Emotional Symptoms Following A Brain Injury

by Steve Holder on June 25, 2008

In the neuropsychology community, some disagreement exists over the degree to which behavioral and emotional disorders following a traumatic brain injury (”TBI”) are caused by the injury itself or by the stress of coping with the resulting disabilities. The consensus seems to be “a little of both.”

The following describes the emotional problems the TBI survivor can experience and some of the reasons they can be expected.

Irritability

Imagine having difficulty with memory tasks or concentration and being fatigued because you can’t sleep through the night. Imagine being unable to add two numbers in your head or looking in your refrigerator and being unable to make sense of its contents. Things that used to be easy are now incomprehensibly difficult. Do you think you would be irritable?

TBI survivors deal with such frustrations on a continual basis, but recent research has associated heightened irritability immediately after an injury with lesions on the brain’s left cortex. Those whose irritability appears some time after the injury are more likely suffering an emotional response to their diminished abilities.

Anxiety and Depression

Anxiety is unreasonable fear and apprehension that can lead to sleeplessness, restlessness, irritability, fatigue, and difficulty concentrating. Given that each of these by-products of anxiety is also a frequent brain injury symptom, it can make an accurate diagnosis of anxiety difficult. For someone coming to grips with what may be life-long disabilities, a certain amount of fear and apprehension about the future is probably not unreasonable.

When a person’s life and future have changed so dramatically, it seems predictable that the individual would become depressed. But depression can be so severe for many TBI victims that it leads to suicidal thoughts and actions.

Many discussions of emotional problems following a TBI list anxiety and depression together because it is not uncommon for the survivor to suffer both. But one small study found that a group of TBI sufferers with both anxiety and depression had lesions on one side of the brain, while another group experiencing clinical depression without anxiety had lesions on the opposite side. What does it mean? Researchers aren’t yet sure, but future data may reveal an organic basis contributing to both disorders.

Mood Swings

Also called “involuntary emotional expression disorder,” mood swings can have the patient literally laughing hysterically one moment and crying inconsolably the next. Angry outbursts over seemingly inconsequential matters may also be part of the package. The patient’s loss of control over emotional responses can strain the family and make social interaction difficult, causing the patient to withdraw and adding fuel to feelings of depression and anxiety.

Most experts agree this condition is a direct result of a brain malfunction because it also occurs frequently in association with Lou Gehrig’s disease, pseudobulbar palsy, stroke, and neurodegenerative diseases. This type of mood swing disorder is associated with frontal lobe injury.

Lack of Emotion

Lack of emotion is also described as apathy, lack of interest, lack of motivation, emotional numbness, or “flat personality effect.” The patient may have no interest in activities and have little response to sad or humorous situations. This condition is also associated with injury to the frontal lobe, which controls emotions and personality.

Behavioral Problems

Some rehabilitation experts make a slight distinction between emotional problems and behavioral problems; possibly because emotional issues affect the patient more severely while behavioral problems tend to have greater impact on people around the patient. Despite this difference in classification, the root causes can also be a mixture of organic injury and stress response.

Typical behavioral problems experienced by traumatic brain injury survivors include:

  • Self-centeredness
  • Aggression
  • Inappropriate sexual behavior
  • Extreme temper
  • Cursing
  • Manipulative behavior

Treatment for Emotional Problems

Treatment for emotional problems typically involves psychotherapy, behavioral therapy or rehabilitation, and/or medication. Each case is unique, and the patient’s physicians must develop an individualized treatment plan suited to the patient’s specific injury, symptoms, and tolerances.

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{ 7 comments… read them below or add one }

Zwelethu Mazibuko February 23, 2009 at 10:00 am

Thank you so much. I was involved in a high speed car accident 6 months ago and was subsequently in a coma for a month. When I awoke the doctors told me that I had a frontal lobe brain injury. During the time since, I have been confused by my inability to feel emotion. It felt as though I was viewing life through a glass screen. I could see and compute, but I could not touch or feel anything, with the exception of irritation and resentment. I could not help wondering if I had in fact died and this was hell, where I was paying for my sins. Little did I know that I was to find an angel on the internet in the form of this article’s author.

Thank you so much for helping me understand what is happening to me.

God bless you and yours.

Zwelethu Mazibuko
South Africa

Steve Holder February 28, 2009 at 2:12 am

Dear Zwelethu,

You cannot know how happy I am that this article was of comfort to you. Thank you very much for taking the time to share your feelings.

We are all wishing you a continuing and complete recovery.

N Naka March 25, 2009 at 6:52 am

I have no emotions after a post concussive, it’s been 2-3 yrs. I can’t calculate things correctly. I was a highly educated person and really fast, but now I’m like a slug with no motivation. just existing…it’s it like that with you….how are you fixing it..? I don’t want to stay like this, my judgements are not good.

Thanks,
Nore

N Naka March 25, 2009 at 6:56 am

I forgot to mention, my mother died and I felt nothing, my puppy is in intensive care and I still feel nothing. I fell backward on marble. I felt like I was not that bad off, no emotions, I was bubblely and happy and loved people and dancing, and I’m trying to improve, but nothing… just sore and empty… I can’t understand what’s happened to me…

Steve Holder March 29, 2009 at 2:23 am

Dear Nore,

You should ask about recovery programs in your area that can assist you in understanding and coping with the effects your injury are having on you.

It may not be possible to regain your previous self, but with professional help you may be able to learn how to live comfortably with your new self.

You may also be interested in learning how other people are adapting to their new selves here:

http://www.headbraininjuries.com/1st-carnival-of-hope

We offer you our sincerest best wishes on your journey toward acceptance, recovery, and peace.

stephanie April 4, 2009 at 9:00 pm

i was in a vehicle accident last june. i experienced a brain injury which affected my balance and coordination and which causes me to see double now. i know that this was fairly recent in the grand scheme of things, but i have not cried. i’m afraid that i damaged the part of my brain that helps emotions to be handled. i’m scared that because of the brain injury, i cannot cry now. i feel sadness, desperation, happiness, love, all of those things. it’s just that i can’t cry. this artlicle was another result in my search of whether brain injuries can result in not being able to cry.

Steve Holder April 5, 2009 at 2:09 am

Dear Stephanie,

Thank you for your comment. It may also help you to read the stories of other people who have already traveled the road you’re on. Visit our blog at http://www.headbraininjuries.com/category/blog/ or just click on “Blog” at the very top-left of this screen.

These people can explain it to you far better than I can.

In the meantime, were wishing you the best.

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