By Georgie Wooding

I’ve had 5 concussions, and I am sat here writing this paper with one. Concussions go by unreported at an alarming rate with five out of ten cases not being reported. Over three

million Americans this year alone will get a concussion. Concussions are defined as an “injury to the brain that results in temporary loss of normal brain function.” Concussions occur in many ways, present themselves in numerous symptoms, have permanent, extensive damage and can alter an individuals both mental and physical health.

A concussion is defined as a change in the mental state of an individual. When it comes to diagnosable symptoms,  there are visible symptoms that are related to and caused by concussions. Although a major factor, the loss of consciousness is not an indicator of the injuries severity. No two concussions are the same and symptoms present themselves in numerous ways depending on the incident and the individual. The effects and recovery in regards to concussions are hard to determine due to ever-changing factors and pre-existing symptoms that could be present in the individual that has suffered the concussion.

There is not a single cause when it comes to an individual getting a concussion. While most believe sports are the number one cause of concussions, it is actually injuries resulting in falls that have the highest rate of concussions and take up 28% of concussions. Sports-related injuries make up 19% of reported concussions, coming in  just behind motor vehicle accidents at

20%. When most people think of concussions, they think of a football player being hit helmet to helmet with blunt force, or an individual falling hitting their head, or a state of unconsciousness, however, a concussion can occur in a much less dramatic scene, and thus can go untreated, undiagnosed and left to further damage the individuals cognitive well being and mental health.

Concussions are visible in many physical aspects,  it can show up in a variety of physical symptoms on the human body. The three main effects that present themselves are frequent headaches, nausea and an imbalance or dizziness. However, the long and short term effects of  a concussion are still somewhat a mystery due to the fact that concussions have only been extensively studied the last 5-10 years, and with no exact treatment or medicine to help diminish these symptoms, the effects are only known once they occur. Repetitive and serious head trauma can lead to permanent decrease in the individuals cognitive functioning. The long-term effects that are associated with concussions include: vision problems, memory deterioration, balance issues, loss of coordination, and persistent headaches. It is known that concussions can also lead to diagnosable disorders such as Alzheimer’s disease, Parkinson’s disease, and related anxiety/ depression disorders.

Although all concussions are treated in a serious manner, the most notable and dangerous complication that can occur due to a concussion is the second impact syndrome. This occurs when an individual who is still recovering from an initial concussion attains another concussion or head injury. This can result in the brain swelling and thus causes severe permanent neurological dysfunctions or in some cases even death.

There are no vast amount of treatments or medications available for individuals suffering from concussions. Although millions suffer from concussions, there aren’t many known treatments available. Some treatments include the individual resting, this assumes both physical rests, including sleep and mental rest, which will require the individual to have no cognitive stimuli to further damage the brain including technology and light stimuli.The Mayo Concussion Test and Post-Concussion Symptoms Scale allows professionals and doctors to indicate the severity and damage of the brain injury and is used as for return to play guidelines.

The Mayo Clinic’s Sports Medicine Center performs baseline tests on athletes in contact sports as part of preseason physicals and will use the obtained results to compare the testing done prior, after and during the athlete’s concussion. These tests and results can make the sideline assessments more accurate for further use in regards to contact sports and its relation to concussions.

The longer the individual goes without seeking professional help and treatment, the more damaging the injury will get in regards to the individuals permanent cognitive state and health. The symptoms regarding head injury can go by untreated due to their normalcy in an individuals life. Millions of people suffer from migraines and headaches daily, and the same goes for nausea and the overall feeling of drowsiness. These individuals may have obtained a concussion but without knowing the proper diagnosis and treatment, they will go about their normal day assuming they just hit their head, and that tomorrow the symptoms will subside.

I personally have been through the return to play protocol and the Mayo Clinic concussion tests twice after receiving concussions in high school playing volleyball. The protocol follows very strict guidelines when it comes to treating and evaluating a concussion in an athlete. Years ago, athletes in contact sports were sent right back out to play after receiving a blow to the head by their coaches and pushed the symptoms of a concussion aside to keep playing. However, with concussions now being a major controversy in the professional and high school sports, these protocols are precisely followed in terms of the concussions and when it is suitable for the athlete to return to play. The Mayo Clinic protocol includes:

1. The removal of the athlete from competition immediately and under no circumstance is that player to resume play for the remainder of the game.
2. The athlete will perform the Mayo Concussion Test and the Post-Concussion Symptoms Scale on-site to compare the results with the athlete’s baseline data prior to the concussion.
3. A healthcare professional, athletic trainer or coach will now need to monitor for worsening of symptoms and/or focal neurologic deficits, including the symptoms of weakness and sensory change, these symptoms should be monitored every 15 to 30 minutes during the first several hours after injury.
4. If symptoms worsen, the athlete should be transported to an emergency department for further evaluation, because changes may suggest an injury more serious than a concussion. After the athlete had rested and the symptoms have diminished, the athlete will slowly resume playing with a day to day protocol in regards to returning to contact sports.

One of the least talked about symptoms of concussions is that of the onset of mental illnesses, specifically depression. Statistics and research have found that for every 10 people who do not have a brain injury, approximately one person will have depression, and for every 10 people who do have a brain injury, approximately three people will have depression. When an individual has a concussion, they are withdrawn from stimuli that will cognitively stimulate their brain. For me personally, I had to lie in a dark room by myself, with no outside stimuli until doctors believed my brain could cope with the stimuli that stimulates the brain. Athletes, including myself, are forced to quit their beloved sport due to the risk of furthering the brain injury or causing second impact syndrome. When the brain has an injury, it can become stagnant and injured to a point where the individual can readily show symptoms that are seen in clinically depressed patients.

If an individual is experiencing an increase in depressive thoughts or feelings or has the symptoms regarding anxiety and its effects after a concussion, there are some treatment options. These options include Psychotherapy and medications. There are professionals who specialize in individuals experiencing depression or anxiety as an onset due to brain injuries.

Carla Ciccone was hit in the head by a stack of plates at a Toronto restaurant. She was told rest would heal her head injury. Instead, her symptoms including headaches, dizziness and suicidal thoughts got worse as time elapsed. When she had to withdraw from all her daily activities, she slowly became depressed. Not able to leave the house for days on end, Ciccone suicidal thoughts heightened. She found out she wasn’t alone, and that she was roughly of the ten percent of concussion sufferers who deal with these feelings. Ciccone’s doctor signed her up for cognitive behavioral therapy, and she was introduced into activities to help steady her depression and anxiety-like painting and writing. It’s through stories like Carla’s that people will understand how a cognitive injury can result in depressive, suicidal thoughts in a seemingly healthy individual.

Unless there is major damage done, blood on the brain or evidence of a tumour, most individuals, including some doctors will not see the effects or damage done by concussions. If there is no physical damage done, some physical disability that someone can see with the naked eye, people don’t usually see the severity of an injury. The symptoms can be minor or non- present at the time of the injury, thus pushed aside and expected to diminish through rest and healing. Concussions are very serious, and these head injuries affect millions worldwide. The symptoms are different for everyone, but one thing shared is the need and want for future testing, possible medicinal treatments and an overall understanding that concussions are very dangerous, and don’t only happen to NFL players.

Header photo from expertwitnessjournal.

References

Ciccone, Carla. “My Concussion Triggered a Deep Depression That I Never Saw Coming.”

Chatelaine, 14 Sept. 2016, www.chatelaine.com/health/post-concussion-syndrome-depression/.

“Concussion.” AANS, www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/ Concussion.

“Statistics.” Prevacus, prevacus.com/concussions-101/statistics/.