Hey everyone,

On January 15th I suffered a mild concussion. Felt incredibly foggy at first, but that improved a lot over time. About 3 weeks later, just as I was really getting back to normal, I hit my head again, with a return of all the symptoms. Then finally, a week after that, I suffered another concussion.

Since then, I've improved a ton. The only lasting symptoms are depression, hypochondria, and (possibly) some minor residual vision problems. Whether the depression and hypochondria are actually symptoms remains questionable though, as the concussions may have just been triggers for those honestly. Regardless, those are currently being treated with Remeron (mirtazapine), good nutrition and exercise, and they're seeing a lot of improvements. The vision problems might be imagined.. I just feel that everything could still be just slightly off, albeit not nearly as much as it was in the past. With hypochondria, it can be kind of hard to tell what's real and what's psychosomatic honestly.

Yet, because of the very severe anxiety I suffered after the third concussion, I clenched my teeth. A lot. And hard. And I didn't realize it was a problem until it was too late. I currently have a moderate TMD. I don't have lockjaw or anything, but I do have head pressure, tension headaches, nummular headaches, occasional ear pain/jaw pain (not as bad as it used to be), and constant ear popping.

To treat it, I've been icing each side for 10-15 minutes every night. I've also been doing my best to eat softer foods. However, while it usually keeps it from getting worse, it doesn't really help it get better. Should I look more into ibuprofen? Or is it still not that safe for me? And are there any other options I could look into besides surgery? Any advice would be great.

Thanks,
Hunter989

Hi Hunter, I wondered how you were getting on.

I often see people say they have hypochondria here. Is that a term the doctor has given to you or is that something you think you have yourself? Do you mean you are worried about your health or have anxiety about your injuries? Not sure why you would be thinking your vision problems are imagined.

The main problem with ibuprofen type drugs is immediately after a concussion as far as I know. You wouldn't want to take it long term on a daily basis though but I find it helps more than something like paracetemol for headaches and pain. You should ask your doctor if you're concerned.

I'm sorry I can't help with any info about the TMD as it's nothing I've experienced. I know it can be exceptionally painful. What type of doctor is treating you for that? I know there are probably older posts if you use the forum search feature. There are a lot in Dentistry forum and some on Trigeminal Neuralgia forum too.

Some psychoactive drugs can cause jaw clenching. I had that problem. Taking gabapentin helped, especially for the clenching I did while sleeping.

There is a procedure where the doctor injects Botox into the jaw muscle to weaken it to reduce the power of the clenching thus reducing the wear and tear on the TMJ.

I was treated for lock jaw and other TMD/TMJ problems by a physical therapist who did 'in mouth' release techniques. They were very helpful.

What symptoms do you think may be due to your possible hypochondria ?

Thank you both, I really appreciate it. I'll have to look into those more!

As far as the hypochondria goes, it's something I struggled with a little bit when I was a little kid for a year or two, so it would make sense in my case (although I had zero signs of it beforehand, for at least the past decade or so). But basically i feel like I don't track things correctly all the time, or at least as smoothly as it was before the incidents. Or that sometimes it takes my brain longer to process everything, leading me to feel more overwhelmed. But the brain is quite a powerful thing I've come to realize, so I understand that a lot of it could be psychosomatic. It does seem to get easier when the anxiety's not that bad, but I don't know if that's because my actual "symptoms" ease, or because my ability to deal with them increases.

It's a brutal cycle. Sometime I feel like I'm losing my mind when I try to figure out what's real and what isn't (which just makes my anxiety skyrocket). I feel like I should be back to normal..

Although this may be a slightly erroneous belief, I'd (unintentionally) found that alcohol was a good test of a concussion for me after the various hits I sustained. I noticed it hit me way harder when I was really concussed. I drank last weekend though and my tolerance was 100% back to normal though.. So I don't know. I feel like that means I'm done recovering, but, I'm really not sure. I think I'm going to start treating the anxiety and the TMD seriously and see what remains after that. I think I'm going to try running again and see how I feel with that. I've done cycling at the gym for a couple weeks now with no adverse effects.

It can all just be so scary sometimes.. My thoughts race so fast that I don't know what to do with them sometimes (a stark contrast to my anxiety about the brain fog not even a month ago). My biggest fear is losing my mind, becoming schizophrenic or psychotic or whatever. I'm a caring, rational person overall so I know that's just the hypochondria taking its toll on me, but still. I'm just so tired of feeling this way, feeling nervous about every little thing, overthinking everything. I want to experience the world again, relax, and be happy. But that's so hard without knowing what's real and what isn't.

Sorry for the length of that in advance.

You say "But basically i feel like I don't track things correctly all the time, or at least as smoothly as it was before the incidents. Or that sometimes it takes my brain longer to process everything, leading me to feel more overwhelmed. "

Those are both symptoms of concussion and side-effects of mirtazapine.

The slowed thinking is very common and should not be a cause of concern. it will take time. As you noted, anxiety can make it worse. There are two types of anxiety common to PCS. Thought based, "I'm going nuts. Is this ever going to get better? Oh xxxx, I bumped my head again." etc. Then there is the physical/mental anxiety of a brain that simply has been overstimulated.

Before seeking drug treatment for anxiety, you might consider how stimulus can be reduced.

For many of us, getting a NeuroPsych Assessment done has allowed us to understand and accept these symptoms as real. Even an ImPACT test can sometimes help show your slowed thinking. Sports Concussion Clinics can often administer them. But, without a baseline, the results will be harder to interpret.

Even though your alcohol tolerance appears to have returned, you should still limit your alcohol intake to a single serving while your brain continues to heal.

What else are you doing to help your brain recover ?

Those are both things I haven't fully considered, thank you. I'd definitely at least realized it; I was on atvian for about 3 weeks and went through withdrawals when I stopped. Before starting on the mirtazapine, I was feeling a lot clearer overall. Though, I was certainly overstimulated by having everything come back at once. The anxiety found its home in that and by hypochondria. I'm working on both of those however. A lot of it is mental at this point.. If not all of it. Getting back to real life can be hard after going through all of this.

As far as how I'm recovering, I've been eating extremely healthy (lots of coconut, avocado, and other fatty brain-healthy foods). I've also been keeping active physically and mentally lately, coming back to school with a fairly normal class schedule. I actually just went on my first run today since before my first concussion, and didn't have any increase in symptoms or anything! I had drank a few times in the past weeks, though fairly limited. I smoked weed or took edibles occasionally, justifying that with the thoughts that it would help me me faster from all the "studies" floating around the internet. While I haven't had any particularly bad experiences with that, I've realized that it's not that great for my anxiety overall. With me starting back on the mirtazapine though, I've cut all that down to just about zero. I try to meditate whenever the anxiety gets too bad, but overall I do like to think that it's been steadily improving. That's about where I'm at right now.