Elite athletes report more anxiety and depression in the immediate aftermath of a concussion than those who have suffered an orthopedic injury, according to a University of Alberta concussion study that further builds the case that head injuries are an injury unlike any other.
“Athletes get injured all the time and they have to deal with the stress of that,” said Martin Mrazik, a concussion researcher in the Faculty of Education. “As we do more research, we want to know if these psychological outcomes from brain injuries are different from psychological outcomes from injuries in general.
“This research just tells us that concussion outcome is a bit of a different animal.”
Participants included 198 players from Canadian Football League and Canadian varsity football teams that performed mental health screening evaluations at the start of their season. Those who suffered injuries, either concussion or orthopedic, were tested at three time points—24 to 48 hours after the injury, when players reported being asymptomatic, and one month after returning to play.
The baseline test revealed that players who had a history of one or more concussions reported a greater number of anxiety and depression symptoms compared with players who didn’t have a history of concussion.
From there, the study showed individuals who sustained a concussion displayed significant changes in symptoms of anxiety and depression over time. Concussed players reported an increase in anxiety-related symptoms 24 to 48 hours after injury compared with the baseline, as well as a significant increase in depressive symptoms from the time of their injury through recovery and one month after returning to play.
The team, which included sports injury researcher Dhiren Naidu in the Faculty of Medicine & Dentistry and Carley Hoyle, who led the study as part of her PhD dissertation, found that players who suffered an orthopedic injury didn’t experience these changes.
“We're not talking about severe mental health outcomes, but it's notable,” said Mrazik.
He noted the results from the study suggest that a history of concussion affects baseline self-report of anxiety and depression symptoms.
“The brain is not a knee. When athletes are dealing with concussions, they need a bit more intervention and an awareness that brain injury can be more stressful than other injuries.”
“The brain is not a knee,” he said. “Whether it's the biological causes of the neurochemical changes or a psychological response to head injuries, concussions are a little more intense.
“When athletes are dealing with concussions, they need a bit more intervention and an awareness that brain injury can be more stressful than other injuries.”
Mrazik said there is an expectation with elite athletes that their mental makeup is also elite.
“Just because they're outstanding on the field and can do things the rest of us can only dream of doesn't mean that the repercussions for them on the health side of things isn't a factor for them as well,” he said
He added when it is clear someone is having a bit more of a problem with something, there needs to be a recognition that they may need more resources.
“In this case, more treatments, more awareness that a player who's had a concussion may be dealing with a few more mental health issues and needs a course of corrective action that is different from other injuries,” he said.
“Concussion has an unknown quality. It's an injury but you can't see the symptoms, and part of the invisible symptoms might be mental health.”