Emotional Effects of Concussion

A concussion is an injury to the brain that disrupts how the brain normally works. Most young people recover completely from a concussion within a matter of days to weeks, although every one's recovery may be different. You should be aware of symptoms that commonly occur after a concussion and consult with an appropriate healthcare provider following any head injury.

After a concussion, children and adolescents may experience a variety of physical, cognitive and emotional symptoms. Although physical symptoms, like headaches or dizziness, and cognitive symptoms, like being more forgetful or easily distracted, are more commonly discussed, emotional symptoms should be monitored as well. Emotional adjustment issues can interfere with recovery.

Do concussions cause emotional distress?

After a concussion (and many other injuries), children and adolescents can experience increased stress and symptoms of depression and anxiety. These difficulties can occur for a variety of reasons but most are indirectly related to the injury.

For example, stress could relate to being removed from sports for medical reasons or falling behind at school. These emotional symptoms typically resolve as usual daily activities are resumed and the youth returns to pre-injury functioning.

How can I reduce the emotional effects of a concussion?

There are a few steps you can take to reduce the emotional effects of a concussion. Following a concussion, it's important to:

• Sleep: Ensure adequate sleep. This is important for reducing stress, improving mood and helping support a return to typical functioning. Sleep deprivation can lead to more severe mood symptoms, along with increased cognitive and physical symptoms. Most school-aged children benefit from 10 to 11 hours of sleep per night and most adolescents need at least nine hours of sleep per night.
• Exercise: Ensure engagement in regular aerobic exercise (that doesn't worsen symptoms, as long as your healthcare provider says it's ok), social and family activities and relaxation. This can all assist with improving mood and supporting recovery following concussion.
• Pre-existing conditions: Pay attention to pre-existing developmental and psychosocial factors such as underlying learning, attention, and emotional difficulties. These pre-existing difficulties can be overlooked after a concussion, but often contribute to ongoing symptoms and school difficulties. By recognizing when pre-existing conditions are impacting recovery, you can minimize family anxiety about brain "damage" and unnecessary restrictions from sports, schoolwork and social activities.

How should I monitor my child for emotional and behavior changes after a concussion?

It's common that a child or teen experiences mild emotional changes within the first days to weeks following a concussion, such as feeling irritable or having low frustration tolerance. If emotional or behavioral symptoms are severe, like depressed mood or significant anxiety, or persist longer than the first few weeks, our experts recommend prompt behavioral health intervention or counseling with a qualified professional familiar with concussion. At Children's Colorado, we have psychologists in our Concussion Program team to help address and evaluate these concerns.

It is important to monitor for these symptoms in children and adolescents who have sustained a concussion:

Mood and emotional well-being

• Increased tearfulness
• Feelings of intense sadness
• Excessive worry (worry disrupts ability to focus or participate in activities)
• Loss of interest in activities they used to enjoy
• Feelings of worthlessness or hopelessness
• Increased fatigue

Social adjustment

• Withdrawal from social activities: for example, no longer participating in sports even after receiving medical clearance or dropping out of extracurricular activities
• Isolation from friends and family: for example, staying in bedroom or not talking to friends

Sleep and eating habits

• Sleep disturbance: for example, takes 30 minutes or more to fall asleep at night and/or experiences frequent night awakenings and has difficulty falling back to sleep
• Change in appetite: for example, eating more or less than usual

Do concussions increase a teen's suicide risk?

The cause of suicide is complex. Increased risk is associated with multiple factors such as severe depression, hopelessness, impulsivity and drug misuse. No good scientific evidence supports a direct relationship between a history of concussion and suicide. In fact, a scientific study found that ex-NFL players were 60% less likely to commit suicide than the general public.

To learn more about how we diagnose and treat concussions, call our Concussion Program at 720-777-2806.