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


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Old 07-18-2017, 10:30 AM #1
Rahruwin Rahruwin is offline
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Default Nervous body , anxious state, sobbing wreck

14 weeks since bad head slam. No loss of consciousness.... Just sizzling swooshy sounds in my head. I was ok for a few days .... Just sore.... .Then my body seemed amped up.... Like on 50 expressos.........

Then came high anxiety, the surreal state, feeling "very off".....and uncontrollable sobbing, which has probably led to this very depressed, "fed up with it all" state of mind. It's the end of life thoughts that scare me.....but I also know from past research that these disturbing thoughts are purely a chemical response to anxiety, as can be the depression. I expect my head slam is the culprit in this thou.


This is day 18 of citalopram 10mg. I don't think it's helping any (I understand it can take weeks)... I'd also hate to think I keep taking it and it just isn't the right med for me this time and I'm prolonging some very needed relief. (I used it 5 yrs ago briefly with great success) It seems most are using Zoloft or Paxil.

I am ridiculously afraid to take meds.... Xanax ....which has been prescribed at the smallest dose to take daily as needed. I'm afraid as I don't want to become dependent.... So I suffer a lot .

I'm here today because I'm just so distraught with it all. I mean ridiculously sobbing on my knees begging God to help me. I sob all the time.

Too much time on my hands (4 days off a week)....I used to love my country getaway.... But just thinking about driving 90 miles away brings we anxious distress... Sometimes it has helped....but lately when I'm there I'm so anxious to get back to town......too much time down there alone.... Dogs and horses can only do so much.

I'd love to hear from y'all who have experienced pcs nervousness, debilitating anxiety and depression and feeling disconnected from the world as you knew it. It's hard for me to be positive and think "one day at a time". I don't see the light at the end of the tunnel......... God bless all of y'all.
Please reply if you can relate and have a positive response. Ive already read plenty to keep me scared to death as it is.
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Old 07-18-2017, 10:53 AM #2
RidingRollerCoaster RidingRollerCoaster is offline
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Rah-

I had to reply to your message because I know exactly what you are going through. Please know - it does get better! I had the terrible nervousness, INTENSE anxiety, uncontrollable crying, and surreal feeling, racing thoughts. Then I started getting suicidal thoughts. It took a while, but this has all gone away. You do have to take it one day at a time and never give up. I didn't, and it has made me a better person today. It will get better, but it takes time.

I took citalapram too, but not sure if it really did anything. I think it may have helped some with the anxiety. I took ativan to help me through some of the really terrible periods of anxiety. You will not get addicted to it unless you take several doses of it a day for several days in a row. It is not the best for a healing brain, but if you are really suffering, you may need to take it once in a while.

What are you doing besides meds to help with this? What are your days like? Are you sleeping? How were you hit? What are your other symptoms? Sleep is very important. So is balancing low-stress activity with rest.

The things that helped me the most in the beginning were:
- My spouse there to support me through the crying spells, terrible anxiety and really low emotional times. If you don't have someone at home, get a friend or a therapist. Tell them you really need help.
- Gentle massages to my upper body muscles. All of my head, jaw, neck, shoulder and upper back muscles were so tight and traumatized by the blow to my head. When I got massages, I could sometimes feel the anxiety lift out of my body for a period. Do you have any muscle tension?
- Talking to someone about all of my thoughts and anxiety. - this helps get the trauma out of you.
- Warm baths to calm me down when the painc got real bad.
- Guided mindful meditations like body scans, breathing, etc... There are a ton of good free sites for this like UCLA meditation center (try the singing bowls - very relaxing) - or the Insight Timer app.
- Acupuncture
- Gentle activities like coloring, walking, things using my hands.
- neck physical therapy - make sure it is a good PT
- if you have dizziness or vision problems - find a very good vestibular therapist - (the vestibular and anxiety centers of our brains are very connected) - there is also vision therapy by a special optometrist if your symptoms are more vision than dizziness (I found that a lot of the surreal feeling was related to my vision being so dysfunctional)

Please keep hope - you will get better over time. I know it is hard to see the light at the end of the tunnel, but you will eventually. Try not to read too much on the internet - I made that mistake and it made things worse. Try to focus on positive, stress-free activities.
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Injury: March 2014. Hit hard on top of head by heavy metal farm tool. LOC. MRIs and Cat Scans clear. PCS ever since. 33 year old female. Trying to stay positive!

