The only symptom I continue to struggle with is my inability to connect with people. My emotional connection with people is completely lost, as is my ability to generate emotionally connected thoughts.

The best way I can explain this is my inability to maintain or make genuine eye contact with anyone, not just strangers, even my mom, my sister, my best friend. I feel intense pressure in my head and headaches if I try to think and use the normal thinking I would have used in the past to connect. In essence, when I sitting alone, I still cannot think and therefore make eye contact with myself in the mirror.

In the moments that I have felt clarity since my initial injury, this pressure and blockage in my head would completely disappear, while I would continue to feel fatigued. All my symptoms came about when I drank alcohol. I am 24, was still working when I last drank, which was Friday July 17, 2015.

The next week when I returned to work, I couldn't interact with colleagues I had become close friends with over the last 5 months.

My other cognitive skills like analytical thinking, visual processing are not hurt. I do think memory is poor because I am forgetting names a lot. But, that I am not as sure of.

What you are describing sounds like 'flat affect.' I think a Neuro Psych Assessment would be worthwhile. It will be able to differentiate cognitive symptoms from emotional/psychological symptoms. I still think you have a high likelihood of depression. You sound like me when I had my depressive episode 32 years ago. I felt like a zombie trying to connect with others.

I had an appointment with a neuropsychiatrist today. The doc does not think this is depression, and referred me to Dr. Cantu's concussion program at Boston University. I will be looking to see if I can get treatment there.

I am a 100% certain this is not depression or anxiety. The excruciating headaches I experience when trying to unsuccessfully think are proof of that. Furthermore, the doctor also had an explanation for the feeling of fogginess I felt that sets in on the very few days that I do feel clear. I explained how speaking and thinking was exhausting on those days even though I felt capable of it, and he noted that it's because I need the blood to flow through the brain faster than it is capable of. I will have to listen to my brain and body and not over-exert on those days. But, since such a recovery day hasn't appeared since October 1st, I need to get looked at professionally.

I will keep people posted on updates here. Thanks again for your help so far everyone, and especially Mark.

I have great respect for Dr Robert Cantu. He has been speaking about concussion for 30 years with nobody listening until 10 years ago. I have his book on my shelf. His office in Concord only take sports concussion patients from the last I heard. Hopefully, the Boston University clinic is open to others.

How much activity are you taking on each day ? What kind of work are you doing ?

What are you trying to do when you 'unsuccessfully think' ?

Hi Mark,

Currently I am not doing any work. I was working till September 13th but took leave from work because I felt extremely awkward interacting with colleagues. Friends and co-workers who had known me for months tell me they don't see me when they look into my eyes.

I think this leads well into the question of what I am doing when I am trying to unsuccessfully think. The best way I can explain is that when healthy we have say x% of social awareness of your self and how to relate to people. The higher your ability to connect with different types of people, the larger that x%. Of course that grows based on experience and your ability to learn as well. But, at any given time, you have a given amount of that understanding.

When I am unsuccessfully trying to think, I essentially mean that this bank of awareness that I can normally easily tap into seems blocked off. It literally feels blocked from access. The harder I try to reach and think, the more my head hurts but I am just unable to access it. In the days that I have felt that clarity that I described, I feel this thinking is no longer blocked. That is all.

So currently in this chaos when I look into someone's eyes, I don't understand and can't maintain the eye contact because within myself I can't think or relate that way. I am not talking about making eye contact with strangers. I am talking about people I have known all my life - my sister, my mom, my best friend, the girl I was dating before I got hurt (Alas!).

I definitely could use more activity. That is the primary focus in the coming days. I had been resting because as I understood from my neurologist exercise after a concussion is detrimental because your brain needs energy to heal. I suppose light exercise is important to get the blood flowing as you explained. So, will definitely plan to get started on that right away by taking long walks everyday.

You have lost me about the unsuccessful thinking issue. I know what it means to struggle to think. Accessing memory. word finding. calculating, processing thought, understanding spoken words, spacial relationships, math, imagining, imaging, recognizing facial expressions, etc. None of this sounds like what you describe.

What kind of work did you do ?

You sound like you have a psychology background, at least to me.

Your explanation of interactions sure sound like what I went through back in 1982-3. The depression that was diagnosed was not the morbid, I feel worthless, suicidal, etc. classic definition of depression.

