The One Question Psychiatrists Don’t Ask…But Should

If you go to a psychiatrist for anxiety, depression, attention problems, anger issues, or another “mental illness,” you’re likely to be asked a number of questions about your symptoms, your feelings, and your family history.

But there’s one question most psychiatrists—and other healthcare professionals—never ask but should:

“Have you ever had a head injury?”

Why is this question so important? In years past, experts believed that mild head injuries were innocuous. However, emerging research confirms that mild head trauma—even if you don’t black out or aren’t diagnosed with a concussion—can impact brain function and lead to serious neuropsychological issues.

In this blog, you’ll learn how common head injuries are, how concussions and mild traumatic brain injuries impact mental health, why it’s common to forget about a past head injury, and how to heal the brain to help your mental wellness.

HOW COMMON ARE CONCUSSIONS?

According to statistics, about 1.7 million Americans are diagnosed with a traumatic brain injury (TBI) annually. Some 80% of them are categorized as mild traumatic brain injuries (mTBI) or concussions.

Millions more head injuries go unreported because the person doesn’t think the injury is severe enough to seek treatment.

Head injuries are common among patients at Amen Clinics, which has treated over 100,000 people over the past 30-plus years. In fact, its database of more than 250,000 brain SPECT scans shows that 40% of patients have experienced a significant brain injury before visiting one of the nationwide clinics.

COMMON CAUSES OF CONCUSSIONS

What are the most common causes of head injuries?

• Falls—falling out of bed, slipping in the bath or shower, falling down steps, or falling off ladders
• Motor vehicle-related collisions—accidents involving cars, motorcycles or bicycles, or pedestrians
• Violence—caused by gunshot wounds, assaults, domestic violence, or child abuse
• Sports injuries—football, soccer, boxing, baseball, lacrosse, skateboarding, hockey, cycling, basketball, skiing, and other high-impact or extreme sports
• Explosive blasts and other combat injuries

Note that sports injuries also include repetitive sub-concussive impacts to the head. These are mild impacts that don’t cause any immediate symptoms—no headache, no seeing stars, no feeling like you got your bell rung.

Think of a soccer player who repeatedly heads the ball or a football player who gets tackled several times per game. Research shows that these repeated head impacts can harm the brain and lead to problems later in life. 

THE LINK BETWEEN HEAD INJURIES AND MENTAL ILLNESS

Did you know that head trauma is a major cause of mental health problems? If not, you aren’t the only one. In fact, very few people—including psychiatrists—know it.

This is because most mental health professionals never look at the brains of their patients. And this is a major oversight.

A growing body of scientific research shows that concussions and other types of traumatic brain injuries (TBIs) increase the risk of:

• Clinical depression
• Anxiety disorders and panic attack
• ADD/ADHD
• Psychosis
• Post-traumatic stress disorder (PTSD)
• Suicide
• Drug and alcohol abuse
• Borderline and antisocial personality disorders
• Alzheimer’s disease and other types of dementia
• Aggression

In some cases, mental health issues and cognitive problems occur soon after a head injury. In other instances, mental health symptoms don’t appear until months or even years after the incident.

Because of this, many people don’t make the connection between the head impact and their emotional symptoms, behavioral problems, or cognitive issues.

WHY PEOPLE FORGET PAST HEAD INJURIES

It’s astounding how many people forget they’ve had a significant head injury. At Amen Clinics, the mental health professionals routinely ask patients several times whether or not they have sustained any impacts to the head.

“Have you ever had a head injury?” is one of the many questions on patient intake paperwork. An historian, who gathers patients’ personal histories before they see the physician, asks them again about hurting their head. Sophisticated computer testing that patients complete asks a third time about impacts to the head.

Typically, when the patient meets with their physician, the question will come up yet again. If they respond no again, they’re generally asked if they’ve experienced any of the most common causes of head injuries, which were outlined above.

It’s surprising how many people think their head injuries were too insignificant to mention. For others, they simply do not remember the incident as amnesia is a common occurrence in head traumas.

When asked the question for the fifth time, one patient put his hand on his forehead and said, “Oh yeah! When I was 5 years old, I fell out of a second-story window.”

It’s hard to imagine forgetting such an incident, but many do. Some patients forget that they flew through a windshield in a car accident, smacked their head after slipping in the shower, or were knocked unconscious when they tumbled off their bicycle.

The vast majority of these people never realize the connection between their head injury and the signs and symptoms of mental health problems. And the traditional treatments they’re prescribed often don’t work because they don’t heal the underlying trauma to the brain.

You may be in the same situation. Anyone who is not responding to traditional treatment for major depressive disorder, anxiety attacks, or other mental health conditions should consider if a past head injury might be contributing to symptoms.

HEALING FROM POST-CONCUSSION SYNDROME

The good news is that the brain can heal, and this can help you overcome a wide range of psychological symptoms. Strategies to enhance the brain following a concussion or other head injury include:

Neurofeedback: Learning to control your brainwaves with this noninvasive treatment can reduce the symptoms of post-concussion syndrome, according to research.

• Hyperbaric oxygen therapy: HBOT utilizes pure oxygen to accelerate the healing process in the brain.
• Balance hormones: With head trauma, it’s common for the pituitary gland to get injured. This gland plays an important role in hormone production. When damaged, it can lead to imbalances in key hormones, such as thyroid, testosterone, and DHEA, which can lead to mental health symptoms. Testing your hormone levels and optimizing them if necessary can be beneficial in reducing symptoms.
• Brain scan: Getting a SPECT scan can help you see hidden brain injuries. This can also help your mental health professional develop a more personalized, effective treatment plan for your needs.
• Take nutraceuticals: Nutritional supplements that help support the brain’s healing process include a multivitamin/mineral complex, omega-3 fatty acids, gingko biloba (to support blood flow), acetyl-l-carnitine (to support mitochondrial energy), huperzine A (to support acetylcholine), N-acetyl-cysteine, alpha lipoic acid (antioxidant support), and phosphatidylserine (for nerve cell membrane support).

Implementing these strategies can help speed your recovery from a head injury, whether it happened recently or years earlier. When your brain is healthier, you’ll experience fewer mental illness symptoms and feel better overall.

Anxiety, depression, attention problems and other mental health issues related to head trauma can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.