The Peril of Self-Diagnosing CTE

Understanding the Complex Link Between Football and Mental Health

A tragic event in Manhattan has raised significant questions about the long-term effects of football on mental health. A 27-year-old man, Shane Tamura, killed four people in an office building before taking his own life. While the exact motive behind the attack remains under investigation, a note found on Tamura’s body suggests he believed he might have suffered from chronic traumatic encephalopathy (CTE), a degenerative brain disease linked to repeated head injuries.

Tamura was a former high school football player who targeted a Midtown skyscraper housing the National Football League (NFL). However, none of the individuals he killed were NFL employees. The league confirmed that one employee was seriously injured but is now in stable condition. In his note, Tamura speculated that CTE could be related to his mental health issues. However, medical examiners have not yet been able to confirm this diagnosis, as CTE can only be definitively diagnosed post-mortem.

This incident has reignited concerns about the long-term risks of playing football, especially at the youth level. Although the NFL has faced legal challenges over its handling of head injury risks, including a 2013 settlement with over 4,500 former players, research continues to explore the connection between football and CTE. Scientists believe that repetitive head impacts, whether or not they result in concussions, may contribute to the development of CTE. Yet, the precise number of impacts required to trigger the condition remains unclear.

The Role of Youth Football in CTE Research

Despite growing awareness of CTE, much of the research has focused on professional athletes. However, most people who play football never reach the NFL. Eleanna Varangis, a University of Michigan professor who studies brain injury, emphasizes that the majority of football experiences occur at the youth level, yet there is still limited data on how these early exposures affect long-term brain health.

Jesse Mez, an associate professor of neurology at Boston University, has studied the risk of CTE across various levels of football. He found that the longer someone plays, the higher their risk of developing the condition. However, for those with shorter careers—such as high school players—the likelihood of CTE is significantly lower. “The relationship starts to become linear after five and a half years of play,” Mez said. For high schoolers, the risk is considered very low, though it is difficult to quantify exactly what "low" means.

The Challenges of Diagnosing CTE

One of the major obstacles in understanding CTE is that it can only be diagnosed after death. This makes it challenging to determine whether individuals like Tamura actually had the condition. Additionally, genetic factors and individual susceptibility may influence how the disease manifests. Some people may develop CTE after fewer head impacts than others, further complicating the science.

Kristen Dams-O’Connor, director of Mount Sinai’s Brain Injury Research Center, notes that while CTE is uncommon among professional football players, many former NFL players believe they have the condition. This self-diagnosis can lead to harmful assumptions, such as the idea that mental health issues are inevitable for football players. “It suggests that nothing can be done, that a person is doomed to irreversible decline,” she said.

Other Factors That May Have Contributed to Tamura’s Mental Health Struggles

While CTE may have played a role in Tamura’s mental health, other factors likely contributed as well. Studies have shown that high school football players may be at greater risk for comorbidities that affect brain health, such as cardiovascular or cerebrovascular disease. Research also indicates that starting football at a young age may increase the likelihood of cognitive and behavioral problems later in life.

Brain injuries from any cause, including football, have been linked to mental health issues such as depression, anxiety, and even criminal behavior. New York City Police Commissioner Jessica Tisch stated that Tamura had a documented mental health history and had been placed on psychiatric hold in 2022 and 2024. These factors suggest that multiple elements may have contributed to his actions.

The Importance of Continued Research and Awareness

The New York City Office of the Chief Medical Examiner has agreed to examine Tamura’s brain during an autopsy, as he requested. The findings could provide valuable insights into the potential link between football and CTE. However, they may also highlight the complexities of diagnosing and understanding the condition.

As research continues, it is crucial to approach the issue with caution and avoid jumping to conclusions. While football carries risks, it is important to recognize that many factors influence mental health, and no single cause can explain every case. The tragedy involving Shane Tamura underscores the need for ongoing studies, better mental health support, and a more nuanced understanding of the long-term effects of contact sports.