He diagnosed me as having a depressed state of functioning. I had extreme flat affect. I struggled to communicate. I would struggle to finish a sentence/thought. I had a scattered presentation. It was like I was not there in my body. I looked gaunt. I lost weight. He explained it as a chemical overload of my brain cells due to stress and over-attending. It had been years since my last minor concussion. I was just under stress due to being ripped off for hundreds of thousands of dollars.

Were you seen by a NeuroPsychiatrist (rare) or NeuroPsychologist ? What kind of diagnostic testing was done ?

I hope the concussion clinic can help you.

It actually does sound like your flat affect. I can overall see when I am being interesting or not to someone. But, I am completely unable to engage in the way I used to before. I can still tell from eye contact when someone has lost interest in what I am saying etc. I am just completely unable to smile in my mind and that doesn't allow me to connect with people.

I was a business consultant in NYC. I have a business background but have always thought heavily about depression, suicidal instincts, interaction stemming from my dad's heart attack and death when I was 12.

But, that said, my personality is of an extreme extrovert. I was going out every couple of days, meeting new people connecting before I got hurt. That obviously feels so far away right now.

The doctor I saw was a Neuropsychiatrist. He is based in Pittsburgh (referred to from a work connection as an expert in PCS) so we had a Skype meeting. I visited his website, he has published several articles on post concussion symptoms, apathy following post concussion, and has been practicing neuropsychiatry for over 25 years.

In terms of testing, he was more interested in just hearing how I interpreted my shortcomings. Since I continued to work for months following my last setback in July, doing a very high quality of work (such that my manager found it hard to believe anything could be wrong other than me just acting "like a weirdo" at work), it seems very unlikely that cognition, analytics are impaired. I can still break down issues and understand problems the same as before, so not as worried about that. I do have trouble finding the right word and accessing memory to some extent, but on days of that blockage removal that didn't feel like a problem at all, so not necessarily my focus right now.

Mark, how did you go about treating that flat affect? Are there certain foods or vitamins more important than others?

Thanks for your answers and concern once again. Since I joined this forum to now, while my "thinking blockage" symptoms themselves have not waned, my anxiety is completely under control which has made life somewhat livable again, and I thank you and everyone here for that.

I still struggle with mild flat affect. Back in '82, I recovered mostly. Not back to 100% but much better. I could relate to my wife. Be there in a supportive way for the birth of our second child. etc.

My injury in 2001 left me with a relapse of flat affect. I have had to learn to cognitively respond as if I am emotionally responding. The emotional response does not come naturally. It is like learning to be polite and courteous. Of all the aspects of emotional response, I am clueless to most but use those that function to almost exaggerate a response to the others. I have to choose to express gratitude based on cognitive observations. Same goes for empathy, etc.

I think some of it comes from a failure or struggle in the part of the brain that recognizes facial expressions.

Oddly enough, I can get weepy eyed in response to some situations but that appears to be an emotional lability issue/ PBA like symptom. (PseudoBulbarAffect) Very light triggers can cause an emotional response in some cases.

SSRI's and such can make some of these issues worse.

Back in '82, I received weekly B-12 shots plus the vitamin regimen.

It is a struggle to understand.

Did you get a consult with Dr. Bernstein ? Or the people at UPMC sports concussion program ?

Are you still in NYC ? Boston will be a trip to see the concussion clinic.....

My best to you.

Mark it definitely does sound somewhat similar. I'm following on the vitamin plan and hoping that creates a difference.

Wondering with some flat affect now do you feel capable of holding engaging conversations for the most part? Like if you were stuck in a room forced to talk to a stranger would you be able to talk and connect without being/feeling awkward, or losing their interest. Cuz I currently wouldn't, and I guess need to learn coping strategies to get there.

There is a saying about topics of discussion.

There are those who talk about people.
Others who talk about things.
And a few who talk about ideas.

I struggle to hold any interest in talking about people.
I spend more time talking about things.
But, I gravitate toward talking about ideas.

Unfortunately, most conversations I witness are about people.

If I was alone with a single person, it that person was interest in 2 or 3 above, I'd be OK. I'd fail at 1.

I am not good at idle conversation, mainly because I do not see much purpose to it.

But, if the conversation is task or activity focused, I'd probably be OK.

But, I don't see flat affect impacting conversation that much. But, that can just be me because I have never been one to talk about feelings. I also do not get a sense of self from my ability to hold a conversation.