Slipping through the cracks: concussions & mental health

Deciphering the lesser-known correlation between traumatic brain injuries and mental well-being

Allison Skoblenick, an athletic therapist at Q-Sports Medicine, said concussions often exacerbate pre-existing conditions of anxiety or depression.
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Concussions can be extremely traumatic—both physically and emotionally.

In fact, a 2019 study from the US National Institute of Health (NIH) found that after a period of six months, one in five individuals who sustained a mild traumatic brain injury suffered from noticeable symptoms of post-traumatic stress disorder (PTSD) and/or other major depressive disorders. By contrast, only 8.7 per cent of patients who had sustained non-brain injuries showed signs of the same afflictions.

To learn more about how concussions might negatively impact mental health, The Journal spoke with Alison Skoblenick, an athletic therapist at Q-Sports Medicine.

“Concussions and mental health symptoms can last longer, but they seem to slip through the cracks a bit more regularly because [people] are not reporting those symptoms, or they don’t recognize those symptoms,” she said. 

As an athletic therapist, Skoblenick helps injured clients navigate their recoveries by providing counsel on treatments and exercises. One of her specific areas of expertise is concussion treatment.

“[A concussion] is more of a functional injury than a structural injury, meaning that you won’t see it on any imaging.”

Concussions are traumatic brain injuries—afflictions which disrupt the natural function of the brain as a result of excessive force sustained to the head and neck region. As Skoblenick explained, they generally don’t show up on scans or imaging devices, which means they need to be diagnosed through symptomology. 

“It can be a very silent injury, as people don’t always recognize the symptoms unless they are the obvious headaches or dizziness,” she said.

According to Skoblenick, only 70 per cent of concussions present normal symptoms including headaches, neck pain, dizziness, and nausea. For other cases, symptoms like confusion, irritability, lack of concentration, and reduced sleep can often go unnoticed. 

Although the average recovery time for a concussion is between one and three weeks, without recognizing the injury has taken place or through using improper methods of recovery, concussions and their effects can quickly carry over into the long term.

“I’ve treated someone up to four years after their [concussion],” Skoblenick said.

“They said that they just ‘felt off’ and because there are so many reasons why someone can ‘feel off,’ it’s easy to put those symptoms aside until someone points out that there’s been an injury, or they ultimately go to their doctor, who recognizes that there’s a problem,” she said.

Skoblenick pointed to prevalent misconceptions surrounding concussions.

“The obvious one is that you need to be [knocked] unconscious to have one, and that’s never the case.”

“People also think that ‘just rest’ will ultimately get you better. We used to have the mantra that staying in a dark room for two weeks, no cell phones, no computers—no anything—was the best way to get over concussions, but we know that’s wrong, based on research,” she said.

Skoblenick also explained that many people might think of concussions as being ‘lone injuries,’ where external resources like doctors, health clinics, or athletic therapists can’t aid in recovery. 

When asked about concussions and mental health, Skoblenick said that she has noticed one particular trend in her experience.

“Those who do have pre-existing conditions of anxiety or depression definitely have their conditions exacerbated with a concussion, unfortunately.”

Skoblenick added that those same students generally took longer to recover from their concussions than those who didn’t suffer from mental health issues. 

This general sentiment is shared in the 2019 study by the NIH. It found that having a history of mental illness increased risk for subsequent issues related to mental health.

Although it’s an ongoing and complicated process, Skoblenick stated that one particular effort made for patients, though small, can have a big impact on their general recovery.

“I am not a mental health specialist by any means, but I will say that more often than not, just being able to speak and explain to someone what’s happening already decreases a lot of the stress and anxiety that they’re having,” she said.

“Knowing that they’re not alone, that this is normal, there’s a plan in place, and that they’re supported—that is a really big thing I’ve noticed with our concussion cases.”

Although they try to treat their clients as much as possible, Skoblenick said Q-Sports Medicine understands that athletes often require outside help to handle issues of that nature.

“We try to do what we can and support how we can, but when we recognize that something is beyond our scope, then we definitely want to bring someone else on the team.”

This can include referring patients to a mental health specialist, sports medicine doctor, sports psychologist, or Student Wellness Services.

Although a specific framework is not set in place, there are many other individuals and resources that Q-Sports medicine can refer its clients to. One of those additional resources is a student-run initiative called the Queen’s Concussion Awareness Committee (QCAC).

“They hold meetings and have guest speakers, just really trying to connect people who have concussions with other people to create some form of dialogue and support network.”

In addition to its social platform, QCAC has a helpline initiative as well—meaning anyone afflicted by a concussion can fill out a form on its website, and members of the committee will provide guidance and support on what to do next.

Ultimately, Skoblenick believes the often-silent nature of concussions and their consequences on mental health need to be better understood.

“It’s just really important to make sure that we have the right resources, but also that people are able to reach out and ask for those resources.”

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