What Are The Most Common Symptoms And Number Of People Who Experience Depression After Traumatic Brain Injury
Past Studies
Past Studies have found that individuals with traumatic brain injuries can develop depression after their injuries. Depression is a real medical condition that can be treated. Depression is not a normal part of every day life. Persons with depression report that they continually feel sad, irritable, tired, and uninterested in activities that they used to find enjoyable. Other common symptoms of depression include having difficulty getting a good nights sleep, moving the body at a much slower pace, and not being able to remember things or concentrate as easily as before. In the past, research has been limited by the use of small study groups and inappropriate tests to diagnose depression. Researchers have not found consistent information about the relationship between depression and traumatic brain injury.
This Study
This Study examined 722 individuals with varying severity levels of traumatic brain injury that were referred to outpatient treatment at one facility. Although participants ranged in age from 17 to 82 years, with an average age of 36.. As a group, time since injury was approximately 2.5 years. Most of the participants were white and had received motor vehicle-related traumatic brain injuries . Depressive symptoms were rated using standardized tests and widely accepted diagnostic guidelines for depression . Forty-two per cent
How Soon After My Injury Might I Become Depressed
Researchers do not know when depression is most likely to occur after TBI. Some people experience depression right after their injury, while others develop depression a year or more later. It is important to tell your doctor about any symptoms of depression you may be having even if it has been a while since your head injury. Your doctor or health care professional will ask you a series of questions or have you fill out a questionnaire or form to see if you have depression.
What Mental Health Problems Are Common
Anxiety and depression are very common, and they can compound the patients symptoms by impacting their quality of life. They can make recovery even more difficult.
Anxiety is often characterized by irrational fears. These fears are not proportional to the situation. Anxiety can mean that a person is trapped in their own world, and can result in severe panic attacks. Anxiety can also lead to depression.
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Why Is Getting Treatment So Important:
Some brain injuries are obvious due to the visible injuries. Others are more subtle. There are no outward signs of bloody wounds, but the brain can be severely injured. In either case, its imperative the injury be immediately diagnosed, and that treatment of the wounds and injury begins. This treatment can help to improve the patients physical and mental well being. It also means that any early signs of depression or anxiety are spotted and that the treatment of those symptoms can begin as well.
Too often when depression and anxiety arent identified early then treatment doesnt begin until a crisis point is reached. Self-medication with drugs and alcohol is a real risk.
What Is An Anxiety Disorder
An anxiety disorder is a type of mental health condition. If you have an anxiety disorder, you may respond to certain things and situations with fear and dread. You may also experience physical signs of anxiety, such as a pounding heart and sweating.
Its normal to have some anxiety. You may feel anxious or nervous if you have to tackle a problem at work, go to an interview, take a test or make an important decision. And anxiety can even be beneficial. For example, anxiety helps us notice dangerous situations and focuses our attention, so we stay safe.
But an anxiety disorder goes beyond the regular nervousness and slight fear you may feel from time to time. An anxiety disorder happens when:
- Anxiety interferes with your ability to function.
- You often overreact when something triggers your emotions.
- You cant control your responses to situations.
Anxiety disorders can make it difficult to get through the day. Fortunately, there are several effective treatments for anxiety disorders.
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Surprising Facts About The Best Ways To Treat Depression
For example, mice that have gone under chronic unpredictable stress have higher levels of inflammation markers . Interestingly, there are individual differences that make some mice more resistant to stress, therefore initiating a calmer immune response .
Depression is a heterogeneous disorder. Each patients struggle is unique given their childhood, genetics, the sensitivity of their immune system, other existing bodily illnesses, and their current status in society.
Being on the disadvantageous end of these dimensions irritates our immune system and causes chronic inflammation. The brain is very responsive to these circulating inflammatory markers and initiates sickness behavior. When the inflammation is prolonged by stressors or other vulnerabilities, the sickness behavior becomes depression.
If you are a professional working with patients suffering from depression, I urge you to consider the health of your patients immune systems. If you are a patient suffering from an exaggerated immune disorder , do not ignore the depressive symptoms that you might be experiencing. If you are suffering from depression, avoid anything that might exacerbate your immune response. This is another example of the beautiful dance between mind and body!
References
Haapakoski,R.,Mathieu,J.,Ebmeier,K.P.,Alenius,H.,Kivimäki,M., 2015. Cumulative meta-analysisofinterleukins6 and 1,tumournecrosisfactor and C-reactive protein in patients with major depressive disorder. Brain Behav.Immun. 49,206.
Keys To Managing Depression Or Anxiety Triggered By A Tbi
For TBI victims whose injuries or symptoms seem mild, they may be able to manage episodes of depression and anxiety through basic self-care techniques such as exercise, eating right, and mindfulness practices. However, since victims of head injuries often struggle with physical injuries and/or chemical imbalances, these strategies may not be enough to help them cope, and they may need more help. Common treatment options include:
Psychotherapy and counseling. Many TBI victims are able to manage their anxiety and depression with the help of counseling. Techniques like cognitive behavioral therapy and dialectical behavior therapy have proven quite useful in helping TBI victims cope with and contextualize their feelings. Some therapists also use innovations like biofeedback to help patients identify and retrain their responses.
