Two Takes on Depression

Treating the very condition you live with––A clinician's dual perspective

Suicide in the NFL

What we can learn from the Junior Seau tragedy.

The suicide of NFL linebacker Junior Seau raises the already great concern of traumatic brain injury that shadows many athletes in the National Football League. Brain autopsy research on Chronic Traumatic Encephalopathy (CTE)—a progressive neurodegeneration of the brain—shows that more than 20 NFL players who died-by-suicide had this brain trauma. Seau’s death is an alert to those in the NFL and to every single parent that has a child playing any form of contact sports.

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According to the Boston University's Center for the Study of Traumatic Encephalopathy, CTE, also known as “Punch Drunk Syndrome,” was first recognized in the 1920’s, primarily afflicting boxers. CTE has been trending in the news since 2007 due to  several NFL players donating their brain to science after dying-by-suicide. Studies confirmed these players had CTE degeneration of brain tissue, including the build-up of a protein called tau, which destroys brain connectivity.

CTE is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, dementia. Originally thought to occur as a result of mistreated or cumulative concussions, research on CTE is showing how just one concussive blow, and below concussive-level hits, can cause tau buildup leading to CTE. 

The trauma of CTE effects brain structures responsible for mood regulation, thought, and impulse control. Suicide research indicates that poor impulse control, corrosive negative thinking and hopelessness are THE MOST significant risk factors for death-by-suicide. It is important to note that CTE involves this lethal triad. Speculation that Seau shot himself in the chest follows the behaviors of recent NFL players who died-by-suicide...not inflicting damage in the brain area so that it can be studied post-mortem.

TIPS:

* Just as with individuals who’ve experienced psychic trauma, athletes need to be monitored emotionally and physically during their tenure as players and after their retirement.

* CTE is relegated NOT only to professional football, but to all levels of competitive and community sports, for children and adults. CTE may also be prominent in individuals serving in the armed forces, as well as any child or adult who has sustained an injury in an accident.

 * Greater education about physical contact and resulting brain trauma needs to be implemented, with a significant focus on behavioral and mood changes.

* Preemptive instruction for coaches, players, staff, and parents of the kinds of cues to look for before a suicide attempt is made can save lives.

* Medical personnel (doctors, nurses, EMTs, radiologists, etc.) need to be educated to look for “below concussive limit” symptoms to protect against suicidal thinking.

* Media should take this issue far and wide in a responsible format, making sure to report CTE and suicide facts without sensationalism. Research shows that the more realistic suicide issues are reported, the less copy-cat contagion occurs. 

Every 40 seconds someone dies by suicide. Every 41 seconds someone is left to make sense of it. Let's lower these statistics with knowledge, prevention and intervention.

 

References

DeKosky, S.T.; Ikonomovic, M.D. & Gandy, S. (2011) Traumatic brain injury—football, warfare, and long-term effects. New England journal of Medicine, 363(14): 1293–1296.

Omalu,  B.; Bailes, J. & Hamilton, R. L. (2011). Emerging histomorphologic phenotypes of chronic traumatic encephalopathy in american athletes,” Neurosurgery, 69 (1):173–183.

 

Dr. Deborah Serani is the author of Living with Depression by Rowman and Littlefield.

 

 

Deborah Serani, Psy.D., is a psychologist and psychoanalyst who lives with depression and specializes in its diagnosis and treatment.

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