Emotional Issues in Brain Injury

• The Role of Attentional and Memory Problems in Emotional Issues
• Mood Swings
• Depression

Substantial discussion has been devoted previously in this page to the organic/neuropathological explanations for the deficits individuals may experience after concussion. Up to this point, we have not addressed the emotional impact upon a person of having a brain injury.

A substantial amount of literature that is written on what is often called the "post concussional disorder", attributes the group with poor results from those they claim have full recoveries, based upon psychological factors. Some authors go so far as to redefine the term post concussional disorder to apply to the non-organic sequelae of symptomatology that has been correlated with the period after recovery that would be expected from concussion. Terms somatic disorder, psychosomatic and psychogenic and even neurobehavioral are used by such researchers.

This author believes that such literature is placing far too great of blame on the emotional issues as being causative of this so called "post concussional disorder". This blame it all on emotional approach ignores the historic neuropsychological research and now breakthrough neuropathological research, which clearly establishes organic deficits as the precipitating cause of the cascade of symptomatology that flows to those who do not achieve the "apparent full recovery."

Yet to diagnose, understand and treat subtle brain injury, we must factor in the emotional overlay that such injury can have upon a given individuals productivity. No one functions at peak efficiency when they are depressed. No one functions at peak efficiency when they are fatigued, which likely results in additional depression. No one suffers a major reduction in ability, without some emotional response. To label all of the cascade of symptomatology which may naturally flow from the disruption of ability and lifestyle that comes with a significant accident, the result of an organic deficit in the brain, is improper. It is important to recognize the functional emotional component in the mix of symptoms.

The emotional issues may require interventions and strategies that an overreaching organic diagnosis might not suggest. Yet, the emotional cascade that can come from a labeling of psychogenic as opposed to organic, can cause as significant of emotional stressors as the "accident neurosis" diagnosis that far too many professionals are so quick to utilize.

It is not necessary to have a loss of consciousness to suffer permanent brain injury.

Source: Definition of Mild Traumatic Brain Injury Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. J Head Trauma Rehabil 1993:8(3):86-87

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