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Depressive Symptoms Could Follow Years Later After Concussion

Harold Mandel's picture
Motorcycle riders with helmets

A concussion may seem harmless, but it could lead to depressive symptoms years later. A lot of sports people and others are not careful enough about potential head injuries, feeling generally with a little rest this will pass them by. However, this is not always true. Research has shown years after a concussion depressive symptoms may set in. Even a single concussion could have long-term consequences, according to EmaxHealth reporter Kathleen Blanchard, RN.

There is an association between traumatic brain injury and depression, reports Biological Psychiatry. Because most people who suffer from a traumatic brain injury are juveniles and young adults, the increased chances of a lifetime of depressive symptoms associated with a concussion is a very significant concern. The cause of what appears to be traumatic brain injury depression is not clear. It has been hypothesized the depression is inflammatory associated with heightened brain sensitivity to secondary inflammatory challenges such as daily stressors, infection, and injury.

The psychiatrists claim clinical depression is a medical illness which affects millions of people every year, writes the University of Pittsburgh School of Medicine. Clinical depression is seen as being more serious than passing feelings of being blue. In clinical depression psychiatrists say there are persistent changes in a persons mood, behavior, and feelings. This becomes so severe that it interferes with and causes problems with a persons' education, job and personal life. Attempts at cheering the person up do not seem to work. The psychiatrists also claim exercise, vitamins, or vacation will not make clinical depression disappear, although many natural health oriented medical doctors and naturopaths generally do not agree with this.

Psychiatrists say that people with clinical depression experience the following:

1: A persistent change in feelings and behavior, such as sad or empty feelings, slowed behavior, and changes in eating and sleeping patterns

2: Negative feelings about themselves and feelings of hopelessness about future

3: Difficulty concentrating on work or studies

4: Feelings of guilt

5: Feelings of anxiety

6: Crying often or becoming irritable over little things

7: Loss of interest in friends, sex and other pleasurable activities

8: Complaints about physical aches and pains, such as backaches, headaches, and stomachs problems

9: Fatigue or loss of energy

10: Changes of weight or appetite

11: Thoughts of suicide or death

The psychiatrists describe major depression, which is also called unipolar depression, as an illness which is identified by many of the symptoms noted above. The label of manic depression, or bipolar depression, is used by psychiatrists to describe an illness which they say alternates between cycles of depression and manic elation. During a manic phase of this disorder people are said to experience the following:

1: Increased energy and decreased need for sleep

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2: Inappropriate excitement or irritability

3: Increased talking or moving

4: Promiscuous sexual behavior

5: Disconnection and racing thoughts

6: Impulsive behavior and poor judgement, such as spending sprees

It is claimed during the depressed phased of this illness, many of the symptoms of major depression are experienced.

This does not however offer a comprehensive view of the validity of the psychiatric approach to mental health issues. No scientific tests exist which can prove so called mental disorders are medical conditions, writes the Citizens Commission on Human Rights International. In fact psychiatric diagnosis is based entirely on subjective opinions. Certainly, people can get depressed, sad, anxious, slowed down, hyped up and even behave in a psychotic manner. This does not mean they are mentally diseased. And each psychiatric label stigmatizes the person being labeled. As long as we continue to use these psychiatric labels to describe behaviors, psychiatry will continue to profit greatly while the public suffers.

There really is no medical “mental illness test.” Yet, the psychiatric/pharmaceutical industry spends billions of dollars a year in campaigns aimed at convincing the public, legislators and the press that psychiatric disorders such as bipolar disorder, depression, attention deficit disorder, post traumatic stress disorder, and others are real medical diseases similar to verifiable medical conditions such as cancer, diabetes and heart disease.

The bottom line is, as stated by the Citizens Commission on Human Rights, there are no genetic tests, brain scans, blood tests, chemical imbalance tests or X-rays which can scientifically and medically prove that any psychiatric disorder is an actual medical condition. Real medical diseases are verified in labs, while psychiatric disorders are actually invented by a committee of psychiatrists and voted into existence.

