Depression & Suicide Among Patients with Traumatic Brain Injuries

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Suicide Depression and Head Injuries
After a traumatic brain injury (TBI), patients experience a number of different challenges during the recovery process. In addition to the mental and physical difficulties, patients can experience emotional and behavioral changes. Though it may be difficult to talk about, a lot of patients may have feelings of depression or hopelessness, or even have thoughts of suicide. Feelings like these can be brought on by the stress of the injury and rehabilitation process, though damage to areas of your brain in charge of your emotional responses can also have an impact on how you feel.

A recent report reveals that major depressive disorder (MDD) may be the most common and challenging mental health condition that patients encounter following a TBI—53.1% of TBI patients in the study experienced MDD at least once in the first year after their injury. Another study showed that suicidal thoughts and attempts are also common reactions to TBI—23% of the participants had thoughts of suicide, while 17% actually attempted suicide after their injury. These higher rates of suicidal behaviors may also be connected to MDD following TBI. Though these statistics may seem a little scary, it doesn’t mean that you have to be without hope when it comes to coping with these issues during recovery; a good TBI treatment center should recognize that addressing their patients’ mental health issues is a key component of the recovery process.

SUICIDE ATTEMPTS CAN CAUSE BRAIN & HEAD INJURIES

Though there’s a lot of research showing increased rates of depression and suicide attempts following a TBI, there is another aspect of the story that’s worth considering—suicide attempts as causes of brain injuries, not just effects of them. Oftentimes, depression or other mental health issues exist prior to a brain injury. Sadly, the feelings experienced as a result of such issues can lead to suicide attempts, which appear to be responsible for a large number of the intentional injuries that cause TBIs. In these situations, addressing your mental health history with your health care team will be an especially important part of the recovery process.

Of course, the recovery process for brain-injured patients can be incredibly stressful on its own. Adding in feelings of depression or suicide may make some of the emotional aspects of recovery even more difficult—all of these things thrown together can seem like a series of overwhelming hurdles to jump. However, that doesn’t mean they’re un-jumpable. Regardless of how or when they are experienced, things like depression and suicidal thoughts must be addressed in your recovery process. Perhaps working with a health care team that includes mental health specialists could help create a more well-rounded approach to your treatment. No matter what, it’s critical that you to talk with someone on your team in order to figure out how to tackle the different feelings you or a loved one may be experiencing during this difficult time.

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.

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24 Responses to Depression & Suicide Among Patients with Traumatic Brain Injuries

  1. Celia August 19, 2011 at 4:35 pm #

    My little brother which is 26 tried hanging himself. He has been having suicidal thoughts when he drinks. Almost a year ago he was involved in a fight which his head was injured with an object and the head was very swollen. The X-ray showed everything was okay? Do u think we should take him to get x-rayed again? I really don’t know how to help him since he gets irritated easily. Thanks

    • Nadine October 2, 2011 at 11:18 am #

      I am not a doctor, but am living with a loved one that suffered TBI, or traumatic brain injury. I am also a special education teacher. Irritation, mood swings and anger can be signs of TBI. Any jarring or trauma to the head can change the electrical patterns. A neurologist and neurosurgeon diagnosed the areas of the brain in my loved one that was affected through a brain scan. Medications have helped, but we are always on “call”. Alcohol can also play a big roll in TBI patients and the brain. Some TBI patients do not remember how much they drink, or when. This is also true when have medications. That is why they are often monitored with meds by a caregiver. Hope this helps.

    • juan August 17, 2014 at 9:34 pm #

      My brother was jumped on by a group of thugs and they beat him. He was hospitalized and bleeding from the brain. A year later he did hang himself. Your article was three yrs ago, so I hope your brother is better.

  2. Larry May 6, 2013 at 11:48 am #

    I hit my head in a car accident and have been emotional and angered easily. Nobody understands really and probably thinks I am making it up or something. I am depressed and think of killing myself and have come close a bunch of times. I am alone most of the time and cannot stand to be around people. I get stressed by just about anything and get angry at nothing, even if nothing is going on I will mentally create something in my mind. I can’t remember anything on a list or too many numbers, have trouble with math and get confused all the time. I am afraid that I will hurt someone. I don’t have insurance so screw me right? no help only tests that do not help at all. I don’t understand why this is all happening to me and can’t control it. I do not think I can go on doing it… Maybe this will help you understand what this is all about?

    • Julie July 21, 2014 at 3:21 am #

      Larry

      I had car accident 14 years ago, and ended up fracturing my skull. This happened in Brisbane while i was living there, but a year later, moved back to NZ to be with my family. I couldn’t get ANY help from dr’s here, as ACC wouldn’t cover it. I’m only getting help THIS year as a result of me nearly doing the haka up and down their butts to get some help and I am. You need to speak to your GP, if that person won’t listen, then go somewhere else. You need help and I sooooo understand the frustration of it all mate.
      The longer it’s left, the harder things get.

