Concussions can impact a variety of brain functions including one’s ability to tolerate stress and overall increase in emotional distress. These moments of distress can be amplified by the difficulty of managing other concussion symptoms, such as pain, headaches, overstimulation, cognitive impairments, and new physical limitations. The stressors of managing daily life with a concussion can also exacerbate these emotional experiences as people struggle to attend work, keep up with finances, manage legal expectations, and feel connected. While all this is happening in your brain and environment, a natural outcome of concussion recovery can include disruption of one’s normal coping skills. It’s no wonder those with concussions may experience higher highs and lower lows than before!
When one has a concussion, some common experiences of emotional dysregulation include increased irritability, anger, anxiety, apathy, and depression. Many describe these reactions to look like:
Oscillating quickly from one intense emotion to another.
Being more irritable toward situations that once were not bothersome.
Finding new situations frustrating to manage.
Acting out toward those around them.
Feeling easily overwhelmed with sounds and other sensory experiences.
Finding less enjoyment in once pleasurable activities.
Managing these symptoms is critical to support concussion recovery as the mind-body connection is strong. An example of this connection is seen when someone who is overwhelmed and anxious may find they store this stress in their shoulders and neck–which may already be tight from the concussion’s instigating incident–leading to worsened pain outcomes. Therefore, if one can find ways to better manage their emotional reactivity, they will improve their recovery outcomes.
Now to the practical skills. Below is a list of distress tolerance skills that come from an evidence-based therapy called Dialectical Behavioral Therapy (DBT). These skills are designed to be used in high emotional moments, although people who practice them in other situations find this helpful in developing positive mental health habits.
Temperature. If you’re feeling “hot” emotions (panic, anxiety, anger, irritability) use cold via holding ice, splashing cold water on your face, or drinking cold water. If you are feeling “freeze” emotions (depression, apathy, dissociation) utilize heat with a heating pad, warm tea, or a hot shower.
Paced breathing. The most effective counting for this skill is 5-7-8. Breathe in for 5 seconds, hold for 7 seconds, and exhale for 8 seconds. Repeat this several times and often throughout the day.
5-4-3-2-1. This sensory skill involves connecting to your senses by observing your environment and listing 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Get as specific as possible and repeat this skill with more detail as needed. Often people use this skill as a mindful moment in nature or at home and seek out pleasurable sensory experiences such as eating one’s favorite treat for the taste sensation.
It can be difficult to learn new skills, especially when your brain is actively working on healing. Some tips to ease the implementation of these skills are as follows.
Don’t wait for the “perfect moment” to utilize a skill. Even if you aren’t dysregulated in a given moment, these skills can still help you ground and aid your brain to remember the skill in the future.
Just try one! Don’t try to master all these skills at once, that’s a recipe for overwhelm. Instead try one and focus on that for now.
Practice, practice, practice. Brains better remember and bring up these skills the more we practice them. It takes time and patience, but the practicing will pay off!
Sticky notes are your best friend. Write down these newfound skills on a sticky note and place it somewhere that will be seen often. This will remind yourself to utilize your new skill as often as you see it.
Go easy on yourself! Concussion recovery involves a lot to juggle at once. Compassion is important to allow yourself to validate your own experiences, take a break, give yourself a pat on the back, be kind to yourself, and have space to try new things! You got this!
So remember, it is normal to experience highs and lows after a concussion and the good news is that there are lots of skills to help you through this time. Practice the ones outlined in this post to better support your distress tolerance and concussion recovery. Please remember that if you are struggling with your mental health, seek out professional help through licensed mental health therapists who can support your needs.
If you are experiencing suicidal ideation or a mental health crisis, contact 988 or 911 if this is an emergency.
