Cognitive impairment and anhedonia after whiplash:... - Headway

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Cognitive impairment and anhedonia after whiplash: what should I do?

chuncho profile image
16 Replies

I am new here. I had a whiplash in January due to a sudden and unexpected stop of the car in which I was a passenger. Since then, "I felt increasingly detached from myself, as if I was a ghost of myself just going through the motions; functioning at a lower level of conscious awareness; not fully experiencing life with the same kind of profound intellectual insight and deep reflection that came so naturally to me before my accident. I became emotionally flat and detached and experienced severe anhedonia; I could not enjoy the things that I most enjoyed in life- music, art, and film." (quotation from a post of Lemon_Pie who perfectly describes what I feel). I am slowly recovering from the point of view of concentration and attention but not so much concerning anhedonia. I saw to neurologists who gave me antidepressant. I did not take them as I think I am not depressed in the usual sense. I also did a CT of the head with a negative result. I would like to see a new neurlogist soon. Please, can you give me an advice about what to ask him. I really hope to recover and I am ready to do all what is possibile for that.

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chuncho
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16 Replies
pinkvision profile image
pinkvision

Sounds like post concussion syndrome. Try to get a referral to see a neuro-psychologist and get some cognitive tests and find out what functions are affected. Then see what happens after that.

chuncho profile image
chuncho in reply to pinkvision

Thank you. I think that you are right. It should be a post-concussion syndrome since I remember that my head moved very rapidly and strongly and I am recovering very slowly, taking also into account that I am not a baby. I will see the kind of specalist you mention as I do not want to go through unuseful and dangerous antidepressants.

pinkvision profile image
pinkvision in reply to chuncho

As to antidepressants some people take them others don't. Personally I didn't. Something else to consider, if you were a passenger in a car when this happened you need to get legal advice. You may have a brain injury and it may last a long time and your life may get very difficult because of it. There is a list of solicitors on the headway website.

chuncho profile image
chuncho in reply to pinkvision

Thank you again.

Pairofboots profile image
Pairofboots

Anhedonia, good word, glad you used it, it will make part of my life so much easier to explain. Actually it won't, because I will have to explain the word, which is explaining how I experience life and have done for nine you years.

Ok a neurologist prescribed antidepressants, which you did not take because you are not depressed in the usual sense.

I am going to sound very unsympathetic, but I do know how you are feeling. I felt very similar nine years back. I had been a RN(MH) nurse specialist. I knew all the lingo, and in fact, I was an intimidating patient to any of the therapies.

I had a stroke, 50% of people who experience an assault on the brain will experience depression, surely not me? 25% of the general population will experience a significant mental health problem, surely not me?

No I didn't have the same causation, and although the symptoms were identical to other difficulties it is important for me to educate others of the difference. But it doesn't change the symptoms.

The treatment is identical regardless of causation. If I was to carry out a core assessment on you, I would probably summarise the assessment as:

Chuncho denies experiencing depression, but his/her (no offense) presentation is that of someone who is experiencing some emotional difficulties of a depressive nature, objectively Chuncho while talking demonstrates flattened effect in tone, and subjectively, Chuncho reports having difficulty enjoying activities that he/she would normally find pleasurable.

I would not necessarily try to give a definitive diagnosis, but an informed opinion. A Dr on that information may formulate an initial diagnosis.

Many people who have experienced something such as a near miss life changing event, will experience mental health issues. Yes the causation is different again from someone who had a traumatic childhood, or from someone who received brain injuries, but the symptoms are the same, and the treatment is the same.

Ok I don't often give my diagnosis, but here goes:

stroke, with incomplete recovery, neuro-psychiatric syndrome, a-motivational syndrome, hyperacusis (noise sensitivity), and now I can add anhedonia (inability to experience pleasure).

Ok, that is a mouthful, there are a few historical events, but they are physical. But how are they treated, generally with antidepressants, anti-anxiety medication, and anti-epileptic medication (I do not have epilepsy, which is also prescribed to others for pain management) but in my case it is a mood stabiliser.

So try the medication. You are not mad or a nutter. If you broke your leg, you wouldn't be debating the cause, well even without brain damage, you have experienced a traumatic event.

