Traumatic brain injury (TBI) occurs when a forceful impact to the head disturbs normal brain function. Aside from affecting learning and thinking skills, it can cause psychological and emotional problems if the regions affected involve emotional and psychological processing.

A study published by Dove Medical Press found that anxiety and depression are common in TBI survivors.  In some cases, emotional and psychological problems may be associated with emotional and mental issues, such as anxiety and depression, that the person already has prior to the TBI. Or, they could be a result of challenges coping with problems experienced after the TBI.

While there are many challenges posted, traumatic brain injury treatment for emotional and psychological difficulties includes psychotherapy and medications.

Psychological And Emotional Impacts of Traumatic Brain Injury


People with TBI may find that they worry in ways they never did before or that their worries have just intensified. Usually, they feel anxious and don’t know exactly why.

 After a TBI, it can be harder for people to handle several situations, such as being rushed, adjusting to unplanned changes, or being in large crowds. This causes anxiety, which makes people struggle to fall and stay asleep, constantly think about how things could go wrong, and feel on edge.

Causes of anxiety after TBI

  • It can be challenging for a person with TBI to solve problems because of difficulties concentrating and reasoning. They can be overwhelmed during these kinds of situations, especially if they have to make decisions. 
  • Pressure can cause anxiety in people with TBI. With demands such as going back to work post-injury, they can be consumed by anxiety.
  • People with TBI can feel anxious when put in situations that require a lot of attention, concentration, and for them to process information. These include crowded places and heavy traffic.


Sadness, frustration, and loss are common post-TBI. These feelings usually come up in the later stages of traumatic brain injury recovery, when the person has processed their long-term situation. However, these normal feelings may turn into depression if they become overwhelming and get in the way of recovery.

Signs of depression ( e.g., feeling worthless, withdrawal from peers, loss of interest, lethargy) are also symptoms of TBI. So, experiencing them does not necessarily mean that the person is depressed. But if the signs show up months after the injury, it’s more likely to mean depression.

Causes of depression after TBI

  • As the person struggles with temporary and lasting adjustment to traumatic brain injury disability, they might become depressed. 
  • In some instances, depression may be biochemical and physical changes in the brain. This happens when the injury affects the areas controlling emotions.
traumatic brain injury


One of the most common problems post-TBI, fatigue (physical, psychological, and mental) is experienced by as many as 70% of TBI survivors. Due to this, they are less equipped to think clearly and perform physical activities.

When fatigue becomes too much to handle, individuals don’t have the energy to care for and enjoy themselves. It also has adverse effects on one’s mood, attention, concentration, memory, and communication skills. More than that, overwhelming fatigue can be dangerous as it interferes with physical functioning.

It’s not clear what the cause of fatigue is after TBI. But brain function is less “efficient” post-TBI, so fatigue may be caused by the extra effort and attention needed to do simple tasks, like eating or talking.

Irritability and anger

Studies by MSKTC found that about 71% of TBI survivors are quite irritable. They express their anger in a range of ways– from yelling and using foul language to slamming their fists and throwing objects.

Causes of irritability and anger after TBI

  • Parts of the brain that’s responsible for emotional expression are injured.
  • Changes and adjustments due to traumatic brain injury frustrate them.
  • They feel depressed, alone, and misunderstood.
  • Pain.

Extreme mood changes

Emotional lability refers to when people go through their emotions intensely and quickly with little lasting effect. For example, they easily get mad but also get over it quickly.

Causes of emotional lability after TBI

  • Damage to the part of the brain that controls behavior and emotions can lead to emotional lability and mood swings.
  • More often than not, there are no triggers to a sudden emotional episode.
  • Sometimes, TBI causes sudden fits of laughing or crying and they don’t always have a connection to how the person is actually feeling. They usually can’t control their response.

What can you do as a psychological and emotional treatment for traumatic brain injury?

It’s best to seek professional help from a psychologist or neuropsychologist to cope with psychological and emotional changes post-TBI. But there are also things you can do to help yourself.

Identify your triggers

When you feel like there’s overstimulation, identify your triggers. If you know what made you suddenly burst, you can prepare or prevent it the next time you experience that feeling.

Ask your family for help

It can be difficult to catch yourself constantly. If you’re comfortable with it, ask a family member or even a close friend to monitor your overstimulation. You might have missed a few cues that they could pick up. They can also remind you to take care of yourself when you forget.

Have a destimulation plan

If you get overwhelmed, it’s good to have a plan to calm you down. Your destimulation plan can include hiding in a quiet space for a few minutes or simply closing your eyes. Keep on working on it until you find what works best for you.


Working out helps relieve stress and tension. It also gives your brain a biochemical boost to get you through the day.

Keep a journal

If you don’t have anyone to talk to, vent through a journal. It’s a way to process your thoughts and emotions on your timetable.

traumatic brain injury

FAQs About Psychological And Emotional Changes After Traumatic Brain Injury

What is it like to have a traumatic brain injury?

Based on severity and injury mechanism, there are three classifications of TBI:

  • Mild traumatic brain injury – The person is conscious with eyes open. Symptoms of mild TBI include brief loss of consciousness, confusion, disorientation, memory loss, and headache.
  • Moderate traumatic brain injury – A person with moderate traumatic brain injury lethargic and opens eyes to stimulation. They can lose consciousness that lasts between 20 minutes to six hours. Sleepiness is caused by some brain swelling or bleeding but is still arousable.
  • Severe traumatic brain injury – Lastly, people suffering from severe TBI are unconscious. Even with stimulation, their eyes do not open. They are unconscious for more than six hours.

Is a concussion a traumatic brain injury?

Yes, a concussion is a mild traumatic brain injury. It happens when the head experiences a blow, bump, hit, or jolt that makes it move back and forth rapidly. 

What part of the brain controls emotions?

Located deep within the brain, the limbic system is responsible for emotional and behavioral responses. It’s a group of interconnected structures made up of the hypothalamus, hippocampus, amygdala, and limbic cortex.

If you are or know someone looking for professional geriatric therapy and traumatic brain injury treatment in California, turn to Persona Neurobehavior Group. You can contact us at 800-314-7273 or request an appointment with us so we can help you. You can also visit us in our several locations:

Pasadena Offices (Main)
2 N Lake Avenue
Suite 800
Pasadena, CA 91101

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516 W Shaw Avenue
Suite 200
Fresno, CA 93704

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Tower B 12th Floor
Bakersfield, CA 93309

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La Jolla, CA 92037

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