Head Injury and Anxiety Relationship Proven
Head injury and anxiety (and other mental health-related consequences like depression and posttraumatic stress disorder [PTSD]) are related, and neuroscientists are increasingly understanding and able to explain why. What they are discovering is that concussions can cause new anxiety, and they can worsen existing anxiety. This relationship between head injury and anxiety is important.
A head injury that is diagnosed as a concussion results from an impact to the head and is considered a mild traumatic brain injury (TBI). They’re only “mild” in that they’re not immediately life-threatening. However, concussions are serious and can have long-term consequences to our mental health--including our anxiety.
Symptoms of Anxiety After a Head Injury
Whether you’ve experienced anxiety for some time before your head injury or anxiety is new to you after sustaining the injury, the symptoms can be similar. Anxiety symptoms post-TBI can include, but aren’t limited to:
- A vague, unsettled feeling that doesn’t subside or subsides only to return
- Restlessness, feeling keyed-up or on edge
- A feeling like you’re going to jump out of your skin
- An inability to be still
- Racing thoughts
- A headache or burning sensation (a symptom of brain injury and/or complications, headache should be evaluated by a doctor)
- Excessive worry about other symptoms of brain injury
- Fear of re-injury and of returning to what caused your concussion
- Generalized anxiety, including “what-ifs” about your future with a brain injury
Proven Connection Between Brain Injury and Anxiety
Until recently, many professionals didn’t officially acknowledge a connection between anxiety and head injury because there was no definitive proof that they could see that brain injury could cause anxiety. Anxiety was sometimes attributed to “just worrying too much” and dismissed. To be sure, many felt that it was logical that a connection existed, but without proof, they couldn’t act on it.
I think that most people who experienced anxiety after a brain injury, myself included, would be able to verify that the relationship between head injury and anxiety does exist. Finally, research is catching up with what TBI survivors have known all along: concussion damage the brain in a way that causes anxiety.
The brain can be damaged in different ways (Brouhard, R.), all of which involve shearing, tearing, or twisting of tissue, and at the neurological level, axons, and dendrites. When there is damage in parts of the brain that are implicated in anxiety, existing anxiety might worsen and new anxiety might develop.
In 2015, researchers were able to see brain damage that caused anxiety by using a type of MRI called diffusion tensor imaging to compare the brains of concussion patients who experienced anxiety with concussion sufferers who did not (everybody’s concussion effects are unique).
Not surprisingly, the imaging showed damage in brains of the people who experienced anxiety. There’s an area of the brain called the vermis, and the functioning of the white matter in this area was seen to be impaired (Cara, E.).
Those of us who’ve experienced both have probably always known that there’s a relationship between head injury and anxiety. Finally, neuroscientists are seeing it for themselves and learning why. This could lead to new and better treatments for concussion-related anxiety.
Brouhard, R. (2017.) The Difference Between Concussions and Traumatic Brain Injuries. Verywell.
Cara, E. (2015). People Who Suffer Depression and Anxiety after a Traumatic Brain Injury May Have Damaged White Matter. Medical Daily.
NCC, T. (2018, March 15). Head Injury and Anxiety Relationship Proven, HealthyPlace. Retrieved on 2019, August 18 from https://www.healthyplace.com/blogs/anxiety-schmanxiety/2018/03/proven-the-relationship-between-concussion-and-anxiety
Author: Tanya J. Peterson, MS, NCC
I'm sorry about your continued challenges with post-concussion anxiety. I can very much relate to your description of your experience with various doctors. Too often, being high functioning actually gets in the way of treatment. Yet being high functioning is desirable. It becomes a matter of discovering ways to address it on your own -- which you are. Regarding professionals, have you tried a counselor/therapist? They don't deal with medical diagnoses and treatments, which means they'll help you with your anxiety and worries about re-injury. This kind of therapy helps people sort things out and customize a plan for either eliminating anxiety or developing strategies to stop the fear from interfering in your life. Also, you can do things on your own to reduce your fear and anxiety. One effective way to deal with this type of reality-based fear is to write it down, dive into the specifics of it, and challenge it. For example, in what situations do you experience your anxiety? Rate them on a scale from 1-10 to untangle the general fear/anxiety and notice when it is better and when it is worse. Then, identify a situation near the low end of your list (jumping in at the top is often overwhelming. The idea is to gradually minimize the fear of re-injury rather than making it worse). Gradually allow yourself to experience the worrisome situation. Be there just past the point of feeling uncomfortable, then leave or stop what you're doing. Day by day, increase the time spent with this activity until it doesn't bother you as much. Write down what it was like, how you felt, what you were thinking, etc. Then proceed to another activity or situation. You might encounter a similar procedure when working with a therapist. You'll also learn other things, both new thoughts and actions, to shrink this very normal anxiety and stop it from bothering you so much. One more quick thing: there is absolutely a correlation between concussion, anxiety, and vision (I know this from experience as well as reading articles and studies). I hope the eye doctor can help. Don't give up your journey to reduce this anxiety. Frustratingly, concussion sequalae can last well beyond a year. But that doesn't mean it's permanent.
