Depression after a brain injury
Depression is a common experience
following a brain injury.
Depression is a mood state, during which a person may feel
'low,' 'down,' 'negative' and generally unhappy about themselves,
the world and their future. In most cases, depression is a reaction
to difficult circumstances, such as a traumatic brain injury (TBI)
or other type of brain disorder.
Apart from negative thoughts and emotions, common signs can
- reduced attention to physical appearance
- withdrawal & loss of interest in formerly enjoyed
- sleep disturbance, appetite changes and tiredness.
- a gradual decline in ability to perform everyday tasks
- decline in ability to cope with every day stressors
- increased irritability, anger, frustration and
Some of these are common effects of a brain injury, so it can be
hard to pinpoint depression as the cause. It is important that
family and friends are aware of the symptoms of depression as once
detected, depression is both manageable and can treatable with the
support of family, carers and professionals.
Most people will feel periods of despair following a brain
injury - this is normal however when it begins to seriously
interfere with progress and functioning, treatment should be
causes of depression
Depression can occur at any stage following an acquired brain
injury, from the acute hospital stage to many years post-injury. In
the early stages of recovery it can be a sign the person is
developing awareness of their brain injury's effect - a promising
sign for the rehabilitation process as the person can identify and
work on areas needing attention.
Depression following a TBI or similar brain disorder is also
related to other factors including:
- Social isolation
- Sleep difficulties
- Difficulties in maintaining employment and relationships
- Injury to the parts of the brain responsible for emotions
- History of mental illness or substance abuse
- Some medications can increase the symptoms of depression.
Diagnosis of clinical
Professional help and treatment is advisable when depression
becomes a serious problem. Ensure you see your GP for a referral to
specialists if you suspect you or your loved one has clinical
depression. The earlier it is diagnosed; often the easier it is to
treat (see our fact sheet on clinical depression).
Coping strategies for
- Adequate sleep
- Listen to music
- Socialize with friends
- Avoid alcohol and other drugs
- Work on a personal project or hobby
- Walking or other exercise
- Scheduling activities and making short-term plans
- Each a healthy diet
- Write in a diary daily five things you are grateful for
- Use positive self-talk - 'I can cope, I can manage this'.
This useful technique involves replacing upsetting thoughts with
constructive explanations or more rational thoughts. You can keep a
diary to monitor and assess your negative thoughts - this can
include the place/event, the thoughts that arose and the feelings
and actions that resulted. This may help you to become aware of
patterns in your thinking.
Do not underestimate the importance of social contact for the
maintenance of good mental health, including depression. Social
contact, and in particular peer support, is often of immense help
to someone with depression. Your local brain injury association or
mental health association can put you in touch with peer support
groups for brain injury or for depression.
How friends & family can help
- Take time to listen and ask questions
- Don't minimize the issue e.g. don't say "Get over it" or "It's
not that bad"
- Help to schedule in activities for each day
- Reinforce any positive coping skills e.g. talking, exercising
- Give encouragement after any tasks are completed
- Encourage them to seek help from a counsellor or
Be aware of any signs of suicide risk. If suicidal thoughts are
present it is important to encourage the person to seek help from a
doctor or psychologist. Warning signs to look for include:
- Statements like "It would have been better if I had died"
- Making threats about committing suicide
- Suddenly becoming cheerful after a long period of depression
(this can indicate a decision to use suicide as a solution)
- Having a plan for suicide, and the means to achieve it are very
strong warning signs and must be taken very seriously.
All suicidal comments need to be addressed, but having a plan
and the means to achieve it is a sign that professional help needs
to be sought as a matter of urgency. If the situation is critical,
References and further information