I want to start off by amending my introduction to the topic of mental health and concussions. The two aspects that I pinpointed that impact our ability to ask for help were vulnerability and stigma; however, as I sat down to write about my mental health difficulties I realized there is a third one: talking about it can be painful.
Soccer was always my escape from the chaos of real life. When I was on the field, nothing mattered but facing the challenge at hand and enjoying myself in the process. Off of the field, I focused on the long-term goals I had for soccer to keep me from getting swept up in the drama around me. I was rigid in my focus which made life difficult at times; however, I do believe this kept me on course to achieve my goal of playing Division I soccer with an athletic scholarship.
I am going to provide some pre-concussion background because it is a part of my concussion recovery. It would be misleading to start my story when I got my concussions as we know that a history of mental health difficulties impacts concussion recovery.
As I reflect on my mental health in general, it’s clear that I always had a heightened level of anxiety. When I was young, I had a habit of throwing tantrums on the soccer field. My behavior came from a place of frustration because I knew I was not doing my job and was letting down my team. Fortunately, at the age of 10, my coach broke me of that habit quickly. He told me that I would not play if I threw fits. I started learning to brush off my mistakes and continue to be focused on the task at hand.
I seemed to be able to hone my emotions effectively on the field, but off the field I started experiencing depression and anxiety. When I was 14 or 15 my doctor prescribed my first anti-depressant, Paxil. I didn’t like how it made me feel so I stopped taking it. I tried to avoid going back to the doctor since I knew he would give me another medication. Side note: if you have never taken an antidepressant, it is a terrible idea to stop taking medication without the supervision of a physician. I remember how bad it was because we were travelling for a tournament and I somehow managed to play three days of soccer without eating much of anything. I was so sick that my mom figured it out and took me back to the doctor. He started me on Prozac which was a much better experience.
In addition to anxiety and depression, I dealt with chronic daily headaches when I was in high school (unrelated to sports). For six months I did the best I could until one day I couldn’t get out of bed to go to school. My mom took me to a neurologist who said that my headaches were a combination of migraines, tension headaches, and a rebound headache that was a result of taking too much ibuprofen. He prescribed Gabapentin and my headaches dissipated.
By the time I reached LSU for my freshman year of college, my mood and headaches were under control. I sought treatment from a therapist and discontinued all of my medication with oversight from a physician. At the end of the fall season my coach basically told me that I wasn’t the type of player he needed for the team and he did not feel I would have a chance to earn playing time. Although I was devastated to receive such feedback, I was fortunate that the University of Miami had previously made me a scholarship offer and the coach was happy to have me transfer to her program.
In the spring of 2007, after two seasons of being a nonstarter, I decided that something needed to change. My goal was to make the starting roster by becoming as fit as possible. Over the summer
of 2007, the workout manual that was given to us by our coaches became my Bible. I made more progress in my physical fitness than ever before. I returned to Miami for the fall season and passed both fitness tests. Coach asked me to start and play at left defense. Even though I had never been a defender, I took the spot without question. It was the best season of my life. We made it to the ACC and NCAA tournaments for the first time. I was feeling stronger and healthier than ever. I couldn’t wait to see what was in store for my senior season.
As we entered the spring season for 2008, my plan was to continue what I was doing and start looking for professional opportunities to continue playing soccer after I graduated in 2009. I suffered my concussions only a month or so into spring season. My recovery was a roller coaster of ups and downs. The fatigue, nystagmus, and vertigo made it challenging to go to class and practices or weight sessions to support my team. I became determined to get back into spring season as fast as possible. Unfortunately, I came back too early and lost my balance while lifting weights. Nothing big came from that incident in terms of injury, but that put me back on the bench.
My anxiety was high as I tried to follow my neurologist’s directions by staying on top of my medications (and the side effects), keeping up with my classes, resting as much as I could, and attending team events. Since my recovery took several months, the time came for a decision to be made about my fall season. My neurologist said that I could not participate in the upcoming season and it was up to me to determine if I would red shirt for a year or declare a career ending injury. After a long meeting with my coach, I decided that it was in my best interest to end my soccer career. I was devastated. It didn’t seem real. I became depressed, confused, and hopeless. In addition, my GPA fell from a 3.5 to a 2.8 as I continued to recover. Nothing was going my way and I felt out of control.
My entire life had been upended. I didn’t know how to schedule my day without practices, games, or weightlifting. What did people do to keep busy? I had no idea so I continued to attend every practice and every game with my team. I even drove to Gainesville to watch them play in the NCAA tournament. Soccer was the only thing I knew, it was how I coped, how I stayed fit, and where I was able to be myself. The soccer field was my home.
The loss of normalcy, routine, coping skills, feeling of belonging, and purpose on top of my brain injury made successful recovery appear unattainable. All of the changes in daily life seems to be the part of concussion recovery that tends to get overlooked, but for me these changes were more difficult than my concussion symptoms.
