Concussion and Mental Health

At this present time, Covid-19 has created a large worldwide impact on our overall health and the economy. This pandemic state which has put everyone in crisis mode can also have a large impact on our mental health. Thinking about this has led me to look a little further on the effects of concussion injuries on mental health.

1 in 5 may experience mental health symptoms up to six months after mild traumatic brain injury.

6% experience some form of depression.

Long-term risk of suicide increases up to three times among adults and children after a concussion.

Research has shown that those with a mental health history (themselves or their family members), use of certain medications, or a history of multiple concussions may be at a greater risk.

 

(Picture source: https://fherehab.com/learning/mental-health-dangers-of-a-concussion/)

Common emotional symptoms that can occur after a concussion include irritability, mood swings, anxiety, depression, sleep difficulty, fatigue or tiredness.

(Picture source: http://mihockey.com/2019/08/nhl-nhlpa-release-new-video-to-help-players-parents-coaches-id-signs-symptoms-of-concussions/)

At times many of the emotional symptoms may be related to sympathetic nervous system dominance ( which I discussed in my previous article), an inability to fully participate in sports, school, or work, or an emotional manifestations over their lack of control over their physical symptoms. Is it as simple as managing their overall symptoms to best minimize the emotional symptoms or do we need to start with managing the emotional symptoms first?  Maybe this direction is guided by the kind of healthcare provider that is working with them and their specific scope of practice.  My recommendation comes with the idea to determine the primary system that is creating symptoms and addressing this system first.

(Picture source: https://www.sgklawyers.com/blog/_clone/2017/03/a-mild-concussion-can-have-lasting-effects-on-longevity-and-mental-health.shtml)

Often educational lifestyle strategies coping mechanisms energy conservation and stress management can benefit both the emotional symptoms as well as the other group of symptoms.

The bottom line is to be aware that emotional symptoms can be present post concussion.  These can affect the recovery process, and also put an individual at risk for more serious emotional challenges when these are present. A referral to more qualified member to your concussion Healthcare team may be required to deal with the emotional or mental health component.

Please call your local crisis line or mobile crisis team or the police, or go to the emergency room of your local hospital if you or a loved one is in need of help. 

Written by

Efan Gonsalves, PT, AT (retired) Clinical Director- Markham
Corporate Professional Services Director
efan@honsbergerphysio.com 

References

https://www.nih.gov/news-events/news-releases/mental-health-disorders-common-following-mild-head-injury

https://primarycare.ementalhealth.ca/index.php?m=fpArticle&ID=57588

https://www.healio.com/primary-care/neurology/news/online/%7Baf725a34-4383-4356-96b3-b9982a02d0c2%7D/experts-discuss-rare-link-between-concussion-suicide

https://www.sciencedaily.com/releases/2019/11/191125145546.htm

Kontos AP et Al.  Mental health implications and consequences following sports related concussion. Br J Sports Med 2016 50(3):139-140

Kreibig SD. Autonomic nervous system activity in emotion: A review. Biological Psychology. 2010 84(3): 394-421.

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