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Neck Injury and Depression Connection

Posted in Neck Pain Disorders on Jul 30, 2019

Do you Know What is the Link between a Neck Injury and Depression?

Understanding the between an Upper Neck Injury and Depression

If you, a family member or a friend has recently suffered a head or neck injury, have you noticed if you or they are not feeling their usual self?

 

Moodiness? Anxiety? Depression?

(I want to make a point abundantly clear from the start of this article: i.e., when I use the word “depression,” I am not necessarily referring to clinical depression with tendencies towards self harm. What I mean when I am talking about depression is best described as, “I'm not feeling myself. I’m feeling down, irritable, hopeless and just generally uncomfortable in my own self, but I don’t know why.”)

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For simplicity, though, we will say “depression.” 

To a certain degree, it’s like when your hormones are in a state of flux. Except you know that’s not it. All of it started after a head or neck injury.

If so, one of the most important things that you need to do first is to have a brain CT or MRI scan with a hospital or depression specialist to rule out the lethal stuff: bleeding on the brain, fractures, and stuff like that. I would also recommend that any such scans include your neck.

The truth is that most of the time, these types of scans will come back as “normal,” although the better description would be “No pathology is detected.” In my experience, it is because most types of neck injuries and functional disorders. Think of it like a computer virus. It isn’t something you can see, but it is something that infects the system and can lead to all sorts of problems.

So if you can rule out the dangerous and scary stuff but are still experiencing a neck injury and depression, the question remains, “What do you do about it?”

When it comes to a neck injury and depression, there may not be a single simple answer. What I do want to share with you in a fundamental piece of the puzzle that many people overlook in their pursuit of wellbeing after a head or neck injury. And that is the role of the upper neck in how it affects the function of your brain and nervous system … including your emotions.

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How to be Aware of Depression Symptoms after a Neck Injury

I once took care of a young man, who was referred to the office by his partner. Six weeks earlier, we was involved in a car accident. He wasn’t experiencing any pain, and his only symptom was that he was feeling depressed. We performed a series of tests and discovered clearly that he had a misalignment at the top of his spine where his neck can affect his brainstem.

Now, I wasn’t treating him for his depression. What I told him we were treating him for was the alignment of his neck because - if he suffered a neck injury from the car accident - it was possible that it was affecting his brain and nervous system. 

What was most remarkable was that after his first adjustment, he said that he felt the fogginess in his head clear, like he was his normal self again.

We continued to monitor him over the next few weeks, but that problem never came back. Here was a case of a young man who had no previous history of injury, and we managed to address the underlying condition in his neck that was manifesting as moodiness and depression.

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I do not share with story with you to give you any false expectation of benefit. If you have been experiencing a neck injury and depression for a long time, it may take a lot more work to help. Plus there may be other things going on that will need to be addressed.

I share this story to simply illustrate that it is absolutely possible for a neck injury and depression to be linked. And if you have been experiencing depression after a neck injury, they are more common than you think!

One of the most insidious things about this process if you are feeling depression after a neck injury is that you feel like you are all alone. Maybe you have been to a medical or healthcare professional who told you that “It will go away on its own” (but it hasn’t). Or that you might want to talk with a psychologist for your depression or to take anti-depressant medication.

But I emphasise again: you know in your heart that you aren’t depressed! It’s like you brain is playing a trick on you where you feel the sense of anxiety and depression - like a false fire alarm - but you don’t know how to shut it off.

Let me emphasise again, please, that these symptoms are exceptionally common after a neck injury. And it is because what you may be experiencing is a form of post-concussion syndrome. Not one because of brain damage, but because of a neck injury that no one has diagnosed before.

 

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What can Cause Depression after a Neck Injury

Only a third of all the nerve receptors in your neck are sensory, which means that you can feel them. Two-thirds of them don’t detect pain at all!

Nevertheless, if there is injury to the neck that those other receipts detect, they can transmit abnormal information back to your brain that will register as an abnormal sensation wherever in the brain those signals go back to.

Your neck, especially the upper neck which includes the C1 (altas) and C2 (axis) vertebrae contain an immensely dense number of nerve receptors that detect motion. In fact, the upper part of your neck is responsible for 50% of the total movement of your head.

If you suffer an injury that affects the ability of these vertebrae to move, research from New Zealand has illustrated that it affects multiple parts of the brain including the cerebellum (balance and coordination centre), the primary motor and sensory cortices (muscle tone and feeling) and also the pre-frontal cortex which is the “human” part of the brain that governs and maintains command of our emotional states, impulses and abilities to use logic. Moreover, the New Zealand researchers have demonstrated that by restoring movement through the joints of the neck that they are able to increase brain function in all of these areas.

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In other words, an injury that has affected the alignment and/or motion of the neck directly affects the function of the brain, which can manifest as any number of potential conditions … even depression after a neck injury.

 

What to Do about a Neck Injury and Depression

The first thing to do if you are experiencing depression after a neck injury is to make sure that you do not have a bleed or bruise on your brain. That is why I have previously recommended that you visit your GP or even the hospital for a CT or MRI scan.

