[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2025\/04\/concussion-after-anxiety\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2025\/04\/concussion-after-anxiety\/","headline":"Coping with Long-Term Anxiety Following a Concussion","name":"Coping with Long-Term Anxiety Following a Concussion","description":"

Discover the causes, symptoms, and effective strategies for managing long-term anxiety following a concussion. Learn how to cope and recover.<\/p>","datePublished":"2025-04-10","dateModified":"2025-08-07","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/services\/sports-medicine-regions","name":"Sports Medicine","url":"https:\/\/www.upmc.com\/services\/sports-medicine-regions","sameAs":"https:\/\/share-dev.upmc.com\/sports-medicine\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/04\/GettyImages-1582422402-e1743800401568.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2025\/04\/GettyImages-1582422402-e1743800401568.jpg","height":887,"width":2048},"url":"https:\/\/share-dev.upmc.com\/2025\/04\/concussion-after-anxiety\/","about":["Concussion","Living and Wellness","Mental Health","Sports Medicine"],"wordCount":1120,"articleBody":"There\u2019s a saying, \u201cConcussion fights dirty.\u201d It means that the symptoms of a concussion can vary widely and feel relentless.One of the lingering symptoms of concussion is anxiety. \u201cAnxiety after concussion is insidious,\u201d says Christopher Burley, PhD, a neuropsychologist with the UPMC Sports Medicine Concussion Program. \u201cNot a lot of people know how to recognize it and treat it.\u201dThough symptoms can feel strong, anxiety after a concussion is treatable. The biggest hurdle with concussion anxiety is making the connection about what\u2019s going on.What\u2019s the Connection Between Concussion and Anxiety?How can a concussion cause anxiety? It starts with a psychological understanding of what a concussion is.\u201cA concussion is an energy problem,\u201d Dr. Burley explains. When you have a blow to the head or neck, it can make the brain move inside the skull. The neurons stretch because of this movement.Chemical changes begin to happen, with calcium flooding in and potassium leaking out. As a result, you have vasoconstriction, meaning your blood vessels narrow, decreasing blood flow.\u201cYour brain has less blood at the very time it needs it most,\u201d he says. \u201cThat causes an energy imbalance, which disrupts your brain\u2019s networks.\u201dThe energy imbalance creates different sets of problems for different people. This is why concussion symptoms are so wide-ranging.People associate concussion with symptoms like headaches, nausea, confusion, and dizziness. But concussions can also affect your vision, balance, concentration, memory, sleep, and mood.There are actually six main types of profiles for a concussion.Cervical (neck).Cognitive fatigue.Migraine headache.Mood\/anxiety.Ocular (your vision system).Vestibular (your balance system).No imaging or blood tests can identify your type, Dr. Burley says. Instead, it’s about identifying and unpacking your symptoms.How Anxiety Shows Up After a ConcussionPeople often ask, \u201cDo concussions cause anxiety?\u201d The answer is yes \u2014 but in a more specific way than you might expect.\u201cAnxiety is a catch-all term,\u201d Dr. Burley says.As a concussion response, anxiety usually has a lot of physiological symptoms. This includes:Feeling overwhelmed, especially in a busy place.Lightheadedness.Panic.Racing thoughts.Rapid heartbeat.Restless sleep.Trouble regulating body temperature.\u201cPeople are often having these symptoms and have no idea where it\u2019s coming from,\u201d he says. It can feel like a very physical type of anxiety.Concussion can make underlying anxiety or depression worse, especially if you’re already not managing it well. Conversely, already managing your anxiety and depression well will put you in a better place to recover from concussion.It\u2019s more common that a person doesn\u2019t even recognize the feelings they\u2019re having as anxiety.Also, people who have anxiety after a concussion are more likely to have vestibular symptoms. This is because the vestibular system and sympathetic nervous system share the same neural pathway.