What an ordeal you experienced and are continuing to experience. I'm sorry that you're going through this. Anxiety after a brain injury is very common. While the healing process tends to be a waiting game, there are things you can do. One of the biggest things is rest. I'm sure that's hard to do when running a hotel. Rest doesn't have to mean lying down in a dark room for hours. It's just important to give your brain a break from thinking, stress, bright lights, and noises periodically throughout your day. Two months is actually not much time at all when it comes to healing the brain and reducing the anxiety that accompanies concussions. Taking even five-minute breaks every hour or two (I really do know how difficult that is, but if you schedule it in it becomes more doable) helps the brain (and accompanying anxiety) recover. Close your eyes and breathe deeply, concentrating on the feel and sound of your breath--and when your mind wanders, simply return to the breath). You can also practice mindfulness, just noting what you see, hear, and feel without judging it, and again, when your mind wanders just return to your senses). Walking helps, too, as does eating nutritiously and avoiding junk foods and fast food. Given that you're a cyclist you probably know that. All of the activities I mentioned work for both concussion and anxiety. As far as diagnosing, I didn't have luck with that. Doctors looked for structural damage, bleeding, etc., and when they couldn't find that they couldn't do anything else. My anxiety was seen as separate from the injury. Granted, that was 15 years ago and things might have changed. Researchers are learning more and more about brain injury and its impact on the whole person, including mental health. It might be worth it to talk with your regular doctor about what you're experiencing and see what he/she has to say. It's frustrating that recovering from all aspects of a concussion, including anxiety) takes so much time. Be patient with yourself in the process. Your anxiety doesn't have to stay this way.
I'm so glad that you're seeing the light at the end of what can be a long, dark tunnel with concussions/brain injuries! I'm hoping that many people read your comment so they can be encouraged that the brain does heal. I still have anxiety blips, too (14 years after the injury), but knowing what they are and knowing what to do about them really minimizes them. When they happen, they're just something I notice in the background rather than episodes of anxiety that interfere in my life. So know, too, that even if blips appear from time to time, they don't have to bother you. Keep on healing! :)
I'm sorry about your concussion, PCS, and anxiety. I'm glad that this information was helpful (and your comment reminds me that I want to write more on this, as it's such a common problem but so little is known about it so too many people feel alone and stuck). Be patient with yourself, as the brain needs time and TLC to heal. Anxiety can linger for quite some time after other symptoms have settled down. That doesn't mean that you're doomed to live with it for the rest of your life. You can return to your baseline.
Resting helps many effects of concussion, including anxiety. At the very least, try to restrict screen time (TV, computer, phone, video games, etc.) as these can be irritating and agitating. Doctors typically recommend this, but many don't realize the importance of restricting screen use in helping anxiety. Calming your brain in other ways, such as deep breathing, mindfulness, meditation, yoga (but avoid poses that cause headache, dizziness, or nausea). In general the first step with concussion-related anxiety is to soothe the brain. Take care of your physical health to help your mental health. Soothing the brain soothes anxiety. There are other steps you can take, but taking on too many things at once actually increases anxiety. Above all, be patient with yourself. The anxiety can absolutely get better, but when a concussion is involved, it sometimes takes longer.