What Is Emotional Flooding?

Question: 

Can TBI be confused with being bipolar? My teenage daughter broke her neck in a bad car wreck. Afterwards, she would have spells of uncontrollable crying. She went to our family doctor who told her she was bipolar and put her on meds. They are not really helping her much.

Answer: 

I am assuming your daughter sustained a brain injury during the motor vehicle accident that also resulted in her broken neck. If she has not had a comprehensive neuropsychological evaluation, I would recommend that she have one to determine the extent of her brain injury and its impact on her neurocognitive and or neurobehavioral abilities.

Neurocognitive issues after a brain injury can effect a person’s emotions, behavior, and cognitive function. Post-traumatic reactions can occur independent of the brain injury and can affect mood and behavior. It is important to note that these are not mutually exclusive. After a TBI, people can experience both neurocognitive and psychological symptoms. When the brain is healing, it needs rest. Engaging in activities or being stimulated past the point of fatigue can result in emotional flooding. For some people, this can manifest as crying spells. Making sure to rest and take breaks will help prevent or at least lessen the intensity of these episodes of emotional flooding. A neuropsychologist can help your daughter develop coping skills.

Posted on BrainLine April 12, 2013.

Jacquelyn Borg

Jacquelyn Borg, PhD is a clinical child psychologist and manager of the Department of Neuropsychology and Neurorehabilitation for Children's Specialized Hospital in New Jersey. She is an affiliate member of the medical staff at the Hospital.

Comments (14)

My daughter's boyfriend has suffered several concussions from years as a soccer player. He talks often about his head feeling "messed up" and claims to have been diagnosed with TBI. I noticed the occasional erratic behaviour while he was dating my daughter, but he seemed very genuine and cared about her. I was a little concerned when he started confessing his love for her very early on, but she put a stop to it by telling him that it was just too soon. Fast forward a little while and he confesses to her again that he's in love with her, but this time the feeling is mutual and she tells him and he's over the moon. Less than 12 hours later he demeanor towards her completely changed and he broke up with her, claiming that "his head was messed up" and he just wasn't sure of anything. I've never seen anyone change their mind about being in love with someone so quickly so I'm wondering if this really could be a by product of the TBI or is he just using it as an excuse. He is still texting her and telling her that he's not moved on, but wants her to. When she asks him why they can't be together and she can help him he just says "I don't know. It's just my head." If he's just using it as an excuse to bow out gracefully, then so be it, but I'm worried that this kid is really struggling and no one knows about it and he needs to get help!

I am needing any help i can get in understanding my son. My son is 16 now 3 years ago he recieved a TBI. He looses his temper so easily. One minute he is happy the next he is suicidal. I do not know what to say or do any more. When i try talking to him he always starts yelling and gets mad. you can not reason with him at all. i do not know how to help him.the TBI is tearing my family apart. How do i help him?

Anonymous. Told have 99.9% CTE so I know what your son feels. Does he have a doctor? Is he on any meds? I just started taking Trazodone 100 two hours before bed.  I'm in stage 3. I am NOT a pill guy but it helps depression and helps me sleep. He needs his rest. I lost a daughter to crib death. Tomorrow is 34 years so have been suicidal since then. Now with TBI, it is magnified. I'm struggling with this all the time. I did some research and they say Lithium Carbonate helps with the emotion of suicide. I am NOT a doctor. I try to think outside the box sometimes to see what works for me. Consult your doctor if this is right for him. I don't know kids. I get into it with my two and they are in their 30's. I try to stay out of things but sometimes you try to save them from mistakes. They argue at everything and don't listen to what I say until its too late and they are semi-normal. So..... but with depression and suicidal thoughts; you have to stay away from conflicts. Try to figure out where his trigger points are. Don't turn into a doormat, but pick and choose your battles, try not to yell and choose your words carefully. Hope this helps.

I have a 26 year old that sustained a TBI more than 10 years ago and he has a mood disorder as a result of it. I wish I had suggestions other than having a lot of patience (which I'm sure you do) and try to find a TBI/Brain Injury support group in your area. It will help A LOT. It helped me. From one Mother to another, I can sympathize and relate completely. I send you love and support.

Aimee

My son is 30 yrs old. Spina Bifida, his shunt failed in 2015. He spent 89 days in the hospital --45 of it in a coma -- from a failed vp shunt. Six surgeries later, he suffers left side weakness, eating and swallowing issues. All is getting better. Behavior, cognitive issues, and damage so far past the brain stem its caused hearing issues and struggles every minute from this. His biggest struggle is getting the right help and right direction from the medical field. He is surely like a TBI patient. Breaks my heart we feel helpless for him. But keep working on getting him better.

Well, I had a minor one, and I need help, I have not been myself since, I want help!

