Beyond the Bump: The Mental Toll of Mild Head Injuries in Kids
Children who sustain concussions may be 25% more likely to be diagnosed with a mood disorder than those who do not experience a head injury.
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Bumps and falls are an everyday childhood experience, an expected side effect of kids running, climbing, and exploring the world around them. Most are minor. But when a fall leads to a concussion, the effects can extend beyond physical symptoms. While headaches, dizziness, and fatigue often fade within weeks, a growing body of research suggests that the emotional and behavioral consequences of concussions can arise later down the line.
Concussions, also known as mild traumatic brain injuries (mTBIs), are the result of the brain rapidly twisting, or bouncing inside the skull. The sudden movements cause chemical changes and can damage brain cells. An estimated two million children in the United States experience a concussion each year.
Richard L. Delmonico and colleagues followed nearly 19,000 children and adolescents (aged 17 years and younger) diagnosed with mTBIs over a period of four years and compared them to non-injured peers. Diagnoses were identified from electronic health records using diagnostic codes across emergency, urgent care, and outpatient visits.
The findings were clear: children who sustained an mTBI faced a higher risk of developing new psychiatric disorders. Overall, youth with concussions were 25% more likely to be diagnosed with a mood disorder, and were 18% more likely to receive a behavioral disorder diagnosis during the follow-up period. The risk was especially pronounced in the second year after injury, when mood disorder diagnoses rose by 34%.
An mTBI can become a ‘foundational event,’ where a biological injury interacts with social context to influence long-term mental health outcomes.
Youth with concussions were more likely to be diagnosed with adjustment disorders, depressive disorder, and anxiety disorders. Behavioral conditions also rose, including conduct disorder (31% higher risk), ADHD (17% higher risk overall, with the greatest emergence in year four), and oppositional defiant disorder. In many cases, new diagnoses appeared years later.
Children ages 10 to 13 were particularly vulnerable; nearly 50% were more likely to receive a mood disorder diagnosis within two years of injury and up to 50% more likely to have a behavioral diagnosis. Researchers suggest this heightened risk may reflect the intense developmental transition into middle school, when academic expectations, peer relationships, and social pressures intensify. A brain injury during this period may disrupt emotional regulation and coping at a time when demands are rising.
Both childhood and adolescence are critical periods for brain development. The brain grows rapidly in early childhood and reaches most of its physical size by age 6. During the teenage years, it undergoes important remodeling, especially in the prefrontal cortex, which supports decision-making, focus, and emotional regulation. After a concussion, this system may function less efficiently, making feelings like anger, sadness, or worry harder to manage.
These findings highlight that a concussion is not always a short-term injury.
Importantly, recovery is not shaped by biology alone. Socioeconomic factors such as household income, parental education, and consistent health insurance play a critical role. Families with greater resources may be better positioned to access ongoing mental health screening and specialty care, while those facing socioeconomic instability may encounter barriers to diagnosis and treatment. In this way, an mTBI can become a “foundational event,” where a biological injury interacts with social context to influence long-term mental health outcomes.
Together, these findings highlight that a concussion is not always a short-term injury. Because emotional and behavioral disorders may develop long after physical symptoms fade, children who sustain mTBIs, especially those between 10 and 13 years old, benefit from routine mental health check-ins and clear guidance for parents on warning signs such as mood changes, anxiety, or academic decline. Early recognition and intervention by clinicians and mental health professionals can reduce long-term effects and support healthy development.
