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12/1/14blog post

4 key points on concussions and depression

The apparent suicide of an Ohio State athlete, who reportedly suffered prior concussions, brings the very real effects of a concussion to the spotlight again. Our sympathies go out to Kosta Karageorge, his family, friends, teammates, and team staff.

How common is depression after a concussion? Do you need to worry about your child? We are only beginning to learn about the effects of repeated concussions in adult athletes. The research isn’t as clear in young athletes.

4 things we do know about concussions and depression

  1. Concussions cause a temporary change in how the brain works.

    Since the brain controls emotions, it is normal to see emotional changes after a brain injury. Whether or not your child has this symptom depends on which part of the brain was injured. Parental observation is more valuable than any test when detecting emotional changes. Symptoms like confusion, headache, and dizziness are more common than depression, anxiety, mood swings, and anger, but do not be surprised if these symptoms also occur. Children with changes in mood may require closer observation than those with headaches. Find a trusted adult to supervise your child while under concussion treatment, especially if they are confused or having emotional changes.

  2. Athletes who were depressed before a concussion are at higher risk of more severe depression after the injury.

    The same is true for athletes with any other medical condition affecting the brain. Athletes with migraines, ADHD, learning disability, anxiety, mood disorders, etc, will often get worse after the concussion. This is almost always temporary, but can last a few days to several months. These athletes usually require specialist care to manage their medical condition and their concussion symptoms at the same time. Treatment plans which worked before the injury may need to be changed.

  3. Concussion symptoms are usually gone in three weeks or less, but 10-20 percent of athletes take longer.

    Athletes whose concussion symptoms last longer than three weeks usually require more extensive treatments than brain rest. If your child was never depressed before the injury, but is depressed after the injury, do not be surprised if the doctor recommends depression treatment. The same is true for athletes with persistent headaches or concentration problems. If these symptoms do not improve with 3 weeks of brain rest, they need more aggressive treatment so your child can return to normal life. It does not matter if your child never had this condition before the injury. It still needs treatment.

  4. Learn the warning signs for depression.

    Feeling down and tired after a concussion, but eager to return to normal activities, can be expected. However, if your child has no desire to get back to school, sports, and social activities, talk to the doctor about the possibility of depression. Also talk to your doctor if your child still acts or feels depressed after a full return to school and sports. Whether the symptoms are from the concussion, isolation, or were present before the injury does not matter. It needs treatment. If you hear talk of suicide or self-injury, go to the ER. This is a life-threatening medical emergency. The worst thing that can happen if you go, but didn’t really need to, is a hospital bill and an evening of inconvenience. The worst thing that can happen if you don’t go, but should have, is the loss of a child and lifetime of regret.

    Depression, whether caused by a concussion or not, is a serious medical issue. It is not normal to feel sad all the time or to lose interest in activities. Seek treatment. Be persistent. People suffering from depression do not always make the best decisions and need you to speak for them if you suspect something is not right.