So you try the usual routes. You talk it through, follow the advice, take the medications, do the breathing exercises. You want to believe it’s going to help. But part of you knows something else is happening. You’re doing the work, but your brain still feels off. You still don’t feel like yourself.
When Mental Health is a Clue, Not the Whole Story
Pernicious Anaemia is a condition that affects how your body absorbs vitamin B12, a vitamin essential to your nervous system. Most people hear “vitamin deficiency” and think it sounds simple. But B12 deficiency can alter your brain. It can change how you think, feel, react, and process the world around you.
It can cause brain fog that makes focusing or finding the right words a struggle. It can leave you feeling disconnected from your body, like you’re watching life instead of living it. It depletes your emotional bandwidth, making it harder to cope with stress or regulate your mood. You might feel forgetful, unfocused, and emotionally numb. You could be irritable, anxious, weepy, or completely flat. These changes often happen slowly. They are hard to describe. Often, these symptoms are misunderstood as purely emotional or psychological in origin.
Even With a Diagnosis, the Struggle Can Continue
While treatment often brings relief, the mental and emotional challenges can persist long after your B12 levels improve. Some people feel dramatically better once their B12 levels are restored. Others find that their mood, memory, or focus never fully return to what they were before. For some, the symptoms come and go. For others, they linger.
There are flare-ups. Setbacks. Weeks that feel foggy or fragile, even when your labs are stable. You might find yourself feeling angry or sad for no clear reason. Or you might go completely numb again, just when you thought you were getting better.
This does not mean the treatment failed or that you are doing something wrong. Sometimes, people with Pernicious Anaemia need more frequent B12 injections than the standard schedule to manage these ongoing neurological or mental health symptoms. Sometimes the injection frequency needs changing over time or with circumstances. It’s important r to find the treatment frequency that truly supports your brain and nervous system recovery. Getting the right injection frequency can be a battle with your healthcare provider which can add to these feelings.
The neurological effects of Pernicious Anaemia are complex, and recovery is rarely straightforward. Listening to your body and advocating for your needs can make a real difference.
Finding the Right Support for You
While therapy can be valuable, it is only one of many tools that can help. Many people find relief through meditation, somatic therapies, Reiki, yoga, or other holistic practices that focus on balancing the mind and body. These approaches can help ease brain fog, reduce anxiety, and restore emotional resilience by supporting the nervous system.
What matters most is finding what helps you feel more connected, grounded, and empowered as you manage the complexities of Pernicious Anaemia. This might mean combining several approaches, being patient with yourself, and communicating openly with all the practitioners involved in your care.
You Are Not Broken
These experiences are very real and valid. They do not mean you are failing or somehow broken. Many people with Pernicious Anaemia face ongoing mental and emotional challenges because this condition affects the brain as much as the body.
Healing is rarely a straight line. It takes time and often requires exploring different kinds of support and practices that address both the physical and emotional aspects of recovery.
Thank you for this excellent article-it’s not just in your head. It is reassuring to read that just because I am receiving B12 injections (every 6 weeks for me) I can still have symptoms and emotional reactions due to PA.
I find the PAS articles are helpful and supportive. I do feel that the system doesn’t offer up anything by way of support beyond the injections & basically it’s just a case of get on with it.
Thankyou for this.
When I first found out that I had B12 deficiency, I had never heard of B12. The doctor told me to book up six injections with the nurse at reception – and that was that. I didn’t realise until the fifth injection that there was any more to it. I wasn’t any better yet, so I asked.
Injections for LIFE ? That was a bit of a shock !
Well that was almost 10 years ago now. Despite frequent injections, I have not rid myself of symptoms. I have managed them as best I can and have gradually improved. It can be a lonely process, continuing with self injections to try and find the way back, nothing else having been found as a cause and NHS treatment offered only at a frequency that proved inadequate for me. I remained honest and determined. And constantly disappointed.
Having to accept that I was unable to work took a while. My phased return was a struggle, but made me face reality.
It would have been easier to get through this past decade had some of the medical professionals I met been more aware of exactly what we stand to lose without their help. And then help. There were a few notable exceptions – if not, I may well have given up. I was lucky in that I had a determined and experienced GP throughout.
The mental or neuropsychiatric impacts of PA shouldn’t be understated but they are definitely misunderstood!
Being told all my symptoms were psychosomatic only to find the low B12 levels later, as well as the brain lesions, was so frustrating.
I feel so much better with regular injections but still have occasional slumps/crashes
I found the article reasuring. I hate the mental side of it and exhaustion
I was given my first injection in 2006 but no loading doses were given even though the GP had downloaded information for me which mentioned that I would get them. I’ve recently found out that I was meant to have them as it’s in my history notes. Not knowing a lot about pernicious anaemia at the time I presumed the Doctor knew what she was doing. Although it worried me greatly.
She had told me that the diagnosis was the answer to the symptoms I’ve had for about three years.
I didn’t and have never felt any better with the injections . Just worse over time but was also diagnosed with fibromyalgia 2 yrs later.
Another Gp let me up my doses every 8 to 9 weeks 4 yrs ago but not made any difference At all.