Protect Your Noggin: Helmets and Mental Health — Better Together!
From circles in my childhood driveway to pedaling to friends’ houses, I was on a bike a lot. This eventually turned to riding a bike to college classes in busy downtown Austin. Additionally, in the mid-90s, I learned to ski, and I fell in love. I would go on to ski often. Not to reveal my age, but this was, of course, all in the ‘80s and the ‘90s, and you know what that means: all this riding and skiing was done with no helmet! These days, you can find me on a mountain or road bike, enjoying the beautiful Colorado scenery, or cruising on bike paths with my kids. And as often as possible in the winter, I head up the hill to ski. But there has been one big change. I wouldn’t even go around the block on a bike or down the easiest ski run without a helmet. As my husband always says, “No one leaves home planning to crash,” so I religiously don head protection. Some of this habit is, of course, being an example to my kids, but it is also about keeping my own brain in tip-top shape.
It wasn’t until the early 2000s that the impact of brain injury was widely recognized, and a variety of organizations, from youth sports to professional leagues, began to adopt concussion protocols. This improved understanding, among many things, led to better helmet technology and stricter protocols.
So, what is a brain injury, and what is its impact? According to the National Institute of Neurological Disorders and Stroke, a traumatic brain injury (TBI) refers to a brain injury that is caused by an outside force. TBI can be caused by a forceful bump, blow, or jolt to the head or body. Some types of TBI can cause temporary or short-term problems with brain function, including problems with how a person thinks, understands, moves, communicates, and acts. A more serious TBI can lead to severe and permanent disability. Symptoms of a traumatic brain injury can manifest in various ways. Physically, individuals may experience sensory sensitivity, such as being bothered by light or noise, dizziness or balance issues, fatigue, headaches, nausea or vomiting, and vision problems. Cognitive symptoms can include difficulty with attention or concentration, feeling slowed down or foggy, and having problems with both short- and long-term memory, as well as trouble thinking clearly. Social and emotional symptoms might involve anxiety, nervousness, irritability, emotional fluctuations, or sadness. Sleep disturbances are also common, including sleeping more or less than usual or having trouble falling asleep. So, are concussions and TBIs the same thing? Yes, a concussion, as it is traditionally thought of, is an example of a mild TBI. Throughout this blog post, I will use the terms “concussion” and “TBI” interchangeably for clarity.
While there are many symptoms of brain injury, I want to focus here on the symptoms connected to behavioral health, like mood swings, depression, and anxiety. Depression and anxiety symptoms are common in the first days to weeks after a concussion. Additionally, a concussion can be a very disruptive experience, especially when symptoms linger, or future plans and activities are disrupted as a result of the concussion. This can lead to frustration and hopelessness. To make matters worse, concussions are sometimes called “the invisible injury.” The Concussion Alliance describes it this way:
“Recovering from a concussion can be an isolating experience, and symptoms persisting over time can add to the sense of isolation. While persisting symptoms after a concussion present many difficulties for those who experience them, there are often no visible, external signs—such as a cut, cast, or bruise—to indicate that these individuals have been injured”
For those suffering, this “invisibility” can lead to feeling alone, isolated, and like no one can understand what they are going through. This can also make it difficult to advocate for oneself because of the fear of being misunderstood. For example, one might not ask a teacher for extended time on a test because they fear the teacher won’t fully understand what they are going through.
How do we go about protecting and treating mental health after a concussion?
First, concussion patients need to feel visible and seen. Concussion patients often feel misunderstood or dismissed by those around them. Offering genuine empathy and validating their experiences plays a key role in their recovery. It is also important to maintain regular, supportive social contact, allowing friends, family, and colleagues to engage at the patient’s pace without judgment or pressure. Encouraging patients to recognize their symptoms and limitations is crucial, as seeking help or accommodations is a sign of strength. Additionally, educating the patient’s support network fosters understanding and reduces the burden on the patient to explain their condition. Finally, helping patients set realistic recovery goals and accept that they may not return to their pre-concussion state can contribute to a healthier and more balanced recovery process.
Second, when recovering from a concussion, practicing self-care is key. It is important to engage in light activities and limit screen time to give the brain adequate rest, as recommended by the Concussion Alliance. Managing sensory sensitivity, such as discomfort from light or noise, can be aided by using tools like earplugs and hats or reducing screen time. Prioritizing good sleep and nutrition is essential, as both play a significant role in the healing process. Additionally, the Concussion Alliance recommends utilizing resources such as meditation apps, stress management tools, and support groups to further aid recovery.
Lastly, seeking help from a behavioral health professional is crucial when needed, particularly for managing anxiety and depression that may arise from a concussion. These conditions respond to treatment similarly, whether they are associated with a brain injury or not. Experts recommend prompt behavioral health intervention or counseling with a qualified professional familiar with concussions if emotional or behavioral symptoms are severe—such as a depressed mood or significant anxiety—or if they persist beyond the first few weeks. Cognitive Behavioral Therapy (CBT) is one effective approach that has shown promise in concussion recovery, as it addresses a range of symptoms, including depression, anxiety, headaches, and PTSD.
But most important is safety and concussion prevention! Helmets and mental health…better together! While no helmet can be entirely “concussion-proof,” they provide valuable protection against serious brain injuries. To ensure helmets offer optimal protection, it is essential that they fit properly, be age-appropriate, and be well-maintained. Most importantly, they must be worn consistently and correctly to be effective. For more information on helmet safety and usage, refer to the resources available at the CDC’s Heads Up initiative.
In conclusion, while the physical impacts of TBI, including concussions, are well-recognized, their effects on mental health can often be overlooked. Symptoms such as depression, anxiety, and mood swings can arise, sometimes persisting long after the injury itself has healed. The isolation that can accompany these invisible injuries further complicates recovery. However, with proper support—through empathy, education, self-care, and, when necessary, professional help—individuals can navigate both the physical and emotional challenges. Prioritizing brain protection and mental well-being together is crucial for long-term recovery and health. So, get out there, enjoy life, and wear a helmet!
Resources:
ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi
cdc.gov/heads-up/signs-symptoms/index.html
apa.org/monitor/2024/07/improving-concussion-treatment
concussionalliance.org/the-invisible-injury