back. I never had to deal with this stuff before the crash. Please help.

I went through the exact same thing as you are with panic attacks. Never had them before my last concussion. At first I didn't even know that these were panic attacks, I thought it was some symptom of concussion until my GP realized what was going on and put me on xanax.
When it was at its worst I couldn't sleep for several days, my BP was through the roof, I couldn't function at all. The realization that it was all just panic attacks helped some, but I continued to have them on a daily basis for about two months. I refused to take xanax so just toughed it out.

Don't really have an answer for you as everyone is different, the only thing I can tell you is that this is "normal" for PCS and it will get better. Also I would avoid any heavy stuff like xanax and anti-depressants as much as possible.

Jeff146,

Welcome to NeuroTalk.

As RR said, anxiety is normal for PCS. But, there are often things you can do to minimize them. Your brain is hyper sensitive to all stimuli, visual, audio (sounds and voices), tactile(touch). It is also hyper-sensitive to caffeine and stimulants. So, reducing these factors can help. Many need to wear foam ear plugs for a while, especially in noisy situation. Shopping malls can be miserable for PCS.

If you can, get your blood pressure checked when you are having an attack. Many have at-home meters. If your BP is elevating, a beta blocker may help better than a benzo (Ativan) or SSRI (Zoloft) or SNRI (Effexor). The latter two take weeks to start to work. A beta blocker like propranolol can be taken at the time of the anxiety attack and work in 30 minutes or so. It is a basic blood pressure lowering med that helps with the other panic issues, too. Maintenance use of benzos are not recommended for PCS.

The first way to move forward is to accept that you need a vacation from normal. You need to slow down and get 'quiet rest.' That means low stress, low stimulation for an extended period. There is no way to push through PCS. In fact, trying to push through will only make your PCS last longer.

Your brain will only heal when stress is low and you have no anxiety. Anxiety is like massive pollution for your struggling brain.

It will help you to read the Vitamins sticky at the top. The injured brain needs additional nutrition far above what a healthy brain can survive on. It also needs to be free of intoxicants (alcohol) and stimulants (caffeine). At most, a single serving per day of either is considered OK by some.

And, most important. Just because you are having a good day does not mean you can return to 'normal' activity levels. Those good days need to last for a week or two before they can be considered recovery. Many end up riding the good day, bad day roller coaster because they do too much on their good days. Year end party and social time is over so you have an opportunity to slow down and let time heal.

Also, nobody can predict how long your recovery will last.

Please feel free to tell us about any other symptoms you are experiencing.

My best to you.

I find doctors almost always rush to Anxiety as the solve all fix even without a strong history of anxiety.

When I went back to the doctor (and I saw 2 different ones) after the concussion symptoms not elevating after a few weeks, they were both heavily implying anxiety as the root cause of my issues. Which just didn't match, since when did anxiety cause headaches and nausea so badly? Especially with no history of it prior.

There is a lot of chicken and egg with the concussion symptoms causing, or caused by the anxiety however.

I do think you can exacerbate or even outright cause symptoms by worrying. But I highly doubt current doctors have a strong enough understanding to really say which it is.

I also had very prolonged recovery from a head injury that involved a cycling accident whilst training for last year's cycling season. Your problems sound somewhat similar to mine in many ways--although I also battled visual and vestibular symptoms.

My anxiety made these symptoms about 10 times worse . . . and although Zoloft did not work for me, Effexor has worked quite well. I have a history of anxiety and depression and my concussion was severe (and docs think a vestibular concussion by the way I hit the back of my head). It was a recipe for severe anxiety and depression for me--yet relatively minor symptoms were turned into major ones because of the psychiatric difficulties.

Please consider seeing a neuropsychologist, if they have them in your area. I got my anxiety and depression in check, and all of my symptoms quickly started to resolve. NPs are very good at explaining the complex soup that is mental illness + tbi. I was also much better able to accept my situation. I do not, and may never feel 100% the same as I was, but that isn't keeping me from racing my bike again this year and leading a full and active life!

Cheers!

Lui,

Glad you brought this up...interesting subject and responses.

I have always been a worrier but this injury turned it into a monster! I have spent countless hours and days thinking I was making stuff up, wondering what came first the chicken or the egg but at the same time something has always seemed wrong.

All I ever got from my docs was the default answer for what they can't test for...anxiety, takes some of these pills and I wasn't convinced it was "all in my head".

I have fought a long hard battle with anxiety the last 18 months and it is retreating begrudgingly. I hope the diagnosis from the neuro optometrist this week proves correct. My eyes are not working together and one is looking up by itself, apparently causing a great deal of anxiety when you can't see straight or focus on a subject easily or for sustained periods.

Bud