For some student-athletes who suffer concussions, the mental aspect of getting back in the game is the toughest part.
Researchers at UCLA are looking closely at the psychological aspects of recovery from head injuries, such as concussions, and have recently begun a program that integrates a common type of talk therapy as part of their treatment for athletes with lingering emotional impacts after their injuries.
At the UCLA Steve Tisch BrainSPORT Program, Doug Polster, a postdoctoral fellow in sport neuropsychology, says the mental aspects of concussions are generally under recognized.
“Many health care professionals either do not have the time or are not fully trained to check for depression symptoms,” he says. “And if the patient’s symptoms are below the threshold for clinical depression, they can be missed.”
Typically, it may take a week or two to recover from the physical aspects of a concussion. But for some people, symptoms—both physical and mental—can persist. The physical symptoms can include headaches, dizziness, sensitivity to noise and light. Psychological symptoms, such as anxiety, depression and social isolation, may last much longer than a few weeks.
One of the most common psychological symptoms reported by athletes, Polster says, is feeling isolated from their team. Often athletes are instructed by coaches and trainers to stay at home and not participate in games, practices and other team events. These restrictions may be particularly upsetting to one group of people: athletes who report that their personal identities are most closely tied to their participation in a sport, Polster says. These students often feel isolation and depression more intensely.
“All of a sudden a month goes by and you’re not socializing much,” Polster says. “Feelings of anxiety or depression can be exacerbated by separation from the team, the pressure of falling behind on academics — athletes may be excused from classes for a week or so as they recover — and just the general stress of being a student.”
Even after the student has largely recovered from a head injury, they may link common physical symptoms — headaches, forgetfulness or trouble concentrating — with the recent injury. “It can become difficult," Polster says, "to parse out what is an everyday symptom of life with something concussion-related.”
To address some of the psychological aspects of depression and anxiety, in December 2016 the BrainSPORT program launched a program in which patients experiencing longer-than-typical recovery periods from concussion are provided with a form of counseling known as cognitive behavioral therapy, with a sports twist. The therapy is provided by counselors who talk to the athletes while they are exercising on a stationary bike or practicing aspects of their sport, such as shooting free throws for basketball players.
“Our goal is to give you the techniques to cope with stress better so that once you are healthy, you are able to perform your best,” Polster says. The program hopes through its research to develop some recommended treatment protocols for addressing the psychological effects of brain injuries.