The Connection Between Concussions and Mental Health Problems

Junior Seau, a pro football hall of famer who formerly played for the San Diego Chargers, made headlines when he committed suicide in 2012. What was especially alarming, however, was that his autopsy revealed he suffered a brain disease likely caused by hits to the head.

A team of researchers who studied Seau’s brain diagnosed him with chronic traumatic encephalopathy (CTE).

“Basically, there’s an association between multiple concussions and CTE,” explains Matthew Daggy MD, a Sports Medicine doctor at McCullough-Hyde Memorial Hospital. “We’re seeing that these people have severe mental issues as they age. Repetitive brain trauma triggers progressive degeneration of the brain tissue. These changes in the brain can begin months, years, or even decades after the last concussion. When they do autopsies on these deceased football players, they’re seeing that their brains are shrunk down to half the size of what they would be normally.”

"Additionally, it's generally thought that multiple concussions in a row increase your risk for CTE and also second impact syndrome," Dr. Daggy adds. Second impact syndrome is a rare, life-threatening condition in which a second concussion occurs before a first concussion has properly healed. Second impact syndrome can result from even a very mild concussion that occurs days or weeks after the initial concussion. Most cases of second impact syndrome occur in young athletes. If an athlete has suffered a concussion, it's best if they don’t return to their sport until the symptoms of the initial head injury are gone and they have been cleared by a physician to return to play.

Baseline Testing Helps Athletes Safely Return to Play After a Concussion

To prevent the potentially life-threatening issues associated with CTE, concussion awareness and following return-to-play guidelines are critical. CTE can lead to:

  • Memory loss
  • Confusion
  • Impaired judgment
  • Paranoia
  • Impulse control problems
  • Aggression
  • Depression
  • Progressive dementia, like Alzheimer’s disease

“We typically treat kids a little more cautiously than we do adults because kids are more prone to getting concussions and the effects are also a little bit worse,” Dr. Daggy says.

Children are more susceptible to concussions because their brains aren’t fully myelinated, meaning their nerve cells have less insulation than adult brains. Additionally, children have weaker necks compared to adults.

Generally, for high-risk sports, like football, athletic trainers will perform a neurocognitive testing, like the ImPACT test, prior to the season. This serves as a baseline test of an athlete’s neurocognitive abilities. This way, if an athlete sustains a concussion, they’ll be removed from play and tested to see if there were any significant changes in his or her neurocognitive abilities. If the neurocognitive test returns to baseline, it’s an indicator the athlete may be safe to play.

Many athletic trainers follow a return-to-play protocol – the same one the NCAA, NFL and MLB use – where the concussed athlete increases his or her athletic activity over time to make sure he or she is fully healed and there’s no recurrence of symptoms. This protocol usually takes about five days.

Tags: Orthopedics

Last Updated: November 19, 2015