Every athlete is aware that there are risks that are associated with sports. Sprains, strains, fractures, and other general aches and pains can go hand in hand with being an athlete. However, one other common and dangerous injury that is beginning to receive more attention is a concussion. Concussions can be sustained in any area of the brain, which can affect emotional regulation, decision making, problem solving, personality, and impulse control (Diehl, Thiel, Zipfel, Mayer, Litaker, & Schneider, 2012). The American Psychiatric Association note in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev. (2000) Post Concussional Disorder is a symptom cluster that includes complaints of becoming fatigued easily, difficulty maintaining normal sleep patterns, headaches, dizziness, irritability, aggression, anxiety, depression, labile affect, changes in personality, apathy, and or lack of spontaneity. With the increased attention to concussions, there has been more and more evidence of the cumulative and traumatic effects they can have on an athlete.
Although the psychological risks of an adolescent sustaining a concussion can be severe, there is limited awareness of how to treat the effects of a concussion (Mittenberg, Tremont, Zielinski, Fichera, & Rayls, 1996). Athletes who have a concussion may often have questions and concerns that their doctor may not have the answers to (Kontos, Collins, & Russo, 2004). McAllister & Arciniegas (2002) noticed a discrepancy in the message that patients received in the emergency room and what they actually experience in the aftermath of a concussion. Athletes as emergency room patients who are told “you’ve had a mild concussion, you’ll be fine” may have a hard time understanding why they are experiencing such severe symptoms and difficulties in their lives.
Post concussive symptoms are grouped into 3 different categories: cognitive, somatic, and affective (McAllister & Arciniegas, 2002). The cognitive complaints can include difficulty concentrating, shorter attention span, and decreased memory. Somatic issues can involve headaches, fatigue, dizziness, difficulty with sleep, and sensitivity to noise and/or light. Patients experiencing affective complaints may experience depressed moods, irritability, and anxiety. It is important to recognize that not all complaints will be experienced and could be experienced in varying degrees of severity.
In treating Post Concussional Disorder, education, individual therapy, and group therapy have been shown to be beneficial as a means to assist in recovery. Mittenburg, Tremont, Zielinski, Fichera, & Rayls (1993) found that giving patients an informational pamphlet, Recovering from Head Injury: A Guide for Patients (Mittenberg, W., Zielinski, R. E., & Fichera, S. (1993) and having patients meet with a therapist individually was helpful in concussion recovery. Six months after treatment, this group of patients reported to experiencing significantly shorter symptom duration as well as fewer symptoms than did the control group. Bertisch, Rath, Langenbahn, Sherr, & Diller (2012) suggest that group treatment may actually be more beneficial in the treatment of Post Concussional Disorder because the group may provide an avenue of support with peers as well as feedback. In addition, it may help members share ideas and strategies that may be effective and helpful to other members in the group. Individuals who have experienced a concussion may feel as though they are helping others in their recovery process and as a result, are not as isolated as they may once have felt by this injury.
If you have suffered from a concussion, it is crucial not to minimize this injury. Rest is essential for brain recovery and trying to “tough it out” and keep exerting yourself mentally and physically will only prolong your recovery. In your treatment, it is important to seek help. You want to make sure you are taking care of all aspects of your concussion. This means you could seek a doctor or physician to see if there is any physical brain damage, a neuropsychologist to take tests (e.g. ImPACT) to understand see how your brain is functioning, a mental health provider to learn how to cope with the injury, and a support group that would provide you a network of people who understand firsthand what you’re going through. Look for resources in your area or online to educate yourself on what you are experiencing. Remember, returning to play before your symptoms have gone away is very dangerous. Make sure you are consulting with all members of your treatment team before you return to your sport.