How to deal with the fear of receiving another concussion
So, I’m wondering if there is anyone like me who has ever lightly bumped or shaken their head and it stirred up all your past concussion symptoms. For example, the other day I was climbing into the car and my head tapped the sun visor. Immediately I could feel my heart rate spike, my seemingly constant headache got worse, and my obsessive-compulsive mind could not stop thinking about what had happened. Logically you know that there was no way you hit your head hard enough to reinjure yourself, however, the fear is paralyzing, and it can make other symptoms worse.
I have some theories as to why this happens, and I will attempt to talk about the physiological logic that may explain why symptoms can worsen after this happens.
When you lightly jerk or lightly hit your head that sensory information comes in through the spinal cord and up into your brain stem. The information then becomes integrated in the thalamus. After integration happens the brain draws memories and experiences from the hippocampus and then compares the current sensory information with past experiences and tries to match your experience with the current stimulus. Once the brain has matched similar experiences it also outputs similar physiological symptoms such as an increase in headache, nausea, and similar emotional symptoms such as anxiety or fear.
I must make something clear here, in all likelihood you did not do physical damage to your brain. According to recent science, it actually takes close to 100 G’s of force equivalent to smashing your head at 20 mph into a wall (Science Daily 2010). However, given the previous injury, your system is now primed to respond to, the two experiences resemble a concussion. This is also known as “glial cell priming”. There are a couple of different types of glial cells, the ones I refer to are called astrocytes and they have functions in immune regulation in the brain. Think of them as the cleaning crew, they clean up pathogens and damaged nervous tissue.
Before the injury, the cells probably responded appropriately to instances where no physical damage was done, however after the injury they can become sensitized to experiences that feel similar to the actual injury itself even if no physical damage occurred. An analogy commonly used is a fire pit. Before the injury, there were no logs on the fire. The fire kept going because of a little bit of kindling that would extinguish itself. However, a concussion ignites the fire placing logs on the kindling and then pouring gasoline on it. Now, anything that you add to the fire such as Little jerks and bumps to the head just continues to grow the fire.
This begs the question - what can be done?
Well, I’m a firm believer to get the best results you must address the physical and psychological parts. For the physical symptoms, reducing systemic inflammation can be helpful so your glial cells aren’t working overtime. Consider your diet and having a clean environment (clean and no mold) and reducing stress. On the psychological front a few free easy techniques I have learned over my time in my own recovery.
1. First, literally talking to your body. It sounds crazy but you can actually modulate your fear response by telling her body it’s safe and no damage has been done. It may not work instantly, but over time you can convince your body that it’s safe. I tell myself all the time “I am safe no physical damage has been done.
2. Another trick I learned is to count backward from one-hundred or if that’s too easy to do some simple math. Apparently doing math bypasses the hippocampus and only uses the rational frontal lobes of your brain, therefore shutting off the memory and experience triggered circuits. Ruminating on what just happened might be a bad idea because we don’t want to reinforce those associative memories. I try to do this as soon after the incident as possible.
In neuroscience, there is a saying - neurons that fire together wire together. The whole purpose of this is to not allow those neurons to fire and be wired together creating negative associations.
3. Another trick is sensory mindfulness. This process is great because it can bring you back to the present and eliminate the anxiety you have living in the future. An example of this in action is to look for five colours that you can see (sight) if you can also hear three things (sound) a couple of things that you’re touching or that you can feel, and maybe something you can smell.
Performing soothing activities can help settle those danger and anxiety circuits and bring the brain back to a safe space.
4. I personally like aromatherapy if you have the financial means to afford aromatherapy. In fact, I think aromatherapy can be very powerful particularly with disrupting memory circuits because the olfactory bulb (where scent molecules are detected and then transmitted via the nerve connecting the brain and olfactory bulb is transmitted) is the only sensory organ that bypasses the thalamus were all other sensory inputs are integrated. This sends signals directly to the amygdala and hippocampus both of which are key parts of the brain involved in anxiety and danger circuits experience in memory. I also use this as a sleep tactic before I go to bed every night I rub some lavender on my palms and take a deep inhale so that my brain knows when I smell the lavender that it’s time to go to bed. To help settle my nerves after a scare I prefer to use something that’s either more intense like peppermint that completely distracts my mind from the incident or a woody smell because that brings me back memories from my cottage.
5. The last and other helpful tools I could think of is to seek psychotherapy to help reframe those past experiences. Once again that is if you can afford psychotherapy, I would highly suggest not trying to do this yourself seek out professional help.
I hope these tips and tricks help, and fear not, your nervous system might need a couple of days to settle down but try not to catastrophize the situation and remember that you’re not where you were when you were first introduced to the injury.
Sincerely,
Mitchel Tunnell - HeadsupCAN Concussion Awareness Facilitator
Sources:
University of Denver. "Most concussions deliver 95 g's, neuropsychologist says." ScienceDaily. ScienceDaily, 25 June 2010. <www.sciencedaily.com/releases/2010/06/100624092526.htm>.