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CRM: Tx: Emotional SxS
Concussion Recognition & Management
Module 6 Delayed Recovery

Tx: Emotional SxS


young woman sadly leaning head on knee

Anxiety (whether due to pre-morbidity, family history, or injury) is a typical emotional symptom mTBI patients experience. Those suffering from anxiety disorder are prone to over-attend and over-attribute their symptoms. Anxiety magnifies their symptoms. Patients with a predilection for stress may be hyper-vigilant, researching their conditions online and heightening their anxiety with self-diagnosis that can become self-fulfilling prophesies. Some become nervous about testing and fail due to nervousness rather than actual symptoms.

Emotional adjustment will involve helping the young person reintegrate into the school environment. Reintegration requires finding appropriate accommodations for all areas of life at school.


Tx surrounded by emotional faces

Treatment
for
Emotional Symptoms



Select each tab below for more information.

Reintegration

Missing even two weeks of school has significant consequences.

Reintegration will take place in the athletic realm when the young person returns to the team. As in the classroom, social dynamics will play a part in the sports setting. The player who sits out with an mTBI is sometimes bullied or mocked as a "wimp". To ease adjustment, it can be helpful for the young person to spend time just being with the team before actually returning to play. Be aware of over-stimulation.

If ancillary therapy is available in the school, the team can incorporate it into the adjustment plan, if appropriate. Reintegration into the school environment is essential to successful recovery. An educational or work re-entry specialist can aid in this reintegration.
sitting on sidelines of football game

Issues

young woman anxious in car with hands over face
Common adjustment issues include:
  • Maladaptive pain coping responses (e.g. activity avoidance due to fear of re-injury).

  • Situational discouragement or depression.

  • Return to Activity anxieties and fears.

  • Normal human emotional reactions that accompany temporary disability, which must be handled appropriately to prevent the emotional response(s) from becoming permanent.

  • Fear of driving.

Impact

Sometimes patients with concussion can develop diagnosable mental health conditions that require a comprehensive treatment approach, such as counseling with medication. These can be full-blown problems or lower level issues. The point is, these emotional problems are real and need to be addressed. For example, being depressed about not being able to play is not the equivalent of clinical depression, but it still can affect recovery.
young woman with sympathetic counselor

Context

young woman in class with question marks above her
It’s essential to consider these problems in the context of everything else happening in the patient’s life. All are interwoven. The treatment team should look for symptoms of emotional problems that can exacerbate concussion symptoms. Some issues are higher level and must be treated first. Ignoring these symptoms may result in lack of treatment success.

Responses

It may help to describe to your patient what you are going to treat. Patients may respond more readily if they are told they are being treated for anxiety due to concussion complications, rather than for high level mood disorder. The concussion may be causing or compounding emotional issues.

In either case, it’s not enough to address these symptoms medically. As you would when treating full-blown mood and anxiety disorders, you should offer a combination of behavioral and medical treatments and referral to specialists, such as psychiatrists.
hopeful young man with counselor



Conclusion

With the help of a treatment team including diverse medical professionals, an ever-expanding array of diagnostic and treatment resources, and a recovery team including the patient and his or her support system, the licensed health care professional can guide the young person to the best possible outcomes following mild traumatic brain injury. To remain well-equipped for treating young concussion sufferers, you are encouraged to return to this site for updated resources and information regarding best practices.
3 medical personnel looking at computer
Module 6 Delayed Recovery

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