What is a concussion?
A concussion is a type of head injury caused when force is applied to the head or body (1). A concussion is considered to be a type of mild traumatic brain injury, where brain tissue is damaged and functioning is temporarily interfered with. The types of events that can cause a concussion vary, from motor vehicle accidents or a blow to the head during sports, for example.
While most people recover fully and quickly from concussion, a small proportion of people find that the symptoms do persist.
This can increase the likelihood of experiencing symptoms of mental health conditions, such as anxiety or depression. Mental health professionals can help provide assessment and treatment if your symptoms do not resolve.
Symptoms of concussion
The symptoms following a concussion vary, but can include a combination of physical, psychological and cognitive symptoms, including:
- An alteration to consciousness. This does not necessarily mean losing consciousness. You might feel disoriented or confused, for example
- Difficulty concentrating
- Slowed thinking
- Difficulties with short-term memory
- Changes in mood, such as feeling anxious, depressed, angry or irritable
- Changes in sleep patterns
- Blurred vision
- Feeling nauseous, or vomiting
- Increased sensitivity to stimuli such as light or noise
Concussion and mental health
Most people recover normally following concussion. A recent comprehensive review of the research found that most people had normal cognitive abilities (such as memory and concentration) by 90 days after the injury (2).
However, the relationship between brain injuries and mental health is complex and some people continue to experience problems. It appears that having mental health challenges before an injury can affect the duration of concussion symptoms. In addition, concussion can affect the likelihood of mental health symptoms following the injury. Research suggests that:
- People who have mental health conditions prior to a mild head injury are more likely to experience psychological symptoms post-injury (3).
- People who experience a mild head injury are at an increased risk of experiencing psychological distress, such as symptoms of anxiety or depression, or trauma (3).
What to do if you have a concussion
It is important to seek medical assessment immediately if a concussion is suspected, to rule out any more serious brain injuries or complications.
In most cases, just rest is required for recovery, and you’ll quickly return to full health.
However, if problems are detected or if symptoms persist, further assessment by a specialist, such as a neuropsychologist, may be required.
How can a mental health professional help with concussion?
- Neuropsychology assessment: If symptoms do not resolve, it can be helpful to see a neuropsychologist. A neuropsychologist will ask you questions and use tools to assess your memory, attention, mood and personality, amongst other factors. This helps them to understand the problem and which aspects of your brain may be affected. Neuropsychologists use this information to help with treatment, education, and rehabilitation, if needed (4).
- Rehabilitation programs: In more serious cases, neuropsychologists can help patients to recover memory, reasoning and other cognitive skills that have been affected by concussion.
- Therapy: Psychological talking therapies in both individual and group contexts can help with psychological and emotional difficulties following concussion. Therapy can be particularly helpful if your mood symptoms do not improve, as expected. Types of therapy to consider are discussed further, below.
What other things should I do to recover from concussion?
- Rest: It’s important to rest, physically and mentally, following a concussion. Just as you would if you sprained your wrist, it’s important to give the injury time to heal before returning to normal activities.
- Self-care: Pay attention to your diet and stick to your regular sleep routine. Speak with your physician about when you should resume some gentle exercise following concussion.
- Support groups: If you experience ongoing symptoms, it’s important to seek medical support, and you may also benefit from joining a support group. Sharing experiences and learning from people in similar situations can be encouraging and helps people to feel that they are not alone. For example, Pink Concussions helps women experiencing ongoing symptoms to find supports in their local area or join their online community.
- Helplines: If you need immediate support, call 1-800-273-8255, or go the National Suicide Prevention Lifeline website.
Therapy types to consider
There are a number of different types of therapy considered helpful for treating any emotional, psychological challenges following concussion. Therapy types include:
- Cognitive Behavioral Therapy (CBT): CBT can help change unhelpful thoughts and behaviors and help people to form a more balanced perspective about their concussion. CBT is also very helpful for people who experience mental health symptoms associated with the concussion, such as anxiety or depression.
- Mindfulness Practices: Mindfulness helps people to be aware more aware of thoughts and sensations without automatically reacting to them.
- Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help people.
What to look for in a therapist for challenges related to concussion
The best-fitting type of therapist for you will depend on individual factors, symptoms, your location and finances. When selecting a mental health professional, it can be helpful to consider the following factors:
Type of therapist
It can be difficult to decide which type of mental health professional to see, with so many different provider types available.
As symptoms of concussion are related to an injury to the brain, you might want to consider working with a practitioner who has specialized knowledge in the area such as a licensed neuropsychologist.
If ongoing treatment or other types of therapy is required they will be able to help you to choose which type of professional this is best done with.
Qualifications and experience
Look for a licensed mental health professional. This ensures that the therapist has undertaken the appropriate education and training.
As is the case when seeking therapy for any reason, it’s important to consider the potential for developing a strong working relationship with your therapist. The trusting working relationship with a therapist is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy.
Talk in advance
The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to oblige. This gives you the opportunity to ask about:
- Their qualifications
- Their experience working with people who have brain injuries
- Any ongoing training they are participating in that relates to brain injuries and recovery
- What type of therapy they suggest, and what that will be like
- Their participation in insurance plans and cost of therapy
Try to speak to a few different therapists before making your mind up.
Sources and references
Find vetted therapists who specialize in concussions
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