Post-concussion syndrome depression: the survivor’s guide (2023)

Contents

CHAPTER 1:

What is depression?

This first chapter is here to explain what depression actually is. So what are typical depression symptoms and why do people get depressed?

Aside from the list of typical symptoms, what does it really feal like to be depressed?

I’ll walk you through it right now.

Depression

Depression is a common and serious medical illness that negatively affects how you feel, the way you think and how you act.

Because depression messes with your feelings, you’ll either feel a lot of sadness a lot of the time or you can’t really feel much at all. Depression  typically has an effect on all areas of your life, like your relationships your performance at work or school, the things you (no longer) do in your free time, and so on.

Depression symptoms

Feelings and experiences belonging to depression are often:

– a deep and unexplainable sadness that you can’t seem to shake

– feeling empty like there is no sense in putting your best foot forward: what does it matter?

– having no energy nor the motivation to do things, even the things you loved to do before

– having no feelings – not the happy ones nor the sad ones: feeling apathic regarding people, choices and your life in general

– not feeling ON: it’s like you’re inside this bubble and you can’t think on your feet and can’t be moved that much anymore

– it’s hard to make decisions, especially emotional ones where you’d normally follow your gut

– feeling like a failure and like you underperform and let people down in all areas of your life

– having a tendency to do passive rather than active things when given the choice (e.g. stay in bed longer instead of getting dressed)

– crying without a specific reason and not being able to snap out of it (that easily)

– not wanting to see other people and avoiding social situations altogether

– thinking about death and ways of ending your life, while not necessarily feeling the urge to act on it

If you have had thoughts of ending your life, don’t make the same mistakes that I already made for the both of us. Try and:

•  Talk to a loved one and ask them to just listen and support you without offering solutions;
• Call the depression / suicide helpline in your country for immediate help and support. I know this sounds intense, but it is anonymous and they are good listeners trained to be there for you;
• Talk to your GP and ask for a referral to a (CBT) psychologist.

See if you can do any or all 3 of them today. The sooner you do this, the sooner you’ll get your life back. Trust me on this ❤️

What causes depression?

Some people experience depression since childhood; others get depressed after a concussion happens. So what causes it?

There are multiple causes of depression. The one we are going to look into in this guide, is called situational depression. Situational depression arises because of some kind of situation – like a concussion. Had the situation not been there, depression wouldn’t have been in your life either.

CHAPTER 2:

Why can concussions cause depression?

Depression after a concussion is often overlooked by ourselves, our doctors and our loved ones. But in medical research it is even described as “common after concussion“.

You are absolutely not the only one! And you are not imagining the way you feel.

So why do you feel the way you feel? It’s biology. How? Let’s look into that so you can understand what’s really going on with you.

Concussion effects causing depression

Right from the moment you sustain a concussion, your body is under attack. There are 2 types of effects that help you understand why a concussion can cause depression:

1. Direct concussion effects: these biological processes kicked in at or after the moment of your incident.

2. Concussion side effects: lasting concussion symptoms always bring about multiple side-effects. These side-effects influence our behavioral systems.

1. Direct concussion effects

Right from the moment you sustain a concussion, your body is under attack. Several processes kick in that are known for their relation to depression.

1. Inflammation

Inflammation rises within 24 hours after impact as a result of the injury to your brain. Acute inflammation is a natural response to heal injury. So it’s helpful. But the downside is that increased inflammation is linked to depression and fatigue.

2. BDNF

After sustaining a concussion, we need a lot of a certain protein called BDNF. It helps heal injury in our brain. But the case is: BDNF levels are reduced in an injured brain. And depressed patients are known to have lower BDNF levels.

3. Hormonal disbalance

A thing that might happen right after impact is that your hormonal balance can be disturbed. That’s because your two hormonal headquarters may be injured, too. This is especially something to check with your doctor if you have moderate or severe TBI (a concussion or post-concussion syndrome is labeled “mild TBI”). 

(Watch our Concussion Stories episode “Mild TBI isn’t so mild” to understand how this is a misleading and outdated label.)

4. Sleep disbalance

Many of us experience trouble sleeping after sustaining a concussion. This can come from many factors, including the hormonal disbalance discussed above. The circumstances of your incident can also have been such that you suffer from PTSD.

Wherever trouble sleeping comes from: poor sleep increases the chance of developing depression.

2. Indirect concussion side effects

It’s clear that a concussion directly puts your body under a lot of stress. Now suppose that your concussion didn’t resolve within 3 weeks or more. This means your concussion now turned into post-concussion syndrome (PCS).  

PCS always sets a cascade of side-effects in motion. This is because lingering concussion symptoms impact every aspect of our lives. For example, it might be impossible to do your work any longer. This can result in discussions with your boss or clients. And if you lose your job or work, the financial stress is profound.

