Mental health disorders and brain injury are often seen and treated as two completely separate diagnoses and are sometimes even confused as being the same. While brain injury and mental illness can be entirely different issues, traumatic brain injury (TBI) can lead to the development of mental health concerns. It is also possible for the two to overlap, with pre-existing mental health issues being exacerbated by brain injury.
How do brain injury and mental health differ?
Traumatic brain injuries are typically caused by a forceful or sudden impact to the head. This often occurs in an accident, a fall or slip, or as the result of a physical assault. The severity of an injury largely depends upon the impact’s force and which areas of the brain are affected.
Brain injury can result in a wide variety of psychological effects. Common injury-related issues include depression, anxiety, cognitive (thinking) impairments, and problems with behavior regulation, such as uncontrolled outbursts of anger. These issues can arise from direct damage to the areas of the brain that manage emotions or as a reaction to new challenges faced by injured persons. Psychological effects are a common result of brain injury, but they can sometimes improve over time.
The broad term mental health includes a range of psychological conditions, such as clinical depression, schizophrenia, obsessive-compulsive disorder, and generalized anxiety disorder. Each condition has characteristic psychological, behavioral, and emotional effects that are significant enough to impact everyday functioning. In extreme cases, mental health conditions may cause some people to have episodes of psychosis, in which they experience hallucinations and delusions.
Schizophrenia, for example, has distinct symptoms such as hallucinations, which can significantly impact daily functioning. Another widely recognized mental illness is bipolar disorder, in which people experience rapid fluctuations in moods that are not triggered by an external event.
Although some people may demonstrate a symptom of a particular disorder, they cannot be diagnosed with that condition unless other symptoms are also present. To qualify for a specific diagnosis, patients need to demonstrate some degree of symptoms as defined within clinical texts such as the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5).
A qualified professional such as a psychiatrist, clinical psychologist, or neuropsychologist can diagnose whether the behavior in question can be considered a direct consequence of brain injury and whether or not it warrants a clinical diagnosis for a specific mental health disorder.
How traumatic brain injury can affect mental health
Research indicates that those who have sustained a brain injury are more likely to develop a mental health condition, with bipolar disorder, schizophrenia, and clinical depression being the most common. The suggested causes for this are the damage to the brain, the psychological trauma itself, and the potential for changes to the brain’s neurotransmitters (chemicals).
When a patient is diagnosed with a mental health condition after suffering a brain injury, it is called a dual diagnosis or co-occurring disorder. In this case, one condition can have an impact on the other. For example, those diagnosed with schizophrenia may experience delusions of persecution (a fixed belief that people intend them harm) and consequently may not trust their rehabilitation specialists.
A brain injury can also exacerbate the symptoms of a pre-existing mental health condition, such as patients already diagnosed with bipolar disorder finding that their mood fluctuations occur more rapidly than before the trauma to their brain.
Diagnosing mental health disorders after brain injury
Brain injuries are not always immediately apparent. Sometimes it is evident due to the extent of the external damage (such as a significant open head wound), but other times, there are no obvious signs of a brain injury. Similarly, there are often no physical or visual signs of a mental health condition. It can be particularly difficult to distinguish mental health conditions from the change in behavior that is typical after a brain injury. Family, friends, and carers can assist by monitoring whether loved ones’ behavior markedly changes over time or if their moods become extreme after brain trauma.
If behaviors change significantly post-brain injury, it is important to seek the opinion of a doctor who can refer the patient to appropriate health care professionals, including mental health treatment for issues such as depression.
Brain injuries and mental health issues are essentially separate conditions but can certainly overlap. The most important factor in dealing with either is to ensure that patients have access to the most appropriate support and professionals to determine a diagnosis and best course of medical action.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
About the Author: Marc Shuman is a personal injury attorney and the founder of Shuman Legal, a Chicago, Illinois based law firm. Since 1996, the Law Offices of Shuman Legal have been helping Traumatic Brain Injury victims, all injured victims, and their families, navigate the complex legal process. Marc’s mission is to make sure that his clients can ask a lawyer anything and that they are getting compensated for their injuries in a meaningful way.
Photo by engin akyurt on Unsplash
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Thanks for explaining that brain injuries and mental health problems are totally different things but they can overlap in some aspects. I’d like to look for a brain specialist soon because I am recovering fast from a concussion that I had. I’d like to be very sure that there’s nothing wrong with my body after this whole debacle is over.