Brain Injury and Mental Illness: CTE

Driving into oncoming traffic.  Drinking antifreeze.  Shooting oneself in the heart.  These are just a few of the bizarre and horrifying ways ex-NFL players with the brain disease chronic traumatic encephalopathy (CTE) have ended their lives.

Traumatic brain injury is perhaps one of the most obvious, straightforward routes to brain dysfunction.  Because the brain controls virtually every function of the body, physical injury to this delicate organ can result in a wide range of problems.

Exhibit A:  dementia.

While not technically a psychiatric illness, dementia is a key feature of brain diseases that are uniformly fatal.  Alzheimer’s is the most common cause of dementia, but there are many others.  Since the 1920s, dementia has been documented in boxers in the form of dementia pugilistica, aka “Punch Drunk Syndrome”.  Brothers Mike and Jerry Quarry are two famous boxers who died from the condition, known today as chronic traumatic encephalopathy (CTE).

But CTE is not limited to professional boxers.  As the PBS documentary “League of Denial” recently showed, football players–even those still in high school–can develop CTE as a result of repeated blows to the head.

One particularly tragic CTE story is that of NFL player Justin Strzelczyk of the Pittsburgh Steelers.  Like many former NFL stars, Strzelczyk descended into a period of depression, substance abuse and suicide after his football career waned.  In his final days, Strzelczyk believed he was being chased by demons and his phone was being tapped.  He threw money from his roof as an offering to the devil.  On the day of his death, he packed $2,600 and some crucifixes into a suitcase and headed down a New York highway in the wrong direction driving 90 mph.  After a long chase, Strzelczyk hit a tanker truck that exploded into a ball of fire, killing him instantly.  Upon autopsy he was found to have no drugs or alcohol in his system.  He was only 36 years old.  (See videos below for the full story).

Sadly, Strzelczyk’s strange and dramatic death is not an aberration.  Other former NFL players like Junior Seau, “Iron Mike” Webster and Terry Long (who killed himself by drinking antifreeze) died in an equally disturbing fashion after a long battle with CTE.  Ex-Chicago Bears player Dave Duerson went so far as to shoot himself in the chest rather than the head so scientists could study his brain for the disease.

Is it possible that other former athletes like O.J. Simpson and Mike Tyson are also affected to some degree by this condition?  Since CTE can only be definitively diagnosed by brain autopsy after death, we can only speculate.  (Near the end of “League of Denial,” one researcher claims the disease is so prevalent that she doubts there are any long-time football players who don’t have it.)  Athletes in other contact sports like professional wrestling and hockey have also been diagnosed postmortem with CTE.

CTE is caused by the brain slamming against the inside of the skull repeatedly (i.e. – “sub-concussive blows”) or by multiple larger concussions.  Like Alzheimer’s disease, CTE is a progressive and fatal condition with no known treatment or cure.  Depression, psychosis and other personality changes are very prominent in CTE, perhaps more than in other forms of dementia.  Interestingly, head trauma is also a risk factor for developing Alzheimer’s later in life.

In Part II of this story, we’ll look at the link between brain injury and other mental health disorders like depression.

Part I:  Justin Strzelczyk Story on ESPN

Part II:  Justin Strzelczyk Story on ESPN



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