Medication. In some cases, the best way to provide relief to head injury victims and restore some quality of life is through the use of antidepressant medications which help balance the brain chemicals that trigger anxiety and depression. Because antidepressants are powerful psychotropic drugs that can deeply affect mood and logic, this path requires constant monitoring and supervision to make sure the right drugs are administered in the right dosages, so the patient truly benefits from them.
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Understanding Emotional Problems After Traumatic Brain Injury: Why They Happen & How To Cope
Elizabeth Denslow, OTR/L Flint Rehab
Emotional problems after traumatic brain injury can be complex secondary effects. A brain injury can cause a wide variety of emotions, from sudden anger to feeling nothing at all. Fortunately, by understanding why emotional changes are happening, individuals can gain self-understanding and seek treatment or therapy, if necessary.
To help you understand emotional problems after traumatic brain injury, this article will discuss:
Depression Following Tbi Can It Be Prevented
Psychiatric Times
The chronic and relapsing course of TBI-associated depression poses a challenge to the management of afflicted patients.
Every year, 1.7 million people in the US sustain a traumatic brain injury , and nearly 1.1% of Americans live with a disability related to TBI.1 Psychiatric disorders frequently complicate the course of recovery from TBI and occur at rates exceeding those of the general population. Major depression is the most common psychiatric disorder following TBI, affecting an estimated 29.4% of patients in the first year post-injury alone.2 TBI-associated depression contributes to higher suicide risk, altered executive function, poorer social reintegration and vocational outcomes, and decreased quality of life.3
The chronic and relapsing course of TBI-associated depression poses a challenge to the management of afflicted patients. Two-thirds of patients depressed at 1-year post-injury remain so in the second year, and the risk of depression remains elevated for 20 to 30 years after the injury.3 In a small trial of citaloprams efficacy to prevent relapse in patients with remitted TBI-associated depression, over half of the sample relapsed at a mean time of 6 months.4 The high prevalence, chronicity, and potentially irreversible consequences of post-TBI depression underscore the importance of developing interventions targeting this disorder.
Defining prevention
Preventive interventions for TBI-associated depression
Potential barriers to prevention
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Openness To New Ideas And A Change Of Perception
This is just a theory. But remember, so is the idea that depression results from a chemical imbalance. Were just not at a place in brain science that we can know anything for sure. So, we might as well be open to new ideas. }
If you viewed your depression and anxiety as a physical injury to your brain, would that change the way you see yourself and your illness? Would it change the way you talk to your doctors? Would you feel validated instead of misunderstood?
Could you more easily compare yourself to someone who had, say, a major knee injury? Would you be able to approach medication and therapy in the same way a person with a knee injury doeswith a little more patience and endurance? Would your family and friends be more understanding?
Would you be kinder to yourself?
Marie Rowland is a neuroscientist, writer, and patient advocate. She founded EmpowermentAlly to help promote patient empowerment in people who have mental illness or a brain injury. You can find her at EmpowermentAlly and you can help support mental health services at Fundable EmpowermentAlly.
Marie is offering subsidized services to people with a mental illness on her EmpowermentAlly website. She has a special offer for Anxiety, Panic & Health readers a thorough review of your mental health concerns, history and a 30 minute coaching session all for a $15 donation at the crowdfunding site Fundable EmpowermentAlly.
How To Get Help
Tell your doctor if you have symptoms of depression. Theyâll want to rule out other health conditions so they can find you the right treatment. You might need to make some lifestyle changes, take medicine, or talk to a mental health specialist. Some people benefit from a mix of all three.
Some treatments for mild or serious depression include:
- Meditation
- Healthy diet change
Suicide is a serious symptom of depression. Get help right away if youâre thinking about hurting yourself. You can reach someone at the National Suicide Prevention Lifeline at 1-800-273-8255. Theyâre available anytime, day or night.
Show Sources
Molecular Psychiatry: âSubcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group.â
Translational Psychiatry: âProfound and reproducible patterns of reduced regional gray matter characterize major depressive disorder.â
Neural Plasticity: âThe Role of Neural Plasticity in Depression: From Hippocampus to Prefrontal Cortex.â
Proceedings of the National Academy of Sciences of the United States of America : âDepression, antidepressants, and the shrinking hippocampus.â
Frontiers in Immunology: âThe Role of Inflammation in Depression and Fatigue.â
The Lancet Psychiatry: âMicroglia and major depression: not yet a clear picture,â âAssociation of translocator protein total distribution volume with duration of untreated major depressive disorder: a cross-sectional study.â
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What Causes Brain Injuries
Brain injuries can be caused by direct, physical damage or by an external force strong enough to move the brain within the skull . A person may suffer a TBI:
- Because of an act of violence
- While playing sports
- Avoiding isolation which usually requires direct involvement by family and friends
- Setting realistic goals and establishing daily routines
If these treatments dont work, more invasive techniques such as brain stimulation therapies may be considered.
