Emotional and Behavioral Changes After Traumatic Brain Injury

Categories: Brain Injury

A victim of traumatic brain injury.

A traumatic brain injury (TBI) is a disruption of normal brain function that results from an impact on or penetration of the brain. Physical traumatic brain injury symptoms range from mild to severe. Mild physical symptoms are confusion, memory issues, dizziness, speech issues, sleep disruption, blurry vision, nausea, vomiting, headache, and ringing in the ears. Moderate or severe physical symptoms are similar but far more long-lasting and debilitating.

But TBIs can cause more than just physical symptoms. Behavioral and emotional effects can be just as life-altering and far more confusing for the patient and their loved ones. These issues generally fall into one of three categories: mood swings, depression, and anxiety issues.

Mood Swings

Damage to the part of the brain that controls emotions can cause mood swings. When this portion of the brain is affected, the resultant behavior can shock both the patient and their family. A person who has always been emotionally stable may suddenly find themselves having dramatic outbursts of laughing or crying, with no idea why. Often, there does not appear to be any rational trigger to the emotions. In fact, sudden episodes of dramatic emotion may have nothing to do with how the person actually feels in the moment. TBI victims may weep in a happy moment or laugh uncontrollably at something very sad.

As you can imagine, this can be incredibly confusing for everyone involved. Family members may wonder what they did to make the injured person upset when, in reality, they did nothing at all. And TBI victims may begin to feel like they are on a continual emotional roller coaster that they cannot get off.

What to Do

Fortunately, this issue can subside completely, or at least improve over time. But in the meantime, there are things you can do to help everyone cope.

The first thing to do is seek the help of a professional. You can speak to the TBI victim’s doctor, a neuropsychologist, or a behavioral therapist to guide recovery. The injured person may benefit from individual counseling, and family members can pursue individual or group counseling as well. Medications can be used if the doctor and patient feel it would be beneficial.

It is usually best for the injured person to tell everyone they regularly interact with about their struggle. This can help in several ways. Generally, those around you need to know that they are not the cause of any outbursts that may happen in their presence. And when they understand that, they can help in moments of crisis. During an outburst, friends and family can:

  • Avoid reacting and remain calm;
  • Help the person by directing them to a quiet area where they can have privacy and calm down;
  • Acknowledge the person’s feelings and let them talk it out, cry it out, or laugh it out with no judgment; and
  • Gently lead the person to an activity that might distract them and help them regain composure.

Your doctor or therapist will have more ideas tailored to your individual needs. So be sure to discuss possible actions that can help everyone to cope better.


Depression after a TBI is common. But it can be hard to distinguish between genuine depression and depression that is a direct result of the injury. Genuine depression can happen in the aftermath of a life-altering accident because the person must come to terms with how their life has suddenly changed. A once healthy person who suddenly finds themselves on a continual regimen of therapy and doctor’s visits may understandably feel sad. If this sadness continues, it can lead to depression.

But the tricky thing about depression in TBIs is that this emotional response can be a direct result of the injury. When an injury impacts the area of the brain that controls emotions, physiological and even biochemical changes can occur in the nervous system that results in depression.

But there is hope. It is best to treat signs of depression as soon as you notice them. Friends and family can help the injured person by reassuring them that depression is not their fault. TBI-related depression is a real medical condition that can not be solved by simply wishing it away or thinking positively. It is not a character flaw; it is a physiological illness. Counseling with a professional who understands TBI is essential. While a good diet and exercise regimen can help symptoms of depression, therapy and possibly even pharmaceutical intervention might also be needed.


Anxiety is a feeling of unease, worry, and concern about something. A person can be anxious about an upcoming event in their life or about a situation where they cannot predict the outcome. But anxiety can become a disorder if a person becomes excessively nervous or apprehensive on a continual or ongoing basis. This continual worry is often accompanied by anxiety or panic attacks. Some people even resort to compulsive behavior as a way of trying to cope with constant anxiety.

For people with TBIs, many things can make them feel overwhelmed and trigger anxiety. TBIs can reduce a person’s ability to reason, use proper judgment, control their behavior, or make good decisions. As the injured person begins to realize their new limitations, anxiety often grows. And when situations arise where they need to make decisions or where they find themselves unable to meet reasonable demands, this can trigger a panic attack.

As with depression, anxiety is best addressed by a professional. Counseling can help injured people sort out their feelings of helplessness and provide them with strategies to combat common sources of stress. Medications can also help. Friends and family can improve the situation by becoming familiar with anxiety triggers and removing them to any extent possible. And of course, responding to any episode with love, compassion, and understanding goes a long way.

You Can Count on Us

The attorneys at Brett McCandlis Brown & Conner PLLC, have years of experience in personal injury cases, including cases that involve the behavioral and emotional effects of traumatic brain injuries. If you are trying to put your life back together after a TBI, our lawyers can help. We will fight to get you compensation for your medical bills, wages you lost while in recovery, pain and suffering, and more. So don’t delay. Call us today or contact us online to schedule your free initial consultation today. We look forward to serving you.

Author Photo

Matt Conner

Matt Conner has a proven track record of success. Following his graduation from Willamette University with a double major in mathematics and economics, Matt worked as an economist for the Office of Economic Analysis for the State of Oregon before moving onto working in mortgage banking and real estate.