Hi everyone,
I am a new member here looking for advice from others who have experienced similar injuries. About 3.5 weeks ago I received a concussion from passing out and hitting the front of my head on the concrete floor. I passed out because I was observing a cadaver, and had not ate anything prior to. The next few days I felt fine and symptoms didn't show up until 4 days later. That day I went to the doctor and they told me I had a concussion and to follow up. I followed up and symptoms have definitely improved compared to what I felt like on the day all the symptoms hit me at once.
Ever since then, I have felt nauseous, severe anxiety/nervous/panicky in the mornings and by about 1-2 PM those symptoms go away and are replaced by fatigue, eye aches, and mild headaches. The afternoons are not as bad and I feel close to normal. The anxiety/nervous feelings are definitely the worst part and I can't tell if it's a product of the concussion, or just me being afraid I am going to start feeling bad or pass out again when I go out of my house. The anxiety definitely feels irrational and I feel like I am going crazy sometimes. Background: I was never an anxious person before this injury. Very laid back and chill.
I am a graduate student in college so it's definitely hard to sit around and not do anything, when I have a billion things I need to be doing (teaching, research, classes, 2nd job, etc). So my biggest question and concern is should I rest, or should I push through? Sometimes I feel like pushing through helps the anxiety but it's a constant struggle to keep it together when I experience it.
Has anyone else had similar experiences? Any advice would be appreciated.

cl16,

Welcome to NeuroTalk.

The latest research says you should not rest during the day after 48 hours post injury. It also says you should not push into and through symptoms. It is best for you to find the level of activity that does not trigger any symptoms. Good quality sleep at normal times with moderated activity during the day. Keep in mind that you can overdo it one day and not suffer symptoms until the next day. Sensory and activity breaks during the day can be good. This can be a quiet walk or sitting quietly for half an hour.

It would be worthwhile to read the Vitamins sticky at the top. The injured brain needs extra nutrition to heal and tolerate stress.

Your rough morning could mean you are not getting quality sleep. Get up the same time every day and plan on reducing stimulating activity, work, study, an hour before you usually go to sleep. Let your brain become sleepy. Don't use caffeine after noon. If you can find your proper natural sleep cycle/ go to sleep and wake up times, you will give your brain the best opportunity to heal.

My best to you.

Hi cl16,

To answer your question about anxiety. Yes, it's not uncommon to have high anxiety during a concussion. As a psychologist i know how badly anxiety/stress can affect someone. Understanding how it works will help you manage it more. There are several reasons why your anxiety can be high right now:

1. Neurological: a possible neurometabolic imbalance (this should level itself out during recovery). Also see Mark's vitamin tip.

2. Psychological: Experiencing prolonged recovery from concussion is very difficult to deal with. It's very important to take your mind of of it. In other words don't constantly think of symptoms, recovery date, etc. Try to keep yourself busy with mild activities. From what you've said, i see that you are struggling with many responsibilities. Nervosity is often a result of worrying about to many things at once. The only worry you should have now is your health and that's it. Accept that you are CURRENTLY in this situation. See it as your life being put on hold, but know that you will have your life back after this.

3. Your body's stress-response system (adrenalin and cortisol): At the moment your body is hyper-vigilant because it knows something is not right. This means it is constantly searching for possible threats. That's why your currently more prone to get anxiety. Pushing yourself will make anxiety worse in the long run and will result in a chronic stress response (just google how it works, to long to explain). But activities that you can endure without symptoms, like Mark said, will counter stress and will keep physical fitness from going downhill.

So i would not advice pushing yourself through your symptoms.

Thanks everyone. The anxiety has definitely got better, but I am still struggling with nausea 4 weeks later. It's every day, and usually better in the afternoons. Is that normal for a concussion or could I have a more serious head injury? I have another DR appointment on the 15th, and that was the soonest available.. Just curious if I should seek more immediate medical attention..?

Only a scan can truly rule out a more serious injury. But i don't think you should worry. What you describe really sounds like a concussion. The doctor will probably tell you the same and will want a scan just to be sure. The first 2 months of my concussion i felt nauseated and groggy the whole morning. It was better in the afternoon too. Eventually that feeling went away with time. Try not to worry to much, it will get better.

Take care

Update: I went to a primary care doctor because I am still having symptoms, and she literally told me anxiety was not a side effect of a concussion... Um, what?! That's not what I have heard AT ALL. This whole process is extremely frustrating! I just want the anxiety gone.

Another update:
I’m extremely worried because my doctor literally told me the following with no information.
I had a CT scan and they said the results showed this:
1. Left inferior frontal encephalomalacia, typical in location for a
contusion in the setting of prior trauma.

I thought I was suffering from a concussion (which I may have had as well) but now they are saying contusion and some other thing that sounds really scary. Anybody had any experience with either of these? What’s the recovery time like and is there anything in addition I can do to help my brain? It’s been a little over a month and I definitely feel better but still struggling with mainly anxiety and nausea.

cl16,

You basically have a brain bruise in a localized area. It appears it did not cause bleeding. That is good. At this point, there is not much you can do other than learn to tolerate the symptoms while your brain tries to heal. A good diet with nutritional supplementation is advised. Omega 3 fish oil with good DHA and EPA plus the B's and anti-oxidants (C, E) are important.

You may benefit from a Neuro Psychologist Assessment. This can help you understand if this injury has changed the way your brain is working. This type of injury can effect executive functioning. If it has, there are some skills you can learn to make up for any deficits.

Is there a neuro rehabilitation hospital near you? A consult with a neuro psychologist and physiatrist at such a hospital would be worthwhile.

Thanks for the info. I’ve been taking b 12, d, and fish oil. My next appointment is with a neurologist so they should be able to point me in the right direction. I obviously think drinking alcohol is a bad idea but is there anything else I should avoid? I’ve been using cannabis oils because it helps with the symptoms and I’ve heard it’s good to reduce inflammation but worry that it could have a negative effect on recovery time? I also wonder the same thing about Xanax which they prescribed me.
Any thoughts?

Cannabis oils is an extremely broad term. There are THC oils, CBD Oils and combination THC and CBD oils. There are properly refined and tested oils and then there is the majority that are junk. Since there are no standardized testing protocols, it is hard to trust a dispensary's claims. Be careful.

Xanax or any benzodiazepines are not a good idea. They can be OK if used at minimum doses for rescue situations. That means your mind has taken off on a panic attack and you need to get it settled down. Beta blockers like propranolol can also be a useful rescue med if you have an anxiety ridden spike in blood pressure.

I recommend you get an at home blood pressure kit so you can monitor your BP when your anxiety is high. You want to void high BP with a brain bruise or any brain injury.

You need the rest of the Bs and the anti-oxidants. Folic acid is needed for myelin sheath repair. Oxidative stress can be rough on the brain so strong dose C and 400 iu of E daily is good. The B-12 should be 1000 mcgs or more of the methyl form, not just the common cyano form.

Don't put too much faith in a neuro until he shows you he understands concussions. Most do not have a strong understanding of concussions.

Avoid caffeine or limit it to a single serving a day.

And yes, you have a concussion but also a contusion. The contusion is just a focal injury that happened during the concussion. You whole brain suffered a mild injury but one small part of your brain was injured more than the rest.