Return to graphic version of Emotional Changes After TBI Infocomic
Infocomic Main Characters
Woman with TBI: A Hispanic woman in her thirties. She has black hair and long eyelashes.
Husband: Partner to a Woman with TBI: A Hispanic man in his thirties. He has short black hair and a goatee.
Daughter: Daughter of a Woman with TBI: A Hispanic girl around 8 years old. She has shoulder-length black hair.
Dr. Cushing: A White woman in her mid-forties. She wears glasses and has chin length hair.
Man with TBI: A Hispanic male in his twenties. He has short black hair and is clean-shaven. He uses a wheelchair.
Woman with Depression: A Hispanic woman in her forties. She has shoulder-length black hair and walks with a cane.
Man with Irritability: A White man with short black hair in his thirties.
The wife of the Man with irritability: A White woman in her thirties with shoulder-length hair.
Doctor: A White man in his forties, balding, with hair around the side of his head.
Infocomic Story Description
A woman with a TBI is having an intense mood swing. Her husband and daughter appear distressed at her outburst.
Some people with TBI may have intense mood swings. They may go from feeling happy, to angry, to sad very quickly. They often can’t control this.
Dr. Cushing points to an image of a brain. She explains that outbursts like this are called “emotional lability.” Damage to the parts of the brain that control emotion may cause such outbursts.
What can you do to help control your emotions?
The woman with TBI says, “Dr. Cushing told me that my emotions will probably become ‘more normal’ after the first few months. For now, my family and I are talking to counselors to help us cope.”
Dr. Cushing responds, “That’s great! Counseling can help you manage your emotions better. There are also medications that can stabilize mood. If you or your loved one are experiencing this, the first step is to talk to your doctor.”
How can your family help?
The woman with TBI, her husband, and her daughter meet with Dr. Cushing. She explains some things her family can do to help, such as:
- Remain calm. Do not react in an emotional way.
- Gently change the subject or suggest doing something else.
- Get them to a quiet area. This will help them regain control.
- Give the person a chance to talk calmly.
- Acknowledge their feelings.
- Provide feedback in a gentle and supportive way after they regain control.
A man with TBI says, “I’m afraid of making mistakes and that makes me feel like everyone is watching and judging me, even when they probably aren’t.”
People with TBI may get anxious about how well they can do things. Anxiety is a feeling of fear or nervousness that’s too strong for the situation. People with TBI may feel anxious without knowing why.
While driving, the man with TBI feels anxious, and constantly thinks of his own accident. Post-traumatic stress disorder (PTSD) is a type of anxiety that can develop after a traumatic event. Reminders of the event may trigger PTSD.
Dr. Cushing notes, “Being rushed, being in crowds, or sudden changes in plans can cause anxiety.”
As he lays in bed, the man with TBI can’t help but dwell on the memory of his accident. Sometimes a person replays the memory of how they got injured over and over in their head. This can interfere with sleep.
Why does anxiety happen?
The male with TBI is talking with Dr. Cushing. He says, “I get anxious when I’m driving, especially when I’m trying to find someplace new. I’m getting anxious just thinking about that stuff...”
Dr. Cushing notes, “After a TBI, anxiety is very common, especially when there are a lot of demands, like taking a test, or being in a noisy environment.”
Anxiety often happens when there are too many demands on a person.
What can you do about anxiety?
Try to reduce environmental stressors that cause anxiety. The man with TBI uses a white noise machine to block out other sounds.
Add structure or routine to daily activities. For example, you could write a list of activities.
Dr. Cushing states, “Counseling is good for managing anxiety. There are also medications that can help. Discuss these options with your doctor.”
A woman points out, “I started feeling really sad a few months after my injury, when I realized it would have a long-term impact on my life.”
It’s normal to have feelings of sadness, frustration, or loss after a TBI.
Common symptoms of depression include:
- Feeling that you are sad or worthless
- Changes in sleep or appetite
- Trouble focusing
- Feeling distant or withdrawn from others
- Loss of interest in life or loss of pleasure from life
- Feeling tired or having little energy
Because these signs of depression are also common effects of TBI, they don’t always mean a person has depression. It’s more likely that depression caused these symptoms if they began a few weeks after the TBI.
