Anger and Depression Following a Traumatic Brain Injury

Family, friends, co-workers, neighbors will all understand and accept that a traumatic brain injury can change your thoughts and memories but very few people understand that a brain injury can and more often does also affect your emotions.   

The two most common emotions affected by a head injury are anger and depression. Someone that may have been quick to ager before an accident may all of a sudden have explosive fits of rage that come out of nowhere about seemingly nothing.  

Anger after a head injury is very different from the usual “oh no, Dad is going to be mad”.   Anger can be instant. The victim of a brain injury can be in a “good mood” not upset and the smallest things, dropping a glass, or losing their keys can bring on an instant rage. Usually that rage will disappear as quickly as it came. They are angry for a few minutes then just as suddenly they are fine. A new conversation starts and the brain injured person soon forgets all about the incident that made them so angry just moments before.  

Many of our clients have sat in our office and said, "I cry very easily, sometimes over the really dumb things."  This is especially tough for men who are taught from a very young age that they must be tough, never cry or show emotion.  Many people begin to feel that they're losing their mind because of the emotional roller coaster they find themselves on after a traumatic brain injury.

Are they crazy? Have they lost their minds? Absolutely not, they have a brain injury.

Scientists have found that feelings of rage and fear, as well as sexual feelings all come from very primitive emotional areas of the brain called the deep limbic system. It is the part of the brain that controls action. And it screams for immediate action. If you're mad, hit something. If you are hungry, eat. Don't wait, do it right now. 

In contrast, the frontal lobe of the brain or the pre-frontal cortex controls impulse.  It is the part of the brain that helps plan and control behavior.  The front part of our brain is involved in saying "NO".  For example, your boss says something that gets you mad.  Your first impulse is to hit him.  The "NO" part of your brain says, "Don't do that--you're going to be fired--you're going to go to jail."  So the pre-frontal cortex and the deep limbic system work together to act a control valve.  If the "NO" part of the brain or the pre-frontal cortex isn't working, the primitive functions or the deep limbic system tends to win out causing the brain injured person to act out in ways they never would have prior to the head injury.

This change in emotion can cause family members and friends to start avoiding the victim of a traumatic brain injury.  Family learns very quickly to walk on eggshells because anything can set off the brain injured person. Friends just stop coming around, invitations are not extended.    

This isolation is usually followed by depression. The brain injured person perceives, and rightly so, that no one wants to be around them.  When there are dramatic changes in your life that you seemingly have no control over it can and often does lead to depression.  

Both of these emotions, anger and depression, must be dealt with as part of the recovery process. It is vital that the spouse or family of the brain injured individual ensure that the symptoms are reported fully to the physicians so that appropriate care can be given to assist not only the patient but the family in dealing with this debilitating injury.

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