Coping with Post-Traumatic Brain Injury (TBI) Emotional Distress
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Send to friendThe most commonly experienced emotional problems after a TBI were depression, anxiety, and substance abuse/dependency:
- Depression is a condition marked by emotional and physical problems. People who are depressed experience a loss of pleasure in things that they usually find enjoyable. They typically feel sad and worthless and have trouble getting through each day. They often complain of altered sleep, appetite and concentration difficulties. In the general population 6 people out of 100 will likely experience a major depression in their lives. Those that suffered a TBI are 10 times (60 out of 100) more likely to experienced major depression.
- Anxiety refers to a variety of disorders. For example, posttraumatic stress is a type of anxiety in which people experience flashbacks in which they relive the event that caused their TBI. Phobias are another common type of anxiety, in which the person experiences great fear centered on a specific situation, such as being in an elevator or car, or flying in a plane. Anxiety was found approximately 50% more often in individuals with TBI than in the general population
- Substance use/abuse was also found more frequently in those who had experienced a TBI then in those who did not.
What Should You Do If You Are Depressed or Anxious?
you are experiencing emotional challenges, the first step is to acknowledge you are having a problem. Next you should seek professional help. The earlier you ask for help the better, as waiting often makes things worse - depression and anxiety can be helped. You should look for a professional who is both familiar with TBI and who specializes in helping people with emotional problems. The professional and you need to jointly determine if your depression or anxiety is getting worse, improving or remaining the same. You should describe the emotional difficulties you experienced before (if any) and have been experiencing since TBI, as well as any attempts you have made to self-medicate, including alcohol and drugs. Treatment for alcohol or chemical abuse may be recommended. The two most common treatment approaches for depression and anxiety: medications and psychotherapy. Either or both of these may be suitable in addressing the difficulties you are having.
What Should You Know about Medications?
Medications to reduce depression and anxiety are often the first step taken in treating severe emotional disturbances. They are used most often in combination with psychotherapy. With many of these drugs, the initial dosage is low and is increased slowly, during which time your reactions to medications are carefully monitored. Three "shoulds" apply to wise use of medications: First, you should keep in contact with your prescribing physician. Second, you should not increase or decrease the dosage without consulting the doctor, and third, you should create a system to help you remember to take medications as prescribed. For example, some people ask someone to remind them or have them administered to them by a caregiver, or they use a pillbox holding each day's medications. Others tie their taking medications to a once-a-day event that they know they don't forget to do, such as feeding the cat or eating breakfast.
Should You Do If You Are Depressed or Anxious?
Psychotherapy (talk therapy) may be used in combination with mood medications, or it can begin before or after medications are started. Talk therapy can occur between you and a therapist, or it can be done in groups, with several individuals meeting together with one or two therapists. Therapy is a place in which you share your fears and worries, mourn the losses you have experienced as part of injury, talk about the new you, deal with the reactions and learn healthy strategies for coping with life's challenges. Therapy should focus primarily on here-and-now issues related to your adjustment to injury. Psychotherapy should encourage your attempts to better understand your situation, help you build flexible ways of thinking, encourage you to use compensatory strategies (such as memory aids), and address the behaviors that you and others find unacceptable. A major focus of therapy is to review recent activities to determine what went wrong in specific situations. This paves the way for anticipating problems in similar future situations and helps you plan strategies for preventing further failures.
What Else Can You Do to Help Overcome Emotional Distress?
Some people find that depression and anxiety are reduced simply by adding structured activities into their daily lives. They may return to work, attend school or volunteer. They might join a self-help group or church activities. Many people find exercise to be useful in overcoming or reducing depression such as walking, swimming, or biking. They may even increase the number of daily household activities in which they engage. Structured activities increase the individual’s self-esteem and enhance his/her well-being. Other people opt for therapeutic approaches such as biofeedback, therapy, counseling, relaxation therapy and desensitization techniques to name a few. A final point. The most important thing you can do is to stay actively engaged in seeking means to improve your mood. This means that you must own your emotional state and define your well-being as your responsibility. Thus, if one path you take to feel better doesn't work, it is up to you to try another approach. Both depression and anxiety after TBI can be helped, especially when you reach out to others in your community to help you find the right path. Your task is to find the way that works best for you.
TBI Consumer Report is a publication of the Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury, supported between 1993 and 2004 by Grant Nos. H133B30038 and H133B980013, to the Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York City, from the National Institute on Disability and Rehabilitation Research, United States Department of Education.