I've come across a few threads which have dealt with acceptance and depersonalization. For me, depersonalization/cohesive brain fog is probably the worst symptom of all. Beyond all the functional deficits which accompany PCS, the fundamental, underlying sense of lack of self has been almost too much to deal with.

I'm not sure if depersonalization (have to be wary of using psych terms) is precisely the right word for what I'm experiencing, but the best way I can describe it is a sense of utter blankness mentally and personally. It's not the kind of emotional hollowness found with depression, it's simply an ever present sense of things being cognitively off/altered and my not being remotely tied to the person I was pre-injury. The only ties I hold to that person are my vivid memories of things past.

This sense of utter mental blankness -- no inner monologue, no sense of or outside awareness of my thinking self -- doesn't come on in spells, but is rather omnipresent. Maybe the best term is loss of not just cognitive abilities but also everything that defines sentience -- emotional, intellectual, philosophical elements and the comprehensive sense of existence/self. My psychiatrist explains it by saying that there has been a fundamental change in the hardware of my operating system. Biologically that makes sense.

I'm sure that some of this is due to the fact that all the stimuli I encounter -- sights, sounds, noises -- is difficult for my brain to properly process, so I feel like it's reaching me through deep water or fog and even then, I only dimly register it. But even when I'm not interacting with external stimuli, there's no inner reality to withdraw into. Meditation is disconcerting when one fundamentally feels like there's a different thinking self inside. Parts of my body/brain seem to remember how to do things -- shopping, walking, cleaning -- but even if I'm "functionally" completing these tasks my experience and interaction is completely different -- foggy and mentally devoid of non-automatic response.

Apologies if this sounds mad. It's difficult to put into words and it's so bizarrely nebulous anyways. Is this what others mean when they speak of depersonalization? Is it post-brain injury psychosis of sorts?

Does acceptance mean learning to inhabit this new, disconcerting and unfamiliar mind? Does it ever lift? Any advice?

There is a similar symptom that is due to depression that feels like one is in limbo or detached. The common intense thought depression is different. I experience this lack of awareness depression 30 plus years ago. My psychiatrist explained it as cognitive fatigue from overload. As he described it, the brain gets clogged with toxins from a emotional or physical stress and just stops functioning.

Has your psych considered anything like a depression due to finishing school ? Sort of a post partum depression ? My brother suffered a depression episode when he finished an intense year long project at work. The adrenaline from the pursuit of the project became his existence. When that adrenaline trigger was ended, he collapsed. People, especially men, often experience this when they retire. It can be a malaise or worse.

Google Post College Depression or Post Graduation Depression. Both terms are used.

It would be worth trying to find something to do that creates a routine.

The defense industry deals with this same issue as Top Secret programs get finished and security clearance employees need to sit in the freezer for days and weeks ( a room with just books and magazines ) so their clearance level is maintained until the next program starts. The stress of going to work to do nothing is problematic.

You could try a 5-HTP supplement. The serotonin that 5-HTP provides helps with some depersonalization issues.

Good grief,

I know of what you are speaking. I know this is old advice but be patient.

Things do come back around.

That blank feeling was around for a good bit, I felt like a different personality, blank and absent.

I am for the most part comfortable in groups and conversations again but it took awhile. The good thing about this is when I don't want to answer the phone or talk to someone in public now I don't.

Bud

There is another poster here on NT who had a head injury and developed depersonalization symptoms. He now posts on another forum here.

Suicidal thoughts always there in the back of my head

Eventually his neurologist tested him for seizures and found seizure activity in his temporal lobe. He now takes an anti-seizure drug with some benefit. He is only 16 yrs old.

I experienced absence or petit mal siezures when I was young. People say I would become vacant as it I was in a different world. Doc could not find anything in EEG that was conclusive.

More recently, a qEEG showed that my brain was not properly processing information in the uptake cycle. This is where information is recognized and processed. Sort of like trying to put a pen to paper but the pen is skipping and not leaving much of an impression. The neuro was shocked that I could function so well.

I wonder if these depersonalization episodes are similar. The brain is not connecting perception and personhood with reality.

I've seen articles that make such a claim. Some say that this is because neurotransmitters are inadequate so there are not enough messages getting through.

That is why I take 5-HTP and L-Theanine in the AM. I tried taking L-Tyrosine but it had a negative effect. Neurotransmitters need to be maintained in balance or equilibrium to function properly.

You might want to look at taurine. Lots of new information coming out about it.
The Forgotten Longevity Benefits of Taurine - Life Extension
Works at 1000mg a day for my long term tinnitus.
There is a poster at TN forum who says it helps her facial nerve pain.

Also l-glutamine. One poster on Bipolar opens a capsule under the tongue to facilitate glutamine getting to the brain. Glutamate is the highest concentration of a neurotransmitter in the brain.
Oral glutamine restores the GI mucosa if it has damage, but less gets to the brain orally than under the tongue.
Glutamate
While glutamate released from cells that are damaged, is toxic to brain cells, as a neurotransmitter carefully controlled, it is important for brain signaling.

GoodGrief -

I know exactly the feelings you describe. Mine was really intense for a long time, but it does begin to subside after a while. Do you have any vision and/or vestibular problems? For me, I think a lot of the feeling came from vision and vestibular problems - my perception was distorted so much that it was giving me all types of strange "psychological" sensations. Vestibular and vision therapy helped with that along with acupuncture. I still experience it, though not nearly as bad.

Mark & Mrs. D -

How does one know how to balance neurotransmitters? For instance, I have been taking taurine 1,000 mg for a while now and have not noticed much change. I actually have tried different amino acids and never really notice much difference from them.

And how does one get a QEEG?

