As an attorney handling brain injury cases throughout Georgia, I have often seen children and adolescents with traumatic brain injury (TBI). Sometimes it is clear that the injury is catastrophic and long-term. In other cases, it is tempting to think the young person simply got his “bell rung” and should shake it off. But we find that while the client may look fine the brain does not operate as before. It is these more subtle “minor” brain injuries that can have an invisible lifetime impact.
These real life observations are confirmed through new research that has found the most common type of traumatic brain injuries, concussions, can raise the risk of developing depression and attention-deficit hyperactivity disorder (ADHD) in teens.
A new study published in the Journal of Adolescent Health found that teens with a history of concussions are more than three times as likely to suffer from depression versus teens who have never had one. The study also found that children who have a history of concussions are more likely to develop ADHD and have difficulty controlling their moods, especially anger, rather that experience depression.
“In our research, we’ve found that about 10 percent of the kids had a full depressive disorder or subclinical depressive disorder 6 months after a concussion,” said Jeffrey Max, M.D., a psychiatrist who specializes in psychiatric outcomes of traumatic brain injury in children and adolescents at the University of California, San Diego.
Many teens experience concussions through accidents or sports injuries, but most research on the psychological effects of concussions have been focused on adults. Researchers felt that it was important to study long-term complications that could arise in young people after suffering a concussion.
The study pulled information from the 2007-2008 National Survey of Children’s Health and included the health data of more than 36,000 adolescents ages 12 to 17. Overall 2.7 percent of those in the sample had experienced a concussion and 3.4 percent had a current depression diagnosis.
The lead study author Sara Chrisman M.D., said that teens that were 15 years or older lived in poverty or who had a parent with a mental disorder were more likely to be depressed than other teens. However she says that what was surprising was “when we took those factors into consideration, it didn’t take away from the association between depression and a history of concussion.
Chrisman noted that although the reason why there are higher rates of depression in teens with a history of concussion she believes it could have something to do with the brain injury itself, repeated medical visits to the doctor, doctors mistaking symptoms of a concussion for depression, or even the social isolation that patients may experience while recovering. Max, however, has observed that the brain injury itself is often the primary cause of depression within the first few months after the concussion.
“In the clinic, we’ve certainly seen cases where within hours {of sustaining a concussion} a kid who’s never had depression before is suddenly depressed and suicidal…One of our studies found that the brain images in children with traumatic brain injury and depression were actually quite similar to those seen in adults who develop depression as a result of traumatic brain injury,” said Max.
Ken Shigley is past president of the State Bar of Georgia (2011-12), double board certified in Civil Trial Advocacy and Civil Pretrial Advocacy by the National Board of Legal Specialty Certification, and lead author of Georgia Law of Torts: Trial Preparation and Practice. His Atlanta-based civil trial practice is focused on representation of plaintiffs in cases of castastrophic personal injury and wrongful death.