When the scan comes back as “normal,” it wlll mean that you will likely be referred to someone else. Your GP may refer you to a neurologist, psychologist, or physiotherapist depending on the nature of your symptoms, and if they recognise that you may be experiencing the symptoms of a whiplash injury with post-concussion syndrome.

Here is where I want to step in. It is not to imply that these other therapies are not important, because they are. You will need exercises with moving your eyes and your neck as part of recovery from your neck injury and depression. However, before you are clear to exercise, it is essential that the alignment and movement through your neck is intact.

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It is the different between swimming with the current … or against it. If you are experiencing a neck injury and depression, one of the foundational pieces is that your neck is properly aligned. Remember, it controls 50% of your total movement and has a major impact on the way that your brain operates.

So do you want your brain working at 50% capacity as part of your recovery or 100%? If you want your brain to be working in your favour as close as possible to 100%, here is way a unique form of healthcare called Upper Cervical care may be able to help you with your neck injury and depression.

 

Most Common Reasons Adults have Depression after a Neck Injury

So what are some of the more common types of activities that cause neck injuries in adults. Anything that involves sudden jerks or snapping of the neck. Whiplash is not limited to car accidents, but is something that can affect adults in all sorts of common activities:

  • Sports Tackles - for the “weekend warriors,” tackles and head collisions playing football (AFL, NRL, soccer, etc) is one very common type of injury … and women who play soccer, the incidence is even greater!
  • Accidents - tripping over the kerb, smacking your head on the ground, getting hit in the car … not all neck injuries cause depression, but just because you “feel fine” immediately after the injury does not make everything okay.

Whiplash, post-concussion syndrome and other neck =-related nerve conditions are finicky and non-linear things. In other words, they do not always appear the same way … and there can also be a time lag before the onset of symptoms. Sometimes days, other times months!

So it is not uncommon for people to completely forget about a neck injury or a concussion that happened days or even weeks ago before the sudden onset of symptoms “for no apparent reason.”

Things don’t happen in the body for no reason. So if you are experiencing depression, consider the possibility that you did suffer a neck injury some time ago. Even if it seemed to be okay at the time, may it was more significant than you thought. 

 

Most Common Reasons Children have Depression after a Neck Injury

Kids are not immune to injuries either. Skateboards, swimming, trampolines, trips, falls, etc. Children are supposed to move, and so physical activity is great for them! Nevertheless, if they suffer injuries it can manifest in so many bizarre ways.

Part of the reason is that their brain is still developing. What doesn’t help is that kids have so many potential forms of stimulus (and overload) these days in the forms of phones, tablets, computers, etc. So it is very unlikely for kids to say to Mum or Dad, “I feel depressed.” It doesn’t work that way. Instead, children will most likely manifest with behavioural challenges that could range from inattention to clumsiness, poor performance at school to just generally being “unwell.” That could include headaches, nausea, frequent illness, etc. 

Again, with kids the range of symptoms is even greater than it is with adults. So it would not be fair or appropriate to say that all these things come from problems in the neck. They don’t. However, if you are exploring the possibilities, make sure that you do not overlook this vital element.

 

Diagnosis for Depression after a Neck Injury

Let me ask you: do you believe that depression is the cause of your problems? Or do you believe it is the symptoms - the effect - of something else?

If you believe that your depression is the cause of your problems, then what I am going to describe next is not for you. Therefore, I would recommend that you have an honest chat with your GP or neurologist or depression specialist to find the best type of therapy that they can prescribe for you. And there is nothing wrong with that! If you want to order Thai cuisine at an Italian restaurant, you will only be disappointed! So I don’t want to make any recommendations for you if it is not what you are looking for.

What I am saying is that at Atlas Health in north Brisbane, we don’t consider depression to be the primary cause, but merely the effect of something else. Therefore, we don’t work to diagnose or treat the symptoms of depression per se. Instead, we focus on the types of physical conditions that can manifest as depression after a neck injury.

So of course, our focus and area of expertise is in diagnosing and treating specific kinds of neck injuries specifically involving the alignment of the top bones in the neck: the atlas (C1) and the axis (C2). As previously mentioned, these vertebrae have a profound impact on the function of your brain. When they are properly aligned, your brain is free of physical interference and is able to function properly. When they are misaligned - not broken or dislocated, but entrapped from their normal range of movement - they have a negative impact on the nerve signals that your brain receives, and therefore can manifest as any number of symptoms.

Here then is the focus of a unique form of healthcare called upper cervical chiropractic. Now, let me emphasise that upper cervical care is not the same thing as general chiropractic or spinal manipulation that you may know about.

Foremost, there is no twisting or cracking the neck. Upper cervical care is a post-doctorate division or special study that emphasises precision diagnosis and precision care, much like the difference between a GP versus a neurologist.

The process first involves a specific analysis of your body structure including neurological testing and scans that show if there is a problem with the alignment or your upper neck. To measure this, we use what is called computerised infrared paraspinal thermography.

