He's Not the Same, and You Noticed First.
You have watched someone you love slip further from themselves since an old hit, and you have run out of people who will connect the two. You are not imagining it, and there is a real place to start.
If you are the one who noticed, this may sound like your house
- A short fuse, a flat mood, a person who withdrew
- Antidepressants and therapy that haven't brought them back
- Sleep, energy, and drive that fell away after an old injury
- A history of a bad hit, a wreck, or a fall that got waved off
- Being told, over and over, that everything looks normal
- The quiet fear that this is just who they are now
You can start the process for someone you love. The most useful first step is often simply naming what standard care has not looked for.
Whichever Story Is Yours, the Biology Rhymes
An old hit can show up across eight areas: mood, thinking and memory, sleep, energy and hormones, the body's autopilot, balance and vision, headache and sensory sensitivity, and personality. Standard depression care usually looks at only one.
- People with a history of a bell-ringing hit are more than three times more likely to have depression than people without. (Beaton et al. 2020, meta-analysis, Frontiers in Neurology)
- Standard antidepressants often can't reach this population. A meta-analysis of antidepressants for depression after a head impact found no significant difference from placebo. (Foreman et al. 2019, J Head Trauma Rehabil)
- Ketamine and esketamine (Spravato®) work on a different system entirely, glutamate, with effects measurable in hours and a 24 to 72 hour neuroplasticity window. (Zanos & Gould 2018, Molecular Psychiatry)
We do not claim to repair, reverse, or cure a concussion or any brain injury. What we do is treat the depression that a head-injury history can make more likely, and more resistant to standard care. A head-injury history is a risk factor for that depression, not an indication for ketamine itself.
What a Clinic With Neurology Available to Consult Can Actually Look At
Depression that follows a bell-ringing hit often has a driver ordinary depression care never checks for. A GP managing fatigue or a psychiatrist managing mood usually is not looking across the whole picture. Because we have neurology available to consult, we can:
Screen the hormone axis
A hit can bruise the pituitary, the master hormone gland, and up to 1 in 6 people develop a deficiency (low thyroid, testosterone, or growth hormone) that looks exactly like getting older.
Take sleep seriously
Sleep disorders affect roughly 30 to 70 percent of people with a head-injury history (Viola-Saltzman and Watson, 2012, Neurologic Clinics), and broken sleep keeps depression from lifting.
Check the autonomic system
A hit can disrupt automatic control of heart rate and blood pressure, which is why some people feel dizzy standing up or exhausted for no clear reason.
Take a real head-injury history
The hit is often remote, years or decades back, and rarely asked about. Connecting it to today's symptoms is the whole point.
This is capability, not a promise of a specific outcome. It means we know where to look before we recommend anything.
It All Starts With a Recovery Evaluation
Everything begins with a Recovery Evaluation, a proper clinical evaluation from a clinic with neurology available to consult, not a sales call. It is $99, fully refunded if you don't qualify. If you do, the treatment pathway is Spravato in our clinic.
Spravato® in our clinic
FDA-approved for treatment-resistant depression. Given only in certified healthcare settings under its REMS program, with supervision and two-hour monitoring, and often covered by commercial plans, MO HealthNet, TRICARE and Medicare, subject to prior authorization and our participation with your plan. We verify your exact cost first.
Your PHQ-9 is measured at every visit, so you see the numbers move, not just how you feel.
He's Not the Same: A Family Guide to Concussion-Linked Depression
A plain-language guide, no cost, no obligation. Start the screener and we'll point you to it.
A Recovery Evaluation is the one front door. $99, fully refunded if you don't qualify. If you do, Spravato in clinic opens up.
Safety & Compliance
Spravato under its REMS program
Every dose is observed by a healthcare provider, with two-hour post-dose monitoring and blood-pressure checks before you leave.
No driving until the next day
Someone drives you home, and per the FDA label you do not drive again until the next day, after a restful sleep. This is a firm rule, not a suggestion.
We screen for substance use
This treatment is not compatible with active substance use, and we screen for it carefully.
Crisis: if you or someone you know is in crisis, call or text 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room. Brain Recovery Centers is not an emergency service.
Spravato® (esketamine) is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. It is not FDA-approved for concussion, traumatic brain injury, or post-concussion syndrome. Use in patients with a concussion history is based on clinical judgment regarding the depression component. We do not offer IV ketamine infusions. This page is educational and not medical advice. Individual results vary.
Common questions
I never had a diagnosed concussion. Does this still apply to me?
Yes, quite likely. Most concussions never make it onto a chart. If you ever got your bell rung, it counts, and even hits that were never called a concussion can affect the brain long-term.
Why try ketamine when other antidepressants haven't worked?
That is exactly the point. Antidepressants act on serotonin and norepinephrine, and the depression that follows a head impact often runs on a different system. Ketamine and esketamine act on glutamate, which is why we lead with this pathway for people with this history.
What is the first step and what does it cost?
A Recovery Evaluation, $99 and fully refunded if you do not qualify. It is a proper clinical evaluation from a clinic with neurology available to consult, not a sales call.
Standard Treatment Hasn't Worked Because It May Not Be Standard Depression.
Start with a Recovery Evaluation. $99, fully refunded if you don't qualify. Or take the 2-minute screener first.
Start the 2-minute screener Book a free consultPrefer to talk it through? Call us at (314) 314-9112.