How Can Concussions Cause Depression
Theres more than one way for concussions to result in depression. The most common way, especially for people who havent previously experienced depression, is overactivation of the behavioral inhibition system . That said, it can sometimes stem from other issues such as hormone dysregulation and sleep disturbances.
Lets explore each.
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People Who Suffer Depression And Anxiety After A Traumatic Brain Injury May Have Damaged White Matter
Over the past few years, its become widely known among the scientific community that traumatic brain injuries, or concussions as theyre more often called, can result in lasting physical and mental damage for the sufferer a reality that only entered the public consciousness with the emergence of lawsuits filed against the NFL, alleging that they had ignored the evidence showing this when it came to their own players.
But while we know that a concussion can leave you with more than dizziness and a temporary headache, its been harder to understand exactly why. Now, new research published in the Radiological Society of North America claims to have possibly figured out part of the mystery. The study authors say they were able to detect unique brain patterns among people suffering from depression or anxiety as a result of their concussion when compared to the brains of those concussion sufferers with no reported mental problems in some cases, these patterns resembled the brains of those whose mental illness wasnt caused by head trauma.
Noting that conventional screening techniques have failed to find substantial differences in the brains of concussion sufferers compared to a healthy population, the researchers instead utilized diffusion tensor imaging, a MRI method that can detect abnormalities in the structure of white matter, namely the fibers that allow signals to be transmitted throughout the rest of the brain .
Supporting A Loved One With Mental Health Problems After Brain Injury
Mental health disorders, especially depression, can be isolating conditions for those who experience them. Therefore, it is critical for loved ones to offer support during this time.
Some concrete ways to help your loved one include:
While these strategies will not eliminate difficulties, they can help make your efforts to support your loved one more successful.
Being a family member or close friend of someone with a mental health disorder can be challenging. Seeking support from others in a similar situation through a support group may help you to better love and care for your loved one. The National Association of Mental Illness has various virtual and in-person support groups throughout the US, and there may be other groups available in your specific area. It is important to ensure that you are emotionally and mentally well so that you are best able to support your loved one experiencing a mental health disorder.
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Coping With Emotional Problems After Traumatic Brain Injury
Emotional problems after brain injury are difficult to overcome. Whether you struggle with flat affect, anger issues, or a different emotional condition, consider working with a neuropsychologist. These are mental health professionals who specialize in neurological injuries like TBI and their effect on emotions.
In the meantime, here are some simple and effective tips that can help you better manage emotional problems:
While these techniques will not eliminate your emotional problems, they can at least help reduce their severity.
How Untreated Depression & Anxiety Affect The Brain
Without treatment, depression and anxiety disorders can cause measurable changes in key areas of your brain. Experts arent entirely sure all the ways in which these conditions can affect the brain, but heres what they know so far.
Anxiety & Depression Can Shrink Areas of the Brain That Regulate Cognitive Function
Brain imaging tests, such as MRIs, show that people living with depression and anxiety disorders have abnormalities in areas of the brain responsible for cognitive functions like problem-solving, memory, and planning and executing activities. But thats not all. Untreated anxiety and depression can actually shrink regions of the brain, including:
- Hippocampus, the region of the brain primarily responsible for long-term memory. The hippocampus also plays an important role in regulating our emotional responses. Constant, severe mood-altering symptoms cause this part of the brain to shrink. Doctors call this shrinkage atrophy, and its associated with Alzheimers disease and dementia. A 2014 study revealed that damage to the hippocampus can also hinder social behavior by preventing you from accurately interpreting and responding to information. Hippocampus atrophy can even affect your ability to use language effectively.
- Prefrontal cortex, which helps regulate your short-term memory and how well you plan and prepare for activities. A shrunken prefrontal cortex can cause short-term memory loss, difficulty planning and executing events, and increased irritability.
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Increased Or Decreased Sexual Appetite
Its pretty common for patients with a history of brain injury to express loss or increased interest in sex. Thats why its crucial to show constant support and affection to the affected individual. Avoid pressuring your spouse or partner as much as possible. Also, try to set limitations to help manage each others expectations.
More often than not, these behavioral problems present challenges to both the carer and patient. In addition, it leads to increased difficulty in achieving recovery and reintegrating into society.
If you have a hard time coping with these, we suggest consulting with a behavioral therapist or a neuropsychologist. They can teach you strategies like breathing exercises or redirecting negative thoughts.
Disrupted Sleep And Other Symptoms: Reinforcing Depressive Feelings
While theyre not often a direct cause, other symptoms of concussion can work in concert with your loss system to worsen or reinforce depressive symptoms. Many post-concussion syndrome patients experience disruption to their sleep, and sleep deprivation itself can result in depressive symptoms. Additionally, the symptoms of depression can make it harder to sleep, so they work together to make everything feel worse.
Being in pain all the time is another factor. Its harder for your brain to believe its safe to go back to normal if its busy reacting to headaches, feelings of overwhelm, brain fog, and so forth.
Finally, all this can lead to altered habits that further contribute to the depressed state. Even though it may be difficult, try to eat well, rest as best you can, and exercise regularly .
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