At home, family members expect you to do things with or for them. How can you explain that even the sounds of their voices is too much? It’s completely understandable (from both sides) if tensions or fights arise. The relational stress can feel like we loose our footing.

And these are only some of the many side-effects. In short: it may feel like you’re under attack on all fronts while your brain is broken already.

So how does post-concussion depression develop?

Normally, you live life from your happy system, actually called the “Behavioral Activation System”. This is our default system. When we reside in this state, we are curious about life and we love learning new things.

Watching a new movie? Cool! Getting to practice something you love? Yes please! A change of scenery? Exciting! This works as long as we are generally healhty.

But when your body and mind are under constant attack due to post-concussion syndrome, the symptoms and resulting stress make relaxing that much harder.

This causes your happy system to wonder less and be less optimistic about life. And it makes you reflect less on yourself and how your life is going. At the same time, a dormant system is awakened within you.

Behavioral Inhibition System

The “Behavioral Inhibition System” is a difficult name for your “danger system“. It arises when you move through times of adversity. As it takes over the reigns, it pushes aside your happy system.

The danger system is constantly warning you and causes you to ruminate more. “Watch all the danger, pain, and negative outcomes that lie ahead!” It tells you that you will only get more of the pain that you have already had to endure. (UNTRUE!) This makes you feel like there is nothing good to look forward to.

CHAPTER 3:

How to recognize depression after a concussion?

In this chapter, you’re going to learn how to recognize depression. We’ll especially explore what depression feels like.

This will help you find out whether or not you suffer from post-concussion depression. It can also help you understand what’s going on with you.

The most important thing is to know that you are not alone in everything you experience: I’ve got you!

There are 2 stages of depression

When it comes to concussion depression, there are 2 stages that you may experience:

1. Beginning depression

2. Long-term, untreated depression

I’ll tell you how you can recognize either one of them right now. 

1. Beginning depression

If you want to know whether or not you’re experiencing the onset of depression, you can ask yourself 2 questions.

Question 1: What has my mood been like lately? Have I experienced any of the following? Hopelessness, despair, a feeling of loss, uncontrollable crying, (intense) sadness, feeling lonely, insecurity, and anger?

Question 2: Have I experienced any of the following things during my normal daily activities?

– It has been harder to be productive at work or in class
– I just couldn’t care much for the things I normally love to do
– I canceled social meetings with friends and family or sports
– I feel demotivated and do things that are sabotaging my well-being

Am I suffering from depression?

Of course, everyone feels a bit off now and then. So when do we enter depression territory? There is no exact science for this, but there is a general rule:

You’re probably suffering from beginning depression if you have experienced more than half of the things listed above for the large part of your week, and for 3 or more weeks in a row.

Also remember that you know yourself best. You know if something is off and that you are just not feeling like your normal self.

In case you recognized that you are suffering from beginning depression by now, this may be a very painful realization. I know it has been for me. Please know that you are not alone in this: I am here to help you.

You can absolutely feel happy again! I know, because I fully recovered from post-concussion depression. There is SO much that you can do! We’ll go through all the steps you can take in chapter 4 (LINK).

But first, let’s read about what it feels like to experience long-term depression, to double check if you recognize these symptoms, too.

2. Untreated depression

After undergoing the above-mentioned experiences for a month or more, it becomes almost unbearable for your system to be constantly overwhelmed by these intense feelings.

A lot of biological processes start to shift in your body, and you probably have been feeling more and more sad and passive.  You may also unconciously have started to protect yourself from feeling all of those painful feelings.

This is a natural reaction: it’s a survival mechanism. But – and there is a big but…

Shutting off certain emotions shuts off all emotions. So locking out feeling the ones that make you feel unhappy, also locks out your capacity to feel the happy ones.

And this causes you to feel (almost) no emotions at all in the long run.

This is exactly how you can recognize long-term and untreated depression: by feeling (almost) emotionless – apathetic. You might feel like what you do today, doesn’t really matter. 

Even though you know your current state should upset you, you might not be able to feel that either. And you might feel like you no longer have an internal compass to make decisions.

Please know that a lot of people with post-concussion syndrome experience depression. You are not alone.

Also, you can completely recovery from this kind of depression. Let me tell you more abou my post-concussion depression story, so you can see how recovery is possible. You are so much stronger than you give yourself credit for.

CHAPTER 4:

My post-concussion depression story

I wrote this chapter to help you see that you are not as alone as you may feel. Even though people can’t see the toll that post-concussion syndrome is taking on your mental health, doesn’t mean it isn’t happening.

The content of this chapter is raw, honest and uncensored, because I want to show you that you are not crazy and that you have nothing to be ashamed of.

