The Latest on Head Injury, Depression and Suicide

(Editor’s note: What follows is a brief excerpt of a piece written by Dr. David M. Reiss, an expert on concussions and frequent contributor to Concussion Litigation Reporter)

It has long been recognized that there is a relationship between head injury, particularly repetitive head injury, and depression and suicide. Common sense, clinical experience and statistical studies have borne out the correlation. However, the specific mechanisms by which head trauma leads to suicidal behavior is complex and controversial. Dating back to a study reported in 2001, it was shown that persons who suffered “mild traumatic brain injury” — what we now generally call CTE, “chronic traumatic encephalopathy”, had an increased risk of suicide, both acutely and over their lifetime.[1] However, even that study found that the probable specific causative factors were complex and inter-related, “The increased risk of suicide among patients who had a mild traumatic brain injury may result from concomitant risk factors such as psychiatric conditions and psychosocial disadvantage. The greater risk among the more serious cases implicates additionally the physical, psychological, and social consequences of the injuries as directly contributing to the suicides.”

More recent statistics, taking into account significant increases in understanding of the neurological pathology that is involved, confirm the relationship between repetitive head trauma and significant psychiatric illness, including suicide — such studies published in 2013.[2]

There is evidence that the damage to the brain that occurs with CTE directly affects the control of emotions and behavior and directly increases the risk of severe depression and suicidal behavior (self-destructive attempts and completed suicides). At the same time, there is a complex vicious cycle or “positive feedback loop” (“positive” in the engineering sense of self-reinforcing) by which the impact of CTE upon a person’s self-image, self-esteem and life circumstances also contribute to these worrisome statistics, beyond the direct neuropsychological pathway to depression.

(Dr. Reiss goes on to highlight a host of secondary factors that come into play. To see the full story, please subscribe to Concussion Litigation Reporter)

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