BLOG: Researchers find link between mental health, concussions
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We often think of elite athletes as almost “superhuman” due to their fitness level, abilities and opportunities.
Despite these advantages, athletes are not immune from mental health problems — and their sport participation may actually increase their risk for depression and anxiety.
Lead researcher Carley Hoyle, Dr. Dhiren Naidu and other colleagues recently conducted mental health screenings of 198 players from the Canadian Football League and university-level varsity teams just before the start of their football season. We were surprised to find that players with a history of concussion reported higher anxiety and depression symptoms than those with no prior concussions. This suggests there is something unique about concussion that can either exacerbate pre-existing mental health issues or bring on new mental health challenges for athletes.
We continued to follow this group of athletes throughout the season, conducting additional mental health screenings on those who suffered a concussion or an orthopedic injury. Evaluations were performed 24 to 48 hours after the injury, at the point at which the athlete reported being asymptomatic and 1 month after returning to play.
We found that players who sustained a concussion during the season also displayed significantly higher ratings of anxiety and depression symptoms throughout the follow-up period than those who were sidelined by an orthopedic injury. This is a very interesting finding. If the increase in anxiety and depression were due to worries about not being able to play or inability to relieve stress through exercise, we would expect similar results after both types of injuries. Our data would seem to suggest that, again, there is something unique about concussion beyond just the stress of being injured.
Importantly, all these athletes were within the normal range, without significant mental health diagnoses. We did not see large differences by group (concussed vs. nonconcussed), but there were notable changes for individual athletes over time. Athletes who suffer a concussion will not automatically become depressed or anxious. But anyone who works with athletes should pay more attention to their mental health after concussion and be prepared to offer psychological interventions, especially to those who might be at higher risk due to a history of previous concussion or pre-existing mental health issues.
Young athletes are most likely to confide in the people with whom they have the best rapport, which could be a parent, coach or athletic trainer. However, anyone who is in a primary care role should be aware of the interrelatedness of mental health and concussion. If a patient doesn’t seem to be responding to treatment as well as expected, depression or anxiety could have a role in the slow recovery. A screening assessment, asking whether they have talked to somebody about their mental health or making a counseling referral are simple steps that could make a big difference in post-concussion rehabilitation.
Reference:
- Hoyle C, et al. Arch Clin Neuropsychol. 2020;doi:10.7939/r3-ctcq-9f80.
For more information:
Martin Mrazik, BSc, MEd, PhD, RPsych, is a clinical neuropsychologist, full professor and associate chair, undergraduate studies in the Educational Psychology Department at the University of Alberta in Edmonton, Canada. His research interests include psychoeducational assessment of intelligence, academics and emotional/behavioral functioning of children, and traumatic brain injury, including sports-related concussions. He currently serves as a neuropsychology consultant to the National Hockey League and Canadian Football League.
Disclaimer: The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of the Neuro-Optometric Rehabilitation Association unless otherwise noted. This blog is for informational purposes only and is not a substitute for the professional medical advice of a physician. NORA does not recommend or endorse any specific tests, physicians, products or procedures. For more on our website and online content, click here.
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