Can Anxiety Disorders Come from a Traumatic Brain Injury?
Can anxiety disorders come from a traumatic brain injury (TBI)? Anxiety disorders can be challenging, and it’s natural to want to know what causes them. Anxiety disorders, like all mental illnesses, are disorders of the brain. The brain is an organ of the body, and it can experience disease and/or injury just like any other organ. Traumatic brain injury can cause serious damage inside the brain. Depending on what part of the brain is damaged, TBI can lead to mental illness. Anxiety disorders can, indeed, come from a traumatic brain injury (Relationship Between Head Injury and Anxiety Proven to Exist).
If you suffer a head trauma, your risk of developing certain mental disorders increases significantly – in some cases by more than 400 percent.1
Anxiety disorders are among the “certain mental disorders” that can come from a brain injury.
The Anxiety Disorders and Traumatic Brain Injury Connection
Life can feel frustrating and difficult after a TBI. Just as a broken leg doesn’t work right in moving you from place to place, an injured brain doesn’t work right in its many and complex tasks. Among other things, an injured brain can be an anxious brain. The Veterans Affairs San Diego Healthcare System reports that approximately 58% of brain injury patients develop anxiety (The Link Between Traumatic Brain Injury and Combat PTSD).
Depending on where and how the brain is injured, the connection between TBI and anxiety disorders can be deep and multifaceted. Anxiety itself is brain-based, so damage to certain areas of the brain can cause anxiety disorders.
Also, the very symptoms of brain injury can be so disruptive, so bothersome to someone’s life, that they cause anxiety. The symptoms of a traumatic brain injury include:
- Concentration difficulties
- Memory problems
- Organizational and/or planning issues
- Decision-making difficulties
- Being easily overstimulated by crowds, noises, etc.
- Increased susceptibility to pressure and stress
- Fear and worry that others will judge you as stupid, incompetent, unreliable
- Worry about making mistakes
- Anxiety about the brain injury symptoms themselves
Hope for Anxiety Disorders that Come From Traumatic Brain Injury
The human body possesses an amazing ability to heal. To be sure, many times brain injury involves permanent damage. However, a degree of healing does occur, and people have remarkable capacity to transcend their difficulties, to adjust, and to fix what can be fixed (Brain Change And PTSD: Proof Recovery Is Possible). Anxiety is very treatable (unfortunately, it’s not always quick and easy, but it is, indeed, treatable).
Some things that people can do when faced with anxiety disorders that come from traumatic brain injury include:
- Rest, rest, rest – that’s how the brain--and with it, anxiety--heals.
- Attend to your environment (reduce noise, keep light levels low).
- Practice self-care.
- Establish a routine to reduce the need for decision making/concentrating and to lower stress.
- See medical doctors and follow their instructions, medications, etc.
- See a therapist to help deal with the anxiety.
My own experiences with anxiety came from a brain injury. I was anxiety-prone before the TBI, but the actual anxiety disorders developed post-TBI -- ditto bipolar 1 disorder. Here, too, I had mild symptoms before the injury, but the brain injury exacerbated them. I know first-hand that TBI can contribute to mental illness. That also means that I know that people can transcend their troubles, rising above even mental illness and brain injury. I am sincere when I write that there is hope for anxiety disorders that come from brain injury.
- Head injury can cause mental illness. (2014, January 3). Retrieved March 21, 2018.
NCC, T. (2016, March 10). Can Anxiety Disorders Come from a Traumatic Brain Injury?, HealthyPlace. Retrieved on 2019, June 25 from https://www.healthyplace.com/blogs/anxiety-schmanxiety/2016/03/tbi-can-anxiety-disorders-come-from-a-brain-injury
Author: Tanya J. Peterson, MS, NCC
I'm the type of person who has been traveling for the past 8 yrs alone and used to being up and about. However everything changed after my accident.