And most of all, I want you to know that reaching out is the single most important thing that you can do right now.

When someone would come and visit me, I’d be so ashamed of my current state that I’d spend my entire week’s energy on cleaning my home and myself up and on acting as much as possible like my old self.

I would overcompensate e-ve-ry time. I’d cook a meal for my guest even though I had been in bed and eaten crap for days. I’d put on make-up and nice clothes even though I laid in the dark until an hour before.

I blocked out my deepest fear: that I was losing everything about myself and my life. And I had no idea how to communicate that with others. And the longer my situation spiralled down, the more I felt ashamed, so the more I would hide. 

Post-concussion syndrome and depression mixed

I felt lost and alone in my situation. My brain didn’t work, so I couldn’t think my way out of it. My loved ones couldn’t see and tend to my broken brain as if it were a broken knee. How could they? Even the doctors couldn’t see it!

I just felt so disconnected. I saw everyone’s lives going on, while I was tumbling down a cliff in slowmotion. Friends got cars, peers bought houses, others were promoted at work. I didn’t blame them, it was just so painfully clear how I had fallen off track.

Of course I wanted to tell loved ones how I felt, but I didn’t have the emotional interaction skills nor the capacity back then. The fact of the matter was that I didn’t even understand it myself.

I continuously tried to push myself to be the old me again. I just wanted to be who I was before. But I couldn’t force it and nobody could help me – and this made me feel so angry and lost and upset and so incredibly alone. 

Depression and post-concussion syndrome are a toxic mix

When you’re suffering from post-concussion syndrome, you aren’t able to reflect that well. That’s because your brain essentially is broken. A depression even strengthens that downward spiral, because it essentially disconnects you from your emotions and thus your inner compass.

That is exactly what I experienced when one day, I found myself overthinking death. As I followed that train of thought, my mind suggested the ways in which I could end it all.

My thoughts were cold and logical, emotionless and swift. By that time, I had been experiencing depression for too long to be alone by myself – and I hadn’t noticed it at all. But it finally hit me. Wait, what am I thinking?

Concussion depression and suicidal thoughts

If you recognize yourself in my story:

•  Talk to a loved one and ask them to just listen and support you without offering solutions;
• Call the depression / suicide helpline in your country for immediate help and support. I know this sounds intense, but they are good listeners to start with and you can do it anonymously;
• Talk to your GP and ask for a referral to a (CBT) psychologist.

Try and see if you can do all 3.

It is common for people with depression to have suicidal ideation. You are not strange or doing anything wrong. Moreover, there is nothing to be ashamed about. It truly is biology. 

If, like me, you would never consider suicide back when you didn’t have your concussion, you instantly recognize that it’s a state that you’re in. And that helps to solve it!

CHAPTER 5:

Post-concussion depression treatment

There are many things that you can do to heal depression.

In this chapter I’m going to give you a 2-STEP STRATEGY to resolving depression after your concussion, closing with a free audio file I recorded for you to recover faster.

Let’s take action together!

Step 1: Treat depression and the concussion side effects

You want to treat depression at least with cognitive behavioral therapy. This is the most commonly used practice for situational depression worldwide. I have had massive results with this myself.

For this, you need a psychologist specialized in CBT. You can ask your GP for a referral, or you can look into the newest apps offering psychological help.

Medical depression treatment

One other way to treat depression is medical treatment. Suppose you suspect that you’re suffering from hormonal disbalance after sustaining your concussion for example, you can ask your GP for blood analysis. You can also ask for a referral to an endocrinologist.

Many doctors don’t know yet about the hormonal effects concussions can have. If your doctor discourages you to look further, follow your instincts. Keep looking until you find the right specialist to help you.

Step 2: Treating the root of depression: your concussion

Treating depression and the side effects of your concussion are going to help you a lot. However, the root cause of your depression continues. And that’s the concussion that caused depression. 

As long as post-concussion syndrome lingers, it will continue to feed your depressed state of mind. That is why it’s very important to cure your concussion as soon as you can.

How to cure post-concussion syndrome? 

For years, I have worked on this question.  Leaving no stone unturned, I dove into cutting-edge research. I studied the brain and its ability to recover from injury. I tested uncountale brain training exercises. I tried tons of dietary changes and experimented on myself with everything that I found.

Based on all of that work, I sculpted a treatment method and applied it on myself. I finally started noticing immense results, and shortly after I realized all my post-concussion symptoms had disappeared! 

Curing your concussion includes specific impactful lifestyle changes. It requires a coherent strategy that involves mindset, exercise and brain training. It may sound like a lot, but it’s actually doable once you know what to do.

In this blogpost on the best treatment for post-concussion syndrome, I explain more about the underlying principles of a successful recovery program.