|
Post by Admin on Jun 29, 2015 10:29:29 GMT -4
|
|
|
Post by Minh Quach on Jun 29, 2015 15:54:06 GMT -4
After reading the article, I am surprise to learn how great the relationship is between concussions and depressions, especially those who had experience more than one concussion in a short period of time. It is alarming to see what athletes have to go though when they are diagnosed with both concussion related depression. Whats shocking is in one study they found that "more serious brain trauma only exacerbates matters and the rate of onset of new psychiatric disorders in children is 50-60 percent. I am glad that there are programs out to help those who suffered from concussions to get treatment as soon as possible prevent further psychiatric problems like depression and thoughts of suicides. Like the UPMC's Sports Medicine Concussion which is run by Micky Collins, which sees over 20,000 patients each year. To me personally I am very shocked to hear such a high number of patients coming in each year for concussions related depression but at the same time I'm glad programs like these have prevented a lot of people from further damage mentally and physically.
|
|
|
Post by Anoop Loke on Jun 29, 2015 19:05:50 GMT -4
This article is very interesting. I was surprised to learn that there was a link between in concessions and depression. It was interesting to learn that some were able to over come this depression with the help of focused rehabilitation on affected areas of their injury. Exercise increases the levels of endorphins in our body and these neuropeptides often trigger a euphoric feeling. Regular exercise is also proven to reduce stress, increase self-esteem, increase energy, decrease feelings of anxiety and depression and also help with sleep. The people described in this article were active athletes who engaged in regular physical activity. But once they suffered a concussion their physical activity drastically decreased and I assume so did the level of endorphins in their body. My theory is that, along with a traumatic head injury, the sudden decrease in their endorphin levels could also have played a role in their depression. Their body was in a state of depravity.
|
|
Kenechukwu Udechukwu
Guest
|
Post by Kenechukwu Udechukwu on Jun 29, 2015 21:55:49 GMT -4
This is a very interesting article. The brain is a very complex organ with an immune-system cells. These cells go on "high alert" and overreact to later immune challenges by becoming excessively inflammatory when there is an injury either from a fall, a hit on the head or as a result of a fight, like the case of Kamzelski's son. It makes sense that once can suffer from concussions but after reading this article, I had better understanding how an injury to the head suffered during contact sport activities, fights or fall could be related to depression. Depression is more than feeling sad every now and then. it is normal for someone who has had a TBI to feel sad by the problems caused by this injury. But for some people, those feelings can extend beyond normal feelings of sadness. Another highlight for me when I read this article is the fact that "more serious brain trauma only exacerbates matters and the rate of onset of new psychiatric disorders in children is 50-60 percent" but thanks to the University of Pittsburgh Medical Center for their immense contribution to ensure that these symptoms are controlled to reduce the chances of further severe developments. Depression can cause some areas of the brain to shrink - and the damage can last so it is very helpful to know that a lot of programs out there are designed towards helping people with these problems. There is HOPE as long as LIFE exist!
|
|
|
Post by Christine Lomiguen on Jul 1, 2015 10:25:37 GMT -4
There has been a lot of research on traumatic brain injury, but it's interesting that these cases seem linked to psychiatric disorders. I'm skeptical because, as the article mentions, the age group is a concern. Many adolescents suffer from mood instability. Many children get used to the extra attention that comes with any medical condition and could seemingly act different after an event such as a concussion. It's easy to say that kids are kids and teenagers are teenagers who have tantrums, mood swings, or hormonal uproars. If anything, I think this article has a hidden message that puts value and importance in primary care - in really knowing your patient and any subtle changes - and in close follow up in weeks after an incident. I also think that these unfortunate instances bring light to psychiatric disorders and to make sports medical personnel, parents, guardians, caregivers, and physicians consider that this could happen and for close monitoring.
|
|
|
Post by Farisa Ali on Jul 1, 2015 10:29:34 GMT -4
This article touched on several significant points in regards to concussions and mood disorders. Multiple concussion injuries are very common to many sports and alarmingly the article states “after a severe head injury, the rate of new psychiatric disorders in children is 50-60%.” Athletes are seen as being tough and untouchable so when a concussion occurs and visible signs of an injury are absent, the athlete never seeks medical care. A young athlete also lacks understanding of depressive symptoms and probably would ignore the key signs which would eventually lead to “dark thoughts” and eventually suicide. It is sad how many lives have to be sacrificed for depression and concussions to be acknowledged in society. I believe enforcing classes that teach athletes about depression and accepting it as a mental disorder would be beneficial along with seeking medical treatment after every concussion to prevent some of the dangerous outcomes of mood disorders.
