Concussions & Mental Health

What are concussions?

Over the past two decades, we have been learning more and more about concussions.  Concussions are a bruising of the brain that can result in severe neurocognitive deficits, permanent disability, and even death. Their severity is often taken for granted and when that happens it may lead to death as we know with the death of Natasha Richardson.  Natasha Richardson was an actress who sustained a head injury while skiing.  She refused medical treatment and said “she felt fine.”  However, she passed away several hours later.  Richardson was not wearing a helmet at the time of her accident.  Even with helmets, we know many athletes have sustained serious head injuries.

Myths

You have to lose consciousness to have a concussion.  This is false!  You do not have to lose consciousness to have a concussion.  In most cases, individuals do not lose consciousness.

Helmets prevent concussions. Helmets are actually designed to prevent skull fractures, not concussions. If a helmet is fitted properly, it might reduce the risk or severity of concussions.  However, a helmet will not indefinitely prevent a concussion.

Everyone recovers the same from a concussion.  Concussions must be treated and managed on an individual basis. Each individual recovers at their own pace.

To diagnose a concussion, you need to do a CT scan or MRI.  the damage is at a microscopic level and cannot be seen on MRI or CT scans. The concussed brain looks normal on these tests, even though it has been seriously injured.

Symptoms of Concussions

-Headache
-Dizziness
-Nausea
-Fatigue
-Feeling in a Fog
-Irritability
-Balance Problems
-Memory Deficits
-Visual Deficits
-Anxiety
-Confusion
-Disorientation
-Slurred or Incoherent Speech

The symptoms associated with concussions can last a long time.  The brain is a complex organism that requires time to heal.  Often times, individuals recovering from a concussion will feel that they are not doing as well at school, work, or home.

Concussions and Mental Health

Many studies are now looking at the relationship between concussions and mental health.  According to research, concussions may increase your risk of developing a mental health issue.  After a concussion, an individual may have difficulties with emotional regulation, depression, anxiety etc.  The exact link between experiencing mental health concerns after a concussion is relatively still unknown.  However, many researchers argue it is a result of the particular part of the brain that was damaged during the accident.

 

Emotional Regulation

Individuals who experience difficulties with emotional regulation such as mood swings and irritability may have had their part of the brain that controls emotion and behavior affected.   Having to deal with the symptoms of a concussion can make a person feel irritable as they may tire quickly or not feel like themselves.  They cry easily, they may not understand physical cues from other people. They might have an angry outburst for no apparent reason. This may be confusing for family members and so it is important to give the person time.

Anxiety

For individuals experiencing anxiety, it may be their concussion has affected them with difficulty in concentrating, reasoning or memory deficits can make it challenging for the individual to complete their regular daily tasks or work.  This can make the person feel overwhelmed, especially if he or she is being asked to make decisions.  Individuals after a concussion may feel anxious without knowing why. They may worry and become anxious about making too many mistakes or if they feel they are being criticized. Many situations can be harder to handle after a concussion which can cause anxiety.  In order to reduce the symptoms of anxiety, the individual should try to reduce the environmental demands and unnecessary stresses that may be causing anxiety.

Depression

Depression can arise as the person struggles to adjust to temporary or lasting disability due to the concussion. Depression may also occur if the injury has affected areas of the brain that control emotions.  Both biochemical and physical changes in the brain can cause depression.  This topic is controversial in research as it is often a chicken or the egg situation (whether the depression was there before or after the injury).  However, it is pure physiology.  When brain function is altered due to an injury, it brings about symptoms of anxiety and depression.  An individual may require medication or psychotherapy.  It is best to see a doctor who can determine what treatment is appropriate for you.

Treatment

The most important treatment for a concussion is REST!!!!!! I cannot say it enough. When I say rest I do not mean just physical rest, it also means cognitive rest.  So this means minimizing your work at school and even work so that you can rest your brain.  You should also minimize your use of computers, cell phones, TV, video games etc.  If you sustained this injury from a sport, you should not return to the game until you have been evaluated by a health professional and they have given you the OKAY to play.  Furthermore when returning to any of these activities, you should do so gradually and be cautious.  If you start to feel unwell and the symptoms begin to reappear, you need to rest.  Listen to your body.

Spreading Awareness

Many concussions go undiagnosed and so it is important to spread public awareness about this serious injury.  It is also important we focus on prevention with safe sport play.   If you sustain a head injury and you are unsure about whether you may have a concussion, see a doctor immediately! Because it may lead death if you are not precautious.

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