Depression and Traumatic Brain Injury

Traumatic brain injury (TBI) is an injury to your brain that can change the way you think, act, and feel. It's easy to understand how a brain injury can change your thinking. It may be harder to understand how it changes your feelings. In fact, dealing with changes in feelings and emotions may be the hardest part of a TBI.

A TBI is caused by a jolt or a blow to the brain. A TBI can be caused by a fall, car accident, fight, or sports injury. A blast injury such as can occur in the military can also cause a TBI. One of the changes that can happen after a TBI is depression.

A TBI may change your brain in a way that increases your risk for depression. The stress of recovering from a TBI can also increase your depression risk. It's important to recognize and treat depression because it can slow your TBI recovery. The combination of a TBI and depression is also dangerous. It may increase your risk for substance abuse and even suicide.

Symptoms of depression after a TBI 

Many of the symptoms of depression and TBI are similar. Having a TBI can get you down. It's normal to have “the blues” sometimes. But depression symptoms tend to be worse and last longer than the blues. Let your healthcare provider know if you have symptoms of depression, such as:

• Changes in sleep

• Changes in your appetite

• Trouble focusing or paying attention

• Lack of energy

• Lack of interest in things and activities you usually enjoy, including sex

• Feeling very guilty, sad, worthless, or hopeless

• Thinking about death or suicide 

Treating depression after a TBI

If you have a TBI and depression, you should be treated for depression in addition to the steps you’re taking to recover from the TBI. Know that depression is a medical problem, not a sign of weakness. You can’t just snap out of it using willpower. Untreated depression can lead to problems at work and at home. The good news is that you're not alone and that there is treatment for depression that works. Here are some types of effective treatment:

• Cognitive behavioral therapy (CBT). This is a type of counseling, or talk therapy, given by a mental health provider. CBT teaches you to recognize negative thoughts and behaviors. You'll learn how to cope with these thoughts and behaviors and how to change them.

• Interpersonal therapy (IPT). This is another type of counseling that helps with depression. In IPT, a mental health provider helps you identify relationship problems that contribute to depression. You'll learn to improve your communication and problem-solving skills.

• Problem-solving therapy (PST). This is a way to treat depression by learning a step-by-step approach to solving problems.

• Antidepressant medicines. These medicines correct the chemical imbalance in the brain that causes depression. Medicines take a few weeks to start working. They're often combined with counseling for the best results.

• Electroconvulsive therapy (ECT). This uses electrical activity to treat symptoms of severe depression that don't respond to other means.

Symptoms of depression and a TBI can be very similar. Let your healthcare provider know about any TBI symptoms that are getting worse and about any new symptoms. If you have feelings of sadness, hopelessness, or grief that are interfering with your life and your TBI recovery, it could be depression.

Call 988 in a crisis

Don’t try to treat your symptoms with alcohol or drugs. These substances make both depression and the TBI worse. Always let someone know right away if you have any thoughts of harming yourself or others. Call or text 988. Thoughts of suicide are a medical emergency. When you call or text 988, you will be connected to trained crisis counselors at the National Suicide Prevention Lifeline. An online chat option is also available at www.suicidepreventionlifeline.org. Lifeline is free and available 24/7.