• Introduction
  • Management
  • Survivor Videoblog


Anxiety can occur at different stages of recovery and will usually be more noticeable in earlier stages in those with less severe injuries. 

Awareness of anxiety often occurs later in people who have more severe injuries because it can take time for understanding and appreciation of the extent of their outcomes to have a cognitive impact.

In many instances, anxiety stems from biological and chemical changes which occur after brain injury. In these cases, the source may feel unknown and will likely be resultant from unconscious fears – triggering in the same ways as PTSD.

The biochemical cascade, which occurs immediately following a brain injury, causes the adrenals to continuously fire due to the biological perception of stress and psychosomatic indicators, both of which can manifest as feeling anxious. The brain knows it is injured and creates unconscious nervousness resulting in the symptoms of anxiety.

Fatigue can also increase feelings of worry, and if not curbed, can lead to panic attacks.

Sometimes anxiety emerges as a result of a build-up of stress and may be caused by fear and worry or circling thoughts about unresolved personal issues. Many people get stuck in a spiral of constantly comparing themselves to how they were pre-injury. This desire to make sense of events can have a negative impact on self-esteem if not managed.

Because it can be so challenging to manage thoughts following a brain injury, it can be difficult for people to distinguish the details, and sometimes people feel overwhelmed with the way outcomes can impact each other. For example, anxiety can exacerbate the ability to concentrate or maintain attention and can affect the capacity to start or finish tasks. There can also be a cumulative effect on sleep patterns, getting to sleep, managing relationship, changes in appetite, and being able to take time out to enjoy hobbies and interests.

These symptoms of anxiety can appear as emotional or physical indications – or both. For example, people may become more irritable and less tolerant of others and could also show less interest in things. At times they may feel panicky, feel short of breath, or notice an increased heartbeat or palpitations.

Many people struggle with obsessive thinking where they become fixated on a problem and have difficulty finding resolutions.


The effects of anxiety can be very disabling.

Many people will visit their general practitioner when they notice problems aren’t going away or are getting worse. Often the symptoms of anxiety are managed in isolation from the overall brain injury, and people are prescribed medications to help them to cope. While some people do better, many people living with brain injury report adverse effects to drugs and notice they can impact on the quality of life and exacerbate other symptoms.

For some people ‘talking therapies’ work well as this helps them break down their issues into more recognisable problems. Writing things down and sorting thoughts into a pros and cons list can help people be more able to qualify priorities.

There are many other ways to combat anxiety, such as reducing stress and addressing inflammation by using techniques like:

  • mindfulness and meditation
  • eating for nutrition/avoidance of inflammatory foods
  • support of the gut microbiome
  • using supplements
  • other therapies and treatments
  • life needs – exercise, daylight and activities such as tai chi or yoga

Many people know what helps them to relax and work on ways of being disciplined about putting time aside for themselves to maybe unwind in a hot bath or take a walk in the fresh air.

Anxiety coupled with depression can cause more severe symptoms such as having ruminating thoughts about self-harm or suicide. It is imperative that anyone experiencing this gets immediate medical support.

You may find the video ‘How do you Develop Mental Toughness,’ by Paul Cummings inspirational.

He says, “Why did this happen to me,” and realised this was a disempowering thought and found that what he needed was to switch to – ‘What am I going to do about it?”