Behavioral and Emotional Symptoms
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I often remind clients that brain injuries can go unnoticed after car wrecks or other accidents, because doctors usually don’t have enough context to compare your pre-injury and post-injury mental, emotional, and personality changes. That means it often falls to you or your loved ones to recognize the signs of a brain injury and communicate them to medical providers so you receive the right care. To do that effectively, you need to understand what those symptoms look like — and this series is here to help.
You may only realize that you or a family member has a brain injury because you notice changes in you or your family member’s behavior or emotional status. Some of the common emotional or behavioral issues that we see from brain injuries are as follows:
Many survivors or friends of survivors find that the injured person is more irritable and much more easily angered. The injured person may also have an angry response to a situation that is greatly out of proportion to what you would normally expect.
Many brain injury survivors have problems with impulse control. They say things they wouldn’t normally say; they take physical actions they wouldn’t normally take; or they demonstrate poor judgment, failing to fully think things out.
Many persons with brain injuries show exaggerated displays of emotion that are way out of proportion to the situation or to the person’s pre-injury self. As mentioned above, some people become explosively angry at something that doesn’t seem justified. Others may become extremely sad over something that doesn’t warrant such a response.
Apathy is very common in persons with brain injuries. One study has found that more than 60% of brain injury victims suffer some form of apathy.
Some studies find that between 30 and 60 percent of brain injury victims have depression. This doesn’t include the significant percentage of victims who experience some symptoms of depression, but not enough for a formal diagnosis. Additionally, if victims had depression prior to their injury, a brain injury can make that depression much more severe.
Psychosis is an infrequent (but high-impact) occurrence with brain injuries. Typical symptoms of psychosis might be delusions, hallucinations, or schizophrenia-like problems. As I said, these are rare problems in brain injuries, but when they occur, they are very problematic for the affected person.
Many brain injury victims describe feelings of anxiety. If a person has experienced anxiety before their injury, then they are much more likely to experience even worse anxiety after the injury.
A small percentage of brain injury victims develop OCD after their injury.
There are a number of studies finding that victims of brain injuries are also likely to experience PTSD. This is a problem that is being highlighted by the experiences of our soldiers in the Middle East conflicts. PTSD is also problematic because it makes recovery much more difficult.
Several studies find that victims of brain injuries are much more likely to experience substance use disorders.
There are substantial studies finding that brain injuries both increase the likelihood that the victim develops dementia and may also result in earlier-onset dementia for those who are already predisposed to developing dementia.