|
|
|
Post by Hiren Darji on Jul 1, 2015 10:37:24 GMT -4
Concussions are a traumatic experience as it is. Pt’s that suffer from concussions in shorter duration are more prone to suffer from depression and suicidal thoughts. The reason being is that patients who suffer from concussions are expected to recover fast or else they are looked down upon and are teased by their colleagues. It is bad enough already that they have a serious medical condition, but now to have fast recovery to avoid being made fun of by their colleagues will increase the risk of psychiatric conditions such depression and suicidal thoughts. However, according to NCAA the rate of depression and suicide among athletes are lower than non-athletes given the fact that there are no other medical conditions they suffer from. Overall, what I gather from this article is that there needs to be an emphasis on education for common medical and psychiatric conditions in high school and college kids that will allow people to seek care if one is suffering from medical and psychiatric conditions.
|
|
|
Post by Chris Yulo on Jul 1, 2015 11:21:29 GMT -4
The link between CTE and athletes in contact sports seems obvious to me. If a person receives a concussion, there is bound to be some penetrating damage to the brain; it's kind of like an egg being scrambled inside of its shell. It's not just football players either. Any athletes participating in contact sports like boxers, mixed martial artists, hockey players, rugby players, etc. are at high risk for developing CTE. Boxers have a strong history of developing dementia pugilistica, although I do not know of any studies giving statistics for the incidence. There are plenty of examples of ex-professional boxers who are suffering from CTE. My question is: will knowing that CTE can follow participating in contact sports change anything? Will talented young people begin participating in noncontact sports more? I am hesitant to say that learning of a link between CTE and football, in this instance, will change anything at all. People will continue to play football because they love the sport.
|
|
|
Post by Maria Bezares-MS3 on Jul 1, 2015 17:27:38 GMT -4
Interesting article! While it is known that certain lesions in specific areas of the brain, such as the ones localized in the frontal cortex and the anterior cingulate gyrus, could result in alterations of the mood and social behavior of an individual, a causal relationship between concussions and development of psychiatric and mood disorder has not been demonstrated. This could be due to the fact that the incidence and prevalence of concussions are higher among college-aged population, a sector that is also one of the most sensitive to environmental factors, adding more variables to the investigation, making it more susceptible to cofounder effect. In other words, since college-aged population, as the article mentioned, are particularly vulnerable due to the changes occurring in their life structure, it is almost impossible to isolate the effects caused by the variable head injury from the ones caused by normal changes in that stage of social, emotional and physical development.
Now, it is imperative to have in consideration the effects caused indirectly by the head trauma, such as the bullying faced by Kaelin at school for his delay in returning to the team and the inability to practice the sport during recovery, which usually is an important aspect of the adolescents’ life, over the mood and psychiatric disorders developed in the kid.
It is for these reasons that I think that, even though it would be fundamental to have a better understanding of the effects of head traumas over mood and psychiatric disorders, it would be nearly impossible to demonstrate a relationship beyond the correlation existing between them.
|
|
|
Post by vfonseca on Jul 2, 2015 8:06:13 GMT -4
It is very interesting to learn how environment plays a role in the development of a psychiatric illness, in this case the relationship between traumatic brain injury (TBI) and depression. Depression is a common problem after TBI. About half of all people with TBI are affected by depression within the first year after injury. Many different factors contribute to depression after TBI, and these vary a great deal from person to person. For example, the physical changes in the brain due to injury.in the areas of the brain that control emotions, could be the cause of developing depression. Another example, is the emotional response to injury. Depression can also arise as a person struggles to adjust to temporary or lasting disability, losses or role changes within the family and society, as in the case of Kaelin. Some factors unrelated to injury ,is the higher risk for depression due to inherited genes, personal or family history, and other influences that were present before the brain injury. There are studies, that have shown that major depressive disorder appears to be the most prevalent psychiatric disorder after TBI, with a point prevalence rate over 25%.The frontal , left basal ganglia, temporal poles are preferentially affected by the focal and diffuse injury caused by TBI , are that have been associated with onset of depression after TBI .
|
|
|
Post by Prashanthi on Jul 2, 2015 10:44:25 GMT -4
It is assuring to learn that treatment has begin to focus on the specific outcomes of concussions and its relationship to depression. The incident in Ohio is an example of how necessary it is to be able to distinguish the difference between the symptoms of depression and the symptoms of concussions as the article outlines. In focusing on the long term effects of concussions , the seriousness of the immediate suicidal thoughts and depression are overlooked leading to unfortunate circumstances like the one in OHIO. There are multiple variables contributing to the depression including the age group of those exposed to injury as well as the bullying these athletes face as a result of not being able to participate. The fact that the clinic sees over 20,000 patients in a year is a sign that more research and awareness should develop to aid in the recovery of upcoming athletes/college students. The fact that there have been document improvements in patients like Kamzelski provides hope for patients in such conditions. Depression should never be overlooked or underestimated, knowing there are alternatives to the suffering and that there is growing help in this field will hopefully provide light to patients who feel they will be stuck in "the dark place" forever.
