Learn / Traumatic Brain Injuries and Your Mental Health
Traumatic brain injuries (TBIs) can be extremely serious. Unlike most injuries, they can directly alter brain function, and have a severe impact on your mental health. Some patients even develop addictions following TBI, whether or not they have a history of substance abuse.
Even a relatively mild concussion can cause long-term symptoms. And because those symptoms won’t necessarily appear right away, it can be hard to see the connection between TBI and subsequent mental health issues. After sustaining any type of head trauma, it’s important to see a doctor and learn about your options for recovery. Depending on your exact experience, you may benefit from getting treatment at a residential rehab.
Although they’re caused by physical trauma, TBIs are strongly related to mental health and addiction issues. Because these injuries can affect brain function, mood and behavioral changes are common symptoms of traumatic brain injury.1
In some clients, head trauma can lead to serious mental health conditions,2 like depression or anxiety. This is even true for people with mild TBIs, like concussions. According to one study, “both moderate to severe and mild TBI are associated with an increased risk of subsequent psychiatric illness.3 Whereas moderate to severe TBI is associated with a higher initial risk, mild TBI may be associated with persistent psychiatric illness.”
The connection between TBIs and mental health conditions goes both ways. Many TBI patients experience emotional changes, regardless of their prior health history. People with a preexisting mental health diagnosis may also be at a higher risk for traumatic brain injury.4 No matter what your mental health history looks like, you may be especially vulnerable to certain issues after a TBI.
TBIs are correlated with major depressive disorder.6 One study found that this condition “occurs with sufficient frequency to be considered a significant consequence after TBI.” And unfortunately, these symptoms may get in the way of your recovery. Many people with depression have trouble finding the motivation to get the help they need.
Anxiety disorders are quite common after traumatic brain injuries.7 TBI is associated with a number of anxiety disorders, including (but not limited to) the following:
In some cases, these conditions are simply emotional responses to the event that caused traumatic brain injury. For example, you might develop PTSD after being in a serious car accident. However, they may also result from changes to the brain itself. Experts have found that anxiety is “a strong predictor of social, personal, and work dysfunction” in people with TBIs.
PTSD commonly co-occurs with traumatic brain injuries. This might be true because of the prevalence of TBI among military veterans,8 who are at risk of PTSD for additional reasons. However, research has found that civilians with a history of head trauma are also at risk for developing PTSD.9 If you’re experiencing the symptoms of PTSD, whether or not you have a history of TBI, consider attending a program that offers trauma-informed care.
Treatment for TBI depends on your exact symptoms, and on their severity. Because these injuries may affect any area of the brain, different clients have vastly different needs during recovery. Most people benefit from a combination of physical and psychotherapeutic interventions for traumatic brain injuries.10
If you’re experiencing mood or behavioral changes, or other mental health symptoms, the following types of therapy can be especially helpful:
CBT is the most widely used mental health intervention for people with TBI.10 In this type of treatment, you’ll regularly meet with a therapist to discuss your emotional experience. During each session, you’ll identify challenging thought patterns and emotional responses, and learn practical tactics to help you navigate them. These skills empower you to approach difficult emotions and situations with equanimity.
Mindfulness techniques may be helpful for TBI,11 especially for people with both cognitive and psychological symptoms. Preliminary research shows that therapies like meditation, yoga, and mindfulness-based cognitive therapy (MBCT) are highly effective in treating a wide variety of symptoms. These techniques can help you come into the present moment, accept your emotions as they are, and find a sense of peace. More research is needed into this form of treatment in the context of TBIs. If you do engage in meditation as part of recovery, it’s important to combine it with other healing methods.
Depending on your symptoms, you may be a candidate for pharmaceutical treatment for mental health issues following a TBI.12 If you decide to try taking medication after a brain injury, it’s important to stay in close communication with your prescribing doctor. Any prescription can have side effects, and you could be at risk for developing serious cognitive or even physical symptoms due to your health history. Some medications, including tricyclic antidepressants, may not be safe for people with a history of TBI.
There is a high rate of substance use disorders among people with a history of TBI.13 Although more research is needed into the exact link between these two conditions, data supports the idea that addiction can make people more vulnerable to brain injuries, and vice versa.
Like other mental health conditions, substance abuse can increase your risk of traumatic brain injury.12 One study suggests that problem drinking is an especially common risk factor for these injuries, because it interferes with physical coordination. Drinking post-TBI can lead to severe mental health symptoms.
