Posted by: jedwardswright | September 13, 2011

Brain Injuries and Suicide

With the recent deaths of NHL enforcers Rick Rypien and Wade Belak by suicide, many questions have been raised about the relationship between traumatic brain injury (TBI), depression and suicide. Are people who have experienced a TBI at greater risk for suicidal thoughts? What about individuals who have had concussions, which are a less severe form of brain injury?

Traumatic Brain Injuries and Depression

There has been extensive research showing that people with TBI are at greater risk for psychiatric disorders.[i] While the injury itself may be largely to blame, there can be other side effects that contribute to feelings of depression.

The TBI itself can lead to cognitive difficulties, poor impulse control, difficulties making decisions, poor judgment and mood swings. In addition, the effects of the TBI can lead to other stressors such as job loss, reduced income, changes in family dynamics and difficulties in functioning and relating as a parent and spouse.[ii]

Given these issues, it is not surprising that many TBI survivors report feelings of hopelessness, worthlessness and the inability to enjoy formerly pleasurable activities.[iii] All of these are characteristics of depression.

Traumatic Brian Injuries and Suicide

People who have experienced severe brain injuries are four times more likely to commit suicide than the general public.[iv] This shocking statistic lends credibility to the belief that Rypien and Belak, who regularly sustained (as well as delivered) serious blows to the head, may have suffered from TBI-related depression which then led to their deaths.

In fact, survivors of TBI are at increased risk of developing chronic thoughts of suicide many, many years after the original injury, so as well as initial screening for depression and thoughts of self-harm, long-term follow-up needs to be in place.[v]

Concussion and Suicide

Surprisingly, even people who have sustained milder brain injuries, commonly referred to as concussions, are also at greater risk of committing suicide. It is possible to argue that this group are more likely to show other symptoms of depression such as substance abuse, psychiatric problems or aggressive behavior, but at this point that is only speculation.[vi]

What can be done?

As numerous articles and debates have suggested, it is time to reconsider the rules of contact sports, the stress that is placed on athletes in these games and the after-care for players who have sustained head injuries. There needs to be greater awareness of the post-injury dangers of TBI (and concussion) so that individuals suffering from depression and suicidal thoughts can be identified and helped.

There have been many advances in safety to protect against TBI. We now wear bike helmets and have airbags in our cars, and hopefully future innovations will continue to improve the chance of preventing or minimizing severe brain injuries.  As we become more aware, we become better prepared.

 

 

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