How Can Athletes and Coaches Recognize the Mental Signs of a Concussion?

Not every concussion comes with a dramatic fall or a blackout (and sometimes, you don’t even hit your head!). I learned that the hard way during a figure skating lesson several years ago.

I was practicing a left forward inside rocker—an edge-heavy turn that takes total body coordination—when I fell hard on my tailbone. I heard and felt a crunch through my spine, but I got up and finished the lesson. I didn’t pass out, and I didn’t bleed; I mainly felt surprised that the fall happened. My coach and I both assumed I was fine.

That evening, though, the mental fog started. I felt “off.” My head hurt. And it wasn’t my first time feeling this way—I had a concussion the prior year from a minor car accident, so I knew the signs. I ended up in the ER, where I was officially diagnosed with a concussion and given a weeklong recovery plan.

It turns out, concussions can be sneaky. And athletes (plus the adults who support them!) need to know what to look for, especially the cognitive and emotional symptoms that can be easy to miss.

What Is a Concussion, Really?

A concussion is a type of mild traumatic brain injury (TBI) that occurs when the brain moves rapidly inside the skull. This can happen from a direct blow to the head—but also from a fall, whiplash, or sudden jolt. Contrary to popular belief, you don’t have to lose consciousness to have a concussion.

Here’s what’s surprising and what a lot of people don’t realize: many symptoms are mental, not physical.

Common Mental Signs of a Concussion

While physical symptoms like dizziness, nausea, and sensitivity to light are often emphasized, the mental and emotional signs can be just as impactful—especially for athletes who rely on focus, coordination, and emotional regulation in their sport.

Here are some cognitive and emotional red flags to watch out for:

Cognitive Symptoms

• Feeling like your brain is in a fog or running on low power

• Struggling to focus or keep track of things you normally remember easily

• Having a harder time following conversations or directions

• Reacting more slowly than usual—whether on the field, in class, or during everyday tasks

Emotional Symptoms

• Feeling more on edge or frustrated than usual, even over small things

• Noticing your mood swing quickly, or just feeling off

• Crying more easily or feeling more sensitive than you typically would

• Feeling disconnected from yourself or like you’re not really “in it”

These symptoms may show up hours or even days after the injury. For me, it took several hours for my symptoms to manifest–feeling brain fog, struggling to focus, reacting more slowly, and feeling disconnected from myself.

In cases where symptoms appear right away, some athletes might try to push through, especially in sports cultures that reward toughness and pain tolerance.

Why These Symptoms Get Missed

Many athletes (and even coaches) don’t expect a concussion unless there’s a dramatic hit to the head. Plus, mental symptoms can be mistaken for stress, fatigue, or burnout—especially in high achievers.

Layer in identity-based experiences—like being a young athlete of color who’s used to minimizing pain, or a neurodivergent athlete already navigating sensory overload—and the chance of underreporting increases.

What Coaches and Parents Can Do

If you’re supporting an athlete, here’s what to keep in mind:

• Ask open-ended questions: “How’s your focus today?” or “Anything feeling different mentally?”

• Watch for personality changes: If your usually upbeat athlete seems flat or irritable, check in.

• Trust your gut: If something feels off, even if there was no head impact, advocate for a medical evaluation.

• Model rest as recovery: Make it clear that healing is part of being an athlete, not a sign of weakness.

Navigating Recovery With Compassion

I’ll be honest: I overdid it during my own recovery. Trying to balance work with resting my brain felt impossible, and I underestimated how draining mental tasks like checking email and attending staff meetings could be. This led to a longer, messier recovery.

What I learned—and what so many athletes experience—is that concussion recovery doesn't follow the same roadmap as a sprained ankle or a pulled muscle. You can’t always see the healing happening, which makes it easier to doubt or push past your limits. And, when you’re surrounded by a culture that values doing over resting, slowing down can feel like falling behind.

That’s why we need to normalize not just recognizing concussions, but honoring the full scope of healing, including rest, patience, and asking for help.

We’ll talk more about that in the next post: How does concussion recovery differ from physical injuries, and why is patience key? 

Takeaway: Pause, Ask, and Listen

Whether you're the one playing, practicing, or supporting from the sidelines, here’s what’s worth remembering: concussions don’t always look as we expect. Sometimes, it’s the subtle mental shifts that tell the real story. Paying attention early can help prevent longer setbacks and create space for healing that actually sticks.

Have you or someone you know experienced the “invisible” symptoms of a concussion? Reflect on how mental signs showed up—and how they were (or weren’t) addressed. If you’re navigating recovery now, know that you’re not alone. Reach out to our team to talk more about managing the mental side of healing.

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Legal Disclaimer:

This blog post is for informational and educational purposes only and is not a substitute for mental health treatment, psychological services, or medical advice. Reading this post does not create a therapist-client relationship. If you are seeking support for your mental health or well-being, consider reaching out to a licensed mental health professional in your area.