Concussions are not only physical injuries. They can also lead to profound emotional and psychological effects. Two of the most common and debilitating effects are depression and anxiety. If not addressed, these effects can negatively affect the quality of life and exacerbate symptoms. This article outlines the physical, mental, and emotional sources of depression and anxiety after a concussion. It also offers helpful tips and resources to manage ongoing mood problems.
The link between concussions and mental health
A concussion is a form of traumatic brain injury (TBI) resulting from a sudden impact to the head. Physical symptoms such as headaches, fatigue, and dizziness are commonly associated with concussions, especially in the first 2 phases. Still, the emotional effects, including depression and anxiety, may not be immediately apparent and can be challenging to identify. These emotional consequences may manifest subtly or emerge after a delay, complicating diagnosis and treatment.
Identifying Depression and Anxiety After a Concussion
Symptoms of depression
- Persistent sadness or low mood
- Loss of interest in previously enjoyed activities
- Changes in appetite or weight
- Sleep disturbances
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Difficulty thinking, concentrating, or making decisions
- Thoughts of death or suicide
Symptoms of anxiety
- Excessive worry or fear
- Agitation or restlessness
- Irritability
- Muscle tension
- Difficulty concentrating
- Sleep disturbances
- Panic attacks
Understanding these signs is crucial for seeking timely help and preventing the worsening of these conditions.
Why do concussions cause depression and anxiety?
The brain is incredibly complex, and a concussion can disrupt the delicate chemical balance needed for optimal mental health. Areas of the brain responsible for regulating mood and emotions can be particularly vulnerable. The stress of coping with the immediate aftermath of a concussion and concerns about recovery can also trigger or exacerbate depression and anxiety.
One of the most complex parts of concussions is the collective misunderstanding of their severity. Twenty years ago, you could sustain a concussion during a sporting event and get thrown right back in. They’d say things like, “You just got your bell rung,” and shrug it off. These invisible illnesses often get downplayed, and some will outright disregard your condition because they “had a concussion, and it healed on its own.” While 80% of concussions do heal on their own, 20% don’t often get depressed because of ongoing complications, minimal relief, and a mischaracterization from those around them.
A commonly undiagnosed source of anxiety post-concussion is autonomic imbalance. Autonomic means the balance of “fight or flight” responses vs the “rest and digest” responses. After a concussion, a variety of factors can skew this system heavily towards fight or flight, leading to burnout, fatigue, worsening anxiety, and panic attacks. When this physical response combines with pre-existing anxiety, the effects can be anxiety that no longer responds to traditional treatments. Identifying the underlying source of excessive fight or flight is the key to unwinding anxiety post-concussion.
How to manage depression and anxiety after a concussion
Professional treatment
- Psychotherapy. Approaches such as cognitive-behavioral therapy (CBT) are effective for treating anxiety and depression, helping to address patterns of thinking and behaviour contributing to distress.
- Rehab for the underlying source of the symptoms is another way to mitigate symptoms. Depending on the dominant symptoms, vision therapy, vestibular therapy, functional neurology, chiropractic, acupuncture, and cognitive training are all good options.
Holistic Lifestyle Adjustments
- Regular exercise. Exercise has potent effects on mood and is a well-known anxiety reducer. The buffalo concussion treadmill test is the best practice to recover after a concussion.
- Balanced diet. Proper nutrition helps support brain function and overall health. Choose foods rich in fat and antioxidants to promote recovery. Stomach health is vital to neurotransmitter production, as most serotonin comes from the gut.
- Supplements. Fish oil, curcumin, nac, and creatine are all well-researched supplements to support recovery. Ashwagandha can help curb cortisol and relieve anxiety.
- Adequate sleep. Rest is crucial for recovery from both concussions and mental health flare-ups. Practise the 3-2-1 rule for better sleep: no food 3 hours before bed, turn the lights down and do minimal work 2 hours before bed, and no screen time 1 hour before bed.
Support systems
- Reaching out to friends and family for support can alleviate isolation and stress. Make sure they understand what you’re going through, and they’re aware of your need for support. Educational resources can be helpful to ensure they correctly describe your condition.
- Support groups or online forums can also connect those experiencing similar challenges, providing a community of understanding and resources.
Mindfulness and Relaxation Techniques
- Meditation, yoga, or deep-breathing exercises can help manage stress and promote emotional stability.
- Cold exposure can be a helpful tool for mitigating depression and anxiety. It creates a long-lasting, powerful boost of neurotransmitters that help with alertness and mood regulation.
Takeaway
It is not uncommon for individuals to experience depression and anxiety as post-concussion symptoms for a variety of reasons. These symptoms can stem from physical, mental, or emotional factors and can significantly impact overall well-being. Recognising that these symptoms are not your fault and should not be seen as a life sentence is essential. With the appropriate diagnosis and treatment from a qualified concussion specialist or mental health professional, many of these distressing symptoms can be effectively managed.
Julian Carter, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.
