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Home / Emotional changes after traumatic brain injury: understanding and managing the impact
Traumatic Brain Injury (TBI) is a life-altering event that can lead to a wide range of emotional changes [1]. These changes can be just as challenging as the physical and cognitive impairments that often follow the injury [2]. This month on Research Digest we revisit Georgia Stevenson’s (former Assistant Psychologist at Brainkind) exploration of relevant research on the emotional changes that may occur after TBI, and her discussion of the strategies available for managing these emotional challenges as part of a comprehensive rehabilitation approach.
Common emotional changes after TBI
Emotional changes after TBI can vary widely depending on the severity of the injury, the location of the brain damage, and individual factors such as personality and pre-injury mental health [3]. Some of the most common emotional changes include:
Causes of emotional changes
The emotional changes experienced after TBI are multifaceted and can be attributed to several factors:
Strategies for managing emotional changes
Addressing emotional changes after TBI requires a comprehensive approach that may include medical, psychological, and social support. Here are some strategies that can help:
Conclusion
Emotional changes are a common and challenging aspect of life after traumatic brain injury. Understanding the underlying causes of these changes and implementing effective management strategies can significantly improve the quality of life for TBI survivors. By addressing emotional health as a key component of rehabilitation, health and social care providers can help people with TBI navigate the complexities of recovery and achieve better long-term outcomes. This evidence-based approach continues to enhance our understanding of the emotional impact of TBI and drive best practices for supporting those affected by this life-changing condition.
References
[1] Gouick, J., & Gentleman, D. (2004). The emotional and behavioural consequences of traumatic brain injury. Trauma, 6(4), 285-292.
[2] Shulman, L. M. (2020). Emotional traumatic brain injury. Cognitive and Behavioral Neurology, 33(4), 301-303.
[3] Schachar, R. J., Park, L. S., & Dennis, M. (2015). Mental health implications of traumatic brain injury (TBI) in children and youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie Canadienne de Psychiatrie de L’enfant et de l’Adolescent, 24(2), 100–108.
[4] Anson, K., & Ponsford, J. (2006). Coping and emotional adjustment following traumatic brain injury. The Journal of Head Trauma Rehabilitation, 21(3), 248-259.
[5] Juengst, S. B., Kumar, R. G., & Wagner, A. K. (2017). A narrative literature review of depression following traumatic brain injury: prevalence, impact, and management challenges. Psychology Research and Behavior Management, 10, 175–186. https://doi.org/10.2147/PRBM.S113264
[6] Choi, Y., Kim, E. Y., Sun, J., Kim, H. K., Lee, Y. S., Oh, B. M., Park, H. Y., & Leigh, J. H. (2022). Incidence of depression after traumatic brain injury: a nationwide longitudinal study of 2.2 million adults. Journal of neurotrauma, 39(5-6), 390–397. https://doi.org/10.1089/neu.2021.0111
[7] Howlett, J. R., Nelson, L. D., & Stein, M. B. (2022). Mental health consequences of traumatic brain injury. Biological Psychiatry, 91(5), 413–420. https://doi.org/10.1016/j.biopsych.2021.09.024
[8] Headway (n.d.). Anxiety after brain injury. Retrieved September 9, 2024, from https://www.headway.org.uk/media/12016/anxiety-after-brain-injury-publication.pdf
[9] Neumann, D., Miles, S. R., Sander, A., & Greenwald, B. in collaboration with the Model Systems Knowledge Translation Center (2021). Understanding and coping with irritability, anger, and aggression after TBI. Retrieved June 6, 2025, from https://msktc.org/tbi/factsheets/understanding-and-coping-irritability-anger-and-aggression-after-tbi
[10] Engelman, W., Hammond, F. M., & Malec, J. F. (2014). Diagnosing pseudobulbar affect in traumatic brain injury. Neuropsychiatric Disease and Treatment, 10, 1903–1910. https://doi.org/10.2147/NDT.S63304
[11] Worthington, A., & Wood, R. L. (2018). Apathy following traumatic brain injury: A review. Neuropsychologia, 118(Pt B), 40–47. https://doi.org/10.1016/j.neuropsychologia.2018.04.012
[12] Schwarzbold, M., Diaz, A., Martins, E. T., Rufino, A., Amante, L. N., Thais, M. E., Quevedo, J., Hohl, A., Linhares, M. N., & Walz, R. (2008). Psychiatric disorders and traumatic brain injury. Neuropsychiatric Disease and Treatment, 4(4), 797–816. https://doi.org/10.2147/ndt.s2653
[13] Weil, Z. M., White, B., Whitehead, B., & Karelina, K. (2022). The role of the stress system in recovery after traumatic brain injury: A tribute to Bruce S. McEwen. Neurobiology of Stress, 19, 100467. https://doi.org/10.1016/j.ynstr.2022.100467
[14] Berwick, D., Bowman, K., & Matney, C. (Editors), National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Board on Health Care Services, Committee on Accelerating Progress in Traumatic Brain Injury Research and Care, (2022). Traumatic brain injury: A roadmap for accelerating progress. The National Academies Press. https://nap.nationalacademies.org/read/25394/chapter/1
[15] Gómez-de-Regil, L., Estrella-Castillo, D. F., & Vega-Cauich, J. (2019). Psychological intervention in traumatic brain injury patients. Behavioural Neurology, 6937832. https://doi.org/10.1155/2019/6937832
[16] Robert, S. (2020). Traumatic brain injury and mood disorders. The Mental Health Clinician, 10(6), 335–345. https://doi.org/10.9740/mhc.2020.11.335
[17] Levy, B. B., Luong, D., Perrier, L., Bayley, M. T., & Munce, S. E. P. (2019). Peer support interventions for individuals with acquired brain injury, cerebral palsy, and spina bifida: a systematic review. BMC Health Services Research, 19(1), 288. https://doi.org/10.1186/s12913-019-4110-5
[18] Perry, S. A., Coetzer, R., & Saville, C. W. N. (2020). The effectiveness of physical exercise as an intervention to reduce depressive symptoms following traumatic brain injury: A meta-analysis and systematic review. Neuropsychological Rehabilitation, 30 (3), 564–578. https://doi.org/10.1080/09602011.2018.1469417
[19] Higgins, L. (2019) The efficacy of mindfulness-based interventions and cognitive rehabilitation on emotional and executive functioning problems after acquired brain injury. [Doctoral thesis, University of East Anglia]. https://ueaeprints.uea.ac.uk/id/eprint/72923/