Hallucinations and Delusions After a Brain Injury

Brian Greenwald, PhD
Question: 

My brother was 19 when he suffered a TBI. He’s made a lot of progress in six years. My family’s main concern right now is that he’s been talking a lot about conversations and events that clearly could not have happened or taken place. He’s also been talking to himself and gesturing like someone is with him — only there is no one around. The doctor has said she’s seen some TBI patients go into their own little world like this.

Our family is obviously very worried and concerned. We don’t want this to set him back especially since he’s come so far. Is this something that can happen to people with TBI and what suggestions might you have for us to help him?

Answer: 

Psychiatric issues, including hallucinations and delusions, are certainly more common after traumatic brain injury. The risk for new onset of psychiatric illness after a brain injury goes on for a long time and can be seen with any severity of traumatic brain injury. If these problem are new for your brother, a careful medical evaluation by a physician who has experience in treating patients with TBI is warranted. So the healthcare professional should take a close look at all of your brother’s medications. Some medications can increase confusion or cause hallucination or delusions. Stimulant medications such as Ritalin, Adderall, and Amantadine all have this potential side effect. Evaluation should also be done to ensure these symptoms are not related to seizures.

Loneliness and social isolation can also be contributing factors and should be considered as well.

If no medical or social issue is found and these problems are not bothering him or putting him at risk, I would be cautious about using any psychiatrically active medication. Neuropsychologic and group treatments can be helpful. Neurolpsychologists will evaluation his mood, insight, and judgment to establish if these are true hallucinations or a way of entertaining himself. Couseling can be useful in improving mood. Group therapy would give him a social outlet and can improve insight by seeing others go through similar challeges. If these symptoms worsen and he became a danger to himself or others, medications can be considered. These should only be prescribed by a practioner who has experience in evaluating and treating.

 

Posted on BrainLine December 16, 2010. Reviewed July 26, 2018.

Comments (62)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Someone replied on

I have mtbi and recently had a episode of hallucinations and paranoia which ultimately led to a couple charges with the law which I had previously gotten into a motor vehicle accident in November of 2016 and had a couple times where I know I was not in the right state of mind but it was never this bad so to make a long story short I altimate Lee and getting charged and I am worried about the outcome of my injury getting worse I am just trying to figure out any preventative things I can do to help myself so I never go through an episode like that again just to even think about it is scary because I do not remember anything which I won't forget I was also prescribed Xanax and Adderall which is no one to be brain stimulants which you should never be prescribed with this type of injury thanks Doc

Anonymous replied on

My son had injury to Globus Pallidis 2-14-17. In hospital had delusional behavior with hallucinations- took alot of monitoring and the help of a wonderful nurse to figure out it was the Neurontin- the least likely of all his meds- but THANK GOD- because no one caught on- or thought it could be that medication, especially pain management- who insisted it was not- so out of 27  doctors, mom and a wonderful nurse named Sheila, probably saved him from not only an injury and near death- but being kept psychotic with a medication. Be careful adding meds- never two at a time- be an advocate for yourself or your family member!!!!! I was thought of as a pain in the butt as my son's "overprotective" mother- but I can only imagine the nightmare we would be living had I not been that "pain"!!!

Anonymous replied on

My fiance and myself both suffered violent assults by our neighbors..He was beaten with double fisted brace knuckles which split his skull.. his tooth was knocked through his cheek and lastly the neighbor hit him in the head four times in head with a breaker bar simlar to a a very large crowbar..For three months I brought him to hospitals who made accusations was he must on drugs but never bothered to run a toxicology test..And because He tried to stop a fully grown man and woman from stomping my skull on the pavement he was put on probation which I can't understand I was and am disabled failed cervical fusion..So we fled our home and after 3 days of watching him talk to noone and smoke fake cigarettes and see dinosaurs and monsters.I brought him to the hospital dredding the drug accusations cuz he can appear intoxicated during an episode..This time they said drugs I said toxicology screen..And he was diagnosed..Up until March 3 it had only happened 3 times during stress..He began acting strange Asking if feds where calling and he thought he heard walkie talkies..But I really did think it would happen again.So I let him leave ..We went to the police and alerted them that he has a servere brain injury and was missing..Well some man failed to turn his car off left the keys in the ignition idling and he began hallucinating and tried to escape in a vehicle that which was is in violation of NY State law..What him suffer with impared speach expressing him self struggle and his fustration ..And now he is being victimized again..And the man who's car it wants vengeance not justice .. Because justice would be having him spend a year or two in in a TBI community..But jail will only provide with more danger to his head and treatment..This is not something he would do he fell in love with despite we both knew that he would have to be my hands..He was not a saint as youth but he's a different man and what can I do to help ..Where do I go we just moved to the mountains..Thank u ..I pray for all TBI paitents they suffer in silence..

Anonymous replied on

I was killed by Ghb overdose now I sufffer from hallucinations , and hearing voices . As if I drank a full glass of LSD , this goes on 24 Hrs a day and I don't know how to stop it

Anonymous replied on

Thank you very much. I thought I was the only one.

Anonymous replied on

I was in a car accident 5 goin on 6 years ago and I am a near death experience patient and I am told by some family that I talk to my self and carry conversations with my self and other people that seem never to have existed

Anonymous replied on

I personally experienced the things you are discussing you actually or I should say I did go thru this rest support limited stress acceptance all play a part

Anonymous replied on

i recently had an accident and hit my head severely hard... trying to get doctors to help me has been a struggle.  I finally convinced my doctor to order a MRI which did show some spots on my brain, and am now waiting to see a neurologist.  I have struggled with hallucinations and extreme paranoia and have headaches all the time.  This has also affected my relationship with my boyfriend as I find myself angry a lot.  I pray to God for relief and pray for others that have problems with their TBI

Someone replied on

I feel your pain it almost feels like I have lost everything in my life since this incident relationships friends all because of my anger and thinking process which is obviously not right good luck with everything I hope it gets better for both of us

Anonymous replied on

Is it uncommon for a TBI patent from 25 years ago, to still go thru anger episodes especially under stress? He is not on any meds but treats himself naturally w/ vitamins/herbs. Also, I see him calling an 'opinion', a 'fact'. For example, If he doesn't like someone (which seems often) - he may call the person a 'jerk'. I will say - 'that is your opinion, I like so and so. He get's angry and says "it's a 'fact' and continuos to defend that it's a "fact", not an "opinion. I and others see there are 'disconnects'. There has been a number of people in & out of his life, from what I have seen, due to anger issues or a breakdown in a relationship due to 'miscommunication' or what seems to be a' disconnect'. Thanks for any thoughts.

Anonymous replied on

Our son with MTBI has also been talking and gesturing to himself and often gets angry. Medication seems to help, but it's gotten worse lately. As parents, it's very disconcerting and scarey. I don't think his doctors realize how difficult this is to live with, both for him and us. I hope it will gradually go away. I pray to Jesus for healing.

Gary replied on

My Mother suffered from brain aneurysm's. As a matter of fact she had a total of 7. Two of them started to bleed and after surgery to repair them, they found an additional 5. She recovered unbelievable well and was pretty much considered to be a miracle. Lately though I am getting worried. She is starting to feel things touch her and walk on her and infact bite her. I have searched for evidence or anything to support what she is telling me but can't find a thing. I don't want to tell her that there is no way what she is saying is possible, or anything to make her feel "crazy". Has anyone been through anything like this before and if so can anyone give me any advice. I am really getting scared something serious is happening.

Pages