# Concussion May Result in New-Onset Bipolar Disorder: A Case Report

## TL;DR

A case report shows that a concussion may lead to new-onset bipolar disorder, highlighting the need for early identification of psychiatric risks after head injuries.

## Contribution

This case study presents a novel example of new-onset bipolar disorder following a concussion, supporting the diathesis-stress model.

## Key findings

- A 50-year-old male developed bipolar disorder one year after a grade II concussion.
- The case supports the diathesis-stress model in explaining the onset of bipolar disorder post-concussion.
- The patient experienced severe complications including a hypertensive crisis and stroke after discontinuing medications.

## Abstract

Emotional dysregulation following a concussion is well established. New onset of major psychiatric diseases such as bipolar disorder (BPD) post-concussion has not been investigated. BPD typically presents with an initial depressive episode followed by mania and concurrent depressive and manic states. Multiple theories explaining the etiology of BPD exist, including the diathesis-stress model (DiSM), though an accepted theory is not established. In this case study, medical records of a 50-year-old ambidextrous male with co-morbid attention deficit hyperactivity disorder (ADHD) inattentive type, obsessive-compulsive disorder (OCD), and a family history of BPD suffered a motor vehicle collision (MVC) resulting in a grade II concussion. New onset BPD was diagnosed one-year after a concussion following an involuntary admission and led to the patient self-terminating his medications and suffering a hypertensive crisis and aortic dissection, and stroke. One year later, the patient was again involuntarily admitted for a suicide attempt. Bipolar disorder persisted unchanged indefinitely. This case study may serve as a real-world example of the DiSM in the etiology of BPD post-concussion. We aim to highlight the importance of early identification of risk factors for progression to psychiatric conditions following concussion.