Persisting Problems:
fatigue, dizziness, lightheadedness, vestibular balance and vision problems, vision static, tinnitus, hearing loss, slight sensitivity to noise, sometimes the insomnia comes back, sensitivity to stress, exercise intolerance, emotional problems - But I still have much to be thankful for.
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Rahruwin (07-18-2017)
Old 07-18-2017, 10:56 AM #3
RidingRollerCoaster RidingRollerCoaster is offline
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I forgot to add that diet is very important. You must get a lot of protein and eat a lot of nutrient dense vegetables like greens (I mean a lot!) Try to eliminate sugar, processed foods, and maybe dairy and gluten as much as possible. It may be difficult depending on your diet now, but it really helped me when I did this. Taking fish oil and other supplements may help too.
__________________
Injury: March 2014. Hit hard on top of head by heavy metal farm tool. LOC. MRIs and Cat Scans clear. PCS ever since. 33 year old female. Trying to stay positive!

Persisting Problems:
fatigue, dizziness, lightheadedness, vestibular balance and vision problems, vision static, tinnitus, hearing loss, slight sensitivity to noise, sometimes the insomnia comes back, sensitivity to stress, exercise intolerance, emotional problems - But I still have much to be thankful for.
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Old 07-18-2017, 11:47 AM #4
Rahruwin Rahruwin is offline
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Thankyou so much for responding. If you would be so kind to look back to my original post...a couple of weeks ago... It's titled "3months post head slam". It may answer some things.

I have some wonderful coworkers and friends to support me. I have a boyfriend but he is very black and white "think positive, take your meds, get out and do things, you will getter it will just take time, go ride your horse, go ride your Harley, hang out with friends....it could be worse you could have cancer". He isn't the best when it comes to this. Last night for example when he got home I went over and sat on his lap, hugged him and laid on his chest. To me that was an obvious sign I needed support. He had seem me bawling my eyes out in the early am distressed as all get out. .... He grabbed the tv remote.....so up I got crying again. I have a counselor... Who has never had anxiety. I have a wonderful Doctor I have been with since my first horrible anxiety issue 5 yrs ago. I just rode my bicycle quite strenuously for 40 minutes outside and had a sincere interest looking at houses for sale on the way.. I don't have any other physical problems other than those I mentioned. Thankyou ma'am for reaching out
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Old 07-18-2017, 01:45 PM #5
RidingRollerCoaster RidingRollerCoaster is offline
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I read through your other posts. Mark has given you some good advice. These are just my opinions...
I would seriously consider a break from work. A stressful job/lifestyle will hinder healing. I had to quit my job in order to really heal.

You may need to have a serious talk with you boyfriend about what you need. For me, I needed someone to just tell me everything will be ok and that I will get better. Someone that could help talk me out of the negative thought pattern that my brain would get into. The injured brain tends to loop around in the negative for some reason, and it is very hard to stop. This is not psychological in nature where you just need to "get out and do stuff" to feel better. Have him read some of these posts maybe to help him understand.

It sounds like you have a good doctor, which is great.

Cognitive Behavioral Therapy may help you to stop some of the thought patterns. It is very hard to do yourself, but therapy may help over time.

I did not find chiro. (even upper cervical chiro) to be helpful. I had to find a PT skilled with necks. A chiro that doesn't work on the muscles will not help in my opinion. A skilled PT that does gentle mobilizations and traction as well as gentle muscle releases is better in my opinion. Finally, I found a PT that is skilled in treating cervical instability, which has helped quite a bit. You may want to look into cervical instability.

You may want to wait a while before using hormones as a treatment. You may still be early enough in your recovery where these are still changing and trying to balance out themselves.

It may be worthwhile to get checked by a specially trained optometrist for any potential vision problems. https://nora.cc
__________________
Injury: March 2014. Hit hard on top of head by heavy metal farm tool. LOC. MRIs and Cat Scans clear. PCS ever since. 33 year old female. Trying to stay positive!

