TBI 101: Behavioral & Emotional Symptoms

TBI 101: Behavioral & Emotional Symptoms

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.
Posted on BrainLine June 13, 2017.

Comments (7)

I was violently attacked with a gun 5 years ago, and though m y attacker didn't pull the trigger, he hit me in the back of my head at least 5 times, leaving a clear mark of a gun busted open near my crown, and several smaller gashed behind my left ear. I had a ct scan that night that came back negative for a concussion, was stapled shut and sent home. After the event I went through visual black outs when moving from seated to standing positions, as well as some slurred speech according to some of the people who were around me in the following weeks. Over the years I have noticed almost all of the symptoms above, and I am starting to question if they are related to my injury. I can remember every detail as if it were happening though, and thinking about it gets me so emotional that I get headaches and physically worked up. Could these symptoms be a part of undiagnosed TBI?

Yes and from what you have described, it sounds like you have Post Traumatic Stress Disorder (PTSD). Please look into a therapist as well as your Primary.

First of all thank you for addressing many unspoken we TBI patients experience on a daily basis at times they lead to actual true physical neuro melt downs. I am now 46 and at 28 (holistic, vegan, health nut to the core plus a daily five-mile runner) I suffered a misdiagnosed double aneurysm and a massive SAH. The one right temporal ruptured the second gargantuan left CVA/avm was clipped via craniotomy. My personality etc changed drastically my emotions intellect interests palet etc etc my headaches are intense on a daily basis. I try to lean on my family except their response is “your surgery was a long time ago and the more you focus telling us why you are tired or why you can’t remember or act erratic or tell anyone you had brain surgery you are just reliving it. You suffered physically but we suffered emotionally” Um I want to scream. I seek to move near the beach their reply? 20 minute drive is too far. I try my best at everything yet I hear I’m too slow I’m too moody and that’s not the surgery. Again screaming anyone? I’ve emailed them articles they don’t read it they do not attend my support groups etc. Stress kills me and this year I’m experiencing the loss of a 24 year relationship/18 year marriage with an extremely evil emotionally abusive man. It’s caused me to suffer a stress-induced seizure due to low sodium. My mother feels I need to look at others suffering and stop being so selfish. Um again I want to scream. How can I help them understand? How can I taper down my frustration?

My son is now 37 yrs of age but at the approximate age of 3-4 (as best remembered due to I, his mother, being a TBI survivor myself) at this very young age he fell at a baseball game from the stands and landed on the knob of an old door that was left on the ground just out in the open as I remember. He hit his bone (eye socket) right on edge of his eye. Fortunately, we were close to the local hospital. We brought him to the ER and they cleaned and stitched it up but I try thinking now if there are any signs of this accident that would imply he has TBI himself. He is well rounded but sometimes when he was a young boy and young teen, he had somewhat of a temper occasionally and he tends to now get a little agitated with certain ones of us sometimes. I am only wondering if there is any chance that he should or is it even possible that he be examined by a doctor to find out if there is any evident reason to believe he has TBI himself?

Thanks for any input and GOD BLESS.

Sandra, that's a tough one. I suffered many brain injuries growing up. More than I can remember. I now told 99.9% I have cte. Stage 3. Just within the last year, I'm starting to get agitated and have to really restrain myself so I don't go off. People are different. Some people are just easily aggravated or may have something against someone that triggers that behavior. I would try to figure out who he takes after. I take after my dad. We are both laid back and pick and choose our battles wisely. Honestly, I don't remember him even yelling much. I'm a little more aggressive now. This CTE didn't start yesterday. Another thing; today told may have Focal Neurologic Deficit. I looked it up. A lot of it fits. Different parts of the brain affect certain things. Look that up. They can give you info on what parts of the brain control certain things. You know where your son was hurt. Do some investigation. Could be that or just personality. Hope this helps

I was struck by a pick-up truck when I was 16, and I'm 27 now. I was released from hospital that night with cuts requiring about 7 stitches total on my face, various scrapes all over my body and a severe limp. I was sore for weeks, but because I was released so soon and because I was underage and my parents would have been given signs to watch for as opposed to me, I have no idea what the results of observation were. I just know my late teens were full of anxiety, stress, emotional outbursts, and risk-taking behaviour. But my childhood involved a lot of outbursts and meltdowns, and I didn't recognize my stress as an anxiety disorder. I just assumed I was a normal teenager.

I told my new doctor this morning that I got hit by a truck as a teen, and this was the first time I mentioned it. My family doctor at the time of my accident wasn't one I was close to or visited often and I don't know if I ever brought it up. Anyway, after describing the accident and whatever memories I have of that day and the following months (I don't remember much) she informed me I likely suffered a concussion. This was the first time I'd ever heard that. She also said at this point it's impossible to know. I do suffer from anxiety and depression, but as this was formally diagnosed sometime between the ages of 20 - 22, I can't say how long I've suffered from it or if it's related.

I have horrible problems with my memory, I have trouble forming fully coherent sentences verbally, often forget key words to make a point and struggle to find synonyms, or lost track of my sentence altogether and then as I try to remember I lose track of the whole conversation; but my written communication is very strong.

I have a lot of trouble with daily tasks like cooking, grocery shopping, making important decisions or prioritizing tasks. An example is trying to come up with a grocery list, which I often forget to do altogether or forget the list at home if I do write one. Without the list, I forget what I wanted to make (or didn't think about this at all) and get overwhelmed trying to decide what to buy. For this reason I often overspend or buy take-out. When I cook, I have to make things that are simple and that I make frequently (a simple stir fry or frozen food that you throw in the oven), or I have to help a roommate or friend cook and follow their directions. With school, I'm fortunate that I can take on;y 2 courses and still be considered a full-time student because of my disability (GAD and MDD), but even this can cause a lot of stress as I struggle to prioritize my readings and essays and what needs to be done first. I get really anxious when I try to look for work because in the past this has been too much and caused me to fall behind.

In sum, I'm still dealing with some apparently severe consequences of delayed diagnoses and if I do have a brain injury and if that is what has either caused or aggravated my anxiety and depression, I may have been able to treat it much sooner. I'll probably never really know at this point.

I guess my point here is advice: follow up with as much medical support as you can access after even a minor head injury. You may uncover other issues you have, and be able to treat them.

My symptoms showed up right away but I blamed it on stress. I was assaulted in the back of the head with a thick wooden door. I show all the signs that you are describing but the doctors are telling me I have bipolar. I do not know what to think?