Brain Injury and Mental Health
12th March 2019
Traumatic brain injury, also known as TBI, is “an injury to the brain caused by trauma to the head” (headway.org.uk). This can occur as a result of various things such as road traffic incidents, assault, falls or contact sports. Often, brain injuries and mental health problems are seen and treated as two entirely distinct problems. However, findings suggest that there are many ways in which brain injury and mental health can overlap.
Sometimes, a brain injury can result in the development of a mental health condition. Many studies have been done in this area, revealing some troubling findings. A study in 2013 by a group of Danish scientists found that individuals with a traumatic brain injury were four times more likely to develop a mental illness than those without a brain injury. Individuals with TBI were 65%more likely to develop schizophrenia, 59%more likely to develop depression and 28%more likely to develop bipolar disorder. These concerning results have been mirrored in another study in 2009 which found that the lifetime depression rates in individuals with traumatic brain injury ranged from 26% – 64%,which is distinctly higher than the lifetime depression rates of the general population, which stands at around 15%. These findings highlight just how big of an impact a brain injury can have on an individual’s mental health and emotional wellbeing. However, nothing can emphasise this more strongly than the figure that suggests that TBI is associated with a nearly two-fold greater risk of suicide.
Clearly, the relationship between TBI and mental health issues is not one to be ignored. So, what are the potential reasons for this overlap?
One explanation is that TBI can result in damage to the physical structures of the brain which regulate emotions. A 2015 study found that people with depression after TBI show different patterns of connections in their brain than those without, especially between the amygdala which has a role in emotional regulation, and areas such as the prefrontal cortex. This could play a part in development of mood disorders and result in problems regulating emotions.
Additionally, social isolation is likely to play a big part in the development of mental health disorders such as depression and anxiety following TBI. Unfortunately, isolation is a common problem after brain injury, with Headway suggesting that more than 70%of brain injury survivors see a deterioration in their social life following brain injury. Many people with brain injuries may struggle with noise or crowds, which can limit their involvement in social situations, leading to the break-down of social networks. This isolation can have severe negative impacts on mental health, as a reduced social network can cause individuals with TBI to feel that they have no one to talk to, which can lead to low mood and anxiety.
While medication may play an important part in addressing mental health disorders for people with TBI, it is also important that as family, friends and mental health professionals we do all we can to reduce their social isolation. There are many ways in which we can do this; encouraging them to attend appointments, popping in for a cup of tea or simply asking how they are and how you can help can have a massive impact. While it is easy to feel helpless when a loved one is suffering from TBI, there are many little things we can do to help. This Brain Injury Awareness month, lets all pull together to increase awareness surrounding mental health following brain injury, and what we can do to target it.
For support around this issue, please visit https://www.headway.org.uk/about-brain-injury/individuals/relationships-after-brain-injury/, call the headway helpline from 9-5 Monday to Friday on 08088002244, or email helpline@headway.org.uk.
References:
https://www.headway.org.uk/about-brain-injury/individuals/relationships-after-brain-injury/
http://sciencenordic.com/head-injury-can-cause-mental-illness
https://www.ncbi.nlm.nih.gov/pubmed/18289429
https://www.headway.org.uk/media/4051/mental-health-and-brain-injury-factsheet.pdf
Whelan-Goodinson, Ponsford, Johnston, Grant (2009