Persisting Problems:
fatigue, dizziness, lightheadedness, vestibular balance and vision problems, vision static, tinnitus, hearing loss, slight sensitivity to noise, sometimes the insomnia comes back, sensitivity to stress, exercise intolerance, emotional problems - But I still have much to be thankful for.
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Rahruwin (07-18-2017)
Old 07-18-2017, 02:18 PM #6
Rahruwin Rahruwin is offline
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I did plan to hold off on the hormonal therapy. Don't want to add too many things in the mix. yes ma'am the more I think about it I am seriously considering a leave of absence. My doctor said I just need to say the word and it's done. He said he thought work would be a distraction but I can physically feel my nerves stimulating as soon as I get there... And they calm down when I go outside for lunch and when I get in my truck to go home. It's very real. I can't control it. I can also take FMLa for 12 weeks and have job security. I am fortunate enough to have some money put away. I was thinking a trip home to the UK might serve me well (cocktails before the flight!). So... Here I am now .. At a Pitt stop...
Driving to see my horse... 90 miles away.... I won't accommodate my anxiety!!
God bless you ma'am.
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Old 07-18-2017, 07:02 PM #7
Mark in Idaho Mark in Idaho is offline
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Rahruwin,

I was in a similar state about 4 years ago after an extreme stress just as I was ending 14 years of Paxil. My new doc put me on Celexa and olanzapine (Zyprexa) for 2 months while the Celexa took effect. I had the same problem with isolation as I was living at my mountain cabin. I was on the Celexa for 8 months and was able to stop.

If you take time off work, don't do it until you have some somewhat structured activities to fill your time. Is there any way you can reduce the stimulation levels at work ?

Regarding hormones, cortisol is released during stress. I bet yours is sky high. Cortisol kills progesterone and can be making everything worse. I would recommend you at least find out what you current levels are. Cortisol, epinephrine, nor-epinephrine, DHEA, Progesterone, estrogen/estradiol, and any others. I would consider this blood work a medical need, not a 'I'll feel better' need.

Does your doctor agree with your using birth control pills for hot flashes ? What do you do on the placebo/no pill days of the month ?

If your chemistry is out of whack, I'd try to balance it before using meds. Bio-identical hormones are not a treatment or therapy. They are just a way to return to balance. It is just like eating healthy is not a treatment. The birth control pill is a therapy because it tries to fake out your body into thinking it has progesterone when it really has progestin, a synthetic that tries to look like the progesterone. Google progestin vs progesterone.

My wife and I know too many women who have needed help to get back to balance.

Use the Xanax if you need to. It is not a problem for occasional 'get past this moment' use, especially in small doses. I have Klonopin (another benzo) and Propranolol (beta blocker) for these emergencies. They can be lifesavers. As long as you do not take them every day with multiple doses, they are fine. I am against benzos but know they are the only solution is some cases. The propranolol is much less risk. You could ask your doctor if you could try it.

Do you have a blood pressure kit at home ? You should. They are about $30. Knowing your BP can be a big help as you cycle through your symptoms. If your BP jumps, propranolol can bring it down. That may be enough to avoid the Xanax. It works for me.

I can imagine what you are going through because I was there in Sept, Oct and November of 2013.

My best to you.
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Old 07-19-2017, 08:27 PM #8
Rahruwin Rahruwin is offline
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Regarding my vision.... I'm 51 and need reading glasses at times. I don't do well with computer screens, my small iPhone screen and fluorescent lights do my head in .... But they always have. On the occasion that my derealization subsides, my vision is otherwise clear and crisp. I did check that vision link you attached. Seems the TBI vision eval is not covered by insurance. I prob don't need it by all accounts. I just want my old brain back :-)
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Old 07-19-2017, 09:38 PM #9
Rahruwin Rahruwin is offline
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Hi mark... Thanks again. Yes I will get my doctor to order those labs you recommended on my next visit... Which will be my 4 week Celexa follow up day coming up soon.

