After a concussion, even a mild one, many people feel completely out of sorts. They’re discombobulated, jittery, depressed, irritable, unable to sleep well—for weeks, months or even years. Doctors call this experience post-concussion syndrome…but they should be calling it something else. That’s because it could actually be post-traumatic stress syndrome—yes, the same thing that war vets and crime victims get. Knowing this can help you and your doctor take important steps to treat these symptoms and get back on track after a concussion…
THE PTSD LINK
Symptoms of post-concussion syndrome can include headache, dizziness, fatigue, light sensitivity, irritability, anxiety, sleeplessness, loss of memory and lack of concentration. All of these are also symptoms of PTSD. Now a team of French physicians has evidence that post-concussion syndrome may really be a form of PTSD.
The researchers followed 1,361 patients who had had traumatic injuries due to assaults, car crashes, falls or some other cause for three months from the time the injuries occurred. A total of 534 patients had concussions and 827 patients had other (nonhead) injuries. Three months after the injury, 21% of the concussed patients and 16% of patients who did not have a head injury had symptoms that qualified for a diagnosis of post-concussion syndrome.
The team then created graphs that plotted out the symptoms of post-concussion syndrome and PTSD in their patients, both concussed and those without head injuries. The graphs became potent visuals to confirm that a diagnosis of “post-concussion syndrome” was not specific to having a concussion. The graphs also showed that symptoms of post-concussion syndrome fit into those of a certain form of PTSD called hyperarousal-type PTSD. They ultimately concluded that “post-concussion syndrome” is a redundant diagnosis and is really a form of PTSD.
BEING PREPARED
Most people don’t know that they should seek medical help for psychological symptoms after a concussion. Standard treatment for post-concussion syndrome is actually similar to that of PTSD. Patients may be prescribed a limited course of an antidepressant, such as amitriptyline, to ease symptoms, including irritability, dizziness, depression and headache. They also may be referred to a mental health specialist for psychological counseling. This may be all a person needs, or a regimen specifically used for PTSD may be better.
Although different types of psychotherapy are used to treat PTSD, cognitive behavioral therapy is considered the most effective. It focuses on identifying and changing faulty thinking (such as misinterpretation of traumatic events) and replacing negative, self-sabotaging thoughts, feelings and behaviors with positive, empowering ones.
Amitriptyline may be prescribed for relief of chronic headache and other symptoms, or a type of antidepressant called a selective serotonin reuptake inhibitor may be given to patients to help them feel less worried and depressed. Selective serotonin reuptake inhibitors include drugs such as paroxetine (Paxil) and sertraline (Zoloft). Of course, no patient offered antidepressant therapy should feel that no other options exist. Naturopathic physicians have a toolbox of natural approaches to anxiety and depression, as well. And therapy doesn’t go on indefinitely. Most people complete cognitive behavioral therapy in three to six months. As for SSRI therapy, treatment to reverse symptoms typically lasts up to three months after which a person may continue taking a lower dose of the medication for up to a year, if needed.
If you or anyone you know suffers a concussion, don’t feel confused or alone if symptoms described above emerge and linger. You might well have post-traumatic stress disorder. You can best help yourself get through it by seeking mental health care.