Understanding the overlap of symptoms means physicians must be skilled at eliciting patient history to get a full understanding of factors that might complicate recovery.
“Often in this age range, issues like migraines, depression and anxiety have not yet been diagnosed,” said Dr. Neidecker. “So, if I ask a patient whether they have one of these conditions, they’re likely to say ‘No’. But when I ask about their experiences, I get a much clearer picture.”
Dr. Neidecker gives an example of a patient with no history of migraines who admitted experiencing weekly headaches prior to the head injury. She thought the headaches were normal, but in fact the patient was suffering from migraines.
He uses a similar approach to uncovering anxiety, mental stress and depression, and says diagnosis is tricky because adolescence is inherently emotional and stressful. To better understand the patient, he recommends asking young athletes whether they are hard on themselves or feel bad about not performing their best.
Patients with Type A personality traits typically have a baseline level of stress about the need to perform and become more stressed when they cannot, Dr. Neidecker explained. Losing the physical outlet of sport for managing their stress compounds the issue during the recovery period.
“It can really become a vicious cycle for some of these kids,” said Dr. Neidecker. “Uncovering and addressing any underlying conditions gets them back on the field faster and ultimately helps them be healthier and happier in the future.”