Attention and Concentration
Often patients notice that their mind wanders more than usual and it may be difficult to follow through with tasks. Patients report problems understanding conversations, particularly when there are many people around or a lot of background noise. They often have to read the same thing over and over in order to understand it, and it can be difficult to switch tasks and start a new activity. Patients often complain they are less able to pick up on things in their environment.
Some patients find themselves confused about directions or are unable to make quick decisions while operating a vehicle. Patients can find driving exhausting and grow anxious at the thought of navigating through traffic. Other problems include the inability to stay focused on the task of driving and problems discerning how close other objects are. Patients may need to concentrate more closely while driving, eliminate distractions such as the radio, and not drive when tired.
Even when patients are able to resume normal activities, they often find they require more energy to do the same quantity and quality of work. In addition, patients find they are more tired at the end of the day, which can be exacerbated by disturbances in sleep patterns.
That lack of sleep often equates to feeling less in control emotionally. Patients frequently complain of mood swings, depression, a "short fuse," crying easily, and big gaps between happiness and despair. In addition to these emotions, patients often feel worried about their abilities and their future in general.
Patients' anxiety also comes from the unpredictable patterns of their day. They may complete a task one day but be unable to finish it the next, feel as though they accomplished something only to look closely and discover it was done all wrong, or they can't get interested in anything at all.Patients also suffer anxiety about their relationships with family and friends. Because their outward appearance remains the same, others will often treat patients as the same person they were before their trauma. However, patients recognize that something is different and get frustrated with people who expect them to be like their old self.
Difficulties with memory are a common complaint for people dealing with post-concussive syndrome. Though their memory is often fine, patients can experience difficulty retrieving information from storage because of less efficient processing, or because they are unable to pay attention to something long enough to store it in their memory. Patients can forget to do things, forget appointments, or forget what they set out to do. They often forget names of people they've known a long time, say the wrong word, or are not able to recall the word they want. These issues happen not because memory is bad, but because patients can easily be distracted by inside (thoughts/feelings) and outside stimulation.
Typically humans can juggle several different thoughts at once quite effectively, enabling an individual to make decisions quickly, solve complex problems, organize effectively and attend to many details simultaneously. Patients who suffer from post-concussive syndrome experience thinking that is less efficient, which means they can often only do one thing at a time. Patients also have difficulty thinking through complex problems or trying to keep track of several things at once.
Patients often report periods of mentally shutting down, or going blank. Though this can be scary, it is very normal as the result of slowed and inefficient mental processing. The brain fills up its cognitive capacity and simply has nothing left.
Speed of Processing
Patients often report feeling as though they are thinking slowly, and that others are talking too fast. Patients also take longer to complete a task, or to catch on to something new. In addition, patients complain that when they are driving, other cars are moving too fast.
It is a common complaint for patients to report problems upon returning to work. They may feel slow or fuzzy, and they often feel they are not as productive or efficient. It is important for patients to pace themselves and learn how to structure the work environment to meet their cognitive, emotional and behavioral needs. Sometimes this can mean simple changes in the workplace, such as cutting back hours or taking more frequent breaks to recharge their mental batteries.
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