On Feb 27 I was traveling by myself to the state of Washington. I had a 1 hr 30 min layover in Utah. The night before I got very little sleep not by choice and my last meal was at 7pm. My first flight was at 5am I felt fine but hadn't had breakfast yet. My second flight was at 9.45 at Utah so I had arrived at 7.30am. I decided to get breakfast & usually I'll get fruit with yogurt something fresh not hot. There was nothing around & I had already walked miles to get to my gate and I was starting to feel lightheaded, besides feeling sleep deprived. I was forced to get a pizza pretzel and unfortunately right after eating half of it, irritated my stomach so bad I wanted to throw up. I panicked cause my flight was leaving soon. I asked if I can change my flight to a later one since I was feeling very sick and couldn't get on the plane. They had me back and forth and everything happened so fast I was feeling worse and worse. By the time I reached the person who would finalize plane changes, I just remember feeling extremely dizzy, saw black & felt like I wanted to sleep deeply. When I realized maybe 2 minutes later, I was on the floor and felt a very sharp pain on my head but couldn't make sense of anything. I couldn't open my eyes for a long time and since it was the airport, a lot of ppl ran towards me, I could hear there footsteps from a distance but it felt like they were far away & could barely hear them. Some would say check if her head is bleeding, her head bounced on the hard floor, get her a pillow, raise her feet up & call the paramedics. Someone was holding my hand and asking me questions so I wouldn't loose conscience again. I could barely speak and I was extremely terrified, I was alone didn't know anyone. I could feel tension, anxiety, pain, panic, extreme fear all over my body, trembling and sweating. Apparently I had fallen flat backwards, I don't even remember the fall or the hit, I just barely remember being on the floor. I was very fortunate to have my backpack on but when I fell my head bounced on the floor, at least I didn't bleed. However, the next 2 weeks were terrible with pain, anxiety, nightmares and got worse and worse. I couldn't eat, sleep, go out. I developed a fear of traveling. There's just so many details. But fast forward till now about 5 months later, just on Thursday I was diagnosed with generalized anxiety disorder and will start therapy on Monday. I tried a medication Lexapro 20mg on Thursday and it made me very sick, worse than ever. It's the first I've tried medication and it didn't help me at all. For the past 3 days I've experienced a lot of anxiety than in the past 3 weeks and can't eat well since medication ruined my stomach. I've lost a lot of weight, I'm 24 and weight 93 pounds when I was 103 and the most I've reached is 110. I'm trying natural remedies and other techniques that have been helping me somewhat. I have anxiety in almost everything I do and it drains me and makes me feel depressed for I haven't felt myself, not normal since the accident.
What a horrible experience, and I'm sorry you've been going through this. Have you had medical evaluations for your head trauma? Sometimes, doctors aren't sure what to do, but other times, doctors are knowledgeable about brain injury (which means you might have to do some exploring to find the right doctor). The Brain Injury Association of America is a great resource for learning about TBI and finding help. https://www.biausa.org/ Many states have their own associations, too. Try searching "brain injury association [your state]. It's great that you're seeking help for anxiety. A brain injury can (but doesn't always) impact the way medication works, so that is something to discuss with your doctor. Thinking of yourself as one whole system rather than compartmentalized into "anxiety" and "head injury" can be helpful. Treat your whole self (nutrition, hydration, sleep/rest, light exercise, stress and anxiety management, etc.) will help healing and anxiety recovery. Both your doctor and therapist can help with this. Head injuries can take a while to heal, so be patient with yourself and know that the brain does heal. You won't always feel this anxious and miserable. Oh, and not feeling normal or like yourself since the accident is extremely common among people who sustain head injuries. I know this firsthand. Just consider it part of your journey toward recovery. :)
Keep believing in yourself like this! It's okay to have fears. Fear and anxiety are part of being human, but it's possible to reign them in and live well with the ones that linger. Eventually, some will be gone and the others will exist in the background and you'll know how to keep them from bothering you. Right now it's difficult because the brain injury complicates things. Be patient, and remember that you are strong and brave and can cope and get through (your words!). As far as the medication goes, I'm not a doctor and would never try to give advice about prescriptions. I will just say that it's okay to be hesitant. If you want to wait for awhile, you can definitely do that. Take time to decide what is right for you. When you do that, any decision you make will be the right one.
Make great moments every single day, and you'll be well on your way to solid recovery!
Thank you for this message! Your "little" story is important because it's yours. I'll do my best to be healthy, and you do the same!
. I lost all sense of taste and smell due to the frontal lobe injury. I worked with many doctors with medication due to outbursts of anger, personality changes, impulsive behavior and depression. Anxiety hadn’t kicked in at this point. I tried many different medications until I got to Lamictal. That seems to do what I need without side effects. All went well for years but in the last few years anxiety has built Closed in places, crowds, social events, fear of getting lost while driving although I drove a truck for a living !! All of this just doesn’t make sense. The “what if’s” are crippling sometimes. The butterflies build in my stomach and it becomes difficult to deal with some situations. My doctor prescribed Klonopin so for years I don’t go anywhere without it “ just in case “. Medical marijuana is now an option in NJ and I know Klonopin is addictive so it may be the way to go. My wife always tries to support me and feels that Lamictal is needed but really doesn’t understand my anxiety feelings so any medication for that she feels is unnecessary. In fact I have to hide it when I take it. This snow balls into more anxiety. So here I am 16 years later, retired and living a dream. Sometimes a good dream and sometimes in a dream like state. All is good, I stay healthy, work out 5 days a week , eat and sleep well. If I could only kick this anxiety!!!!!!!!!!!!!! Thanks for your website and giving a shoulder to cry on. Enough of the “ Poor Me “ stuff. Be healthy.
