TBI 101: Behavioral & Emotional Symptoms

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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 (20)

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.

I am so grateful for this information. My husband suffered a TBI before we met. This helps me understand as he is not willing to talk about how the brain damage effects him.

This information is extremely helpful!! I had a stroke a few years ago (at age 41) and I haven't been able to figure out what was wrong with me me, until now!!!

I recently had a craniotomy and I can’t control my emotions and actions. No one believes me. I’m all over the place and I don’t know what to do

I'm not a doctor or care giver but I do have TBI and can relate to the feelings, frustrations, and experience you seem to be describing. I believed I was having a "breakdown" rather than suffering from a head injury. My loved ones told me to either "toughen up" or expressed their disappointment (those that stayed in touch). You are NOT weak or "nuts". I'm sure you have heard it but go to a doctor. Just having someone confirm what you already know inside will be a huge relief (it was for me). I'm inclined to ignore advice suggesting "professional help" as much as anyone but this is not the kind of thing that lends itself to that. If the person(s) in front of you can't help or don't understand move on to someone who does. Things get better.

26 years ago I survived a very violent attack from a stranger/intruder that left me in a coma for three and a half days. He kicked me repeatedly in the head, and I had over 400 bruises on my body. I wasn’t recognizable until 2 weeks after. He’s been out of prison for 12 years now, but I feel like I’m still in mine. So grateful to find this website and a community of people who can relate. Literally no one else in my family or social circles can relate. This site makes me feel far less alone/ashamed/helpless. Thank you all for sharing your stories and suggestions here. It really is a big help. All the best to all of you.

Praying for you! My husband was assaulted 6 months ago and was in a coma for about two weeks. He still can’t speak or use gestures but communicates in other ways...hugging, laughing. Its hard to accept that the person who did this is still out there, living their life as my husband and I struggle in out current situation. I quit my job to become his caretaker and I am up at all hours of the night checking on my husband. When I reach low points, I remind myself that God is in control and He will fix things. Sometimes we can’t understand His ways, but one day things will make sense again. Dont give up hope!

I was in a car accident when I was 16 yrs old. Collapsed lung, compound fracture to my femur, and a traumatic brain injury that left me in a coma for six days. Spent four months in hospital and another six months in at home rehab.

Life has been good to me as far as blessings are concerned. I am 100% fully functioning adult, a beautiful wife and kid, wonderful job (thankfully don't have to think too much at it) that enables me to live a have a pretty comfortable lifestyle. Here it is 26 years later and I'm still chugging along but have been thinking and looking into my future and what I can expect.

EVERY Seen websites showing life expectancy of TBI patients to be around 20 years, so I expect the lights to go out any day now, but also seen websites of people living a full life.

I have had and still have issues with every common behavioral and emotional problem listed above. I can 100% say without a doubt that every common emotional and behavioral problems listed above is something I have dealt with, and continue to deal with daily.

I am usually ashamed of my behavior after I get through my "funk" and look back at my actions, or see the stress that I have caused on my family due to my behavior. I am fortunate to have a wonderful wife, who teaches psychology and physiology, that has the patience and endurance to deal with me. I am forever grateful to her!

Sometimes it really hurts me to see her reactions to my f%^@ed up ways, and unfortunately, due to my lack on apathy and empathy, I am left standing there watching her hurt, yet all I do is just stand there watching. That destroys me inside. I wish I could turn the a**hole off, but I can't seem to flip that switch off.

Gotta get back to work. just wanted to reach out, vent. Be back later.

My 19 yr old son was in a horrific accident in May of this year. He was thrown from a rolling truck going at least 75-80 mph. Upon paramedics arrival he was unresponsive. He was flew to thee most worst hospital ever known to man. Besides the malpractice, and the disrespectful care that I had to watch my youngest son go through, he had 3 fractures in his skull, a broken collarbone and pelvic. His brain was shifted to the left, so there was bleeding in the brain. So for 5 weeks, we were stuck in this hospital that wasn't certified or qualified for his injuries, I don't know how I made it through that but I did. After the 5 weeks there, by the grace of God I somehow found a way to get him transferred to Where we live. A place where he should have been from day one of his accident. Since then he's been in 3 different facilities and now he's home with me, my patience are running short and thin. I know better to argue or yell back, its just so hard to deal with or cope with this different child of mine. I guess I'm asking for any advice on how to help both of us, to learn how to take steps on our actions towards each other. Or maybe just some technics or exercises to relax one another. He feels I'm being to protective of him, I feel like I'm just making sure it doesn't happen again. Dr.states that hes not ready to be on his own, but he thinks he is. I'm not recieving any help from any services or facilities with this matter. So, please any information is better than none..Thanx

My fiance` had a TBI 20 years ago. When he gets into his "rages" the only way he makes himself feel better is by apologizing for being an "a**hole".
I understand how he lacks empathy (he also lost the ability to cry). It is very hard to deal with, at times I'm afraid to stay in the relationship (for my children). He has never been physically abusive but his "bits of rage" can be very frightening. He can get very vulgar in his language and slam doors - which my children are NOT used to. I am sorry for you all that your injuries have happened but I am glad to know that we are not alone in this.

