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The Overlap Between Concussion and Mental Health

It is easy to artificially separate the physical and mental aspects of concussion. But are they really that separate?


A recently published commentary by Talin Babikian, PhD, ABPP (1), highlights the importance of understanding the connection between mental health and concussions in youth patients. (you can find that GREAT commentary here).

The commentary was spurred by a large-scale study by Ledoux and colleagues(2) that showed that youth that had suffered a concussion had a greater risk of developing mental health issues. 

Dr. Babikian points out that there is significant overlap between diagnostic criteria for concussions and mental health conditions. For example, the commonly used 22 symptom survey used for concussion diagnosis asks whether a patient is experiencing sadness, anxiety, trouble sleeping, feeling more emotional, and irritability. 

This led Dr. Babikian to ask an interesting question: How do we avoid artificially separating the physical vs mental aspects of concussion effects? 

My recent experience with a concussion is what made me cling to this question. I took a hard impact of a shin to the bridge of my nose. And no, it wasn’t some weird fight club… just jiu jitsu training… so maybe a sort of fight club… but I digress. The kick gave me a nice gash on the nose and I certainly had a concussion from the acute symptoms I experienced that evening and into the next few days.

While I had what some may consider “expected” symptoms of headache, feeling slowed down, and difficulty concentrating, I had a striking uptick in feelings of anxiety, sadness, irritability, and feeling more emotional. 

Interestingly, this was also a very stressful week for me in terms of professional and personal demands that week. I certainly may have felt some of these symptoms regardless. Right?

Or would I have? Was it my stressful week causing these symptoms or the physical disruptions from the hit to my head causing these symptoms? Or a combination of both? Would increased mental health treatment and resources have been just as instrumental to my recovery as other current concussion standard of care recommendations (i.e. rest, symptom-limited activity, etc.)?

These are some of the questions inspired by Dr. Babikian in the commentary. It will be critical moving forward to understand the context of each individual patient’s scenario: the physiological components combined with personal and environmental factors that may cause mental health issues in the acute phase and beyond following a concussion. 

I highly recommend you check out the commentary to find all of the great thoughts in it.

References:

1) Talin Babikian,JAMA Netw Open. 2022;5(3):e221242. doi:10.1001/jamanetworkopen.2022.1242

2) Ledoux et al., JAMA Netw Open. 2022;5(3):e221235. doi:10.1001/jamanetworkopen.2022.1235

 

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