Depression

Depression is sadness than can last a few days or weeks, or a long time. It can also manifest as a loss of enjoyment in life, even in the activities that once gave a person great joy and sense of self. It is characterized by feelings of sadness, despair, and discouragement. It often follows a personal loss or an injury, like TBI. When someone's life has changed drastically, it's normal to feel depressed. It is not a sign of weakness, nor does it represent a moral failure. It is definitely not something to be ashamed of.

Depression can result from the chemical changes in the brain itself. It can also be a symptom of post-traumatic stress disorder. If the depression becomes extreme and affects the way you live your life, it may become pathological. Seeking help early is crucial.

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When Depression Is Not Depression After a TBI

When Depression Is Not Depression After a TBI
Many symptoms after brain injury can appear as if they are depression, but they may or may not be depression. So, being sad all the time or most of the time, being tearful, with problems with sleep and energy and concentration--they could all be explained by depression. However, in many circumstances, those other symptoms are other brain injury symptoms. So, having fatigue, sleep disorders, cognitive problems such as tension and memory are separate problems from depression. You can treat the depression, but those problems may persist. Some people may appear depressed because they don't want to do things, but really it's apathy. It's lack of interest. It's not being sad, which is a separate problem which needs a different type of intervention and treatment.

Why Is Depression Common After Brain Injury?

Why Is Depression Common After Brain Injury?
How do you counsel families on dealing with depression? Well, as you said, I think it is a common phenomena. There are different types of depression. Certainly in response to seeing a loved one injured catastrophically, reactive depression in caretakers is common. And it can be more acute, or it could be longer term. After they realize that someone is not improving the way they thought they would, the message--sort of--hits home, as has been mentioned earlier. Then you may see that even several years after the injury in a caretaker. Within the population of patients who get brain injured, depression is probably most common in the first year to two, post-injury on an organic or brain injury-basis, and ultimately, it needs to be recognized by the people taking care of that patient and addressed through not just medications, but also non-medication intervention, such as psychotherapy, which has been shown to also be effective, even in people with brain injury.

Why Is Depression the Number One Symptom After a Brain Injury?

Why Is Depression the Number One Symptom After a Brain Injury?
The most common mental illness that would occur after a brain injury is depression, which can occur, depending on the study, from anywhere from 20% to 60% of individuals after traumatic brain injury. It can occur in the first few months, but it can even occur--you know--months or even, studies have shown, years after the actual traumatic brain injury. Why is it more common? You know, we don't know. It may be that the areas of the brain that get injured are those that are more involved in producing depression. And certainly some studies show a correlation between the area of the brain that's injured and then subsequent depression. It could be that the chemical systems involved, the neurotransmitters involved during brain injury that get disrupted affect mood more than, maybe, some other behaviors. We have to appreciate that depression is a common disorder and it's one of the most common psychiatric disorders. So, certainly depression can be as a result of physiologic dysfunction of the areas of the brain, but we also know that other things make individuals depressed whether or not they have had a traumatic brain injury. So, being in a traumatic circumstance, having loss of certain functions, having problems with your social system and support, being unemployed, being in chronic pain--all can produce depression in addition to the effects of having the brain injury.