The Psychology of Concussion
April Clay, Registered Psychologist
Katie, a young hockey player, sustained a concussion a few months ago during a game. Her parents are concerned her recovery is not progressing. She is still having difficulty focusing at school, and by their insistence has not returned to her sport or any activity.
Upon further inquiry, it is discovered that Katie has met recently with a neuropsychologist who conducted objective testing. Her results revealed no evidence of physical damage, and the neuropsychologist informed them that she had likely healed from a concussion perspective.
Her parents remain fearful something is wrong with their daughter’s brain. What could be causing her lingering symptoms?
It turns out this family had been the victim of considerable misinformation and mixed messages from their physician and well-meaning family and friends. This included remaining in a dark room and avoiding all electronics, physical activity and social interaction. Katie had become increasingly frustrated with her situation, and her parents remained anxious and on alert, vigilant to what they believed to be unresolved post concussive symptoms. In reality, the “symptoms” Katie was experiencing were the result of heightened stress and anxiety. The family was given accurate information regarding concussion recovery and underwent cognitive behavioral therapy to correct thinking errors that sparked anxiety and fear.
After a few sessions Katie’s symptoms began to clear, her focus returned and she was engaging in a gradual return to her beloved sport. This family offers a poignant example of how important accurate information and appropriate messaging can be to concussion recovery. Excessive media coverage of especially traumatic brain injuries of high profile athletes has to some extent created a culture of fear. Understandably parents are worried their child may suffer similar permanent consequences.
Yet the research suggests that most concussions or mild traumatic brain injuries (mBTIs) usually resolve within three months. No prolonged sequestering in dark rooms is required, nor is a complete cessation of thinking and movement. Rather, a gradual return to normal activity is recommended with supervision and follow-up.
Emotional and psychological aspects of concussion are emerging as important factors in recovery. Responses to an injury of this nature can produce a sense of loss- in skills, normalcy and physical activity. Others, like Katie and her family, begin to develop symptoms of depression and anxiety that can go undetected and untreated, masquerading as ‘post concussive symptoms’. Many can experience confusion, “I just don’t feel myself somehow” and feel vulnerable and isolated. Without a bandage or cast, others may not be understanding of their invisible injury and judge their non-participation in school or sports negatively.
There will always be a psychological response to physical trauma. Recovery can go awry if psychological and emotional factors, both present and preexisting, are not taken into consideration. Successful recovery is best obtained through a multi-disciplinary approach, utilizing qualified physicians, neuropsychologists, physiotherapists and clinical psychologists. The latter can ensure that relevant psychological factors are managed and provide useful guidance in navigating the various challenges a concussion can entail.
Consider psychological help if:
*Research citations for this article are available upon request.
April Clay is a Calgary based Psychologist specializing in sport psychology and injury rehabilitation. Copyright April Clay, originally published in Calgary's Child, 2017.
April Clay, Registered Psychologist
Katie, a young hockey player, sustained a concussion a few months ago during a game. Her parents are concerned her recovery is not progressing. She is still having difficulty focusing at school, and by their insistence has not returned to her sport or any activity.
Upon further inquiry, it is discovered that Katie has met recently with a neuropsychologist who conducted objective testing. Her results revealed no evidence of physical damage, and the neuropsychologist informed them that she had likely healed from a concussion perspective.
Her parents remain fearful something is wrong with their daughter’s brain. What could be causing her lingering symptoms?
It turns out this family had been the victim of considerable misinformation and mixed messages from their physician and well-meaning family and friends. This included remaining in a dark room and avoiding all electronics, physical activity and social interaction. Katie had become increasingly frustrated with her situation, and her parents remained anxious and on alert, vigilant to what they believed to be unresolved post concussive symptoms. In reality, the “symptoms” Katie was experiencing were the result of heightened stress and anxiety. The family was given accurate information regarding concussion recovery and underwent cognitive behavioral therapy to correct thinking errors that sparked anxiety and fear.
After a few sessions Katie’s symptoms began to clear, her focus returned and she was engaging in a gradual return to her beloved sport. This family offers a poignant example of how important accurate information and appropriate messaging can be to concussion recovery. Excessive media coverage of especially traumatic brain injuries of high profile athletes has to some extent created a culture of fear. Understandably parents are worried their child may suffer similar permanent consequences.
Yet the research suggests that most concussions or mild traumatic brain injuries (mBTIs) usually resolve within three months. No prolonged sequestering in dark rooms is required, nor is a complete cessation of thinking and movement. Rather, a gradual return to normal activity is recommended with supervision and follow-up.
Emotional and psychological aspects of concussion are emerging as important factors in recovery. Responses to an injury of this nature can produce a sense of loss- in skills, normalcy and physical activity. Others, like Katie and her family, begin to develop symptoms of depression and anxiety that can go undetected and untreated, masquerading as ‘post concussive symptoms’. Many can experience confusion, “I just don’t feel myself somehow” and feel vulnerable and isolated. Without a bandage or cast, others may not be understanding of their invisible injury and judge their non-participation in school or sports negatively.
There will always be a psychological response to physical trauma. Recovery can go awry if psychological and emotional factors, both present and preexisting, are not taken into consideration. Successful recovery is best obtained through a multi-disciplinary approach, utilizing qualified physicians, neuropsychologists, physiotherapists and clinical psychologists. The latter can ensure that relevant psychological factors are managed and provide useful guidance in navigating the various challenges a concussion can entail.
Consider psychological help if:
- Symptoms persist beyond expected recovery (possible development of depression/anxiety)
- Preexisting anxiety or depression returns and/or seems intensified
- Thoughts of self-harm or sense of hopelessness emerge
- Concussion occurred as result of traumatic incident/other injuries involved
- Anxiety about return to school work/sport interferes with progression
- Persistent changes in mood, including anxiety, sadness, anger/aggression
*Research citations for this article are available upon request.
April Clay is a Calgary based Psychologist specializing in sport psychology and injury rehabilitation. Copyright April Clay, originally published in Calgary's Child, 2017.