Regarding my work.... I doubt they can accommodate me with a lighter stress load. They would say 'not fair to other nurses" blah blah blah. It can be a nightmare job and patient turnover is ridiculous... Admitting new ones as soon as we discharge and clean the room. We always tend to be short staffed to boot.

Yes I am very familiar with my fake bc pill. :-) i bought Dr Lees hormone books years ago . My doc offered me an estradiol pill but it was 15-20x higher dose than what I took and after I took one my whole body felt tingly all over. It was rather bizarre. So I went back to my bc pill. He thought that was just my anxiety (this was before my head slam) but didn't argue with me. I don't typically do 21 days straight... 7 off. I try to spread them out evenly over the entire month so I don't have a big gap without any.

I agree about time off and having a plan or many plans!! I find being outside helps me. Today I worked 3 hours picking up 5 dead trees we had cut down.

Mark.... Did you have the "disconnected from the world" feeling I have? I can't explain it
unfortunately. It's just a weird state of mind. An "off kilter" thing. You know what's sad....when I see people happy and laughing. It just makes my new reality more profound for me and I even feel envious. Isnt that sad.

I tried atenolol for a couple of days back in 2010 when I was having increased pulse and throwing PVCs. I was just going thru the change . My heart rate is not doing crazy things like it was the first 2 months after my injury. My sleep is still good. I tend to sleep in on my days off (which I never did prior).

Because I was a sobbing wreck first thing yesterday morning I did take a 0.25mg Xanax. I was not panicking or having nervous sensations in my body.... I just had high anxiety and was distraught with it all. I must say it took away my surreal state, but I noticed my joy for anything was still absent. It's awful not to laugh or feel happy.

The Xanax kind of gives me an "after headache" I can't explain it. About 9 hours in.... I can feel it and I don't like it. I may ask to switch to Klonipin or Ativan . Rest assured I will never abuse them. I'm terrified of meds.
Oh .... My BP is always fine. I check it at work and at Walmart and cvs. :-)

Did you have depression prior to your TBI? I did not. I'm assuming it's what I have now.
Has it been an ongoing issue? Meaning...-maybe part of the brain didn't heal ?
Thanks again. I appreciate y'alls input and support very much.
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Old 07-19-2017, 11:10 PM #10
Mark in Idaho Mark in Idaho is offline
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I first started struggling with depression as a 10 or 11 year old after my first severe concussion in 1965. I've ridden the depression roller coaster for most of my life. Most of the vitamins regimen was prescribed to me by an orthomolecular psychiatrist in 1982 when I had a bad period. I could not finish a sentence. I was gaunt . (I had just been ripped off for $250,000) My wife was pregnant with our second. He had me back going in 8 weeks without meds.

I have tried to avoid meds but had to use Paxil because my mind would get stuck repeating the same mundane thought ( a line from a song, spelling a word, a license plate ) diagnosed as a form of OCD/perserverance, booth common to PCS.

I quit the Paxil 4 years ago and now take 5-HTP and L-Theanine instead. I feel much better. My wife likes me off the Paxil, too.

I asked about BP because when your anxiety and symptoms are worse, you should check your BP. You might be surprised. Over-stim triggers can send my BP to 185/155 or higher. Stroke range. The propranolol works to get the BP and rest of the anxiety under control. I use the Klonopin when the beta blocker does not work. I only use either for rescue, not prevention. But, having it ready for the first sign can help a bad episode from becoming worse.

I have had the disconnect. It usually was anxiety related. It's been quite a while so I don't remember the details. My PCS memory is virtually useless.

I suffer from anhedonia. Testosterone helped when I tried it a decade ago. I'm seeing a doc in Sept to try it again, just a lower dose. The last time, T made my face explode. My PCP thinks it will help my malaise.

You should try to keep a sleep schedule that does not change between work and days off. The PCS brain struggles with sleep rhythm. A neuro rehab sleep specialist explained how important it is. Sleeping in on days off can mean you are not getting what you need on work days. Trying to get to sleep earlier may be worthwhile. Sleep is more dependent on wake up time.

People and even many docs do not understand that a concussion is a process, not an event. For some, that cascade of chemistry and such takes a long time to resolve.

Time for bed.

My best to you.
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