Mental Health Among High Schoolers
Concussions as an Invisible Injury
Concussions are mild traumatic brain injuries that can occur when the head, neck, or body experiences a blow resulting in an impulsive force being transmitted to the brain, causing the brain tissue to stretch, compress, and twist inside the skull. Although concussions are an invisible injury, they can significantly impact your overall well-being and mental health. It is essential to recognize that concussions are not just physical injuries; they can also affect your emotions, thoughts, and behaviors.
Concussions can have physiological effects on brain function, leading to mood changes and cognitive difficulties. Both concussion recovery and persisting symptoms can impact how we feel and interact with our peers in many social settings and affect our overall well-being. In this resource, we'll explore ways to cope with challenges after concussion, highlight the importance of seeking support, and provide strategies to maintain your overall well-being throughout your healing process.
Overview
Statistics on Concussions
Concussions are alarmingly prevalent among adolescents and young adults, particularly in high school settings. The prevalence of at least one self-reported lifetime concussion among US adolescents was 24.6% in 2020; that’s almost 1 in 4 of your peers! Falls are the leading cause of concussions among high school students, accounting for about 42% of all reported concussions. This statistic highlights that concussions are not just sports injuries; they can happen to anyone. These alarming statistics highlight the prevalence of concussions among high school students and the importance of understanding their impact on mental health and overall well-being.
Why Focus on Mental Health After a Concussion?
While many patients, advocates, and even healthcare providers focus primarily on the physical symptoms of concussions, such as headaches or dizziness, the impact of a concussion on mental health often remains overlooked when it comes to education and treatment. Symptoms like anxiety, depression, mood swings, difficulty concentrating, executive dysfunction, and memory problems can develop following a concussion. Some individuals experience PTSD, either preexisting, stemming from the event (car crash, bad hit in a sports game, violence, physical abuse, etc.), or occurring as a result of a difficult recovery process. Concussions can also worsen pre-existing mental health challenges. One study found that youths who experienced concussions are 39% more likely to develop mental health problems than those with other injuries. Understanding and addressing these mental health challenges is just as crucial as managing the physical and cognitive aspects of the injury.
The Path to Recovery: Nurturing Your Mental Well-being
The journey to recovery after a concussion is no longer about resting and waiting for physical symptoms to subside; leading researchers and clinicians now recommend a more active recovery starting in the first days after injury. Proactively taking care of your mental health is vital.
How Can a Concussion Affect My Mental Health?
Concussions are more common than you might think and can affect your mental health during high school in many ways. Let's dive into some essential points you should know.
Recognition and Understanding of Mental Health Symptoms
After experiencing a concussion, you might notice changes in how you feel and act. It's essential to recognize these potential mental health symptoms so you can seek help if needed. Many people experience a worsening of pre-existing mental health issues, so if you are experiencing this, you are not alone. Maintaining your mental health takes work in general; having a concussion adds another layer to that maintenance. Concussions disrupt your day-to-day routine; therefore, you may no longer receive positive stimulation from physical activity, sleep schedules, and social connections. When you begin to regulate the disruption concussion causes, your mental health will begin to improve.
Concussion Alliance has a great resource to learn about the signs of mood swings, irritability, anxiety, depression, and how to cope with academic and social pressures (You can check it out here: Mental Health - Concussion Alliance). Remember, it's okay to ask for support from your friends, family, or a healthcare professional.
Persisting Symptoms
For a significant number of people, concussion symptoms can linger, affecting your ability to get back to your usual day-to-day life. Symptoms that last longer than four weeks are considered to be persisting symptoms. Don't worry; you're not alone, and there are things you can do for pretty much every concussion symptom. You might need to work with rehabilitation specialists to aid in your recovery process. Take your time to heal, and don't hesitate to seek help from medical professionals for proper guidance.
Therapy Doesn't Make You Weak
If you're dealing with the effects of a concussion on your mental health, remember that seeking therapy doesn't make you weak; it shows strength! Therapy can be a powerful tool to help you cope with the challenges you may face during your recovery. It's completely normal to have misconceptions about therapy, but let's clear things up.
Therapy is Supportive: Therapy is a safe and non-judgmental space to express your thoughts and feelings. It's like having a helpful guide who understands what you're going through and offers support along the way.
It's Okay to Ask for Help: Seeking therapy doesn't mean there's something wrong with you. It means taking charge of your well-being and making positive strides to feel better. By being open about your feelings and seeking therapy, you display strength and courage while actively taking care of your well-being and working towards feeling better.
Benefits of Therapy: Therapy can help you develop coping strategies, manage stress, and improve your mental well-being after a concussion.
