Individuals who suffer a TBI often undergo changes in behavior as well as emotional difficulties. Common behavior changes associated with TBIs include:
- Less effective social skills
- Impaired self-awareness.
Emotional difficulties associated with TBIs include:
- Mood swings.
Behavioral/Emotional issues can be due to the injury to the brain itself, and/or they may reflect the person’s distress in adjusting to changes since the TBI.
Patients suffering from a TBI often encounter bouts of depression during their recovery in the year following the TBI. Risk factors for depression following TBI include prior history of depression, younger age at time of injury (18-29 years vs. >60 years), and lifetime alcohol dependence.
Emotional and behavioral changes experienced by persons with TBI are often one of the more significant sources of difficulties and stress for the individual and his/her family and may have a substantial impact on performance in work and school settings.
- Personality changes are often associated with TBIs. Examples of personality changes include but are not limited to the individual becoming more or less outgoing, irritable, active, etc. or experiencing changes in interests (e.g., loss of interest in previously enjoyed activities).
- Anger/frustration: After experiencing a TBI, the individual may become “short tempered” and quick to get angry/frustrated. Individuals may also seem less patient and become less tolerant of changes (i.e., daily routine, etc.). Problems with frustration tolerance may be noticeable in new situations and/or when the individual is tired or stressed. An individual who suffered from a TBI may become more likely to have anger outbursts, and may become verbally or physically aggressive.
- Emotional distress: TBIs are commonly associated with symptoms of emotional distress such as anxiety and/or depression. Individuals may experience anxiety in the form of panic attacks or general nervousness or restlessness. Individuals may also experience fear/anxiety in situations that are similar to that which led to the TBI such as riding in a car after sustaining a TBI during a car wreck.
- Difficulties in social situations or in relationships: TBIs are often associated with deficits in communications skills such as taking turns in conversations and listening to other participants; Using appropriate eye contact; Awareness of and respect for other’s personal space; and awareness and appropriate use of non-verbal communication skills (e.g., gestures, facial expressions, body language). Individuals with TBI may also become less sensitive to social norms and have less sensitivity to the feelings of others. Such difficulties may be evidenced by the individual’s use of inappropriate language or socially unaccepted behavior at home and in public.
- Executive function difficulties: TBIs often impair an individual’s ability to regulate their behavior or to use logic to respond to given situations. Reduced self-control and increased impulsivity are common consequences. Problems with judgment and reasoning may also arise which can lead to increased suggestibility (ability to be led or influenced by others) and poor decision-making (e.g., related to managing finances) may occur. Individuals often experience decreased motivation and/or interest (apathy) to engage in activities after suffering a TBI. The individual with TBI may becomes more likely to fail to follow through with plans; be less likely to speak unless spoken to; and may spend most of their time not engaged in activities (e.g., staying in bed late).