Understanding Behavioral Changes After a Traumatic Brain Injury

Published by Claudia Giunta. 

Traumatic brain injury (TBI) is a life-altering event that may lead to a range of neuropsychological problems. Beyond the immediate physical impact, a TBI often causes significant behavioral and emotional changes that can profoundly affect an individual’s daily life and those around them. The repercussions of a TBI will depend on the severity of the injury and the part of the brain affected. No two brains are alike, and similarly, no two brain injuries are the same. An individual’s deficits following a brain injury are unique, which is why personal prognosis and recovery tailored to each individual is challenging, yet prioritized. 

Understanding behavioral changes that come with a TBI is crucial for both the individual with a TBI and their support system to navigate the road to recovery effectively. Common changes include personality changes, memory issues, judgment deficits, lack of impulse control, and more. The road to recovery may be long and challenging, but the patient, their support system, and their professional care team will need to explore a combination of strategies that help improve the functional and behavioral skills of the individual with a brain injury.

Nova Vita Solutions

Nova Vita takes a holistic approach to TBI treatment, beginning with a thorough assessment of each individual’s physical, cognitive, and emotional needs. Our team of experienced healthcare professionals will develop a personalized treatment plan and address which services may help in conjunction with other treatments set forth by their neurologists and therapists. Our NAD+ therapy can help people with a TBI by enhancing cellular function and promoting brain healing, as well as improving cognitive function, reducing inflammation, and alleviating other symptoms with TBIs. 

Our team is dedicated to providing comprehensive solutions for all individuals on their path to wellness, including those with traumatic brain injuries. Our innovative therapies like NAD+ therapy, nutritional guidance, infusions, and lifestyle modification guidance aim to empower individuals to achieve meaningful recovery and improve their quality of life. Learn how our holistic services can support you and book an appointment online today.

Why Behaviors and Emotions May Change After a TBI

Depending on what part or parts of a person’s brain are injured, the individual may experience significant behavioral and emotional changes. For example, if the frontal lobe is damaged, the individual’s self-control may be inhibited. The individual will have difficulty controlling anger and be more prone to make impulsive decisions or inappropriate comments. Someone’s personality may also become muted and lack emotional response. This is called flat affect. 

Behavioral and emotional changes may occur if the TBI affects areas of the brain that control emotions. Changes to these brain regions and the chemicals that support brain function can affect how an individual with a TBI  experiences and expresses emotions.

Common Behavioral and Emotional Changes 

Some of the most common behavioral and emotional changes people with a TBI may experience include the following:

Personality Changes

The behavior of someone with a brain injury is not fully in control of their reactions due to their damaged brain cells. Regardless of the severity of the injury, all people with a TBI may experience some personality changes. It’s easy to compare the before and after of how a person with a TBI expresses themself, however, personality changes can be seen as an exaggeration of the person’s pre-TBI self. People with a TBI may have a sudden change in mood, have an extreme emotional response to a situation, raise their voices, cry, laugh, and interrupt people. 

These personality changes can occur quickly after the TBI or may develop and change over time. How long these changes last depends on where the injury is, how severe it is, and other health history factors. While a severe TBI may mean long-lasting personality changes, the good news is that they get better with the right treatments and coping strategies. 

Lack of Emotion

After a brain injury, a person may come across as withdrawn and lacking normal emotional responses such as smiling, laughing, crying, and experiencing anger or enthusiasm. They may respond to a situation inappropriately. Remember this is not personal and is a consequence of the injury to the brain and its ability to function.

Lack of emotion can disrupt an individual’s social skills and ability to engage in social interactions effectively. Consequently, they may withdraw from social situations, isolate themselves, and have difficulty maintaining friendships and relationships. If you know someone with a TBI try to encourage them in social situations and support them in improving their social skills.

Emotional Lability

Neurological damage from a brain injury may also cause emotional volatility, referring to rapid or exaggerated changes in mood, where strong emotions or feelings occur. Examples include uncontrollable laughter or crying, or heightened irritability or temper. It’s important to understand that people with a TBI have lost some control over their emotional responses and their behavior is unintentional. Their heightened irritability often stems from their frustration and difficulty in expressing themselves effectively. 

Emotional lability after a TBI is an emotional response to the injury. People with a TBI are not just relearning behaviors, these behaviors are now new to them. They may feel a sense of loss in losing their independence and control over their situation. Reinforcing techniques that produce emotional responses that are under the person’s control, while respecting their current feelings, is important in de-escalating emotional situations for people with a TBI. 

Impulsivity and Risk-Taking Behavior 

Following a brain injury, a person may have increased impulsivity and risk-taking behavior. Individuals may act without considering consequences, laugh inappropriately, have poor judgment in decision-making, and engage in reckless activities. This can pose safety risks and may require additional supervision and support from support systems. 

Saying inappropriate things or making inappropriate decisions can lead to embarrassment for both the brain injury survivor and their caregivers. Brain injury survivors must be surrounded by people who they can trust and understand their health situation. Developing coping strategies will take time and a cognitive behavioral therapist or neuropsychologist may help. 

Cognitive Impairments

Oftentimes, behavioral changes following a TBI include cognitive impairments, such as memory problems, difficulty concentrating, or impaired judgment. These cognitive deficits can increase their emotional responses and lead to outbursts and risk-taking behavior. Providing reminders to people with a TBI can help improve concentration and attention. It’s important not to overload them with information, repeat if necessary, and ask them simple questions to ensure they understand. Ask them if they are sleeping well because sleep quality greatly affects cognitive performance.  

Depression and Anxiety

Brain injury survivors are at an increased risk of developing depression and anxiety. Hopelessness, anger, confusion, and other emotional responses following a TBI can lead to these mood disorders. While the exact cause of the mood disorder after brain injury is unique to each individual, research points to a few factors. Physical changes in the brain, emotional struggles, and genetics may influence post-TBI depression. Identifying and addressing mental health concerns through therapy, medication, and support groups is crucial to improving overall well-being and quality of life for all people, not just those with a TBI. 

Getting Support

Coping with behavioral changes after a TBI requires identification and acceptance of the deficits of the individual after a brain injury. Changes to the brain may bring on a range of challenges and a comprehensive neuropsychological assessment will help assess the damage and changes as a result. Neuropsychologists, psychologists, and speech and occupational therapists will help guide people with a TBI (and their support system) with strategies and behavior modification that will improve their quality of life. 

By recognizing these challenges and implementing appropriate coping strategies, individuals with a TBI can overcome challenges and achieve their fullest potential. Support from caregivers, healthcare professionals, and support groups can play an important role in setting individuals living with a TBI on a smooth journey toward recovery. Recognizing personality changes and cognitive deficits may be doable, but resolving the changes can be difficult and overwhelming. A neuropsychological evaluation will help develop a treatment plan that breaks down deficits and enables professionals to help the person with a TBI and their caregivers overcome them. Lastly, family members of a brain injury survivor should reach out to receive additional support as they deal with their emotional responses to caring for someone with a brain injury.