Recognizing Emotional and Psychological Symptoms in Children and Teens Following a Concussion

Recognizing Emotional and Psychological Symptoms in Children and Teens Following a Concussion

 By Jim Windell

           Psychologists and parents know that if a teenager has a head injury from sports then they should be aware of headaches. They are a reliable sign of a concussion. But most are not as familiar with the mood and emotional disturbance symptoms that might accompany a concussion. And even the pediatrician or family physicians will not be as knowledgeable about the student-athletes’ baseline of brain function and mood before they were injured to be able to make an informed diagnosis.

          Therefore, according to Dr. Rory Tucker, a sports medicine physician with Penn State Bone and Joint Institute and Penn State Health Medical Group – Camp Hill, it is very important for parents, siblings, coaches and friends to corroborate their symptoms.

          “Parents may notice a change in their teen’s sleep patterns,” Dr. Tucker said in a Penn State University news release. “He or she may be more withdrawn, socializing less with friends or family members, more emotional or tearful. They may have anger outbursts or be more nervous than they were before.”

          These kinds of symptoms need to be brought to the attention of the young person’s medical provider. If the physician is able to recognize the symptoms of concussion early on, they can explore treatment options. Those options may include medication.

          “Medication is rarely necessary in the long term,” Dr. Tucker notes, “but while a concussion is healing, it can sometimes be beneficial to take medication to control moods.” Dr. Tucker also stated that medication can assist with sleep. If the child or teen isn’t getting enough sleep, their emotional health and relationships with others can be affected.

          Another important consideration following a young athlete’s head injury, said Dr. Craig DiGiovanni, a postdoctoral fellow with the Department of Psychiatry and Behavioral Health at Penn State Health Milton S. Hersey Medical Center, is the overlap between the diagnostic criteria for depression and concussion symptoms. Both involve difficulty processing information quickly, impaired concentration and fatigue.

          “The same can be said for anxiety,” Dr. DiGiovanni said. He added that kids who have had anxiety and depression before their injury are more at risk for a reoccurrence. “Parents should look out for more concerning symptoms of depression that are outside the scope of common concussion symptoms,” Dr. DiGiovanni said. This includes loss of interest in activities, significant weight gain or loss, feelings of worthlessness and suicidal thoughts.

          Children and teens who have cognitive and emotional symptoms that persist for weeks and even months after an injury, according to Dr. DiGiovanni, should be referred for a comprehensive neuropsychological evaluation. Such an evaluation may help to determine if there are specific cognitive concerns that need to be addressed or if anxiety and depression are primary concerns that will require other treatment and support services.

          Dr. DiGiovanni noted that it is hard for athletes to temporarily give up their primary activity, and it’s important to provide them with a sense of purpose in other forms. He recommends that parents establish a routine and give them tasks to do around the house, like walking the dog if they are able. “Sometimes we even suggest that the athlete goes to practice to be with their team, even though they can’t participate, “ Dr. DiGiovanni said. “It’s a way for them to feel like they are still part of the experience.”

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