|
|
|
Post by Ugo Okeke -MS3 on Jul 2, 2015 11:24:19 GMT -4
This was a very interesting article and I have seen what concussions can do to adolescents. Sports injuries in soccer and football are very common, and each case is very unique as far as how patients react to their symptoms. Concussions continue to be a problem in youth football all the way up to the NFL and it has scared parents away from letting their children play football at a young age. As the article stated, I believe the best way to help better patients prognosis from these head injuries that can lead to depression is diagnosis of injuries at their genesis to insure the best possible outcome.
|
|
|
Post by Biju Babu on Jul 2, 2015 15:41:52 GMT -4
I felt that this article was very informative. We have learned in medical school that damage to the frontal lobe of the brain will cause behavior changes as the frontal lobe is responsible for executive function and personality. It is very likely that athletes that suffer a concussion could have been hit on the frontal lobe and experience signs of depression and personality changes and it is usually the family that notice the change first. Depending on where the athlete was hit, there can be balance changes, auditory and visual changes, and mood changes such as those shown in the article.
|
|
|
Post by Biby Babu on Jul 2, 2015 16:25:41 GMT -4
In the course of my eight weeks in this rotation, I can safely say that this article is relatable to several of the patients being seen in our clinic. For example, there was one young athlete who suffered many concussions playing football, so much that his entire personality changed. He became very aggressive, triggered at the smallest things. He had one episode during his appointment where he was set off by something very small and could not control his anger.
Another example that comes to mind was when I personally interviewed a new patient complaining of obsessive sexually intrusive thoughts. He was an athlete as well, and suffered 11 concussions in his life. He stated that the thoughts were impacting his daily life and most days, he would think about suicide.
It is tragic to realize that the etiology of their mental health illness is not a neurotransmitter imbalance (where we can easily treat with SSRI and SNRIs), and their cases are much more complicated that meets the eye.
I like that the article pointed out the question, "Is it coincidence or causation?" The aftermath of any trauma can trigger feelings of depression, especially if there was a new loss of function that affected daily life, as well as the trauma can have a direct pathogenesis affecting the prefrontal cortex. There is just not enough concrete evidence to point to one or the other; however, I do believe that patients with a strong history of head trauma must be ruled out for mood and psychiatric disorders.
|
|
Mary Rodríguez - MS3
Guest
|
Post by Mary Rodríguez - MS3 on Jul 2, 2015 18:47:16 GMT -4
This case reminds me of Phineas Gage’s left frontal lobectomy. His traumatic brain injury (TBI) was caused by an iron rod that perforated his skull. History tells us that Gage’s personality was never the same; he became cynical and reportedly, unpleasant to be around. His left frontal lobe was removed, to salvage him from the injury. Frontal lobe damage is associated with changes in flexibility, problem-solving abilities, as well as changes in attention and memory (CNS, 2015). It is important to note that some of the sequelae to watch out for in concussions, include stiff neck, difficulty walking, speaking, or moving arms, severe headache, repeated vomiting, worsening confusion, convulsions, and unusual sleepiness (Family Doctor, 2014). There is contradiction as to the correlations between location of the traumatic brain injury (such as, concussion), and the neuropsychiatric sequelae. For instance, some studies indicate that right hemisphere lesions are more likely to result in depressive mood symptoms, and others indicate the occurrence of mania (though, this one is reportedly milder and more transient). Pseudo bulbar affect is commonly one of the differential diagnosis, because it features symptoms of emotional lability (ex: pathological crying and laughing, etc.) A study by Liebert (2009) reviewed previous research projects in which the treatment and management of major depressive disorder following traumatic brain injuries were discussed. They concluded that there currently is no best management practice; rather, they suggest the introduction of low-dose antidepressants and incorporating the use of tools, such as the PHQ-9. When choosing an SSRI (particularly, citalopram or sertraline), TCAs are reportedly discouraged because of potential for seizures, as these are already featured in the neuropsychiatric sequelae of TBI. I noticed that more research is needed, in terms of how to apply these treatment and management practices to young adults and teenagers. References: Center for Neuro Skills. (2015). Frontal lobes. Retrieved from: www.neuroskills.com/brain-injury/frontal-lobes.phpFamily Doctor. (2014). Concussions. Retrieved from: familydoctor.org/familydoctor/en/diseases-conditions/concussion.printerview.all.htmlJournal of Neurosurgery: Pediatrics, news release, Sept. 24, 2013 Liebert, A. (2009). Treatment for depression after Traumatic Brain Injury: A systematic review. Journal of neurotrauma. 26: 2383-402. DOI: 10.1089=neu.2009.1091 Mayo Clinic. (2013). Depression: Major Depressive Disorder. Retrieved from: www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983?pg=2
|
|