In this video, David Brimacombe explains why people with post‑concussion syndrome (PCS) often experience symptom flare‑ups that seem to occur for “no reason.” He frames concussion as a functional injury that does not appear on imaging, which leaves the nervous system in a protective, hyper‑vigilant state. Because the autonomic system now has a higher baseline stress level, everyday stressors accumulate and can push the system over a threshold, producing symptoms even though no single event appears to be the cause. Brimacombe describes how to lower that baseline through sub‑threshold exposure training: deliberately and gradually exposing oneself to mildly stressful stimuli, labeling and acknowledging the nervous‑system response, and reinforcing safety cues. He contrasts this approach with the outdated avoidance strategy that tells PCS patients to stay in the dark and limit activity. Over weeks, incremental exposure builds tolerance, down‑regulates the sympathetic response, and allows the parasympathetic system to dominate, reducing irritability, anxiety, and fatigue. The video ends with a call to continue learning about autonomic healing and to apply the exposure principles consistently.
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If you still have post-concussion syndrome and your symptoms flare for no reason, no distinct cause or trigger, well, this video is going to help dispel some of the myths around symptoms flaring and what actually causes it. Hi and welcome to the PCS Resilience Collective. My name is David Brimacombe, and after 20 years and 7 concussions, I learned a lot about the lifestyle modifications needed in order to help heal your body from PCS. Spoiler: It's not necessarily what you think. Let's begin. Let's start with this. When your brain suffers a concussion, it is a functional injury. And again, I've mentioned this in previous videos. This means that it won't show up in a scan. You go to the neurologist, you go to your doctor, those scans don't show up with any visible issues with your brain. And how does this relate to the symptoms that you're feeling? Well, Your brain goes in a protective loop. So what you need to know about your nervous system is your nervous system is a very basic system. Its main job is to keep you safe. If it feels there's a threat, it is going to go ahead and sound off the danger alarms, just like a smoke detector would. Now, the problem after a concussion is that smoke detector is highly sensitive. Burnt toast, something boiling over onto the, uh, to the burners is going to cause that thing To go off. Now, does that mean that there's actually danger here? No, not necessarily, but your body perceives it to be so, and that is all that matters. All that matters is your nervous system has now found that to be a threat, whether that's a loud noise, um, somebody cut— someone cutting you off in traffic, whatever the case may be. That is now perceived as a threat, and your body's going to react accordingly. Your body's going to go into a highly stressed state. Okay, it's going to go into this sympathetic state. Your body's going to go into that fight or flight, and you're going to have to bring it back down to baseline. Why it feels like nothing actually caused those symptom triggers? Well, in a lot of cases, it isn't one distinct event. Now understand that the nervous system works on a cumulative effect. If you have a poor night's sleep, you have a poor breakfast, a long commute, and you have a tough meeting as soon as you get To work. Now your body's now building up stress. So layer upon layer, you're building stress upon stress. There has to be a breaking point. Now maybe you go ahead and you go for lunch and they don't have your typical menu item, and you lose it. And you're like, why am I losing it? It's not because of that one distinct event. That distinct event is only the straw that broke the proverbial camel's back. It is one singular event. It wasn't so much that that restaurant didn't have that item on the menu. It was the buildup. Okay? It was all those successive stressful events. Again, the thing you have to understand about PCS is your baseline is now likely going to be higher than everyone else. So prior to my concussions, I could tolerate a lot of stress. I was— I'm a teacher, so I'm in busy environments, lots of lights and sounds and noises and kids doing crazy kids things. Now, I could usually tolerate that prior to my concussions. After my concussions, little things would drive me crazy. Little things would set me off to the point where I don't know where I'm getting angry at a child who's done something pretty innocuous, but it's not him. It was the things that led up to it. It was not that last event. It was the ones that preceded it. So it's important to understand that you have a lower threshold for stress. And this doesn't mean that you can't get stressed. This doesn't mean that you are bound to be in a stressed and angry and an irritable state the rest of your life. But you have to be cognizant that your baseline is higher, meaning your starting position is going to be higher than most. Where everyone's starting down