\u201cThey\u2019re both primitive systems deep-rooted in our brain that help us do basic things,\u201d he says. This shared pathway is the reason that even simple tasks, such as shopping in a grocery store, can cause increased anxiety.The feeling of \u201cbrain fog\u201d is a common vestibular symptom that people with anxiety also face. Part of getting the right treatment for concussion is figuring out which system is causing the symptoms.For example, someone might present with migraines after a concussion. If you treat their migraines, the anxiety might go away.But it might not if it’s the other way around \u2014 if anxiety is at the root, and migraines are secondary.Treating Anxiety After Concussion\u201cWe often need to treat anxiety to help with other concussion symptoms,\u201d Dr. Burley says.Treatments include:Exercise \u2014 \u201cAerobic exercise is the gold standard for treating anxiety,\u201d Dr. Burley says. Exercise, or exertion therapy, can bring down your nervous system response and release dopamine.Medication \u2014 Drugs, such as selective serotonin reuptake inhibitors (SSRIs), aren\u2019t usually the first line of treatment. But SSRIs can help because some of them also act on the shared vestibular and autonomic pathways. \u201cDaily SSRI use can calm the system down over time,\u201d he says.Psychotherapy \u2014 Talk therapy can help, especially if someone also has some post-traumatic stress from an accident or injury. \u201cBut we tell people not to focus too much on symptoms because rumination can increase anxiety.\u201d People should work through their stressors in therapy, rather than fixating on symptoms.Vestibular therapy \u2014 Vestibular therapy helps improve balance and feelings of dizziness. It can involve balance training, head movements, eye movements, and gaze training. Sometimes, it entails doing what makes you dizzy so your brain can relearn how to stabilize.To Reduce Anxiety After Concussion, Stay ActiveDr. Burley says the days of treating concussions by lying in a dark room are over. Prolonged rest is no longer a key part of all concussion recovery plans. \u201cPeople weren\u2019t really getting better,\u201d he says.The thinking on this began to change nearly two decades ago. \u201cWe realized the active approach helps people get better significantly faster,\u201d he says.For example, UPMC Sports Medicine runs a Saturday Morning Injury Clinic each fall for kids injured in Friday night football games and other sports \u2014 and they often see concussion symptoms there. \u201cSometimes, we\u2019ll have our athletes running on the treadmill Saturday morning.\u201dThis exposure\/recovery model leans into the idea that you can\u2019t get better if you avoid the activities of daily life. \u201cI tell my patients, be social, exercise, use screens,\u201d he says. \u201cDepending on the type of concussion you have, feeling the symptoms can be essential to the recovery process.\u201dWhat About Anxiety and “Post-Concussion Syndrome?”Post-concussion syndrome and post-concussive disorder are terms that get tossed around a lot. People sometimes use them interchangeably with concussion.Post-concussion syndrome refers to chronic symptoms after a concussion and is more aptly characterized as \u201cpersisting symptoms after concussion.\u201d Post-concussion syndrome suggests these symptoms may be permanent, which can be demoralizing for patients.Seek Concussion Care Right Away\u201cOur research has shown that if you see us within a week, you can reduce recovery time by half,\u201d Dr. Burley says.UPMC Sports Medicine Concussion Program experts now see patients at nine locations throughout western Pa. The Greensburg and Erie locations are the newest. Virtual visits are also an option in some cases.Because UPMC Sports Medicine is renowned for its concussion program, people come from all over. \u201cSometimes, we can treat vestibular or ocular concussions quickly, and it helps,\u201d he says. \u201cOther times, people have been overtreated and feel like they will never get better.\u201dBut they can get better. It\u2019s all about getting to the root issue, he says. \u201cIn my mind, there is not a concussion that cannot be treated with the right treatment plan.\u201dSources"},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2025","item":"https:\/\/share-dev.upmc.com\/2025\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"04","item":"https:\/\/share-dev.upmc.com\/2025\/\/04\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"Coping with Long-Term Anxiety Following a Concussion","item":"https:\/\/share-dev.upmc.com\/2025\/04\/concussion-after-anxiety\/#breadcrumbitem"}]}]