    • Matthew February 16, 2016 at 8:46 am #

      I understand you completely! I had a brain injury for about 10 years now. I’ve only accepted it to myself in the past 3 years. But I have the exact same issues. Every single day is a struggle and absolutely no one will understand. I have zero friends now and have come to the conclusion that I am impossible for a woman to love. So I’m always alone too. I also have no insurance.

      • Kate February 16, 2016 at 7:08 pm #

        Matthew–
        You wrote this today. All the other replies are years old. I do understand. I am going through the same thing, that’s how I found this site. It’s funny that we both landed on it on the same day. But I want you to know that I absolutely DO understand….and you’re not impossible to love. Hang in there.

    • Andrew February 26, 2016 at 7:42 pm #

      Hey Larry, not sure if you will even see this, but I am in a similar boat as you, and I’d like to hear your story

  3. Wendy July 3, 2013 at 6:46 pm #

    I have had 14 brain injuries in my life. First one was when I was 5 (unconscious after hitting head ice-skating). Have had multiple “mild” concussions – no loss of consciousness, but memory loss, confusion, etc. and at least 3 other major concussions. I now have epilepsy and my last bad tbi was July 19, 2012, when I went into grand mal seizure while jumping a horse. I landed on my head while seizing. Screwed my brain up really good – didn’t know who president was, year, etc. Have had 4 more brain injuries – last one was actually food poisoning, where vomitting caused my head to feel like it was going to explode. Packed my head in ice, and after 15 minutes was able to manage headache with tylenol/advil/valium. Am now stuck taking these 3 things together 3 to 4 times a day. Still feeling head-injured from headache. Anyone else have this happen? Memory is bad, and not sure what day/year it is. Keep thinking its 2014 or 2015 and the day is Friday (sometimes Wednesday) – so at least somedays I’m right! Can’t be bothered with what month it is. Feeling very alone, lots of people hate me because I was on Topomax which made me a very awful person for 2 years – became suicidal, self-cutting, bitchy, loud mouthed, mean to everyone. So now I’m off Topomax and just sad and lonely. I know I don’t really want to die, but I am so tired of so many people not liking me. I grew up with my life only having meaning if I kept people around me happy, and now I can’t do that, I have mood swings, get angry/depressed really easily. Feel like whole world is against me. Sometimes wish I would just get stage 4 cancer and start saying my good-byes, which is horrible, because I feel really sad about the people who actually have this, and don’t want to die. No one seems to get psychological pain I am in and no one wants to be around a loser. I get that. I’ve lost my creative side (used to knit, weave, make jewelry, learning piano, etc.) but have lost all interest in creating. I’m broke (in debt) and can’t afford therapy. Wish I could find a support group, but no luck there either. Might try al-anon, as I’m living with a drunk. And at this rate I’m becoming one myself – 3 drinks per day – one at noon, 2 in the evening. And have tons of psychological issues – trichillomania, depression, anxiety, and now stupidity – used to be smart mathematician/computer person, but brain doesn’t think that wide and far anymore, very tunnel visioned. Does anyone else feel mis-understood and that people hate them – due to meds they were on, or behaviors that only occured due to meds or tbi? How do I let them know I want to try friendship again? or do I just move on and hope to meet new friends/?? Can anyone relate to this mess????

    • Ashton September 10, 2015 at 3:48 pm #

      I’m so sorry. I am 17 and an recovering from a brain injury that happened a over a year ago. It’s a long,difficult and stressful process. If you ever need someone to talk to, I’m here.

      • robin January 23, 2016 at 4:29 pm #

        tell me about it, i had one in 2000. life has changed so much,

  4. Wade February 16, 2015 at 6:34 am #

    I had a TBI at 6yrs old (hockey) coma 2 days. At 19 a TBI loss of memory 2 weeks, blood clot in the brain, tenitis, and seizures. I am and turning 50 now. Recovering alcoholic. Depressed constantly, anger is very often. Thoughts of suicide still creep in from time to time. There is no help out there, except pill pushing doctors. Can anyone lead me in a better direction????

    • Travis owsley January 26, 2016 at 9:41 pm #

      Exercise buddy

    • Eric February 25, 2016 at 6:09 am #

      I am 54,suffered a TBI in 2007 and again in 2014. First one in a car accident and the second one in a shower slip. My doctor is prescribing lyrica and norotrypline for the pain. I have days when I do not take my meds and feel great but the next day I feel bad. Suicide is always on my mind. I have tried letting my doctor know but he just wants to try a new med. I know in canada if you have suicidal thoughts and go into any hospital they will keep you for 3-5 days to assess you. I am also very frustrated at the pain, thoughts, and meds.

  5. Travis owsley January 26, 2016 at 10:12 pm #

    I’m TBI and would like to tell all who are tbi an or having thoughts of suicide to stop there’s know need to end your life for life has it’s highs an it’s lows but theres only lows because were not perfect an one day will be for no doubt we are supposed to be perfect an be living great. That day will come but don’t take ur own life for ur showing the creator ur weak an can’t take this test my best advice is to exercise and eat healthy.

