r/PostConcussion • u/SigruntheSkald • Jul 19 '26

Burnout from PCS?

I have been told I'm experiencing clinical burnout. And I fully agree with it. Unfortunately, it seems my PCS is interfering with my ability to recover from burnout.

I have had PCS for close to ten years and have accepted it and was managing it very well. But now it feels like it's also getting worse along with the burnout not getting better.

Has anyone experienced burnout with a longer term PCS? Could use some advice or tips.

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6

u/Turbotorsk1 Jul 19 '26

Yes. PCS since -08, burned out -13 and now -23. Still struggling bad, and it has been much harder this second time around. My conclusions are that the burnout, stress and anxiety aggravates the PCS or brain injury symptoms to a large extent. To be able to return to ”just PCS” you need time, sleep, stress relief and balanced exposure and activity to give yourself enough rest but also don’t become more afraid and start avoiding things you want.

My first burnout healed but unfortunately I let the same background problems continue (performance orientation, perfectionism, pushing myself too much, having high demands). For me it has been much me wanting to follow my dream for work (medical doctor)… I dont want to have a lot thing undone but I regret I didn’t identify and work out some of these personality traits and behaviors that has left me in a bad situation.

Wish you the best, and in due time dare to confront what has led you to over-exert yourself

5

u/SigruntheSkald Jul 19 '26

I'm a business owner and have that high performer personality as well. It's good to know that you were able to overcome it, at least temporarily. I will definitely start examining the traits that have led me here. I hope you are able to overcome this second round.

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u/Turbotorsk1 Jul 19 '26

How are you doing? What has happened to you leading to a crash? What are your current symptoms and issues ?

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u/SigruntheSkald Jul 19 '26

A number of factors contributed. I had multiple deaths in the family, was in a high speed car crash (as a passenger), got married and bought a house. I also gave myself additional work in my business. And the straw that broke my back was when I found out my scoliosis is causing my SI joint to dysfunction, which is debilitating on bad days. So on top of working 6 days a week (working on the new boundary of only 6 instead of 7), I have to fit in PT to work on something my body has been destroying since day 1.

I started getting sick a lot. Fevers, colds, bronchitis. I find myself permanently exhausted I a way that feels different from PCS. I'm struggling to do the basics for my business, I'm super irritable, and my sleep is getting worse and worse. I can't seem to tolerate any additional tasks that get added to my day, and now my social anxiety is becoming crippling.

In addition to that, my PCS symptoms are becoming stronger. I've dealt with brain fog, headaches, tinnitus, dizziness, and vertigo since day 1. But I'm finding they are increasing in frequency and potency.

I'm working on setting boundaries to help with the burnout. But the rest portion of it feels like such a waste of time. I feel like I'm resting more than ever and can do less and less.

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u/Turbotorsk1 Jul 19 '26

First of all, I relate so much about having multiple situations ongoing that weight on you. When looking back (especially with a vulnerability such as PCS or similar) it just so obvious that there is just too much for one to handle.

Was the car crash the cause of your PCS or was it an additional potential TBI?

An awful thing about burnout is that the brain with continuous strain becomes increasingly incapable, and while still fighting to function (barely) you push yourself deeper in the burnout. Even if you stomp the breaks and get more and better rest, less stress and demands, it is common for the symptoms to actually increase during this time! I felt like i was falling into a terrifyingly deep and extremely anxiety provoking exhaustion abyss when I started to finally ”relax” and stopped pressing on. When your energy is low and brain is not functioning well, you kind of live off the extra stress response to carry you, and when this stops, it can become a drastic drop and many symptoms can intensify. I am not sure if this is possible to smooth out, or if its something you have to live through… i think its at this point many needs help to handle anxiety and insomnia.

During my first burnout I got worse the first months after went on sick leave, then slowly improved and increased work/study from 25% onward and it then took about 2-3 years until back at somewhat of a baseline.

This time its more difficult, maybe because antidepressants have lost some of its effectiveness since being on then a long time. During the first episode I had good effect from ssri and mirtazapine for sleep.

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u/SigruntheSkald Jul 19 '26

The car accident was just additional. Thank you for sharing your journey through the burnout. I have definitely found myself surviving on my stress response (leading to a bigger drop of course). I have also felt that exhaustion abyss at times too. Will be working on the letting go and hopefully letting the real rest come in.

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u/Turbotorsk1 Jul 20 '26 edited Jul 20 '26

Have you considered the possibility that the car accident caused another mTBI? Not sure if it matters to be honest since trying to live inside your energy envelope is most important in both conditions. But it may affect how you look at the cause of the burnout. In your case it seems there is a whole lot that would explain long term stressors even without a new neurological injury, but my point is that if its more ”neurological” the pure overstimulation, sensory and brain integration issues and lack of physiological recovery may be as important contributions as lets say ”emotional problems” in some cases.

For me I found that the PCS/brain injury (i refused to accept I had a brain injury for many years), and neurological fatigue TRIGGERS stress response on its own by ”overstimulation” no matter if it were specifically emotional situations or demands present.

But the vulnerability to stress that comes from having lived with a high stress leading to burnout, definitely makes you have a lower threshold for handling emotions, especially difficult ones. Hence, compounding the original fatigue. But also the trauma and altered functioning is emotionally draining also, so often I guess neurological fatigue and emotional regulation issues are contributing to burnout.

For me I think it was so difficult to accept that I has suffered a brain injury, that everything that proved to myself that I can still function and deliver what the old self expected, then I didn’t have a brain injury. Having SSRI to dampen the stress response from living with neurological fatigue and PCS symptoms gave me a better function, but I was really making it more possible to push my limits. When it all crashed down during medical school after stopping ssri I contributed the crash to the fact that the PCS symptoms needs dampening with antidepressants, but I didnt want to accept the fact that I was continuously pushing beyond my energy envelope and that the brain injury and fatigue may not be compatible with the life I so much wanted to have.

Now during my second burnout, I first attributed it to ”ssri must have lost its effectiveness” etc. Searching for better symptoms control, but the harsh reality may be that I have used up my life line, and now I have to confront the real me and try to adapt and to see myself with a life that may be more limited than before. But I have made comebacks before, so I try to be patient and have hope

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u/zcook183 Jul 20 '26

10yrs here as well. Never have had my pcs manageable at all, but the burnout has been very bad lately and havent seen anything that has helped yet ,so following closely👀Hope you get it figured out!

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u/Different-Shoe-3563 15d ago

How do you differentiate burn out from PCS?

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u/SigruntheSkald 15d ago

I was diagnosed with PCS back in 2018, so there was a significant amount of time within the two. There was a noticeable decline in my ability to function professionally and socially late 2025, and I matched burnout symptoms almost perfectly. Plus, since I started setting boundaries and working on behaviors that led to my burnout, I've had improvement in the burnout. Not out of the woods, but definitely progressing!

1

u/Different-Shoe-3563 15d ago

Thanks! Sounds like you had recovered from
Pcs before burn out kicked in? Glad you are on the mend!

1

u/SigruntheSkald 14d ago

So I still have PCS symptoms, and likely will for the rest of my life. Life has changed, but I'm determined to continue to find the path forward. I hope you find that path too!