THE HARD HEAD KNOCK SERIES - PART 1: Understanding the Impact of Mental Health Concerns Post-Concussion
*This article is 1 of 5 in a Series of articles on Mental Health & Post-Concussive Disorder.
Did you know that post-concussion syndrome is commonly associated with a plethora of mental health concerns?
The largest study that was done on this topic was in Denmark which used 113 906 participants to investigate the development of mental health disorders after they had suffered a traumatic brain injury. They concluded that the risk of developing a psychiatric illness increased significantly after a traumatic brain injury (TBI) and that this risk is highest within one year of sustaining the injury. In addition, the study concluded that the incidence of depression or schizophrenia are elevated in not only the first year post-injury but remained high after 30 years post injury. Children aged 11-15 had the highest risk of developing depression or schizophrenia. Lastly, this study also concluded that the risk of developing bipolar disorder is 28%.
Other studies have shown that 25-50% of individuals will develop depressive disorders within one year of sustaining the trauma (1) and 25-64% will develop it in their lifetime (2). A diagnosis of major depressive disorder after concussion was found to be commonly associated with aggressive behaviour, anxiety, past history of mental health concerns and substance abuse (3). Another concern after a TBI is insomnia. Approximately 30-70% of those who have suffered a TBI will also suffer from sleep disturbances. In children, this prevalence is 10-38% which is often in the acute phase of recovery. A lack of sleep creates an insurmountable barrier for the brain as it seeks to recover and further aggravates changes in outlook, behaviour, cognitive function and mood.
When the head undergoes trauma there is an increase in inflammation in the brain in addition to the emotional reaction that one has when sustaining an injury. Both of these in conjunction can lead to an imbalance in the neurotransmitters in the brain. Neurotransmitters are chemicals which allow for communication between different areas within the brain. This imbalance in neurotransmitters is commonly associated with mental health concerns. Trauma to the head also results in a leaky blood brain barrier and dysfunctional blood flow in the brain. All of these things can contribute to the symptoms associated in post- concussive disorder.
How Can Naturopathic Care Help?
As naturopathic doctors, we can provide strategies and recommendations to help lessen the inflammation in the acute phase and support the brain / body through necessary healing for up to years after you have sustained the injury. NDs who focus on treating mental health will also ensure your unique foundations of healthy mental function are provided throughout concussion recovery in acute and chronic phases. We have knowledge on the exact supplements you should be taking after a traumatic brain injury, when the right time for return to play is, and how to support you with your mental health concerns throughout this process. We are equipped in providing you with dietary & exercise recommendations, both for concussion recovery and mental health. Naturopaths can provide acupuncture, which is shown to improve sleep disturbances, anxiety, and depression. More importantly, naturopathic doctors will collaborate with your health care team to ensure you receive the well-rounded care and support as you .
**Stay tuned as we update this series with 4 more articles all about Mental Health & Post-Concussive Syndrome!
References
1. Orlovska S., Pedersen M. S., Benros M. E., Mortensen Dr. P. B., Agerbo Dr. E., Nordentoft Dr. M. Head injury as risk factor for psychiatric disorders: A nationwide register-based follow-up study of 113,906 persons with head injury. American Journal of Psychiatry. 2014;171(4):463–469. doi: 10.1176/appi.ajp.2013.13020190
2. Seel RT, Macciocchi S, Kreutzer JS. Clinical considerations for the diagnosis of major depression after moderate to severe TBI. J Head Trauma Rehabil. 2010;25(2):99–112.
3. Koponen S, Taiminen T, Portin R, et al. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry. 2002;159(8):1315–21.
4. Bombardier CH, Fann JR, Temkin NR, et al. Rates of major depressive disorder and clinical outcomes following traumatic brain injury. JAMA. 2010;303(19):1938–45.