Keeping these thoughts in mind about the controversy which exists in dealing with psychiatric labels, it appears a concussion can lead to depression years later, according to Ohio State University in a review of this research on Dec. 9, 2013. In this review of the research dealing with the association of concussion to depressive symptoms, Ohio State University says in the aftermath of brain injury, cells which are on high alert prolong the immune response, which is said to affect behavior.

A new animal study has suggested a head injury can cause immune-system brain cells to go on a high alert state and thereafter overreact to immune challenges by becoming excessively inflammatory. This condition is linked with depressive complications. The researchers say these findings may help to explain some of the mental-health issues suffered at middle age by individuals who experienced multiple concussions as young adults. The depressive symptoms seen are likely to be associated with inflammation.

There is a consideration that aging already increases brain inflammation. It is felt that along with concerns of normal aging, people who have had a traumatic brain injury experience added inflammation which is caused by magnified immune responses to so-called “secondary challenges,” including a second head injury, infections or other stressors. These high-alert cells in the brains of mice are called microglia. Microglia were seen to have an exaggerated response to an immune challenge just one month after a moderate brain injury. It was observed that the increased brain inflammation corresponded with the development of depressive behaviors which were not seen in uninjured mice.

Lead author Jonathan Godbout, who is an associate professor of neuroscience at Ohio State University, has said, “A lot of people with a history of head injury don’t develop mental-health problems until they’re in their 40s, 50s or 60s. That suggests there are other factors involved."
This is why the researchers have considered a double hit concept, with the brain injury being the first, followed by an immune challenge. The researchers compared uninjured mice with mice that had experienced a moderate traumatic brain injury.

There were some initial coordination problems in the injured mice, which resolved within a week.
There were also signs of depressive symptoms in the injured mice that improved within one month. Those depressive symptoms were said to be associated with the expected neuroinflammation that occurs after a traumatic brain injury. As anticipated, thirty days after injury the immune cells in the injured mice had remained on high alert. In other words the microglia in the injured brains had stayed in a primed state.

The uninjured mice did not have the same characteristics in their brains. When microglia are primed they are in a higher state of alert. When they are activated, they generate an amplified immune response which lasts longer than is necessary. When there is an activation of these systems with nothing to fight, the circulating chemicals and proteins generate an excessive amount of inflammation.

30 days after the traumatic brain injury, the mice were injected with lipopolysaccharide, which is the dead, outer cell wall of bacteria which stimulates an immune reaction in animals. Over the course of 24 hours after the injection, the traumatic brain injury mice were much less social than the uninjured mice. This was one type of depressive symptom in these mice. The brains of the traumatic brain injury mice also had dramatically higher levels of inflammation-related proteins than did the brains from normal mice.

There were more depressive symptoms seen in the injured mice seventy-two hours after the lipopolysaccharide, which included minimal interest in sugar water. This was a sign that these mice avoided what is generally a pleasurable activity. These mice also showed signs of simply giving up. The uninjured mice behaved in normal manners and the levels of inflammatory proteins in their brains had come back to baseline over the same time period. Godbout said,
“These results tell us the TBI mice are having an amplified and prolonged activation of microglia, and that was associated with development of depressive symptoms in the mice.” These researchers are now investigating potential treatments that could either prevent the priming of microglia immediately after injury or reverse the high-alert characteristics of these cells at a later time.

It is my firm opinion that too many people do not take proper precautions to avoid head injuries. Sports players should be extremely cautious at all times, and motorcycle and bicycle riders should always wear helmets. Proper helmet fit is the most important factor in preventing concussions, reports EmaxHealth reporter Tim Boyer, Ph.D.

I agree with the Citizens Commission on Human Rights that psychiatric labels and the psychiatric approach to mental health issues cause more harm than good. However, this does not negate concerns about possible depressive symptoms which may occur in association with head injuries. Certainly, injuries to the brain can be for real, even though psychiatric diagnoses are based on the subjective whims of psychiatrists. So, you should at all times take precautions to prevent head injuries. And anyone who suffers from a head injury should be taken to an emergency room immediately for evaluation.