Traumatic brain injury survivors undergo many changes, not only physically and mentally, but also emotionally and behaviorally.
People who have survived traumatic head injuries may face a variety of neuropsychological issues. Experts will tell you that the effects of such injuries can vary greatly and depend on the area of the brain that was affected, as well as the severity of the injury. Some of the common effects of traumatic brain injury include impaired judgement, memory lapses, partial or complete paralysis, and difficulty organizing thoughts and ideas. TBI can also result in behavioral and personality changes that can be difficult for the patient’s families and caregivers. To effectively provide the care that their loved one needs, the caregivers must learn to adjust their communication methods and alter their expectations of what their loved one is able and unable to do.
Common Issues Associated with TBI
The behavioral and emotional problems faced by head injury survivors are possibly due to the injury itself, or a reflection of the person’s distress in adapting to the neuropsychological changes they undergo following the traumatic brain injury.
Behavioral changes can include:
Personality changes – Some patients experience personality changes that are an exaggeration of their pre-injury personality. Others experience a diminishing of theirs, while there are those who experience a complete reversal. These changes can include but are not limited to becoming more or less outgoing, active, easygoing, and considerate. Someone who used to be cheerful and patient may now seem unenthusiastic and easily angered. It is also common for patients to demonstrate changes in interest (e.g. loss of interest in activities and hobbies they previously enjoyed).
Difficulties with social relationships – Persons with TBI may experience difficulties with skills related to interpersonal communication, such as listening attentively to other people or taking turns in conversations; awareness of and respect for personal space; appropriate eye contact; and, awareness of and proper use of non-verbal communication skills, such as gestures, facial expressions, and body language. They may be unaware of social norms and insensitive to other people’s feelings and use socially unacceptable language and behavior. They may also have difficulties picking up subtle nuances and non-verbal cues in social relationships and may need to be directly told when they are exhibiting inappropriate behavior.
Executive function issues – It is not uncommon for a traumatic brain injury to affect a person’s ability to regulate their behavior as well as use logic to respond to different situations. Persons with TBI may demonstrate reduced self-control and increased impulsivity that may manifest in ways such as uninhibited automatic, sometimes inappropriate, responses during conversation; or, increased impulsivity in behaviors and decision-making. Their reasoning and judgement may be impaired leading to poor decision-making and increased susceptibility to others.
Emotional changes can include:
Emotional distress – Anxiety and depression are common results of TBI, which may manifest in general nervousness, restlessness, or panic attacks. They may experience anxiety and/or fear when they find themselves in situations related to their TBI (e.g., getting into and riding a car following a car wreck).
Anger or frustration – These emotions are commonly associated with TBIs. The injured person may become quick-tempered and get easily frustrated or angered. They can be less patient and tolerant of changes, which may be noticeable in new situations or when they become tired or stressed. TBI patients are more likely to demonstrate angry outbursts and may become physically or verbally aggressive.