The Connection Between Concussions and Suicide

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

The topic of mild traumatic brain injury and/or concussion has been in the news for several years. The release of a major motion picture, a concussion sustained by a professional sports star, or the passage of a law tends to rekindle interest in the topic. Recently, another issue was linked to concussion — the concern of suicide. But, I am optimistic. Why? By nature, I’m an optimist, but I’m also hopeful that parents, community leaders and politicians will pay attention to the epidemic of suicide in our country.

When I worked in the U.S. Navy, one of my careers was serving as their Suicide Prevention Program Coordinator. Every death by suicide crossed my desk. The number of Marines and Sailors who attempted and completed suicide staggered me.

In our country, the number of people — servicemembers or civilian — who die by suicide is almost too much to comprehend. Compared to 16,000 homicides each year in the U.S., the number of suicides is nearly double that at almost 32,000 a year, most due to untreated depression of some form.

Let’s put those numbers in another perspective: In the last decade of our troops fighting in Afghanistan and Iraq, just over 7,000 Americans have made the ultimate sacrifice and almost 50,000 have been wounded. During that same time, more than 300,000 have died by suicide and more than 50,000 have been children between the ages of 14 and 24. The number of suicide attempts is in the millions.

Researchers are also finding out that some of the consequences of concussion are linked to depression and suicide. Untreated brain injuries can lead to devastating consequences.

My optimism lies in the hope that coaches, parents, athletes, and community leaders understand that the physiology of a concussion caused by a blow to the head or body prompts the neurons to function ineffectively due to a disruption of their normal chemical process.

I’m optimistic that these same parents, coaches, athletes, and community leaders will make the connection that the neurological process of a concussion is to depression. That these neurons which govern our emotions and self-esteem for a variety of different reasons — the death of a loved one, loss of a job, bankruptcy, medical conditions — can lead to a disruption of the neurons and cause depression leading to suicide.

I’m optimistic that the people who form every individual’s support system, from parents and teachers to friends and fellow athletes, will ACT if something seems amiss:
A — ask an individual if he or she is thinking about suicide
C — let him or her know you care about them
T — get the individual to treatment with someone who specializes in suicide evaluations: a counselor, pastor or chaplain, family doctor or pediatrician, psychologist, or psychiatrist or local emergency room

Concussion-Suicide-Risk-March-2016-900x900I’m optimistic that people will realize that depression can be considered the “common cold” of psychiatric conditions and has a variety of effective treatment options.

I’m optimistic that people will pass on the suicide prevention hotline number and website to those in crisis: 1-800-273-TALK and www.suicidepreventionlifeline.org.

And finally, I’m optimistic that people will pass this blog and information onto at least FIVE other people and in doing so, might just save a life.

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Honoring Brain Injury Awareness Month

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Since HeadFirst Sports Injury and Concussion Care launched just three years ago, we’ve already seen the tide turn about the public’s understanding of concussion (mild Traumatic Brain Injury or mTBI). We’ve gone from hearing “It’s a only a mild concussion,” and “You just got your bell rung a bit,” to an acknowledgment of the severity of this silent injury.

Locally here in the Capital region, HeadFirst has been extremely active in hosting educational seminars for coaches and parents, and participating in dozens of community outreach programs.

In 2014 alone, HeadFirst’s team of professionals participated in more than 80 community events reaching more than 180,000 people. These events included partnerships and sponsorships with the Brain Injury Association of Maryland, Hockey for Heroes (benefitting the Wounded Warrior Project, USA Warriors Ice Hockey Program and Disable Veterans of America), Sports Legacy Institute, Touchdown Club of Annapolis, as well as educational seminars for school and county recreational coaches and athletic directors, presentations for school nurses on concussions and mental health, and attendance at community health fairs.

These groups have welcomed our educators with open arms to help their coaches and athletic trainers understand the right protocol in managing a suspected head injury, from those critical first moments to long-term treatment for proper healing.

Our outreach programs are one of our cornerstones, we’d like to think they’ve helped change the traditional way of thinking about concussions.

HeadFirst is also a gathering point for professionals from around the region to share their expertise. Our monthly Concussion Consortium pulls together physicians, neurologists, neuropsychologists, physical and vision therapists, and other specialists, school administrators and nurses, athletic trainers and coaches, who discuss scientific research and resources for concussion treatment and protocols.

The Consortium often hosts a respected guest speaker who shares information about specific topics and issues related to concussion. Next week, we’re welcoming Sarah Loeffler, LCSW-C, of The Neuropsychiatry Program at Sheppard Pratt Health System in Baltimore, Md., who will discuss mTBI’s connection to anxiety and depression.

Also next week, HeadFirst Chief Executive Officer Robert G. Graw, Jr., M.D., and HeadFirst Program Director Tony Doran, Psy.D., are presenting their lecture, An Integrated Community Model for Concussion: Update, at the Brain Injury Association of Maryland’s annual conference.

Of course, all of this is in addition to our 11 clinics throughout the DC-Baltimore region, which is our reason for existence. From the thousands of neurocognitive ImPACT® tests we’ve administered to the patients for whom we have cared, we’ve heard amazing, heartfelt stories of the trials of living with a concussion and the willpower to overcome it. These serve as our inspiration to push ever forward.

