Teen and his father together Concussion serves as a significant source of stress for all patients. Disrupted routines, concern about missed school or make-up assignments, and worry about ongoing symptoms present unique challenges to a child’s mental health following a diagnosis of concussion.

While most concussion symptoms resolve within one month after their injury, a subset of youth have concussion symptoms that last longer.

The link between mental health and concussion recovery

As many as one-third of youth with concussion reported having elevated symptoms of anxiety or depression after their injury. Among these youth, about half reported having similar mental health concerns before their concussion, while the other half described these mental health concerns as new.

A growing body of research suggests that mental health concerns – specifically anxiety and depression – place patients at an increased risk for persistent symptoms from concussion. Researchers from CHOP’s Minds Matter Concussion Program have found that youth with pre-existing anxiety or depression took twice as long to recover from their injury compared to their non-affected peers.

In addition, youth who sustain a concussion via car accident or other trauma are at risk for post-traumatic stress symptoms like hyperarousal and avoidance.

Left untreated, mental health concerns after concussion are associated with major challenges, including:

  • Persistent concussion symptoms
  • Academic decline
  • Reduced social engagement
  • Increased suicide risk

Cognitive behavioral therapy: An effective tool

Fortunately, there are many effective tools and therapies that can help improve the mental health of children and adolescents. Cognitive behavioral therapy (CBT) is a well-researched intervention which teaches youth new ways of coping with difficult emotions and physical symptoms.

In addition to reducing symptoms of anxiety, depression, disruptive behavior, and post-traumatic stress, research has demonstrated that youth who complete CBT report decreased concussion symptoms. This suggests that many children or adolescents struggling to get back to their regular activities after a concussion could benefit from CBT.

What families can do to help youth in their concussion recovery

Families should be aware of the role mental health plays in concussion recovery. Be open to talking to your child and healthcare providers about the mind-body connection, and ways to improve both concussion and mental health symptoms.

Tips we recommend to families include:

  • Normalize mental health by talking about it openly and often. Acknowledge that injuries like concussion are stressful.
  • If your child has a history of mental health concerns before they sustain a concussion, continue any medication or therapy previously prescribed. Make sure your child’s concussion provider is aware of your child’s prior mental health concerns and notify them of any changes in mood or behavior.
  • Talk with your family about the mind-body connection and the links between physical and emotional health.

Encourage your child to:

  1. Lean on their existing social supports like family and friends
  2. Ask for additional or professional help if needed
  3. Practice relaxation strategies like deep breathing, meditation, progressive muscle relaxation or journaling
  4. Make time for activities they enjoy that do not worsen their concussion symptoms (i.e., talking on the phone instead of video calling)

If your child experiences emotional or behavioral changes after a concussion – or their concussion symptoms do not resolve within expected time frames – talk to  your child’s healthcare provider and ask about CBT as a possible treatment to promote recovery and improve overall well-being.

Resources

  1. Guided Relaxation for Kids
  2. Concussion Information for Parents

Jamie Shoop, PhD, is the psychologist in the Minds Matter Concussion Program at Children’s Hospital of Philadelphia.

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