Post-concussion anxiety and depression

Is there a history of anxiety and depression for you? I also had a concussion in 2019...had many of the same symptoms as you. But I have a history of severe panic attacks for years plus some depression. Yes, it was made worse initially by my fall hitting my head. Only b/c I was worried about brain damage...and it kicked off terrible migraines (never had before) which I am still coping with 6 years later. The migraines can be quite severe and I can't take triptans b/c of heart disease, only CGRPs which are not really effective.
You could be suffering from PTSD from your concussion which has the presentation of severe anxiety. If you are worried about long term effects down the road, yes, this is normal and certainly contributing to your anxiety. Have there been any unwelcomed triggers for you besides your fall resulting in anxiety? Anything else going on in your life that is upsetting you and may not even be aware of? Anxiety is a reaction to real fear or imagined fear in your mind. And, yes, the fall might have "re-wired" your brain and not in a good way. Depression is considered anger turned inward. All issues to explore with your therapist (hope it's a good one, if not, change). The Lexapro will kick in - you are only on it 10 days. Be patient. Don't know your age (I am 70) but I can tell you anxiety and depression can rear its ugly head at ANY time in life. Sometimes it is an obvious cause, sometimes you have to dig deep. I understand you completely. You are not alone. If the Lexapro does not help (give it at least 3 months) there are always other SSRIs or SNRIs to take. The very best of luck to you, hang tight.

My moderately-severe concussion was the result of tripping over my feet. My body tensed up and I fell flat on my face. I finally went to the ER and they ordered a CAT scan. Thankfully no broken bones. I was concerned about any breaks in my cervical bones. What they did find was a meningioma of no consequence. Following their advice, I saw a neurologist. She sent me for physical therapy. WOW! The PT group I saw specialize in concussions. The exercises basically involved reconnecting the eyes, brain and muscle control. Primarily eyes to brain. They did some rebuilding of the core muscles through light cardiovascular (riding the bike) exercises. Talking with the neurologist, we also found that the anti-depressant I was on (for nearly 25 years) had significantly suppressed some of the processing of external visual signals which were involved in my balance. I contacted my GP and made some adjustments in my medication, which has helped tremendously with my overall health. Medicare paid for all of my therapy sessions which was a tremendous relief. One additional observation was that after one session I realized that this therapy would have been SUPER advantageous to have done after my cataract surgery. The eyes and brain connection is vitally linked and is important to maintain.
Depression is a major side effect of a concussion. From what I have learned, it is part of the brain’s healing process. I strongly suggest finding someone who will refer you to a physical/occupational therapy group. They are not just about rehabilitating broken bones and recovering from surgery. They are more about reconnecting the overall body operation.
I sincerely hope that your situation improves. There are so many phases to a concussion mentally and physically. It takes time, care, and patience. Best regards.
P.S. All of this “physical therapy” has brought me to the point of totally going off using antidepressants. I feel reconnected to life for the first time in 35 years.

Wow! You have been through a lot! I, too, had a concussion, when I fell flat on my face! Additionally, I have an incurable neurodegenerative disorder. So, I was assigned physical therapy, by my physician, where my balance, gait etc. was improved, through many ‘re-learning’ exercises! However, I had a co-pay of $60.00, for each therapy session! Medicare did not pay my physical therapy bill!

Concussion issues9 months into TBI and getting very discouraged. My major symptoms are anxiety and fatigue. I worry about things that haven't even happened yet. Anyone in a similar position.

@margaretallen - I moved your message here so you could chat with others talking about post-concussion anxiety, fatigue, depression and discouragement on Connect:

- Post-concussion anxiety and depression https://connect.mayoclinic.org/discussion/post-concussion-anxiety-and-depression/

This will help more Connect members see your question and invite responses from people with this condition and its aftereffects who may be able to help and let you know what to expect. Fellow members such as @foundryrat743 @gjcremers @briarrose and others may have ideas on this from their experiences. @lakelifelady also may have some thoughts.

Are you currently undergoing therapy for your TBI, margaretallen? If so, what have they said about your physical progress? Has your doctor or therapist talked with you about emotional/psychological effects of this injury?

@lisalucier yes. I am doing CBT and I go to a psychiatrist who handles the meds.

I, too, have suffered from severe anxiety since my accident, and also have difficulty reading and working with digital devices. A few in this group have made mention of the eye-brain connection. This is a HUGE issue and often overlooked in post-concussion/TBI treatment. Here are some facts that everyone should know: (1) 80% of all perception is visual, four times the input of all other senses combined; (2) 44% of brain energy is devoted to sight, more than breathing, heartbeat, and digestion combined; (3) 90% of TBIs/concussions result in an acquired visual dysfunction (AVD) -- blurred vision, difficulty focusing on a stationary object and/or tracking a moving one, eyes "skipping", eyes not coordinated, etc.; (4) AVDs can oftentimes lie at the heart of what looks like ADHD and PTSD, and can cause problems with anxiety, reading, and memory; and (5) the extent of brain energy devoted to sight explains the exhaustion experienced by persons with AVDs as they struggle with focus, non-convergence, processing, etc. Everyone who is struggling following a TBI/concussion should consult with a neuro-optometrist or neuro-ophthalmologist to see whether they are suffering from an AVD.

This is a new area of medical discipline, so be careful who you choose. Demand to know: (a) their diagnosis and treatment plan; (b) what the treatment is intended to address and how; and (c) how your treatment progress will be measured and your progress. I am currently working with my fourth neuro-optometrist/ophthalmologist -- he is the only one that has met the foregoing standards (and I didn't have to demand he do so), whereas the other three failed and sometimes refused to meet at least one of the three. At our initial consult, he had formed some initial impressions of my condition based on my history, and then quickly confirmed in brief testing that my eyes "skip" and are not coordinated in their movement, and that my perception of my "midline" is completely off (which is why I can't center myself in a doorway or often nearly sit on my husband's lap when I'm just trying to sit beside him). A competent practitioner cannot and will not guarantee an outcome. A competent practitioner will work with you to get you at your point of maximum improvement, and then work with you further to embed the neural work-arounds they have established with their treatment.

For those of you who are struggling, put this at the top of your priority list if you have not already explored this area of treatment.

Good advice thanks

@lisalucier I am doing CBT and other therapy. I am on Zoloft but it hasn't fully kicked in yet
I fell sick every morning and think that is a hormonal issue