Anxiety and Depression: Common Sequelae of Brain Injury and Other Neurologic Disorders

About a month after my right medullary stroke in 2014, I was home from the hospital, walking without an assistive device, and making continual progress in outpatient therapy.  I had experienced an outpouring of love and support from friends and family and was even getting the ball rolling on getting back into nursing school to finish my final year.  It seemed I should feel very lucky to be alive and even more lucky to have regained so much function, after much initial uncertainty if I would ever be able to walk again.  But I had hit an invisible wall, or fallen into an invisible pit, and I never felt so deeply miserable in my entire life.  I felt I should have a zest for life, knowing I had survived a tremendous crisis, relishing in every precious moment.  But every moment felt more like quicksand, and my awareness of this led me to feel tremendous guilt and shame.  I had completely lost my joy.  My happiness, a trait that had rather embodied ‘Jeni’ was totally broken.  I languished for weeks, living in my pajamas and staring at the wall, feigning smiles for friends and family when I could muster it. 

As a nursing student, I thought I had heard remnants of information about hospital-related and post-stroke depression.  The scientist in me got busy fighting – or researching – for my life.   I found lots of information about stroke and depression, much of which hinted towards the debility following stroke being the inflicting factor of depression.  But I was not terribly debilitated, at least not enough to warrant my big time blues, so this did not resonate.  It became clear to me that I most certainly was not alone; most articles I encountered had a slew of commentary from brain injury survivors whose suffered from new onset anxiety and depression following their injury.  Much like me, they were desperately seeking answers that simply weren’t out there.   Most all the research I encountered always stated the same thing: “more research is needed,” and of course the only solutions available were medications and the basic minimally useful self-care tips.   

A study in New Zealand on childhood brain injury survivors revealed a very strong correlation between childhood brain injury with adult anxiety and depression.  Study participants who had suffered a childhood brain injury were five times more likely to suffer from an anxiety disorder as an adult, and four times more likely to suffer from panic attacks, phobias, and depression (Kennedy, 2017).  Modern medical science points assumingly towards the trauma and debility experienced during or after a brain injury as the major causative agents.  But if the brain is an organ and it is damaged, and the brain regulates emotions and healthy thought patterns,  and there is a tremendous correlation between brain injuries and these mental health concerns, then why are we not looking at damage to brain tissue as the primary causative factor?  When we start to approach the problem from this perspective, new solutions begin to reveal themselves.  A damaged brain is not fixed with antidepressant meds, and it is certainly not fixed with anxiety meds such as the potentially dangerous and addictive drug-class of benzodiazepines.  But we most certainly can stimulate positive neuroplastic changes and establish more efficient neural pathways through brain rehabilitation, which can have a tremendous impact on overall brain health and emotional regulation.   

Medical science is undoubtedly behind the game when it comes to brain injuries.  The world of functional medicine takes a more holistic approach to matters of health.  Functional medicine practitioners strive to be on the forefront of medical research outside of the typical medical paradigm.  And because of this, the approach to treating health problems shifts away from symptom management, and more towards tapping into the body’s amazing ability to heal given the right tools and fuel to do so.  Chiropractic neurologists, also dubbed functional neurologists, are applying cutting edge therapy techniques to rehabilitate injured brains.  Thanks to a functional neurologist, Dr. VanWinkle, (who I am now proud to call my colleague) I experienced tremendous improvements to my neurologic health; simultaneously my mental health stabilized without the use of medications.  Now I am honored to be part of the healing journey for so many of our patients who commonly report a marked reduction in their anxiety and depression symptoms following a brain rehabilitation program.

The field of functional neurology has developed brain rehab techniques using existing research on our complex neural networks.  One example of how rehabilitating certain areas of the brain can promote positive emotional changes is discussed in Mukkadan, et al.’s review of research (2017) exploring the connection between the vestibular system and the limbic system.  “The vestibular system is extensively networked with the limbic system, and hence vestibular stimulation can influence emotional behavior by regulating several higher centers in the central nervous system and autonomic nervous system” (p. 14). The vestibular system is what tells our brain where our body is in space and helps coordinate our movements in regard to that spatial orientation.  Our limbic system has a huge role in producing and regulating our emotions and memories and interacts with our endocrine (hormonal) function in response to our emotions  The vestibular-limbic connection is just one example of how we can positively affect our emotional wellbeing by stimulating and activating our brains properly.  A functional neurologist can determine what areas of your brain may not be functioning optimally and will develop a therapeutic approach to stimulate those areas to promote better function and bring balance back to your nervous system. 

Kennedy, M. (2017, June 7). Childhood brain injury tied to adult anxiety, depression … Retrieved from https://www.reuters.com/article/us-health-anxiety-brain-injury-idUSKBN18Y2S5

Mukkadan, J., Rajagopalan, A., Jinu, K., Sailesh, K., Mishra, S., & Reddy, U. (2017). Understanding the links between vestibular and limbic systems regulating emotions. Journal of Natural Science, Biology and Medicine, 8(1), 11. doi: 10.4103/0976-9668.198350