Embracing Identity Change
It's natural to feel like you've changed after a concussion, and for some, this process can be painful, stressful, and difficult. Dealing with a concussion may challenge (or change) your sense of identity. Remember, your identity can shift even without a concussion; a personal revelation or discovery of a passion or talent might make you a totally different person than you were 5 seconds beforehand. High school can be a time of self-discovery; a concussion might add some extra layers to that process. Embrace the changes and contact friends, family, or counselors for support as needed.
Timelines
Recovery from a concussion is unique to each individual. It's crucial to set realistic expectations for yourself and understand that healing is not always linear. Be kind to yourself, and remember that it takes time. Despite what you may see on tv and from professional athletes, the standard recovery time is four weeks; after that, symptoms are considered persisting. If your symptoms persist, it doesn't mean you won't get better. A concussion is considered a multidisciplinary rehabilitative injury, which just means that it can sometimes take working with a team of different specialists to help your symptoms go away. Don't feel rushed; it's okay to take breaks when needed. Your well-being comes first, and allowing yourself the necessary time to heal is an essential part of the process.
Concussions can really mess with your emotions, relationships, and how you handle school and social stuff. But don't worry, we've got your back! It's super important to take care of your mental health during recovery. Concussions might increase the chance of having some tough times, like feeling down or facing social challenges. But you've got the power to make things better! Being proactive about your well-being can help you handle this.
Academic Support and Accommodations
The transition back to school can certainly be challenging. Luckily, there is a great tool called return-to-learn that can make your transition not only easier but more effective. A detailed explanation of the stages you should follow is linked below in a handy PDF. Note: while it’s written for college students, these strategies can apply to you too!
College Students Return to Learn Guideline
Gradual Reintegration into School Activities
Get back out there: It’s a myth that you must be locked in a dark room and sleep for a week. In the first 24 to 48 hours, you should take it easy but keep doing some activities that don’t make your symptoms way worse, such as light aerobic exercise, limited screen time, and some social activities. Safely and gradually returning to some aspects of your daily life not only helps physically and cognitively, but getting back to your social life is essential in feeling less isolated.
But don’t push yourself: Whenever you move to the next stage of return-to-learn, take your time and continue assessing your symptoms. If you feel your symptoms reappear or worsen, stay at the current stage for at least an additional 24 hours or move back a stage. While you may be eager to return to your everyday life, it’s always better to be safe than create further stress on symptoms. Your recovery path is unique to you and to this injury, so it’s important to let your body tell you when you’re ready to progress.
Ask for help: Anywhere on your journey you may find yourself struggling to keep up with your academic work or in your clubs or extracurricular activities. Mental health difficulties often present an additional challenge. Most teachers will be willing to provide accommodations during your recovery if you let them know your needs.
Communicating with Teachers and Requesting Accommodations
Develop an academic team: You will want to form a team of adults who can support you in different ways as you recover. It’s critical to make sure everyone on this team is communicating with each other. Your team can include any and all of the following if applicable:
Guidance counselor, academic advisor, accessibility office, school nurse’s office, dean of students, teachers, assistant principal, principal–and, if relevant, athletic academic advisor, coach, etc
Don’t stop if someone pushes back: Not everyone understands concussion and mental health concerns. If you experience any issues with someone not believing you, find another person who does understand what’s happening to you. It may take a few tries, but adults who are in positions to advocate for you are vital.
Advocating for yourself: Knowing how to advocate for yourself can be tricky, especially what to ask for. By identifying triggers that make your symptoms worse, you can better understand what accommodations you may need. For example, if bright lights are hard for you, consider asking to wear sunglasses at school even if it is against their policies. Or, if your homework load is hard to get through, politely request aggregated problem sets that contain the most important information.
Create a personalized strategy: Every person is different, and it would be wrong to advise everyone in the same way. So, create a personalized strategy that works across your family, academic, and medical teams. This can require a lot of communication, and if that’s difficult, you can lean on others to pick up some slack in organizing.
Available Resources and Seeking Help
We know recovering from a concussion can be challenging, but you're not alone in this journey. Here are some helpful resources to consider because you have the right to the best care possible!
If you’re feeling isolated and hopeless, in crisis, or don’t feel safe with yourself, you might want to consider calling 988 or texting “Hello” to 741741.
Coping Strategies for Mental Health Symptoms: Managing the Challenges
Dealing with concussion symptoms can be tricky, but we've got you back with practical coping strategies to help you manage the challenges. Check out these helpful techniques that you can try!
Deep Breathing Exercises: Take a few moments each day to practice deep breathing. Inhale deeply through your nose, hold for a few seconds, and exhale slowly through your mouth. A longer exhale than inhale can help you relax further. This simple technique can help you reduce stress.
