Mild Concussion Causes Emotional Upsets
Short-Term Depression, Headache, Dizziness Are Common
By Jeanie Lerche Davis
WebMD Medical News

April 15, 2004 -- You're not bleeding. There are no broken bones. But a mild concussion can cause all sorts of temporary emotional problems, such as confusion, anxiety, or depression, new research shows.

The emotional effects of having a mild concussion have not been studied much, writes researcher Lynda M. Mainwaring, PhD, a psychologist and professor of physical and health education at the University of Toronto. Her study appears in the April issue of Journal of Sport & Exercise Psychology.

Mild concussion is likely under-diagnosed, and the effects may be underappreciated in the sports community because its symptoms are often invisible, she writes. Also, the athlete's eagerness to continue playing when injured -- and the "culture of risk" that surrounds sports -- means that athletes play through the pain of injury.

But after a mild concussion, athletes have displayed significant emotional distress: frustration, depression, tension, confusion, and anger, writes Mainwaring. Some athletes report sleep problems, fatigue, headaches, dizziness, nausea, sensitivity to noise, vision problems, and sensitivity to light, trouble thinking, and an "off" memory.

Athletes with severe or long-lasting injuries report greater mood problems than athletes with lesser head injuries, notes Mainwaring. Nevertheless, by returning to play too soon, athletes risk a re-injury.

Athletes' Moods Dive
In her study, Mainwaring enrolled students from the University of Toronto -- 16 athletes with mild concussion, 325 uninjured athletes from 10 sports teams, and 28 physically active students with no head injuries.

At the study's outset, each volunteer took tests to determine baseline mood. Within 72 hours of receiving a mild concussion, each injured athlete was tested for mood changes -- and tested several more times during the season.

"Whereas pre-injury profiles were similar across groups, the [concussion] group showed a significant post-injury spike in depression, confusion, and total mood disturbance that was not seen in the other groups," Mainwaring writes. "The elevated mood disturbances subsided within three weeks post-injury."

Given that athletes are highly motivated to return to play, her data could be applied to other concussion cases -- even if they don't involve sports injuries, Mainwaring explains.

Did athletes with emotional problems before their injury have them afterward? No, Mainwaring's research dispelled that theory. The athletes all had similar mood ratings before anyone got injured; only injured athletes showed changes.

Did getting benched cause the athlete's depression -- not the concussion itself? Not likely, says Mainwaring. The athletes returned to competition about 25 days after their injury, but their good mood was beginning to return within the first week after their injury.

Also, scientific evidence shows that short-term biochemical disturbances occur in the brain after mild concussion and other brain injury -- and could create the mood changes.

SOURCE: Mainwaring, L. Journal of Sport & Exercise, April 2004; vol 26: pp. 119-135.