Concussions affect between 1.5 and 2 million Americans annually, including many athletes, but can have more severe effects than a few days off the playing field. In particular, they can lead to post-concussion syndrome, a condition with side effects that can last longer than the usual 7 to 10 days and can cause psychological problems such as anxiety and depression. Given the stakes, it is troubling that the responsibility to cure athletes falls upon physicians, many of whom are not fully qualified to deal with cases of mental illness.
According to an article in the Journal of Clinical and Experimental Neuropsychology, 38 percent of those diagnosed with a concussion also experience post-concussion syndrome, and 40 percent of those diagnosed with PCS are given psychological treatment. These patients are either referred to psychiatrists or treated by general physicians. But PCS does not have a cure, and there is little research on the disorder’s nuances. In fact, cognitive issues associated with concussions can arise as late as 5 to 10 years post-trauma, according to Steven Kornguth, a senior research fellow in the Department of Kinesiology.
“The real issue today in 2015: We do not know immediately if there is going to be a traumatic brain injury develop later,” Kornguth said.
Due to this lack of information, it should not be the general physician’s place to administer antidepressants to a patient suffering from PCS. Rather, the patient should be referred to an expert in brain chemistry, like a psychiatrist or a neurologist, for treating the disorder.
According to psychology professor David Schnyer, the limited research on PCS can lead medical practitioners to prescribe drugs that treat the symptoms of the disorder rather than addressing the causes of the disorder itself.
“If you have someone who shows up with a disorder, and if the symptoms of that disorder fit a particular symptom profile, such as anxiety or depression, you are simply going to prescribe the drug that you know works for one of those two things,” Schnyer said.
That approach is a problem given the potentially harmful side effects of antidepressants.
The antidepressants used today are usually SSRIs, or selective serotonin reuptake inhibitors, and have the potential to increase suicidal and homicidal thoughts, according to Joseph Mercola, a New York Times best-selling author and surgeon. The treatment for PCS may include antidepressant drugs, but due to the lack of substantial experiments confirming this idea, many but not all practitioners prefer to begin with therapy. This form of treatment should be the first step in all cases, as therapy does not directly affect chemical makeup, therefore carrying less risk.
Considering the complexities of PCS, antidepressants should be applied conservatively. Medication is vital in cases of mental illness, but it also carries potential risk factors. Given the current status of PCS, this treatment should not be given immediately by one not trained in the complexities of mental illness. Discretion should be left to psychiatrists.
Vernon is a PACE freshman from Houston. Follow her on Twitter @_emilyvernon_