Mindfulness and Meditation: Try mindfulness exercises to stay present and focused on the moment. Meditation can help calm your mind and reduce anxiety. You can find guided meditation sessions online or through apps perfect for beginners.
Yoga and Stretching: Engage in gentle yoga or stretching exercises to relax your body and mind. Yoga can improve flexibility, reduce tension, and promote well-being.
Journaling: Write down your thoughts and feelings in a journal. This can be a safe space to express yourself, track your progress, and identify any triggers for your symptoms.
Creating a Relaxing Environment: Surround yourself with things that bring you comfort and peace. Consider listening to soothing music, using calming scents, or creating a cozy, relaxing space.
Physical Activity Within Limits: Engage in light physical activities that don't worsen your symptoms by more than 1-2 points out of 10. Going for a short walk or participating in low-intensity exercises can boost your mood and energy, but make sure to do these safely. If you have symptoms like dizziness and lightheadedness, you can consider using a stationary bike. Communicate with coaches or instructors about your concussion status and follow their guidance for a safe return to full participation in sports or activities.
Connecting with Supportive Friends and Family: Reach out to friends and family members who understand and support you. Talking to them about how you feel can be comforting and help you feel less isolated.
Limiting Screen Time: Reduce your screen time to 65 minutes daily for the first two days, as limited screen time is associated with faster recovery. Consider prioritizing connecting with your friends with your limited time. Alternatively, you could call people important to you or invite them over. Even after two days, take regular breaks and rest your eyes when screens are making your symptoms worse.
Establishing a Routine: Create a daily routine to help you stay organized and manage your time effectively. A structured schedule provides a sense of stability during your recovery. This can also help maintain your sleeping habits.
Seeking Professional Help: If your symptoms are overwhelming, don't hesitate to seek help from a healthcare professional or counselor. They can offer personalized guidance and support.
Remember, these tactics may not work for you, which is okay! Try a couple out and see how it goes. Don't push yourself too hard; healing takes time. If you want to try out a mental health app, Virtual Hope Box, Insight Timer, and Calm are great places to start.
Where to Seek Help: Athletic Trainers, Physical Therapists, and More
Finding help can be intimidating, but it doesn't have to be! Here are some resources and tips to make the process go smoothly.
Educate Yourself: Learn about the different types of healthcare professionals specializing in concussion care. This includes athletic trainers (ATs) who can help with sports-related concussions and physical therapists (PTs) who aid in rehabilitation.
Consult Your Healthcare Provider: Talk to your primary healthcare provider, such as your family doctor or pediatrician, about your concussion symptoms. They can help you determine what kind of specialist you may need to see.
Ask for Recommendations: Seek recommendations from your healthcare provider, school nurse, or friends and family who have experienced concussions. They may have valuable insights on who to see for specialized care.
Search Local Healthcare Directories: Check online healthcare directories in your network to find PTs, OTs, concussion clinics, and other healthcare professionals who specialize in concussion care near you. Concussion Alliance has a page right here to help you out! Psychology Today is another useful tool for finding therapy.
Reach Out to School Resources: If you sustained a concussion during sports or other school-related activities, your school's athletic department or sports medicine staff may be able to connect you with the right professionals.
Cost Considerations: Traditional in-person therapy can be costly, but there are more budget-friendly options available. Explore online therapy platforms that offer specialized care without the need for physical travel. Concussion Alliance has recommendations on how to find online therapy laid out on the Cognitive Behavioral Therapy page that will work for any type of therapy!
Be Cautious: If you’re unsure about anyone’s recommendations, or you feel like you’re not getting the proper treatment for your symptoms, you can always use Concussion Alliance’s resources for up-to-date information.
Finding the right healthcare professionals can make a big difference in your recovery. Take your time to research and connect with experts who understand concussions and can provide you with the best care possible. Your well-being is a top priority, so don't hesitate to seek the help you need! Remember, you're unique, and so is your recovery journey.
Support from Friends and Peers
Recovering from a concussion can be challenging, and knowing that you don't have to go through it alone is essential. Social support from friends and peers plays a vital role in your recovery journey and mental well-being. Let's explore how others’ understanding and encouragement can make a difference.
Social and Peer Support
Having friends and peers who have your back can make a world of difference in your recovery. When your friends and classmates support you emotionally and practically, it can help you cope with challenges and make you feel like you belong, even during the healing process.
Understanding Peers: You're Not Alone
Your peers can be total rock stars, especially when they understand what you're going through. Peers who "get" your situation can make you feel better and help you adjust after a concussion. Whether they've had a similar experience or simply care about and make space to hear you, their friendship can make you feel less alone during this challenging time.