Thanks

In regards to amino acids:

It is best to take them on an empty stomach. They are often slow to show benefits. But after 2-3 months if you notice nothing different, then, there is no reason to continue.
They often compete with each other so spacing them may help if you only take 2 or 3 kinds.

I used to take taurine for my gall bladder and it did work to improve bile flow. I was only using 500mg a day, but when I upped to 1000mg a day, after reading the new information, that is when I noticed the tinnitus improving. That took a week or so.
It is also improving blood flow to my feet, which are not as cold as they once were.

The glutamine is new for me. I am trying this at 1000mg a day to see what it can do for my recent severe heartburn. This is working out really well too... so I am pleased with that, and not needing to use RX drugs for it. It took just over a week to reduce my heartburn, and now I don't even think about it anymore!

So non response may be due to low dosing, as well. It is recommended to not go above 3000mg a day of taurine. Bodybuilders use alot of glutamine for muscle fatigue. I wouldn't recommend their high gram doses for the average person.

Wow, thanks for the responses all!

Bud and RidingRollerCoaster, thanks for sharing your experiences with depersonalization (if we are calling it that). I am glad that you are no longer suffering from dp in such severity. RRC -- Yes, I do experience extreme difficulties with my vision...my eyes seem to be "seeing" everything 20/20 but not processing it and I often get visually disoriented to the point of being lost in familiar places. I also get dizzy when trying to focus on something too close to my face -- does this sound like something to be treated with vision therapy?

And thanks for the suggestions about rebalancing neurotransmitters, mrsD. I'm sure that that is part of the picture.

Mark, I know you mentioned, perhaps in another post, that anxiety can greatly amplify existing symptoms such as depersonalization/derealization, and I will say that I think you are somewhat correct. However, I think your theory about lack of cognitive overload resulting from impaired processing abilities hits at the true heart of the matter.

It seems to make most sense from a physiological point of view...if the brain's normal processing pathways, whether visual, auditory, etc., are not working correctly and information either cannot be processed or is processed incompletely and slowly, then one comes away feeling distinctly dazed. In my experience, with PCS the brain seems to be very good at knowing that it is not working as it is meant to, and thus we feel very out of sync. I'm fascinated that your qEEG was able to pick up on processing issues. How does one go about getting a qEEG?

I am often thinking (and forgive me if this is more philosophical than scientific) that much as we like to think of our cognitive "selves" as independent of our bodies, that "cognitive self" is actually directly predicated upon a particular brain. Once our brain changes, structurally and chemically, we are actually different. Perhaps this is particularly true if one has multiple concussions or diffuse damage like mine where there is not a focal problem but multiple areas which are dysfunctional.

Another question is about recovery of cognitive functions. I know many have said that some of the headaches and dizziness go away, but has anyone had extreme difficulty with basic cognitive skills like reading and comprehending/synthesizing information? I find that reading or listening to someone explain something beyond the complexity of "today I went to the store" is like running a mental marathon...processing the information, trying to store it and comprehend it, and then trying to put all the pieces of information together = impossible. It seems to be a combination of slowed processing speed, problems with working memory, and actual inability to synthesize and comprehend information.

Finally, I just wanted to say thanks again and send supportive wishes towards everyone here on NT. I'm finding the holidays particularly hard given the expectations and memories, and hope that others, if experiencing similar difficulties, stay strong.

gg,

You need to try to separate your different symptoms and address them individually. You will not find anybody who can address any cluster of PCS symptoms.

If you have vision issues that are not resolved, they can contribute to balance since a good part of balance is visual. A way to demonstrate this is to walk across a room in the dark with just a small visual reference across the room. When your vision does not see the floor moving or try to use the floor as a reference, the balance system can function better.

When you struggle to sleep, what goes on ? What is your mind doing ? What sensations are you perceiving (tactile, heat, sound, etc)? What do you do in the few hours before trying to sleep ? When do you eat your last meal and/or snack before bed ? What time do you get up in the morning?

The struggling brain often loses the ability to ignore sensory and other information. This interrupts the ability to relax to fall asleep.

This same problem can interfere with cognitive processing because there are distracting or irrelevant information getting into the processing stream.

I can see from your posts that you tend to be a finite thinker. Something is or something isn't with not much vagueness between. That makes PCS miserable. I don't understand what you mean when you say "However, I think your theory about lack of cognitive overload resulting from impaired processing abilities hits at the true heart of the matter. " ?

Regarding regaining cognitive functions, Many have to learn new ways to receive and process information. It might mean getting out of noisy environments or writing things down or other ways to break down an issue. Learning to actively focus rather than passively listen can also be an issue. For some of us, this means we have to 'Stop to think.'

Many of us lose ground with 'digit span.' Digit span is the number of items or concepts that the brain can hold and manipulate in a process. Digit span follows age from 2 to 8 years old. A 2 yo can process 2 concepts, like yes and no. An 8 year old can usually stay aware of up to 8 concepts. Digit span can increase beyond 8 for some. It is a function of memory and some other issues. If the memory can hold the 8 items, they can be used in the processing.

Wechsler has a digit span test. Gronwahl authored the PASAT. There are adulterated versions of both. A properly administered PASAT can be informative.

A full Neuro Psych Assessment will have these or similar tests in the battery.

Don't get your hopes up about a qEEG. They are widely available but few know how to fully understand them. My neuro did over 6000 and developed new research about what the various waveforms mean. He could use a qEEG and predict symptoms based on the waveforms. For example, he saw mine and said "You hear everything ! How do you handle that?" To which my wife answered, "That's why we are here." My brain does not filter out the myriad of background and conflicting sounds so my brain gets easily overloaded. He also predicted my IQ and other characteristics. Unfortunately, he never published his work except for one article. He went blind in 2007 and closed his practice and shredded all of his files. He just passed way this past year at 89. It is unfortunate he never passed his knowledge on to others.