The brain is a delicate and vital organ. Our voluntary and involuntary physiological processes all rely on the brain. But what is less clear about this organ is how it responds to physical head trauma.
Of course there is the famous case of Phineas Gage, the construction worker who survived an accident during which an iron bar pierced his skull, severely damaging his frontal lobe. In 1848, this incident catalyzed the first reported study of psychological and behavioral changes following head trauma.
His doctor John Harlow observed severe changes in Gage’s personality following the injury. He became ill-mannered, disrespectful and lackadaisical.
While not all head injuries may have such drastic effects, it’s hard to dispute the fact that the damage—large or small—could show itself before long.
An article published in 2008 discusses how the occurrence of psychiatric disorders following traumatic brain injuries (TBIs) is extremely common. After a brain injury, the person may undergo personality changes including increased apathy and aggression, rapid mood changes and emotional instability, impulsivity, paranoia and impaired self-awareness. What’s more, specific psychiatric disorders may also follow an injury.
The most common TBI-related disorder to arise is post-traumatic stress disorder (PTSD). Some researchers, such as Sbordone and Liter and Mayou and colleagues, consider TBIs and PTSD to be mutually exclusive. On the other hand, plenty of studies have found incidence of PTSD following mild to moderate cases of TBIs. Because many symptoms of PTSD and TBIs overlap, diagnoses can be difficult.
Additionally, even though findings linking depression and mania following a TBI to specific brain regions have been sparse, a 2007 study by Kim and colleagues found a trend in the development of depression and mania after brain injuries. Depression following a TBI may be attributed to a damaged hippocampus, according to Campbell and MacQueen (2004), as this region is particularly vulnerable to head trauma of any kind.
Phineas Gage suffered a traumatic brain injury in 1848. His personality changed drastically as a result.
Many socioeconomic and interpersonal consequences can also arise after a head injury. These include poor social functioning, work dissatisfaction, unemployment, low economic and educational status and a loss of personal relationships. These symptoms are similar to those that result from severe depression and mania. Some symptoms are even amplified when a TBI is involved, as is the case with anxious episodes of depression lasting an average of over six months longer than those in depressed people without TBIs, based on results from a study by Jorge et al (2004).
Not enough conclusive data exists for one treatment for TBI-related depression and mania. However, most specialists would refer patients to pharmaceutical options as their first choice.
A 1999 study by Deb and colleagues found that TBI-related obsessive compulsive disorder (OCD) is uncommon. According to a 2003 study conducted by Coetzer, it is more difficult to diagnose OCD in TBI survivors because many of them may exhibit repetitive behaviors from memory loss.
The combination of typical OCD treatments, including cognitive behavioral therapy and serotonergic antidepressants—with the other treatments for the TBI is the best approach to treating TBI-related OCD.
What’s more, a 1998 study by Harper linked alcoholism and the misuse of alcohol to traumatic damage of the frontal cortex, the hippocampus, the hypothalamus, the cerebellum and even the locus coeruleus and the amygdale.
For all of these disorders, a combination of adapted treatments for the specific TBI as well as established rehabilitation options for the resulting psychological disorder or condition is the safest approach to finding normalcy again following a debilitating TBI.
Most importantly, a clear understanding of the possible side effects from head trauma will help one move forward and cope with the accident.
Ade Ilesanmi was born in Dallas, TX to two Nigerian-born parents. She was raised for most of her life in NC but also spent a few years in Nigeria with extended family as a young child. She is currently a junior at Wake Forest University and is a pre-med biology major with a strong interest in mental health, health communication, and mass communication. She enjoys writing and blogging and eating snacks off of her chest while she watches her favorite shows on her laptop. She looks forward to finding a lot of excuses to travel during her adult years.