Any history of addiction can have an impact on your recovery from these injuries. One study found that people who had already entered recovery for substance misuse, and then sustained a traumatic brain injury, were at an increased risk of addiction relapse after their TBI.13 And since new symptoms can appear long after the original injury, it’s important to make a long-term plan for your recovery.
Evidence suggests that people who sustain early-life TBIs are at a greater risk for developing substance use disorders.14 Head trauma can impact brain development, and it sometimes changes the way you respond to certain stimuli. In particular, research shows that the “regions of the brain associated with the perception of reward” may be directly affected by brain injuries.
If these areas of your brain are changed or damaged, you’ll be more vulnerable to addiction. A wealth of neuroscientific research confirms that drug use hijacks the brain’s reward system.15 According to neuropharmacologists Wilkie A. Wilson, Ph.D., and Cynthia M. Kuhn, Ph.D., “when addictive drugs enter the brain they artiﬁcially simulate a highly rewarding environment.” This modifies brain chemistry, provoking behavioral changes. Habitual drug use causes “the reward system to modify the brain to crave the drug and take action to get it.”
Professional athletes may also be more vulnerable to developing addictions16 following TBI. According to one study, athletes are “more susceptible to the intoxicating effects of substances and may get in trouble more easily due to the disinhibiting effects of the brain injury.” Because addiction often starts as an attempt to self-medicate mental health symptoms, early treatment may help you avoid more serious consequences.
If you have a history of either drug abuse or brain injury, be sure to inform your doctor when you seek treatment for either condition. Healing is absolutely possible, but you may need specialized care during recovery.
Traumatic brain injuries are common among athletes.17 Experts estimate that 10% of all TBIs “are due to sports and recreational activities.” And if you’re a professional athlete, this type of injury can directly interfere with your ability to do your job.
Fortunately, several luxury rehab programs are designed to meet your unique needs. Orenda at Futures offers the Orenda Athletes Track, in which clients can continue physical training during residential treatment. This empowers you to recover without sacrificing your long-term career goals in the process. At this facility, “a team that has provided training and physical therapy to MLB, PGA, and more helps athletes heal and train while receiving comprehensive care for mental health and substance use disorders.”
You may be eligible for one of these specialized programs even if you’ve already retired from professional sports. All Points North Lodge treats both active and former professional athletes. Their experts continue offering support even after clients complete inpatient treatment. With their guidance, clients can start planning for long-term recovery from the moment they enter rehab. For some, that recovery plan may need to include medical care alongside mental health treatment.
If you develop mental health symptoms after a TBI,18 you may be at greater risk for additional symptoms. Specifically, mental health issues could be a warning sign for functional limitations, like memory loss and difficulty performing regular activities. Your healthcare team may be able to recognize those signs in advance, and help you prepare for challenges.
TBIs may be classified as mild, moderate, or severe.19 According to the CDC, symptoms may last as little as a few hours, or they may linger for the rest of a person’s life. These injuries are especially dangerous for children and older adults. For children, TBI symptoms can affect brain development and result in long-term cognitive issues. Older adults are often misdiagnosed, and fail to receive the care they need as a result.
In mild cases, common symptoms of a traumatic brain injury5 include, but are not limited to:
Moderate or severe TBIs present with the same symptoms, and may also cause the following issues:
If you exhibit any of these symptoms after a head injury, no matter how minor, it’s very important that you consult a doctor.
Traumatic brain injuries can have long-term health impacts. And if your brain functions differently than it did before, it can be difficult to imagine what healing will look like. Recovery might not mean returning to life as it used to be. Instead, this is your opportunity to get to know yourself again, and decide how you’d like to move forward.
It’s extremely important to get comprehensive care after a TBI. Physical and mental health are always connected, especially if you’re healing from a brain injury. By working with a skilled team of doctors and therapists, you can decide on a plan of care that feels right for you.
If you’re concerned about the impact of an injury on your mental health, talking to a treatment facility can be a good place to start. See our directory of luxury rehabs for program information, photos, reviews, and more.