Navigating Extracurricular Demands
High school life often comes with extracurricular pressures and expectations, which can become even more challenging after a concussion. During your recovery, peer support becomes essential in helping you manage these demands. Peer encouragement contributes to recovery, reducing stress, and promoting a positive mindset. You may need to step back from the activities and sports you love. Surrounding yourself with friends and teammates who understand your limitations and support your well-being can make a tremendous difference in your ability to navigate social activities during your healing journey.
Remember, it's totally okay to lean on your friends and peers for support. Reach out to those who show understanding and empathy, and don't hesitate to share your experiences. A strong support network can help you overcome challenges, handle emotions, and feel like you belong during your concussion recovery. You've got fantastic people around you, so let them be there for you every step of the way!
Support from Parents or Gaurdians
Recovering from a concussion is tough, but having your parents or guardians on your side can make a big difference. They care about you and want to help! Here's why their understanding and support matter:
Your Parents Got Your Back!
Did you know that research shows having your parents involved in your recovery after a concussion can be super helpful? They can help you cope with those concussion symptoms and create a supportive environment for you to heal.
Parents May Get Stressed Too
Your parents might feel stressed during your recovery, but it's essential to talk about it. Addressing their stress is vital for your concussion care. Research has shown that parental stress prolongs recovery time. Open conversations about your feelings can help them understand your needs better.
Let's Talk About It
Mental health is crucial, so let's talk! There are strategies to discuss mental health issues related to concussions with your parents or guardians. Sharing your feelings and progress can lead to better support from them.
Choose the Right Time: Find a calm and comfortable time to talk with your parents. Avoid bringing up the topic when they are more busy or stressed than usual.
Be Honest and Open: Share your feelings and emotions honestly. Let them know how the concussion is affecting you mentally and emotionally. It might help you to plan out and practice what you’re going to say, as these emotionally difficult conversations can make it harder to think in the moment.
Educate Them: Sometimes, parents may not fully understand the impact of concussions on mental health. Share information about concussions and their effects on mental well-being. You can even show them articles or resources from reliable sources like Concussion Alliance to help them understand better.
Explain Your Needs: Let your parents know what kind of support you need during your recovery. It could be things like more rest, time to talk, or seeking professional help like therapy.
Listen to Their Perspective: Be open to hearing their thoughts and concerns too. Remember, they care about you and might have their own worries.
Seek a Neutral Mediator: If you find it challenging to talk directly, consider involving a school counselor, teacher, or another trusted adult as a neutral mediator to facilitate the conversation. Neutral mediators can also be helpful if your parents don't seem to be understanding what you are trying to say!
Give It Time: Sometimes, parents need time to process the information and adjust their approach. Be patient, and continue to communicate with them.
Remember, your mental health matters, and talking to your parents about it is essential for your well-being. By being honest and open, you can create a supportive environment that can lead to better understanding and support from them. Don't hesitate to share your feelings and concerns; you deserve the best support during your concussion recovery journey
Need Extra Support?
Sometimes, you might want therapy or extra help, but your parents might not fully understand. It's okay! Studies show that other high school students face similar challenges, but there are ways to seek help, like talking to a school counselor or a trusted adult.
Remember, your parents care about you, even if they don't always get it right. Talking openly and sharing your feelings can make your recovery journey smoother. You don't have to go through this alone—your parents are there to support you every step of the way!
Journeys Unmasked: Personal Stories of Mental Health After Concussion
The videos below showcase various personal stories of individuals discussing their experiences with mental health and concussions. Please note that concussion recovery strategies have been updated since some of these individuals received their injuries, and you should still follow the guidelines we’ve outlined above.
Colin, soccer
Alex, bike crash
Hannah, basketball
Kaia, soccer
Conor, soccer
Maya, dance
Rachel, sailing
For Parents/Guardians: Tailored Information for Supporting Your Loved One's Concussion Recovery
As a parent or guardian, your support is crucial in helping your loved one recover from a concussion. Concussion Alliance offers tailored information designed just for you!
Check out these valuable resources to better understand concussions and how you can be a rock-solid pillar of support.
We understand how important it is for you to have the correct information and guidance during this time. These resources can equip you with the knowledge and tools to provide the best possible support for your loved one's concussion recovery. Together, we can help them heal and return to their awesome selves!
Related Blog Posts
A recent study in the Journal of Athletic Training explored the role of mental health in predicting lower extremity musculoskeletal injuries (LE MSK) after sports-related concussions in NCAA student-athletes. Previous research has found that the rate of LE MSK is elevated post-concussion, although the cause of this increased rate is unknown. In addition, poorer mental health is common post-concussion.