1949liz profile image
1949liz in reply to Pairofboots

Hi Pairofboots, your reply is amazing and so spot on gosh until your reply I was going to have to go to my dictionary to see what some words meant. The word anhedonia ( never heard of the word) that’s just what I felt like after my TBI/ bleed on the brain and stroke it fits into how I would have expressed my feelings if asked. Awesome and thanks, I have a Tremor and have now been put on the medical Gabapentin 200 mg three times a day it’s doing nothing at the moment I am only three weeks taking them ( .question) do you think it’s long enough after three weeks to have shown so form of progress ? Again Many Thanks for your information to pink vision as I say it was amazing. Liz x🌹🙏

1949liz profile image
1949liz in reply to 1949liz

Sorry it was a reply too chuncho x

Pairofboots profile image
Pairofboots in reply to 1949liz

Hi Liz. Was this given so it increased over the three weeks to your current dosage? Most meds have a therapeutic range, a bit like a one way single track road, too low it doesn't work and you slam into the left verge, too much, you get increased side effects, and you slam into the right hand verge. I've not known it used for tremor, but most medication has a number of uses. If you have been titrated (fancy word for increasing or decreasing medication over time) you may have only just reached a therapeutic dose (one that works). The prescriber should have discussed this with you. It is worth talking to the chemist, the prescriber, or even 111(or is it the other number 101? I never know which is medical). The tremor might not have improved, because the dose is too low/high, your tremor might not respond to Gabapentin. So worth a chat. Good luck. And thank you for your praise, nice to get to get feedback, good or bad. X

1949liz profile image
1949liz in reply to Pairofboots

Hi, and thank your for the reply, yes I am increasing the does by 100 mg I am NOW taking 200mg at night and 100 mg in the morning and another 100mg in the afternoon increasing this today by another 100 mg then at the weekend hopefully I will be on the 600 mg a day. Sounds an awful lot of tablets, yet so far no better still shaking and head nodding ( like a dog in a car ha ha ) Do you think this should work? Many thanks for the information Liz x🌹🙏

Pairofboots profile image
Pairofboots in reply to 1949liz

Like I said Liz, I haven't come across Gabapentin used for this, but I would think that the prescriber knows what to use. Often they start many of these medications low and then build up. They want to know that you tolerate the type of medication, and that they ideally want to you to have the lowest effective dose. When you reach the optimal dosage, it might take a few days to give good effect. So if you haven't noticed any significant relief at the end of next week, then early the following week it might be worth asking. But although I know the name, and it's dosage range, I don't know if this works quickly or gradually effect. But in general, I'd wait a week from when you are on the full dose before I'd question it.

Let me know how it goes Liz. X

chuncho profile image
chuncho in reply to Pairofboots

OK, I understood, thank you.

1949liz profile image
1949liz

Dear Chuncho, I think you should consider the antidepressant for a short time just to get you feeling better again. There is NO shame in taking tablets which are there to help you cope when you need them so give them a try and see how you feel. Liz x🌹🙏

chuncho profile image
chuncho in reply to 1949liz

OK, thanks. I will think carefully about your suggestion.

cat3 profile image
cat3

Hi Chuncho. Your symptoms are classic brain injury ones but will hopefully will be of a temporary nature sounding, as they do, to be concussion damage from a contra-coup type jolting of the brain.

Take a list of your symptoms when you see the neurologist (so easy to go 'blank' after suffering a brain injury) .......although I'm sure he/she will ask relevant questions.

PCS can persist for 12months or longer so be patient with yourself and forgiving of your diminished cognitive skills ; not easy I know. I used to play 'Devil's Advocate' just to test both sides of an argument yet now I struggle with everyday interaction.

But my after-effects are for life ( SAH 8 years ago) ; hopefully your brain will heal in time and you'll both function better and adapt to any lingering issues. I do hope so m'dear.

Please update us after your neurology appt.

Cat x

chuncho profile image
chuncho in reply to cat3

You give me some hope, many thanks . Actually, as I said, the cognitive impairment symptoms are regressing slowly whereas the emotianal symptoms are more persistent even if I feel that they are correlated with the cognitive symptoms and the neck pain. I also hope that there would be a general improvement through systematic physical therapy. I must add that I had a whiplsash with a car crash (again as a passenger) in 1996. In that occasion, symptoms were more ralated to the spine.

1949liz profile image
1949liz

hi again, your amazing and so helpful I will continue on the given plan and hopefully see some positive results I am so grateful for your advice as it sounds so sensible Liz x🌹🙏

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