What is Depression?
Depression is a common illness. Globally, more than approximately 264 million people are impacted by depression. Towards this, the prevalence of depression is projected to globally increase.
Depression is characterized as an illness that severely diminishes quality of life. Specifically, depression can cause feelings of sadness and lead to the development of physical and emotional issues.
Depression symptoms may vary from moderate to severe and may include:
- Feeling sad, down or hopeless
- Feeling guilty or worthless
- Loss of pleasure or interest
- Fatigue or loss of energy
- Changes in sleep patterns and/or appetite
- Difficulty concentrating and thinking
- Thoughts of suicide
What are Persistent Post-Concussion Symptoms?
A substantial proportion of concussion patients will continue to experience post-concussion symptoms for months or years following a concussion. These symptoms are known as persistent post-concussion symptoms. Among these symptoms are: headaches, memory, thinking and concentration difficulties, anxiety as well as depression.
What is Post-Concussion Depression?
Post-concussion depression is the onset of depression or depressive symptoms following a concussion.
Post-concussion depression is correlated with lower quality of life, deterioration in social functioning and health quality as well as lower adherence to post-concussion medical regimens. Moreover, post-concussion depression is frequently correlated with other persistent post-concussion symptoms.
Post-concussion depressive symptoms may include, but is not limited to:
- Feeling sad or down
- Feeling lonely
- Fatigue or loss of energy
- Irritability
- Moodiness
- Changes in sleep patterns and/or appetite
How Common is Post-Concussion Depression?
Post-concussion depression is immensely common. Individuals who suffer from concussions have a higher risk of being diagnosed with depression in comparison to non-injured individuals. Approximately 50% of concussion patients are diagnosed with depression or depressive symptoms within a year of a concussion.
What Causes Post-Concussion Depression?
Direct Physical Injury to the Brain: Concussions can cause direct physical injuries to brain regions that may be associated with the development of depression. The frontal lobe, temporal lobe and left basal ganglia may suffer from lesions due to concussions. Studies have found that these regions may be associated with post-concussion depression.
Changes in Natural Brain Chemicals: Concussions can modify levels of natural brain chemicals, known as neurotransmitters. Researchers have indicated that changes in neurotransmitters may be associated with depression.
Emotional Responses: Many individuals will experience temporary or chronic disabilities, job losses or other modifications in their life due to the concussion. Many concussion patients will also find it difficult to reintegrate school, work, extracurriculars and hobbies because they feel significantly less competent. As a result, many concussion patients will emotionally struggle with adapting to post-concussion life.
Factors Unrelated to Concussions: Many individuals have a higher risk of post-concussion depression due to family and/or personal history or inherited genes. Additionally, age, gender and number of previous concussions are post-concussion depression risk factors. For instance, youth experience higher rates of post-concussion depression, in contrast to adults. Research has exhibited that children are 3.3 times more likely to suffer from post-concussion depression.
Marginalized Groups: Minority groups, people of colour, immigrants and refugees, single parents, and women have a higher risk of experiencing post-concussion depression. Low socioeconomic status is also correlated with higher rates of post-concussion depression.
Post-Concussion Depression: Implications
It is pivotal for healthcare professionals and family members to be aware of post-concussion depression. Among this, healthcare professionals must offer support that is respectful towards socioeconomic status, family and personal history, as well as cultural heritage. Supplementarily, healthcare professionals must be respectful and sensitive towards post-concussion depressive symptoms. This may improve health outcomes as relationships with concussion patients will be characterized with communication and trust. Conclusively, this would enable healthcare professionals, concussion patients, and family members to collaborate and work towards treating post-concussion depression.
Written by Dorothy Dinh
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5 (Fifth Edition). American Psychiatric Association Publishing.
Fann, J. R., Hart, T., & Schomer, K. G. (2009). Treatment for depression after traumatic brain injury: A systematic review. Journal of Neurotrauma, 26(12), 2383-2402. doi:10.1089/neu.2009.1091
Ho, R. A., Hall, G. B., Noseworthy, M. D., & DeMatteo, C. (2020). Post-concussive depression: Evaluating depressive symptoms following concussion in adolescents and its effects on executive function. Brain Injury, 34(4), 520-527. doi:10.1080/02699052.2020.1725841
Oldenburg, C., Lundin, A., Edman, G., Nygren-de Boussard, C., & Bartfai, A. (2015). Cognitive reserve and persistent post-concussion symptoms—A prospective mild traumatic brain injury (mTBI) cohort study. Brain Injury, 30(2), 146-155. doi:10.3109/02699052.2015.1089598
Malhi, G. S., & Mann, J. J. (2018). depression. The Lancet, 392(10161), 2299. doi:10.1016/S0140-6736(18)31948-2
World Health Organization. (2020, January 30). Depression. https://www.who.int/news-room/fact-sheets/detail/depression