I'm sorry to read of all you've been through. You seem to have a fantastic outlook on life and are still embracing it. You can have this great attitude and do the things you're doing and still be frustrated with anxiety. You're not wallowing in "poor me" -- just venting. Given the nature of anxiety, the brain, and brain injury. there is a chance that the anxiety might be here to stay, at least the physical/structural/neurological component. This doesn't mean you have to give into it and give up! I'd never advocate that. You might consider shifting your perspective about anxiety and developing ways to live well in spite of it's presence. It may be there, but you don't have to get caught up in it. This concept helped me a great deal with my own anxiety after my brain injury. Two approaches to doing this are mindfulness and acceptance and commitment therapy (ACT). These two articles briefly introduce mindfulness and ACT. If you'd like to do so, you can take a look. Even if you choose a different path, keep living well!
Acceptance and Commitment Therapy: Stop Avoiding Anxiety https://www.healthyplace.com/blogs/anxiety-schmanxiety/2015/07/stop-avoiding-anxiety-acceptance-and-commitment-therapy
Using Mindfulness for Anxiety: Here's How: https://www.healthyplace.com/self-help/anxiety/using-mindfulness-for-anxiety-here-s-how
Thanks for joining the conversation and sharing your insights. I'm sorry to read that you've had anxiety ever since your coma. How disheartening. This might be a silly question, but I'll ask it anyway. :) Have you consulted a doctor who specializes in diabetes? Blood sugar levels are crucial to brain functioning, and it's possible that something was off in the time you were in a coma. The cause of anxiety can be hormone and neurotransmitter surplus or deficiency, blood sugar levels that are just slightly off, and nutritional deficiencies. It's not too late to investigate this. Also, talking with a mental health professional about your spiritual experiences can help you process them and explore different possibilities. Above all, you can turn your personal hell around to be a personal "paradise."
While I can't give you a diagnosis, I will say that it is indeed possible. I've read research reports about the connection between head injury and anxiety, and I know from personal experience that head injury can cause anxiety. So it's definitely possible. This can't take the place of medical checkups and advice, of course. Unfortunately, while researchers are finding connections, they haven't found solutions to TBI-induced anxiety. Time helps. So does treating your injured brain with continued rest, nutrition, hydration, shielding yourself from bright light and noise, and reducing screen time (TV, computers, mobile devices). Doing things to reduce your anxiety helps, too. Things like deep breathing, mindfulness, exercise (with a brain injury, you don't want to jar your head, but walking or swimming are good), and doing things that occupy your thoughts and attention in positive ways. Seeing a therapist can be helpful, too. Even though it's been almost 2 years, it's not too late to do these healing activities and reduce anxiety.
To keep seeking help and improvement after almost 30 years is amazing, and your son is fortunate to have your support. You likely already know all of the resources available, but I'll share one just in case: https://www.biausa.org/ It's the Brain Injury Association of America. They have a lot of information, although they don't recommend medications.
Part of the answer to your question, "Why are answers so hard to find?" is one that you are probably well aware of: No one knows enough about the brain. Of course I can't know what it is like to be you, so I won't minimize your experiences by trying. I will say, though, that my own experience with TBI has been frustrating, especially because no one has really known what to do. There are doctors, researchers, and other professionals out there trying. They're even making progress. It's so complicated that the process seems agonizingly slow.
I have a feeling that you might have come across TBI information while seeking answers. I'm wondering if you've seen this brain injury referral site: http://www.headinjury.com/. It has a referral number plus links. If you call the number, the people might be able to point you in the right direction to find help. Also, HealthyPlace has a list of hotline numbers and referral services. While none are TBI-related, you can call about anxiety and other mental health concerns and tell them about your brain injury and past experiences. They can very likely give you some numbers of professionals in your area that could help. You can feel normal again, or at lest define a new normal that is very good, not sedated and crazy. Don't give up!
What a terrible experience. Have you visited a neurologist who specializes in brain injury? Sometimes you have to travel to see one, which is inconvenient and complicated with insurance. If you can do so, it is well worth it. Also, have you visited with a therapist or psychiatrist? Some of what you describe does fit with PTSD, although I certainly wouldn't tell you with certainty that PTSD is the issue. It just might be worth checking out in person where you can receive a thorough evaluation.
These resources might help. The first is an article about PTSD and traumatic brain injury. It's from the VA, but it applies to everyone, not just military. https://www.ptsd.va.gov/public/problems/traumatic_brain_injury_and_ptsd.asp
These sites may also be helpful:
http://www.tbinrc.com/ (National Resource Center for TBI)
Hopefully these are a good start to help you recover. And of course, try to see a brain injury specialist and a mental health professional if you can. Finally, you might also find a brain injury support group helpful. You can learn information, ideas, and resources. Check with your doctor, mental health professional, or search online for brain injury support groups in your area.
