Brain injury and Post-traumatic stress disorder (PTSD)

While the general effects of brain injury can often include a level emotional distress, affecting your ongoing health and well-being, it’s not uncommon for people with a brain injury to experience more specific symptoms of post-traumatic stress disorder (PTSD).

What is Post-traumatic stress disorder?

PTSD is an anxiety disorder that can develop after extremely traumatic events, such as life-threatening accidents, violent attacks and natural disasters. When faced with such an experience, we may feel intense fear, panic and helplessness.

In the time after the traumatic event a range of triggers, symptoms and reactions can contribute to emotional distress, to the extent that they have a noticeable impact on our day-to-day functioning. This can include:

Triggers

Intrusive thoughts and memories
Nightmares
A sense of reliving the trauma

Avoidance Symptoms

Avoidance of thoughts and feelings associated with the trauma
Inability to recall aspects of the trauma
Withdrawal from others and a sense of emotional numbness

Heightened Reactions

Irritability
Difficulty concentrating
Hypervigilance, or heightened startle response
Distress when reminded of the trauma

PTSD and Brain Injury

For many years it was believed that people who sustained a traumatic brain injury (TBI) couldn’t develop PTSD as the injury itself would make it difficult for them to remember the traumatic event. However, there is now evidence to support our understanding that PTSD can indeed develop following mild TBI and in some cases of severe TBI.

In the case of mild TBI, recent research suggests it carries an increased chance of PTSD developing. As mild TBI can damage parts of the brain that regulate fear, the risks of PTSD are sometimes increased. It has also been found that the effects of brain injury on memory and concentration make it more difficult to manage symptoms of post-traumatic stress, further increasing the risk of PTSD.

Most commonly however, PTSD affects people with mild TBI because more memories of the circumstances surrounding the injury are retained. A great amount of distress can occur when people remember or are reminded of their trauma.

As a result, people may develop a fear of circumstances similar to that of their injury (e.g. safety hazards), with some fearing a repeat of the traumatic event or a worsening in the severity of their existing brain injury symptoms.

Diagnosing PTSD

The first step in treating PTSD is proper diagnosis. Research shows there are improved outcomes when trauma is treated soon after the event, however symptoms must persist longer than a month after the event for an accurate diagnosis of PTSD to be made. With this in mind, it’s important to engage with an appropriate psychological professionals as soon as possible following a traumatic brain injury event.

Some of the criteria that are used to diagnose PTSD include:

Details of the exposure to a traumatic event
The presence of intrusive symptoms such as memories, nightmares and heightened reactions
Persistence of desires to avoid memories and circumstances relating to the trauma
Ongoing negative changes in thoughts, mood and emotions
The presence of other co-existing mental health issues such as anxiety disorders

Why it’s important to find the right support

When symptoms of PTSD are a result of a brain injury there can be a greater degree of complexity in both diagnosis and treatment. The impact of brain injury on a person’s ability to remember the traumatic event needs to be considered and approached differently. Similarly, the ongoing effects of the brain injury on a person’s cognitive and mental function will require specific approaches to treatment.

It’s important to find psychology professionals who understand these complexities, such as neuropsychologists, and who can work with you to develop an appropriate treatment plan . If you need support to find professionals to assist with brain injury related PTSD, our Information and Referral team can help.

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