I feel for anyone who shoved antipsychotic meds after a TBI. After my TBI in 1985, I was on a roller coaster of meds. One to help the other to deplete the next symptoms... I had flooding (a lot of it.) I knew I was different, I was told by loved ones I was crazy. I had both sudo seizures as well as simple complex, later found I had sleep apnea, along with partial paralysis with a left foot drop. I also suffered with hearing loss and everything just sounded like bla bla bla... My eardrums were not moving my brain was very swollen. They tried hearing aids it just made bla bla bla louder - I refused to use them. Later tested as my hearing 3 years later began to come back - I had trouble understanding words beginning of words I was called a liar and that I was faking it. Who the hell would take that? Later they tried to pin all kinds of labels of mental illness, bipolar, personality disorder, major depression, and more.

I'm happy to report today after 31 yrs - I'm finally reading articles seeing doctors who have my best interest in mind. I had situational depression, seizures, flooding from over-stimulation because I pushed myself to do things when I needed to not push so hard. Emotional flooding because of people in my life who didn't understand. So much has happened but like most TBI I am left all alone. People don't understand because I don't look sick... It is an Invisible illness... I can't work a full time, I have family members who think I am lazy. Really because I'd really like a job full time and have money to do things... My brain won't allow me to. Always working and seeking to better myself. On another note where I had front and back TBI, then several more TBI wrenching my neck all the time I'm looking at some serious surgeries.

I suffered a "mild" concussion after a slip & fall on the ice.  Thank you for this article! This information would have helped me tremendously had I known this 4+ years ago.  Luckily this uncontrollable laughter & crying only lasted a few days after the injury but it confused my family and landed me in a psych ward for 3 days on an involuntary commitment.  I wish people in the medical/mental health industry would have more training to identify these obvious symptoms that I am still learning.  Thanks for the article and description that helps define my injury.  I pray that the woman with the daughter being falsely accused of bipolar disorder finds better doctors.  I have stood up to doctors and a neuropsycholigist who have tried to label my injury a mental illness.  A registered nurse practitioner who held me in lock down tried to medicate me with an anti seizure & anti depressant combination for my "condition".  It was 2 years later that my best friend who is a RN with 10 years experience in mental health explained to me that they had attempted to treat me for bipolar disorder.  It is inappropriate to make such a diagnosis or recommendation without an extensive history.  The medical world is too quick to medicate rather than locate the true problem through testing that is now available to make sure they are not adding dangerous drugs to an injured brain.  Luckily I refused her recommendations and advised her I wanted to speak to my regular doctor before considering these medications.   Humans are not guinea pigs.  I was drugged against my will twice before leaving the hospital with antipsychotic meds. I now have uncontrollable muscle spasms/tics.  I am hopeful that it is just stress, PTSD or gut health all of which can be healed.  One of the side effects of the forced meds is tic disorders.  Although I doubt that is the case for me I think doctors are calloused & negligent in using dangerous psychotropic meds on any patient with an injured brain. Extreme caution should be used when labeling a person with mental illness and or medicating.  I learned the term differential diagnosis while being sued that doctors can actually admit they are not sure what is causing symptoms before putting labels on a person that can damage them for years to come. 

Exactly...neuropsychologists who do not know about brain injury should not attempt to treat those with suspected brain injuries. They cause more harm than help. The misidiagnosis in my case impeded treatment, I was rubber stamped a nut job instead of getting the help I desperately needed. I am now too traumatized to seek help. I won't go near a doctor.

All of the articles I read address all kinds of symptoms and issues such as flooding after the TBI in such a way that it sounds like these things happen initially when the brain is healing in the first months to year.   What about long term studies that show these issues, problems, symptoms persisting years later.  My TBI was 15 years ago next month and I have these issues.

My head injury was in 1987 and I am really having issues with cognitive decline. When I try to reason or figure issues out, my brain floods and I can't think straight. My life has become simple because I can't figure out how to move ahead anymore so I have learned to settle for a very simple day to day existence, can't work, can barely function at this point. I have to keep my stress level down and I sleep alot. It's been 30 years and I have been pretending to be ok for many years. The first five years after the accident I was an absolute mess, I faked it for many years, now I am finding out how my brain is losing the ability to be a part of society. No one really knows how challenging it is unless you are experiencing it yourself.

Learn about pseudo-bulbar. The laughing part is kind of fun but can be embarrassing and the crying part is embarrassing. Regardless of pseudo-bulbar, when there's too much stimuli without enough rest... that's a recipe for disaster for anyone who's had a TBI. But, you can learn to manage it. And there are some meds that can help (not eradicate) with the mood swings, but you have to find the right mix.

The Pseudobulbar affect causes irrepressible laughter and/or crying. It is a symptom of brain damage from TBI, stroke or advanced degenerative neurological disease.

Its like a hiccup.

In some people, including me, the laughter (or crying) can be triggered by emotional states, but having pseudobulbar effect has nothing to do with your overall emotional state.

Anyone who needs more info on pseudobulbar affect should head to stroke.org and Wikipedia.

Do you know anything about the Emotional Nervious System?  Many of the issues we deal with are centered there i.e. anger - fight or flight - The Limbic System.  Mindfulness training is good way to control these unwanted emotions by staying calm and relaxed.  It is better to be pro-active than reactive to these issues.  You can read all about neuroplasticity, mindfulness, biofeedback on Wikipedia without all the pro-industry slant.