As debilitating as brain injuries can be, you can recover some functioning and learn how to cope with permanent issues. Treating accompanying issues, such as possible PTSD, will improve your quality of life, too. Stick with it and be patient. It's hard, but possible and worth it.
Thank you for sharing this bit of your story. It will be comforting to others in a similar situation to know they're not alone. Brain injuries can wreak havoc on lives (I know firsthand!). Everyone is different, of course, so this is just my own experience: medication made everything worse for me. Finally, doctors found a good combination of low-dose medication that works. Doctors are supposed to be partners in care. They have medical knowledge, and you know your own brain and how you respond. If Xanax has worked and the new stuff doesn't, you have the right to speak up (and definitely communicate about the suicidal tendencies that the new meds cause). If these doctors don't listen, you also have the right to find a new doctor who will listen. Be true to yourself and what works for you!
There is still so little known about what to do for brain injuries. That alone can be anxiety-provoking and incredibly frustrating. I went through something similar. I'm not a medical doctor, and HealthyPlace in general isn't in a position to make recommendations -- that could be very harmful. The safest and most effective way to make medication changes is to talk to your doctor. Be open about your experiences and concerns. If you feel like your doctor isn't fully listening (some are great at collaborating with patients, but others not so much), it's okay to find a doctor who does listen and talk to you about pros and cons. It's good that you're thinking about the present and the future. Doing so will help you thrive.
Thank you for your comment. Medication is an important--and often heated--topic. It's great that you shared your experience with medication and what works for you instead. HealthyPlace doesn't promote or condemn medication because it's such an individual thing. It's a decision that each person has the right to make with his/her doctor (and doctors should always be consulted because medication, including stopping medication, can be dangerous. Between posts, comments from readers, and even ads, we hope to arm people with a wealth of information so they can be an active part of their treatment process and are able to have informed conversations with doctors. Thank you for being part of the conversation!
Very interesting! I love that new questions are being asked, old ones are being asked again, and research continues. You are so right about the mind-body connection, and the impacts of this connection are greater than people realize (or, rather, greater than what has been proven empirically -- yet). As far as reversing damage,etc., I am a firm believer in the human ability to heal and to find and maintain deep wellbeing. To do so means a positive (but not naive or Pollyanna) approach that honors both the mind and the body. Chronic conditions can be difficult (an understatement), and sadly there are't quick fixes, but with time people can overcome great obstacles and adapt to what can't be overcome. That's part of the brain's networks, too.
Your question is great. I have seen research and read articles about TBI causing anxiety disorders and about anxiety and the brain itself -- the brain with an anxiety disorder looks different in fMRI tests than a brain without anxiety. I have not read anything about an "anxious brain" causing damage like that found in a TBI. Of course, that does not mean that there isn't research and writing out there, only that I'm not aware of it! If there isn't research, there should be because that's a really valid question. Brainline.org is a site that provides a wealth of information about TBI, including TBI, anxiety and stress. This takes you directly to the anxiety and stress page: http://www.brainline.org/landing_pages/categories/stress.html. Don't give up on your question!
Any type of blow to the head can potentially be damaging. Not all are, though. Concentration and memory difficulties and anxiety can be bothersome and interfere in daily life. If you have concerns and/or you would like to improve these things, it would be a great idea to see a doctor. A doctor can potentially evaluate brain functioning as well as discuss anxiety medication with you. A therapist can be beneficial as well, once a doctor has done a physical examination. Consider seeing a doctor and therapist taking action for your quality of life!
Thank you so much for your feedback and for sharing a bit of your own experience. Whether brain injury is traumatic or acquired, it's still brain injury. I'm glad that there's an increasing awareness about the seriousness of brain injury, but there's a long way to go. Too often, people suffer in silence, sometimes because they don't know what to do, sometimes because it's hard to admit these various functioning problems, and sometimes for different reasons altogether. It's frustrating how it changes our functioning, isn't it? I felt for awhile that I lost significant IQ points, that my problem-solving ability was destroyed, and more. And sleeping difficulties were new problems for me, too. Anxiety and its racing thoughts loved to be active at night. I'm very glad, and not surprised, to hear that cognitive therapy has been helpful for you. Others who read your comment will be encouraged. While I do notice lasting difficulties, they're minor and I've learned to compensate for them. Exercising my brain through reading, going to graduate school, attending therapy both in and outside of a hospital were all very helpful for me. The brain injury, bipolar disorder, anxiety are now things I deal with but aren't who I am (for awhile, I felt that these things were my identity). There's hope and healing for everyone, as you are seeing!