Sports Therapy Lambourn

Traumatic brain injuries and the link to depression – focus on the source not the symptoms?

Have you or someone close to you ever suffered a head injury? The effects of even mild concussions can have lasting effects, sometimes more so when you think you’ve fully recovered.

On the 23rd of June Grand National winning jockey Liam Treadwell took his own life. He was the second jockey in as many months to do so. His last post on social media, read, ‘Simpler and happier times in life’. It referenced a photo posted four years previous of him enjoying a beer in Barbados. The photo had him leaning against six crates of beer. I thought it poignant that the crates be labelled ‘Banks’, the surname of Liam’s weighing room colleague, James who died in February under similar circumstances.

Liam had suffered a severe head trauma in 2016 in a fall at Bangor leaving him unconscious for four minutes. The rehabilitation process continued for six months and he was left with a number of side effects. Remarkably he continued his career as a jockey but retired in 2018 after a marital breakdown and other difficulties. Unable to shake his love for riding he took out his licence again in 2019 and rode successfully until Lockdown halted racing in March 2020.

Around 50% of people suffering traumatic brain injuries are affected by depression within a year post injury. This rises to nearly two thirds within the first seven years*. Changes in neurotransmitter levels and damage to emotion centres in the brain can cause the change. And yet we still perceive depression as being a disease of the mind. An area of our being that can’t quite be reached, seen, measured or corrected. An overwhelming prospect to face for sure.

The impact of brain trauma can be physical, life changing and dramatic. Alternatively it can subtly entwine into the existing personality of an individual until the wearer is no longer recognised as their original self. Symptoms take over the life and the life becomes the symptoms as we lose sight of the root cause and the person.

People will say that Liam was depressed and that led to his suicide. I would argue that perhaps his death ultimately was simply due to his head injury. Perhaps we need to recognise and focus on the root cause instead of waiting for the symptoms to engulf the person. This will undoubtedly lead to more prompt supervision of individuals.  

The racing industry is increasingly encouraging jockeys to ‘reach out’ to get help if they are feeling depressed or suicidal. I feel that many will fall through the cracks if this is their principal tactic. Jockeys are tough and face potentially life threatening situations daily. They innately control fearful situations by concealing emotions. Furthermore being a jockey allows them to practice this art until it is not just habitual but ingrained. So you’re dealing with individuals who are profoundly set up to supress emotions. They are literally experts.

Waiting for some jockeys to ‘reach out’ would be like waiting for Trump to lead like Obama. It’s just not going to happen. If you were to remove the onus to step forward away from the jockey and replaced it with compulsory mental health screening for all you’d surely have a better chance of detecting and monitoring those in need. Psychological screening, blood tests and brain scanning are all potential methods for detecting mental health issues.

www.mind.org.uk and www.headway.org.uk are organisations that can help with mental health issues.

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* Fann, J.R., Hart, T., Schomer, KG. Treatment for Depression after Traumatic Brain Injury: A Systematic Review. Journal of Neurotrauma 26:2383-2402, 2009. Cited in http://www.msktc.org

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