If there are signs of dysfunction with your upper neck, what we do are a series of advanced 3D x-ray images that allow us to see the alignment of your neck from angles that aren’t examined with standard x-ray or even MRI views. You see, everyone’s bone structure is unique. Unless these differences are taken into account, you may never see what is actually going on … and as a result your tests will come back as “normal” when you know in your heart that there is something going on.

So when it comes to the structure of your neck and your health, we don’t leave things to chance. And we take a different approach, which allows us to provide something that is unlike anything else in healthcare. (Our only regret is that of the 4000 chiropractors in all Australia, we are one of only 6-12 practices - and the only upper cervical chiropractic practice in Brisbane - doing this type of specific work).

 

Atlas Health Chiropractic Treatment for Depression after a Neck Injury

I must reiterate that the upper cervical work that we use at Atlas Health in north Brisbane is not a treatment for depression. It is a treatment to help restore the alignment and motion of your neck. And if the depression feelings you are experiencing are the effects of your neck not functioning right, then it is possible that we may be able to help. If the symptoms are the result of something else, however, we will be certain to refer you for the appropriate care.

After performing the appropriate tests, we will know how to tailor a customised adjustment for you that will allow us to use the least amount of force but in a safe manner with the greatest potential for success. The adjustment that we perform does not involve any twisting, cracks or spinal manipulation. Instead, the process uses only the amount of pressure that you need to feel your pulse.

As light as it is, people are often amazed that just a little force directed in the right way can make sure a powerful difference. That is the difference that upper cervical care can make.

As I close, I want to mention something important. If you are experiencing discomfort after a neck injury - especially if there is pain involved - it is actually the abnormal person whose mood isn’t affected. Especially if you are feeling anxiety or depression - and especially if you’ve tried all sorts of therapies that just haven’t worked for you - it’s normal to feel a sense of helplessness, or that you are alone in this, or that no one is able to help.

What I want to say is that you are not alone. That we do listen, and we do care. And if there is anything that we can do to help you get your life back, we will be happy to help to the best of our abilities.

For more information, or to schedule a consultation to find out if upper cervical care is right for you, please contact our office in north Brisbane at 07 3188 9329, or send us an email. Our office is located in North Lakes, just off the Bruce highway to serve the greater Brisbane and Sunshine Coast communities.

 

References

Caccese JB, Buckley TA, Tierney RT, et al. Sex and age differences in head acceleration during purposeful soccer heading. Res Sports Med. 2017 Oct 25:1-11. doi: 10.1080/15438627.2017.1393756. https://www.ncbi.nlm.nih.gov/pubmed/29067816

Daligadu J, Haavik H., Yielder PC, et al. Alterations in cortical and cerebellar motor processing in subclinical neck pain patients following spinal manipulation. Manipulative Physiol Therap. 36(8); 2013:527-537. https://www.ncbi.nlm.nih.gov/pubmed/24035521

Gouttebarge V, Aoki H, Lambert M et al. A history of concussions is associated with symptoms of common mental disorders in former male professional athletes across a range of sports. Phys Sportsmed. 2017 Sep 13:1-7. doi: 10.1080/00913847.2017.1376572. https://www.ncbi.nlm.nih.gov/pubmed/28870119

Haavik-Taylor H and Murphy B. The effects of spinal manipulation on central integration of dual somatosensory input observed after motor training: a crossover study. J Manipulative Physiol Therap. 33(4);2010:261-272. https://www.ncbi.nlm.nih.gov/pubmed/20534312

Haavik H and Murphy B. The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. J Electromyography Kinesiology, 22(5);2012:768-776. https://www.ncbi.nlm.nih.gov/pubmed/17137836

Lelic D, Niazi IK, Holt K, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural Plast. 2016;2016:3704964. doi:10.1155/2016/3704964. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800094/

Ogura T, Tashiro M, Masud M, et al. Cerebral metabolic changes in men after chiropractic spinal manipulation for neck pain. Altern Ther Health Med. 2011 Nov-Dec;17(6):12-7. https://www.ncbi.nlm.nih.gov/pubmed/22314714

Rosa S, Baird JW. The craniocervical junction: observations regarding the relationship between misalignment, obstruction of cerebrospinal fluid flow, cerebellar tonsillar ectopia, and image-guided correction. Smith FW, Dworkin JS (eds): The Craniocervical Syndrome and MRI. Basel, Karger, 2015, pp 48-66 (DOI:10.1159/000365470).

Rosa S, Baird JW, Harshfield D, Chehrenama M. Craniocervical Junction Syndrome: Anatomy of the Craniocervical and Atlantoaxial Junctions and the Effect of Misalignment on Cerebrospinal Fluid Flow, Hydrocephalus Bora Gürer, IntechOpen, DOI: 10.5772/intechopen.72890. A

Smith FW, Dworkin JS (eds): The Craniocervical Syndrome and MRI. Basel, Karger, 2015. DOI:10.1159/000365463.

Wong JJ, Shearer HM, Mior S, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. Spine J. 2016 Dec;16(12):1598-1630. doi: 10.1016/j.spinee.2015.08.024. Epub 2015 Dec 17. https://www.ncbi.nlm.nih.gov/pubmed/26707074

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