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Schachar, R. J., Park, L. S., & Dennis, M. (2015). Mental health implications of traumatic brain injury (TBI) in children and youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry / Journal de l'Académie canadienne de psychiatrie de l'enfant et de l'adolescent, 24(2), 100–108. Retrieved from https://psycnet.apa.org/record/2015-40258-004
Fann, J. R., Burington, B., Leonetti, A., Jaffe, K., Katon, W. J., & Thompson, R. S. (2004). Psychiatric illness following traumatic brain injury in an adult health maintenance organization population. Archives of General Psychiatry 61 (1), 53–61. https://doi.org/10.1001/archpsyc.61.1.53
Fann, J. R., Leonetti, A., Jaffe, K., Katon, W. J., Cummings, P., & Thompson, R. S. (2002). Psychiatric illness and subsequent traumatic brain injury: A case control study.& Journal of Neurology, Neurosurgery & Psychiatry,72 (5), 615–620. https://doi.org/10.1136/jnnp.72.5.615
Traumatic brain injury | national institute of neurological disorders and stroke</i>. (n.d.). Retrieved from https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury
Rosenthal, M., Christensen, B. K., & Ross, T. P. (1998). Depression following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 79 (1), 90–103. https://doi.org/10.1016/S0003-9993(98)90215-5
Hiott, D. W., & Labbate, L. (2002). Anxiety disorders associated with traumatic brain injuries. NeuroRehabilitation, 17(4), 345–355. https://pubmed.ncbi.nlm.nih.gov/12547982/
Loignon, A., Ouellet, M.-C., & Belleville, G. (2020). A Systematic Review and Meta-analysis on PTSD Following TBI Among Military/Veteran and Civilian Populations. Journal of Head Trauma Rehabilitation, 35(1), E21–E35. https://journals.lww.com/headtraumarehab/Abstract/2020/01000/A_Systematic_Review_and_Meta_analysis_on_PTSD.12.aspx
Stein, M. B., Jain, S., Giacino, J. T., Levin, H., Dikmen, S., Nelson, L. D., Vassar, M. J., Okonkwo, D. O., Diaz-Arrastia, R., Robertson, C. S., Mukherjee, P., McCrea, M., Mac Donald, C. L., Yue, J. K., Yuh, E., Sun, X., Campbell-Sills, L., Temkin, N., Manley, G. T., & and the TRACK-TBI Investigators. (2019). Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: A track-tbi study. JAMA Psychiatry, 76(3), 249–258. https://doi.org/10.1001/jamapsychiatry.2018.4288
Gómez-de-Regil, L., Estrella-Castillo, D. F., & Vega-Cauich, J. (2019). Psychological intervention in traumatic brain injury patients. Behavioural Neurology, 2019, 6937832. https://doi.org/10.1155/2019/6937832
Bédard, M., Felteau, M., Marshall, S., Dubois, S., Gibbons, C., Klein, R., & Weaver, B. (2012). Mindfulness-based cognitive therapy: Benefits in reducing depression following a traumatic brain injury. Advances in Mind-Body Medicine, 26(1), 14–20. https://pubmed.ncbi.nlm.nih.gov/22875545/
Schwarzbold, M., Diaz, A., Martins, E. T., Rufino, A., Amante, L. N., Thais, M. E., Quevedo, J., Hohl, A., Linhares, M. N., & Walz, R. (2008). Psychiatric disorders and traumatic brain injury. Neuropsychiatric Disease and Treatment, 4(4), 797–816. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536546/
Olsen, C. M., & Corrigan, J. D. (2022). Does traumatic brain injury cause risky substance use or substance use disorder? Biological Psychiatry, 91(5), 421–437. https://doi.org/10.1016/j.biopsych.2021.07.013
Cannella, L. A., McGary, H., & Ramirez, S. H. (2019). Brain interrupted: Early life traumatic brain injury and addiction vulnerability. Experimental Neurology, 317, 191–201. https://doi.org/10.1016/j.expneurol.2019.03.003
How addiction hijacks our reward system. (n.d.). Dana Foundation. Retrieved from https://dana.org/article/how-addiction-hijacks-our-reward-system/
Morse, E. D. (2013). Substance use in athletes. In D. A. Baron, C. L. Reardon, & S. H. Baron (Eds.), Clinical Sports Psychiatry (pp. 1–12). John Wiley & Sons. https://doi.org/10.1002/9781118404904.ch1
Sahler, C. S., & Greenwald, B. D. (2012). Traumatic brain injury in sports: A review. Rehabilitation Research and Practice, 2012, e659652. https://doi.org/10.1155/2012/659652
Zahniser, E., Nelson, L. D., Dikmen, S. S., Machamer, J. E., Stein, M. B., Yuh, E., Manley, G. T., Temkin, N. R., Adeoye, O., Badjatia, N., Boase, K., Bodien, Y., Ross Bullock, M., Chesnut, R., Corrigan, J. D., Crawford, K., Diaz-Arrastia, R., Duhaime, A.-C., Ellenbogen, R., … Zafonte, R. (2019). The temporal relationship of mental health problems and functional limitations following mtbi: A track-tbi and ted study. Journal of Neurotrauma, 36(11), 1786–1793. https://doi.org/10.1089/neu.2018.6172
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