What causes depression after TBI?
Depression can arise as someone struggles to adjust to a temporary or lasting disability. This may include needing a cane to walk or struggling to do tasks that used to be simple, like unlocking a door.
People may become depressed when adjusting to their new role in their family or community.
Chemical changes or damage to parts of the brain that control emotions can also cause depression.
What can be done about depression?
Dr. Cushing notes, “Depression is not a sign of weakness. You can’t just ‘get over it.’ Depression is an illness.”
While riding a bike, the woman claims, “Aerobic exercise and daily routines helped me reduce my depression.”
Dr. Cushing notes, “Either counseling, medication, or a combination of both can help some people with depression.”
It’s best to act as soon as possible. If you or someone you love has these symptoms, talk to your doctor. Don’t wait!
A man complains, “Ahhh! I just get irritated so easily!!!” Studies show that 71% of people with TBI are often irritable.
Dr. Cushing states, “Family members or people with TBI often describe having a ‘short fuse’ or a quick temper.”
Why does this happen?
People with TBI get angry for many reasons:
- I’m frustrated and unhappy with how my life has changed.
- I’m in a lot of pain.
- I lost my job and a lot of my independence.
- I get tired easily.
- I forget things and can’t concentrate well.
- I feel alone, depressed, and misunderstood.
- I have damage to the part of my brain that controls emotions.
What can I do about my temper and irritability?
Reduce stress and decrease irritating situations. The man closes a window to block the sound of a barking dog.
People with TBI can learn some basic anger management skills. These include self-calming, relaxation techniques, and better communication.
Counseling, medication, or a combination of both can be helpful when working with a doctor.
Family members can help too!
They should remember not to take the anger personally. The anger is likely due to the person’s TBI.
Dr. Cushing advises the family about people with TBI, “Make sure they know that it is not OK to threaten to hurt people or to yell at them. Don’t argue with them while they are having an outburst. Let them calm down first. When the person is calm, set rules for communication. Don’t give in just to calm them down after the outburst is over. Have a conversation.”
Some other ways to calm down are meditation, leaving the room, or going for a short walk. If you go for a walk, make sure to tell people when you will be back.
What’s the next step?
The man advises, along with his wife, “If you or someone in your family is dealing with depression, anxiety, or emotional lability, talk to you doctor. Ask them if medication, a psychological evaluation, or counseling could help.”
More about medications
If you or your family member is taking medications for any of these problems, it’s important to work closely with your doctor. You should also keep your follow-up appointments.
There may be a delay before the medication starts working.
Your doctor may need to adjust your dose. You may also need to try different medications before you find the one that works best. Except in an emergency, do not stop taking the medication your doctor prescribed without talking to them first.
A doctor advises a patient, “It may take some time to see results. Be patient.”
Peer support and other resources
Remember that not all help comes from health care professionals! Peer support groups can help.
The woman with TBI talks with the man experiencing irritability. She admits, “I laugh at strange times.” He reflects, “I had that too. It got better after a few months.”
Peer mentoring is when somebody who is in the same situation helps you cope with problems, they may have dealt with themselves.
A TBI support group can be a great source of peer support. Some groups are open to people with TBI or their family members. Other groups are open to everyone.
The man with TBI concludes, “Contact your local brain injury organization to find out what resources they may be able to offer!”
Source
The Content of this infocomic has been adapted from the factsheet Emotional Changes After TBI, which was developed by Tessa Hart, PhD, and Keith Cicerone, PhD in collaboration with the Model System Knowledge Translation Center (https://msktc.org/tbi/factsheets/emotional-problems-after-traumatic-brain-injury). This infocomic was written by Silas James and illustrated by Matthew Cory, in collaboration with the Model Systems Knowledge Translation Center. Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the SCI Model System directors.
Disclaimer
This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatment. The contents of this infocomic were developed under grants from the National Institute on Disability and Rehabilitation Research (NIDRR), Department of Education (grant numbers: H133A120028 and H133A110004). However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the federal government.
Copyright © 2015 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.