To Danae, you are not bipolar. I survived a very violent and abusive childhood. My sister told me a psychiatrist helped her. Because I moved a lot, I was seen by different psychiatrists, here are the different diagnoses I’ve received: depression, bipolar, PTSD, PTSD with recurrent depressive episodes,generalized anxiety disorder...now I’m back to bipolar “because your sister had it”. I’ve also been placed on medication with life-long side effects. NONE of this prepared me for the severe, unanticipated emotional roller coaster I have now after my TBI. CT and MRI negative for bleeding, must be no injury. In fact, I had a grade 3 concussion (does not show up on CT or MRI). I was told I needed to see the psychiatrist about my “bipolar disorder. NOPE, increasing drugs made it worse. Bipolar is episodes off depression, and episodes of mania. NOPE, since my TBI, I’m not bipolar, I’m mega polar; depression, anxiety, paranoia, hope, no motivation, insomnia, disturbance in smell and taste, anger, those are just the emotional part of TBI. It can change at any moment. What is hardest to deal with is people telling me I look just fine, i’m Crying inside and being shamed on the outside.

thank you for sharing your experience i learned alot about what i've undergone, i havent really had an overall formal medical consultation, just some, my resources are limited, right now i had a hard time working, only had 1CT Scan (the day of the event), 1 MRI only 10 years after, a consultation after 3 years from neuro, conclusion i still dont have the exact therapy or medication that i needed, all this made possible by friends and family, but everything else would be costly, its my fault though, because i havent researched enough on who to go to, life was very very difficult, mostly critizied at work, tardiness and all, had resigned from jobs i love, and now i am very helpless in making a living, but im trying and giving my best, i want to recover, i have dreams, i have plans, i
still cry it out, because we need to be sad sometimes, im very emotional right now because im not alone with this case, and i am thankful because im lucky to just have this case, others have had worse cases ,i had head trauma way back my elementary days, I was the smallest of the class, people always made fun of me, the tallest girl in our class carried me like a baby while she was spinning, i cried for her to stop, until she went out of balance and hit my head on the metal foot of the school's water tank, from that very moment i saw white light like crack on my vision, i kept vomiting, CT scan was difficult but i had to hold my vomit in, none was seen, no bleeding, no fracture, not even a bump, after the CT scan i signal for something to throw up, to their panic they handed me a trash can, only to find out it has holes and no plastic on it, it was hilarious, my humor for a 12 year old child, now i am 26, eversince that event my life changed, but i kept being strong and smiling all the time, i have been mostly laughing, i mostly wanted to be happy, but inside i feel so psychotic, yeah it would drive you nuts, sometimes im so down and crying, i have no idea why crazy was happening to me, at times i was so angry, at times i feel so lonely, i havent had the right professional help, i only had me to help myself for my crazy, still improving on everything, but giving it my best, well im sick as of the moment, got gastro and ENT Amoeba, side effect of the medicine is vertigo, 10 days, 3x a day, have 2 more tablet to go!!! gave my best not to puke, but imagine the hell i have to go through after 3-4 hours of taking it, well i must survive, i want to earn so badly even though i dont have a living right now, very lucky to have people close to me fund my needs, just kept praying and praying, i know the future is bright, and it ok to complain, it is ok to show im hurt and having a hard time, but i try my best to calm down and not have panic attacks, succeded yesterday drank hot water, focused my breathing, applied ointments, i sweat it out while on lotus position, no fan and all, after sweating i wiped it had a clean shirt, and rested, still no fan, would strive harder for me to get a massage and acunpunture, also yoga, and go to doctor for professional help, well thats when i can afford it, fighting for me! thank you for sharing and thank you for reading :)

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.

It’s hard to know with head injuries. Depends where the injury occurred on the head, and the force of impact. I came out of the hockey world where concussions are common. Typically a concussion doesn’t have life altering consequences. Now if there are say 3-4-5 concussions, the accumulative affect can add up. But one concussion isn’t likely to affect you unless it an injury whereby you were KO’d and have been in a coma.
But it’s really hard to know. If your behaviours and habits are noticeably different before head injury compared to after with multiple people verifying that, than you have an idea.

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?

Prior to my TBI (presumably falling off the stairs, if I’m honest, I can’t remember - amnesia?) because of horrifically bad childhood, I had been diagnosed