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Behavioral & Emotional Symptoms

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A young man is soft-spoken and gentle. During his college football career, he sustains several concussions. In his late 20s, he is fired from his job for his uncontrollable bouts of anger. His girlfriend leaves him, and his parents are at their wits’ end with his behavior. He doesn’t recognize himself; he feels out of control. It’s as if someone else is controlling his body and mind. When he finally seeks help, he is diagnosed with mild traumatic brain injury, a result of the repeated blows to his head.

Why behaviors and emotions can change after TBI
Depending on what part or parts of a person’s brain are injured, the individual may experience significant behavioral and emotional changes. The frontal lobe, for example, helps govern personality and impulsivity. If damaged, there might be no “braking mechanism” for self-control. A person may find he cannot control his anger or aggression. He may also make inappropriate comments to friends or strangers not realizing they are off color.

Or the opposite might happen … someone’s personality may become muted or seemingly emotionless. This is called “flat affect.”

Some of the most common behavioral and emotional problems people with TBI can experience include:

“Mood swings”
Some people call them mood swings because for people after TBI, emotions can often be hard to control. Because of the damage to the brain, a TBI can change the way people feel or express emotions. A person may feel she is constantly on an emotional roller-coaster — full of glee and excitement one moment, devastated the next. Another person may experience unpredictable bouts of laughing or crying, which have nothing to do with how the person is actually feeling or what is going on around her.

It’s crucial for people with TBI and their families to understand that these behavioral and emotional changes are a result of the brain injury; they are not the injured person’s fault. That said, dealing with these issues can be even more difficult, especially for family and friends, if the person with the brain injury is unaware of the fact that he is different from how he was before his injury.

What to do
Consulting a neuropsychologist or behavioral therapist is a good place to start. They can help with strategies like learning to breathe deeply when you feel you are getting angry or intolerant or like redirecting your thoughts and actions to more positive choices.

With support and patience, people with TBI can learn to take action to regain a sense of control over their moods and behaviors. Here are some practical suggestions for people with TBI who experience emotional highs and lows:

• Let friends, family, and coworkers know about your difficulties with behavior control. Enlist their help and support. For example, they may be able to help you better understand what triggers inappropriate behavior or emotional responses and help you learn how to avoid those triggers.
Confide in friends or family members. Sharing your worries helps lift the burden.
• Clean up your messes. If you have acted inappropriately, apologize.
• Tell people to walk away from you if you have an emotional outburst. They can talk to you once you have calmed down.
• Avoid people, places, or situations that trigger inappropriate responses.
• Join a support group or find a peer mentor. Talking to others who have “been there” can help.
• Get regular exercise. It’s good for the body and calms the mind.
• Try learning to meditate to keep your mind clear.

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