here, okay, you're starting midway, meaning you've already stacked half of the blocks. Okay, once you add more stress blocks, you get to the top, it's going to fill up a lot quicker. Now, the one question that changed everything for me, okay, it wasn't, what did I do to make me feel so upset? It wasn't, how do I avoid all these stimuluses? It was, what made me feel unsafe? What made my nervous system feel like it was unsafe? Now, that's sometimes hard to depict because in any given moment, again, you could be in a highly stressful environment with lots of stimuluses around you. But it's important to understand that your nervous system is sending you a signal. It's telling you how it perceives the situation. Not to say that it is scary or dangerous, it's how it perceives it. Again, it is now on high alert. It's on hypervigilant mode post-concussion. So how do we bring that down? How do we actually temp that, that baseline down? Now it is possible. You can draw your baseline down so you don't get stressed so quickly. Now, one of the things you need to do, you need to understand that you need to talk to yourself. You need to convince your nervous system that the environments that you found your— you find yourself in, that it thinks are going to cause danger, it thinks are stressful, are not actually. And how, and how do you do that? You do that through exposure training. Now, exposure training is basically exposing yourself to a stimulus to the point where you almost reach that threshold where you're going to get to that stress state, but you don't quite get there. So you're going to go sub- Threshold training. So again, if it's— if after 10 minutes at a grocery store I start to feel irritable, I start to feel my heart rate pick up, I know that 10 minutes is my maximum. I'm only going to go to the grocery store for 6 or 7 or 8 minutes, and then I'm gonna, I'm gonna leave because I know that that is my threshold. And over time, the more you stimulate yourself to these events, to these environments, and prove to your body and your nervous system That they are not going to cause you harm, that they are actually safe, it increases your tolerance. It increases your body's ability to perceive this as a safe situation. Now, you can layer up by telling yourself as you're going through there, I am safe. I am supported. I am fine. Look at this. When your brain starts to send those signals, you can, you can acknowledge it. You don't have to ignore it. Ignoring it is going to make it worse. Acknowledge those symptoms are there. I'm starting to feel agitated. I'm starting to feel anxious. It's okay. It's not that I'm actually anxious. My nervous system is hyper-aroused. Remind yourself of that because that's going to change your body's reaction and make it less stressful, and therefore over time reduce your stress load in those situations. So here's what I want you to do next time you find yourself in a situation that is highly stressful. You feel like you're bubbling over, you're about to hit your, your maximum threshold. I want you to label what you feel— the heart rate, the irritability, the fatigue, whatever the case may be, whatever your symptoms come up in those environments. I want you to label it, and I want you to acknowledge it, that this is not me as a broken human. This is my nervous system that needs some help. It needs some work. And given the right exposures over time, it will happen. Now, this is not a wake up and feel better the next day Uh, situation. This takes time, but what I want you to do is week over week see how you're improving. Again, go to the grocery store. Maybe it's 12 minutes this week and it's 15 minutes the next, but you're showing your body that it is safe. And with safety, you're starting to downregulate that nervous system, which tells your body that we are okay here, that we don't need to be stressed. We can go into that parasympathetic state. Which drops everything down and you lose that anxiety, you lose that irritability. Okay, but in most cases, it's not one singular event that's going to throw you over the edge. There's a cumulative effect of these. The more stresses you have in your life, the more you need to be cognizant of where am I going, what is my threshold, do I need to leave, do I need to remind myself that I'm safe. But remember, Okay, if you never expose yourself to the things that are causing you these symptoms, you're never going to heal. Avoidance is what they used to tell people with PCS. Stay in your room, stay in the dark, don't exercise, your brain will heal on its own. We know that is an absolute terrible suggestion. It is what I think caused my PCS to get to the point where it did, because I, I followed that instructions to a T, weeks on end, lying in bed. wondering what's going on. Okay, exposing yourself provides that stimulus in a small dose that you can eventually layer up over time. Now, I appreciate you staying to the end. If you want to learn more about how your autonomic nervous system— the healing structure is quite messy— okay, I want you to look up above. I will post a video about that. I hope you have a great rest of your day. Thank you.
