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Emotional and Behavioral Changes Following Brain Injury by Charles Watson


Posted on August 7, 2020

An injury to the brain, whether a mild concussion or a more significant TBI or ABI, often causes more than just9 physical and cognitive disturbances. Clinical reports and research describe brain-injury caused symptoms as 

Affective: depression, irritability, impaired frustration tolerance, mood lability/ dysregulation, apathy, impaired judgment and insight, and self-esteem issues.

Behavioral: impaired anger management including verbal and physical aggression and assault, motor or physical hyper-reactivity or hyper-arousal, reduced energy levels, appetite changes, sleep-wake cycle disturbances, sexual changes, social withdrawal, drug, and alcohol abuse and work and school performance issues.

Emotional-behavioral disturbances following a brain injury can be attributed to changes in the emotional centers in the brain, including the type and severity of the injury, length of time since the injury, and age of the patient. Patients face increased risk of loss of friendships, marital/relationship discord, loss of social status, and estrangement after a brain injury. 

Research also indicates that pre-existing/pre-concussive personal history of mood, behavioral or psychosocial disturbances can greatly increase the risk for psychological impairments post brain injury. 

Damage to the temporal and frontal lobes of the brain can cause depression, mood, and behavior changes. Depression is more evident post-injury in persons that experience memory deficits. Whereas anxiety and PTSD disorders are usually related to damage to the amygdala and frontal lobes. The risk of suicides is especially high if there is increased aggression or hostility in patients post-injury.   

It is important to follow certain guidelines to make life easier for a TBI or ABI victim. 

  • Listen more and talk less using a more consistent and regular tone
  • Give short and simple instructions as processing and following instructions can be confusing.
  • Organize routines and keep regular timings, for example, meal and bedtime, doctor appointments, medication timings, exercise regimens. 
  • Regular attendance and monitoring by a mental health professional who is properly trained in the treatment and rehabilitation of brain injuries and its disorders. 
  • Communicate openly and establish a collaborative approach with the patient’s doctors, team of rehabilitation professionals, employers, and teachers.
  • Brain injury victims and family members must attend support groups to gain insight into how to overcome the challenges faced during the recovery.
  • Participating in social activities like school clubs, sports teams, friends, co-workers gradually. 
  • Recovery after a brain injury can be deterred by alcohol or drug abuse or pursuing high-risk recreational sports such as bike-jumping, contact athletics and un-helmeted skateboarding, bicycling, etc.
  • Persons who already had a history of drug and alcohol use before the injury often have a more difficult time adjusting to the need for a new, healthier lifestyle.
  • Discussions about the past of unresolved fights, issues, and other stressful arguments that may have caused problems in family or marriage can slow down the recovery process.

Sustaining a brain injury can be a life-changing event. It has its negative as well as positive aspects. Physical disabilities, visual and speech defects as well the pain, all become bearable as a person learns to treasure life and relationships.

Some people, after a brain injury, emerge with completely changed personality as they realize how fragile life, and the human body and brain can be.