I dealt with long-term anxiety after a concussion but mostly, it was manageable. This changed at the beginning of 2023, when my anxiety got worse, and I stared to get those TBI panic attacks. I started to read books about this subject, looking for anything that might help to control those thoughts and feelings. In one of the books, I found helpful exercises, which I’d never heard of before, which helped me immensely. I hope they will help you too.

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Table of contents

• Credit to Klaus Bernhardt

• Stop searching for the cause! Long-term anxiety after a concussion

• Managing your anxiety after a brain injury - General exercise

• Exercise 1: Auditory (your thoughts) - Moving technique

• Exercise 2: Auditory (your thoughts) - Cartoon

• Exercise 1: Visual - moving technique

• Exercise 2: Visual - slow motion

• Exercise 3: Visual - Zoom out

• Exercise 1: feeling: doing the opposite

• Exercise 2: feeling - The pencil

• Exercise 3: Feeling - Chef pose

Credit to Klaus Bernhardt

I didn’t come up with these exercises myself, so all credit goes to Klaus Bernhardt, who’s been working for years as a medical and science journalist, when two of his friends were struck by anxiety attacks and asked for his help.

He dived deep into anxiety research, retrained as a psychotherapist and developed his own treatment method, with amazingly successful results.

After I read his book: “The Anxiety Cure, Live a Life Free From Panic” (or for the Dutchies: Angst en paniekavallen overwinnen). I found very useful tools about managing anxiety after a brain injury, especially moments when I feel I am losing control.

Stop searching for the cause! Long-term anxiety after a concussion

Before I share the exercises, I think it’s important to highlight this, it’s important to let go of your past. Stop searching for the cause of your anxiety, your physical symptoms, where it’s coming from. This only feeds your anxious thoughts and everything we focus on grows. The longer we struggle with anxiety, the more chance we have to develop generalised anxiety disorder.

Start focusing on all new and great techniques that might help. There are so many new techniques out there, new research is done, and that’s why I am a big fan of trying new things. As human, we change, so all techniques need to change too.

So, let’s dive into the techniques and start managing your anxiety.

Managing your anxiety after a brain injury - General exercise

When it comes to long-term anxiety after a concussion, we’ve all developed our own pattern even without being aware of them. Thoughts will always cross your mind. This can go clockwise or counterclockwise, or in a spiral. Just notice what is happening in your brain when you feel the anxious thoughts spinning in your head.

Do you notice they are going clockwise? Then try to move them counterclockwise. Your brain will get a mindfuck and this might stop the anxious thoughts as we break through this circle.

Exercise 1: Auditory (your thoughts) - Moving technique

Let’s discover your personal anxiety triggers. Grab a paper and a pen.

Write on top of the page: Auditory (this means your thoughts).

Write down 2 sentences that come to your mind right before you start to panic.

Then write 2 other sentences down that someone said to you that made you really happy (maybe a compliment).

Say the first 2 negative sentences in your mind. Do you hear those sentences more in the left or the right side of your brain?

Say the last 2 positive sentences in your mind. Do you hear them left or right?

91% of all people can really notice a specific positive and negative side. If you don’t, don’t worry I will share some other exercises that might help too.

For everyone who noticed a specific side, I want you to repeat the first negative sentence and try to move this one to the positive side of your brain. It’s not easy, but it gets easier. Once this happens, you may notice the sentence will fade away, or your words will change into something positive.

Exercise 2: Auditory (your thoughts) - Cartoon

If the first exercise didn’t work for you, you can try this second one. It’s a bit funny, and I use it daily, and it makes me laugh.

Every time a negative sentence, a panic sentence is popping into your thoughts, try to imagine a funny cartoon is telling this thought instead of your own voice.

Your brain likes routine, and this breaks the pattern. You can also imagine this funny cartoon with a high voice is popping out of your head and saying those panic sentences in a funny way and making crazy movements at the same time.

It helps to take those thoughts less seriously.

Exercise 1: Visual - moving technique

For some people, the visual aspects are a bigger trigger when it comes to anxiety than their thoughts. For example, you see yourself running out of the supermarket because you’re getting a TBI panic attack.

Also, in this case, you can use the moving technique of moving this image in your head from the negative side to the positive side. (see exercise 1 auditory how it works). You might notice this image will change from panicking and running out of the supermarket, to seeing yourself just calmly grabbing products and smiling in the supermarket.

Exercise 2: Visual - slow motion

If we watch a scary movie on television, the fast scenes scare us the most. What if this scariest scene is played in slow motion? No one would feel frightened from that.

What if you play your anxious visuals in slow motion? Try it, it really helps!

Exercise 3: Visual - Zoom out

For this exercise, imagine the anxious visuals and try to zoom out from that situation. For example, you’re so scared driving a car, you feel your heart beating out your chest, just zoom out, make this picture very small, so small until it’s a tiny dot.

Then you switch this image for an image that shows your goal. In this case, an image of you driving a car, feeling very happy and confident; it gives you a good feeling.

Then focus on the anxious visual again and zoom out again until that little dot. Then replace this image for the goal image.

Do this around 7 times and end with the positive image.

Exercise 1: feeling: doing the opposite

When it comes to physical symptoms, it can help to think the opposite. For example, when you’re dizzy, it’s mostly a dizziness in a certain direction. For example, you can feel the dizziness from left to right. If that’s the case, imagine the dizziness goes from front to back.

Same for all other things. If you feel pain/stabbing on your head, try to imagine the pain is not going from outside into your head but the other way around.

Or when you start to feel very warm and sweaty, imagine you’re under a cold shower.

If you feel tingling in your hands, try to imagine ants are walking the opposite way.

And you can do this for every physical sensation you experience. In the book, he ignores the breath and the heart as those symptoms are regulated automatically. He believes the more attention you spend on those things, the more it can bring them out of balance.

But when you feel shortness of breath, for example, you can imagine your ribs are made of steel and when you push a button, your chest is getting bigger and bigger until the strap that’s around it will break.

Exercise 2: feeling - The pencil

Your body sends signals all day to your brain. When you smile, for example, your brain thinks you’re safe and okay. I totally understand you can’t smile when you’re feeling anxious, but what if you put a pencil in your mouth horizontally so you create that smile.

A study showed that this already sends a lot of signals to your brain that you’re okay.

Exercise 3: Feeling - Chef pose

This is a funny one, and I do this right now once a day as I notice it’s helping me. Just sit in your chair and put your legs on the table and your arms at the back of your neck. This gives a sign to your body you have everything under control. Try to stay in this pose for about 5 minutes.

These are the exercises that are explained in the book: “The Anxiety Cure, Live a Life Free From Panic - Klaus Bernhardt”.

You don’t have to do all of them to reduce your TBI panic attacks or your anxiety, just try them and feel which ones work best for you. And if you want to dive deeper into it, I can really recommend his book.

Good luck, and I hope this helps everyone managing their anxiety after a brain injury a bit better.

Let’s keep those anxious thoughts away.

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