How Concussions Really Impact Mental Health
Olympic Cyclist Kelly Catlin's suicide is drawing attention to brain injuries and their ties to mental health.
At just 23 years old, Kelly Catlin was an Olympic silver medal cyclist and a graduate student at Stanford University, spoke fluent Chinese, was a mathematician and musician, and had dreams of becoming a data scientist.
Those who knew her well believed she was going place-which is why it came as a huge shock when she took her own life last week.
The Head Injury That Changed Everything
Being a professional athlete at a young age isn't easy, and Catlin had often opened up about struggling to balance school and her career.
"It's most difficult when you have to retake a three-hour final exam the moment you step out of the final round of a team pursuit... and things still slip through the cracks," she wrote in an article for VeloNews in February. "Most of the time, I don't make everything work. It's like juggling with knives, but I really am dropping a lot of them. It's just that most of them hit the floor and not me."
But things didn't take a turn for the worse until she got into a series of crashes while cycling last year.
In October, she broke her arm. In December, she suffered from a concussion after slipping and hitting her head while biking on a slick road. (Related: My Neck Injury Was the Self-Care Wake-Up Call I Didn't Know I Needed)
Initially, Catlin didn't realize she had a concussion. She went about life as normal, but her parents noticed a change in her. Her attitude changed drastically and she began complaining about vision problems and severe headaches, and she struggled to complete workouts with her team.
"We didn't know about the racing thoughts and the obsessing over different things and the nightmares," her sister Christine told NPR. "We only knew about the headaches."
The Suicide Attempts
In January of 2019, Catlin tried taking her life for the first time. The suicide attempt left her with lung and heart issues, forcing her to withdraw from the 2019 Track Cycling World Championships.
But Catlin was angry and frustrated. "She told me she hated failing the suicide attempt," said her brother Colin. (Related: Finding Fitness Brought Me Back from the Brink of Suicide)
Yet, just a couple of months later, she did commit suicide and died from asphyxiation. Catlin's family still couldn't believe it. "She promised us she wasn't going to kill herself," her father told NPR. "Waves of despair [came] over us."
Can Concussions Impact Mental Health?
Given everything Catlin had accomplished at her age, it's no secret that she was under a lot of pressure, which could have, in part, played a role in her decision to end her life. But her abrupt change in personality and behavior following her concussion has sparked debates on how traumatic brain injuries can affect mental health.
Studies show that experiencing a concussion can increase a person's risk of suicide twofold. Not to mention, elite athletes are already at a higher risk for anxiety and depression-both of which are risk factors for suicide. (Last year, Michael Phelps Opened Up About His Battle with Depression and Suicidal Thoughts)
"Your brain, in a sense, controls everything you do and feel," says David Kruse, M.D., a sports medicine and concussion specialist at Hoag Orthopedic Institute and USA Gymnastics Team Physician. "A brain injury such as a sports concussion has the potential to impact any aspect of your brain function. There are common deficits, such as visual sensitivities or sleep disturbance, but this can also lead to alterations in personality, mental status, mood, and/or behavior."
What's more, the damage a concussion causes to your brain has the potential to unmask or exacerbate brain conditions that are pre-existing, says Dr. Kruse.
He uses a hypothetical to explain exactly what that means:
"An athlete may have no personal history of anxiety or depression but may have a family member who struggles with the condition," explains Dr. Kruse. "We know that mental disorders can be genetic, so that athlete is already susceptible to developing anxiety or depression. If this athlete sustained a concussion, he or she would be more predisposed to developing anxiety or depression as a symptom compared to another athlete who has no family history of the condition."
It's not known whether mental health issues are present in Catlin's family, but it could explain the rapid devolvement of symptoms following her concussion, says Dr. Kruse. (Related: I'm Done Keeping Quiet About Suicide)
"This, of course, can be a complex matter," adds Dr. Kruse. "There are many layers to the development of symptoms such as these and it is hard to know in retrospect the role a concussion may play on a case-to-case basis."
What We Can Do Moving Forward
Following her death, Catlin's family donated her brain to research. They hope it will help determine how a concussion resulted in the mental and behavioral changes that they believe ultimately led to their daughter's death.
While additional research can help, Dr. Kruse says more awareness is crucial too: "Most people don't realize that concussions are traumatic brain injuries," he says. "Some concussions are easily recognized, but some can be subtle and pervasive, so it's important to educate people on how concussions can present and how they can affect all aspects of brain function." (Read: What Everyone Needs to Know About the Rising U.S. Suicide Rates)
Athletes, in particular, need to take brain injuries more seriously. "Athletes can be exceptionally driven and focused, which of course can lead to great success in their sport. But it can also result in the masking and downplaying of symptoms since they are motivated to return to their sport or team quickly," says Kruse. "If an athlete returns to their sport prematurely, before appropriate recovery has occurred, symptoms and deficits can be prolonged and exacerbated, which can result in a complicated concussion course."
If you're struggling with thoughts of suicide or have felt deeply distressed for a period of time, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) to speak with someone who will provide free and confidential support 24 hours a day, seven days a week.