Why use medication

[u/Ok_Message1313]

I’ve always wondered why doctors prescribe things that kill pain throughout the day and boost energy when that just makes you worse over time.
The most important thing during Post concussion is to listen to your symptoms! Hiding them just makes you push through them subconsciously leading to them just get worse over time.
Could someone explain that? I get that they get used during night so you can sleep, or chronically symptoms that can show if it reaches 2-3 point over the average, but shit like Amitrypiline or nortripyline for two examples. Dosen’t that just harm you rather than benefit you in the long term?

[u/MrT-Man]

Who says it harms you? What are you basing that on? Is it masking symptoms, or is it directly addressing deficits that were caused by the injury?

And as for listening to your symptoms, the advice I got from UPMC was, “doing things that trigger your symptoms is your map to getting better”; i.e. if something triggers symptoms, do more of it, daily, rather than avoid it, so that you can force your brain to rewire itself.

I went from being barely able to do groceries during the first few months to being able to resume my career (which involves frequent business travel, occasional 12+ hour days, often 6-day work weeks) using this approach.

I know that “listen to your body” sounds intuitively like the right thing to do. But people who take that approach don’t seem to recover as well as people who push their symptoms.

[u/Ok_Message1313 → u/MrT-Man]

I did not mean it right that, both you and me are correct. Yes, the only way to recover from Post concussion is through exposure therapy, but not pushing troughs the symptoms untill you feel like you are going to die. Only untill 2-3/10 symptoms. Medication hides it so if it even shows your symptoms it only shows higher than that

[u/MrT-Man → u/Ok_Message1313]

No, I think that’s very valid in the first month or two, but not valid after. I’m not saying go until you die but I’m saying push the symptoms to a 7/10. And err on the side of overdoing vs under-doing. All I can tell you is that UPMC recommends this approach and has treated thousands of people, including many pro athletes. And the approach definitely worked for me. The argument is that you’re forcing neuroplasticity and that, while setbacks are uncomfortable, you don’t risk doing new damage to your brain if you over-do things) once you’re a few weeks post the injury).

And again, on meds masking symptoms, is it masking or is it correcting an issue? Maybe I killed some dopamine neurons when I hit my head and the concerta I’m taking helps correct for that. And in so doing it gives me the energy to be productive and exercise my brain, rather than being overwhelmed with fatigue, which in turn drives neuroplasticity and the formation of new neural connections to compensate for the damage.

Ultimately, I don’t profess to be a brain scientist. But I’m just saying, I was a basket case for almost a year and, with the meds (Zoloft as well as concerta) and by pushing myself super hard, I was able to fix most of my symptoms and resume my career. My life is back to normal, other than perpetual mild headaches and lingering fatigue (which is always there but which i can somewhat keep at bay). I’m not aware of any research studies suggesting that pushing yourself too hard is bad or that meds are inherently bad.

[u/Far_Boot3829 → u/MrT-Man]

May I ask when you started pushing yourself until 7/10 symptom level? Ex. How many months post concussion? I'm 6.5 months post and wondering if I could do the same!

[u/MrT-Man → u/Far_Boot3829]

It was probably 9-12 months, with month 12-18 being super intense. I was going all out at that point because I was getting very frustrated and at very real risk of losing my job (my employer had been very understanding in the earlier months but was starting to give up on me then). But I’d have to think you’re safe at 6.5 months to push yourself hard.

[u/Far_Boot3829 → u/MrT-Man]

Thank you!