After I declared a career ending injury, I became hopeless, sad, and angry. I often wondered why this happened to me. I struggled with my emotions because while I was dealing with my injury,
one of my teammates was diagnosed with cancer. She was going through chemo with a smile on her face and I was complaining about a headache. I realize that I didn’t just have a headache, but it seemed benign compared to cancer. I started to minimize my experience, but my teammate and I had a chat about the situation. She told me that her cancer diagnosis in no way diminished the pain and loss I was experiencing. I did my best to stop comparing, but it was tough. She was supportive and checked on me when she could as I did for her. It blew my mind that she was able to return to play that fall, but I wouldn’t play any time in the near future.
Throughout my recovery, support was minimal and I really struggled with feeling lost. I sought therapy at the counseling center on campus and was fortunate that they had an intern who worked with athletes. Although I don’t remember a lot about that time of my life, I remember my first session. After I unloaded everything that happened and how I was feeling, my therapist told me that I had experienced a tremendous loss in my life and I was grieving. She was right. In her words, it was like my best friend died. In my words, it was like a part of me died.
The grieving process was tough, especially since my main coping skill had been physical activity and that was stripped out from under me. Even though I looked the same to those around me, I was experiencing intense internal turmoil. My first turning point was after I engaged in therapy and I started heart rate variability biofeedback. I was being taught a skill that helped to calm my mind and body which helped with my mood and cognitive difficulties. After 10 weeks of this treatment, I felt that I had a good foundation for successful recovery. Although biofeedback helped my healing process, I continued to deal with anxiety and depression. I maintained my biofeedback exercises and stayed on medication until I graduated from college.
After I graduated I returned home to Ohio. I felt extremely lost and was convinced no one else understood. I was no longer a soccer player or a student… who was I? The transition from college to a job was tough and losing my identity as an athlete around the same time made it even more difficult. Luckily I fell into a job pretty quickly after I got back to Ohio. The next year I got a job at the Ohio State University which prompted my interest in going back to school. My grief was still present and over time my bouts of sadness grew further apart. I saw a counselor on and off for a few years to work through the loss I felt. I couldn’t watch soccer games without becoming upset until two years ago (6 years later).
In 2012, I suffered another concussion in a car accident right before I started my doctoral program. My anxiety spiked and I was concerned about my ability to perform in school. Dread took over and I couldn’t help but think, “here we go again.”
About one month in to my recovery I decided that I was not going to face my concussion recovery alone this time. Although my concussion was from a car accident, I was hoping to find someone who had experience with sport concussions as the loss of sport had resurfaced in a painful way. Fortunately, I found the blog Life After the Game and read Lauren’s story. Our stories were so similar: our dedication to soccer, suffering concussions, and ultimately losing the ability to play the game we love. Our friendship began with that first email exchange. I would never wish my experience on anyone and yet I was so grateful that Lauren understood what I was experiencing and how I felt. Her support got me through a number of tough times. She was there to listen and never tried to fix anything. She let me be where I was in my recovery and encouraged me when I needed it. I know that my recovery would not have been the same without her support.
In addition to the social support I received from Lauren, I decided to seek the help of a sport psychologist to address the lingering issues from my sport concussions. There was no way I was going to let concussions interfere with my success in school. After one year of seeing my therapist, taking medication, and going to vision therapy, I was pretty much healed. I continue to have a tremor that is controlled with medication and some vision difficulties that cause issues on occasion. At this point I am content with my new normal.
It’s true that I view my life as two distinct parts, before my sport concussions and after. While that may be true, I am realizing more that my distinction may be better described as before and after soccer. Am I different after my concussions? Yes. The biggest change is the dulling of the intensity of my emotions, but I am not sure that this is a bad thing. When defining my new normal, I always viewed change as bad. Through years of therapy, lots of grieving, and dedicated self-exploration, I am finally emerging as the woman I am now.
As I reflect on my experience, I know that I faced a lot of transitions in a short period of time: the transition from before concussions to after, from the identity of Sammy the soccer player to Samantha the woman, from being an undergraduate student to a working adult, and from the dream of playing professional soccer to the dream of helping elite athletes. I found that I made the most progress in my concussion recovery once I started to accept that things are turning out different than I planned. That doesn’t mean I like it, but if I didn’t accept the reality of my situation then I wasn’t going to live a fulfilling life. I also had to learn to stop expecting and wishing that my life would eventually go back to the way it was before my injury. This was a long process and I still have moments where I wonder, “what if,” but therapy has taught me that the “what if’s” were keeping me lost in transition.
I have learned that I am not much different than other people my age who struggle with finding who they are and are learning to deal with changes as they come. My experience is just a bit more complicated due to my concussions. I’m not a weird person who can’t handle life, I am doing the best I can to handle adulthood as effectively as I can. Adjustments, good or bad, are difficult for most people, but my concussion recovery experience has taught me that asking for help and seeking support are imperative for me to be successful.
My anxiety and depression are managed through medication. I always thought, as I have found most people do, that it was okay for other people to need medication, but not me. What I was really saying to myself, “if I have to take medication than I am a failure.” Over time I have realized that my mental health and happiness are more important than struggling through life to feed a false belief that needing medication is a weakness. Acknowledging that I need medication to be successful and attain my professional dreams is a strength not a weakness.
Although it has taken a number of years, I have come so far from where I was in the spring of 2008. If my past is any indication of what is to come, I am excited to see what the future holds.