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We continue to read emotional articles in the news about concussion awareness, including yesterday’s announcement of San Francisco 49er linebacker Chris Borland’s decision to retire due to the high potential of long-term brain injury from playing. Turning away from a lucrative career in the name of your health surely must be one of the most incredibly difficult decisions to make, and we applaud this young man for having the guts to make this choice.

HeadFirst Sports Injury and Concussion Care is proud to honor March’s designation as Brain Injury Awareness Month, as well as Brain Injury Awareness Day today, March 18. Looking back, it’s been a fulfilling journey, albeit a short one. The starting line is still in our sights and we know the finish line is a long way off—and very likely will continue to move even as we do.

Concussions can and do happen to anyone, anytime, anywhere. The non-discriminatory nature of this injury is what continues to motivate us to do our work.

Brain Injury Awareness Month is Winding Down

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Brain Injury Awareness Month is drawing to a close. I hope that you have taken the time to look at a few websites, read a journal article or attend a talk or two to learn more about concussions and mild traumatic brain injuries. The Brain Injury Association of Maryland’s conference last week was a tremendous success. Attendees told me about some exceptional presentations: Brianna Scurry’s personal story of recovery, Dr. Jeff Barth’s research data on concussion as people age, HeadFirst’s own Dr. Robert Graw’s presentation on a community-based concussion clinic and Dr. Kevin Crutchfield’s talk on cervical injuries.

Sadly, we are reminded all too often that brain injuries can affect anyone, at any time, even those close to home. Close to us here in Maryland are two midshipman from the U.S. Naval Academy who have been affected. Please keep in your thoughts and prayers MIDN William McKamey, a Naval Academy football player suffered a neurological event while at practice three days ago and succumbed to his injuries at University of Maryland R. Adams Cowley Shock Trauma Center in Baltimore on Tuesday, March 25th. Also please keep in your thoughts MIDN Hans Loewen, who sustained a severe brain injury while skateboarding and is being treated at the same medical center. We pray for the McKamey and Loewen families, the Naval Academy football coaches and team, and their Naval Academy Family.

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March is Brain Injury Awareness Month

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

In the past several years, few medical problems have generated as much public interest as sports-related concussions. Coaches, parents, and players are increasingly aware that a concussion involves an injury to the brain and that an athlete suspected of having a concussion should be removed from play and evaluated by a licensed health care professional. I’d like to share a little bit about myself and how I became interested in the area of mild traumatic brain injury (mTBI).

My name is Dr. Tony Doran. I was a clinical psychologist for the Navy for the past 20 years. The Navy sent me to Harvard Medical School and I specialized in pediatric neuropsychology. Over the course of my career, I have worked in a variety of diverse positions at Portsmouth Naval Hospital, Iwakuni Medical Clinic Japan, and the United States Naval Academy. I have treated kids and adults with everything from adjustment reactions and craniosynostosis to mTBI and PTSD (post-traumatic stress disorder).

As my time in the military was winding down, I began to explore where my next adventure would take me and I naturally gravitated to conducting evaluations for Special Forces Units throughout the United States. After more than 10 years of war, I have treated and evaluated hundreds of service men and women who were dealing with the wounds of war coping with PTSD and mTBI. As the war was coming to a close, I began to look at what other avenues I could explore. My contracting position of evaluating Special Forces Units involved a lot of travel away from my family, which initially was exciting and interesting, but after 3 years was beginning to wear on myself and my family. So I began to look for a permanent position.

Having been a consultant, I had performed some services for a new company in the area of concussion care called HeadFirst. HeadFirst was evaluating and treating hundreds of kids with mTBI and a substantial percentage of these kids had some special needs – autism, learning disabilities, attention problems or other psychological problem. My experience and training in mTBI and childhood disorders would help me treat and evaluate these children. HeadFirst was looking for someone to evaluate the enormous amount of data they were beginning to collect and also help them branch off and start new research projects. My years of data analysis and research in the Navy would assist me in this area. Several weeks later, I was hired as the Program Director of HeadFirst. I look forward to educating parents, children and coaches in the area about mTBI, treating children and teens with mTBI, and conducting research in the area of mTBI.

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I was at a meeting the other night with several health care providers and asked them to please share a story about what a concussed child or family member had asked them about after brain rest had been explained to them. As we went around the room, kids and family members asked about playing the drums, going snowboarding, playing football with dad in the yard, sleigh riding, mountain climbing, just shooting baskets or just swinging in a batting cage. Answers like theirs beg the question: Are our kids, families, and coaches getting the message about the seriousness of mTBI?

Pardon the Navy analogy, but sometimes big ships take a while to turn. I am encouraged when I hear teens make comments like “Hey, that kid has to stay out of competition for at least 7 to 10 days” after witnessing a concussion and a parent discussing with a child that she might need to permanently switch to a different sport – like track or swimming – after her fourth concussion in soccer. However, when I still get questions like “Can I go ride my go cart?” after explaining brain rest, I am reminded that we, as providers, educators and researchers, have more work to do.

If you are interested in joining the concussion discussion, please visit this blog as we will be having different providers, coaches, parents and recovering patients contribute. Also please see our website for community events.

The Brain Injury Association of Maryland is having their annual conference March 20th-21st – please see their website to find out more and I hope to see you there.