    • Enessa May 19, 2016 at 2:22 am #

      I do eat healthy, I have PTSD after TBI, and its been a year and 4 months. Nothing has gotten better. I think more and more about suicide than ever. If that makes me weak then so be it. I think when I’m dead I won’t feel this way anymore, cause I will just be dead and tbh that’s what’s really comforting. I don’t wanna be dead, but I don’t see an alternative. I also got sick on a vacation and it’s killing me really slowly and just making my life hell. I don’t even have family members other than 1 who really cares about me, but we fight a lot. I have no more friends because I’ve become a complete loser, asshole. I don’t want to be this way. but i can’t seem to control it. dr.s don’t care. I’m starting to not leave my house unless I absolutely have to. If this is some “lesson” our creator is testing me with its fkin bullshit & just utterly cruel. I just want it to stop. I wish someone I knew has gone though the same only so I can talk to someone who’s gotten through this or at least to know I’m not alone. Cause I have never been so alone physically and mentally and I am scared. I’ve tried to get professional help, you’d think it wouldn’t be so difficult but apparently it is. unless you want to pay $200/session to see a professional. which Ive spent all my money on so called help. The lady wouldn’t even give me any advice or say anything she just say her ass in her lazy boy, feet up & Idont even know if she was actually listening. It was awkward to say the least, and all she did was sent my dr. a letter saying I should be on meds. This was before my head injury. Yet, she didn’t diagnose me for anything. & when I asked her if I had any mental disorder bipolar or OCD or whatever she said no. Usless dr. I just feel so hopeless, useless and lost, I want help but no matter what i do, even straight out asking for doesn’t work.

      • Fallon June 27, 2016 at 6:28 am #

        ENESSAAA HI! HELLO! I AM IN YOUR BOAT BUT A LITTLE FURTHER DOWN. Well… I was hit by a truvk in 06′ when I was ten. So I’ve had to deal with this bull**** for QUITE. a few years. AND YOU’RE RIGHT! It is bull****! A brain injury can make you want to rip out all of your hair and run back into the street or however you got your injury just to finish the job. It’s diffcult. And inconsistent and it sucks. And sometimes you dont see any progress at all! And it kills you inside. BUT this isn’t the narrative. We aren’t doomed to be dysfunctional. Even though a lot of the time, thats EXACTLY what it feels like. BUT it’s all about YOUR journey. This is YOUR storybook! And we’ve just passed the part where the tragedy births a hero!! It’s all about writing your story, man. I have a mood disorder with my tbi. Every few days I am the most dysfunctional person in the world. Every few days I am completely useless. I contribute nothing
        And I want nothing more than to die. BUT every other day! I’m working hard to go to school to help lil brain damaged kids like I was! And honestly? It makes those suicidal days worth it. One of the biggest tips I can give you is to not let your lows define your highs. Or you. All this s*** may have occures, and it sucks and it hurts and you wish it were any other way. BUT it also gives you this kick*** superhero origin story! that’s how I look at it.

  6. Tim February 4, 2016 at 8:31 pm #

    I had a TBI in August 2014 and it was from a skateboarding accident. I am really lucky that I am still all here. Half a year after i recovered I got into graduate school for radiation health physics. This is one of the most stressful times in my life and I have thought about suicide more than ever now. I dont think it is the TBI I just think its school and living in the Pacific Northwest. I feel normal after recovering but I act on impulse too easily and it has got me into some serious trouble. My family is in orange county and I am alone up here but I am doing this for a purpose. This is how I stop thinking of suicide. We all have a purpose no matter what. If you are suppose to be dead then it would have happened when you has your TBI. Dont give up at life because there are a lot of people that are way worse off in other parts of the world.

    • Keven March 3, 2016 at 9:21 pm #

      Tim, this would be my second TBI and my first from a skateboarding accident. Thanks for sharing your story and perspective. Glimmer of hope in a vacuum of despair.

  7. Rolf Gainer February 17, 2016 at 6:50 am #

    When I wrote this blog on Brain Injury and Depression in 2011 I didn’t anticipate that five years later readers of NeuroNotes would still be commenting. In my almost 40 years in the field I have learned that the issue of brain injury and depression is a very real problem for people living with brain injury and clearly it cannot be swept under the rug.

    Brain injury produces complex psychological losses for people and affects the very core of a person’s identity. We have learned over the years that psychological recovery is not necessarily a linear process. Each person will be on their own trajectory of recovery, with different phases and with a timeline unique to each person. Resilience is an important factor in that recovery. Our goal in rehabilitation and in the post-rehabilitation phases is to help each person through the process of dealing with a very real loss and in accessing their strengths and resilience to move forward.

    I want to thank each person who commented on this blog for their contribution to the topic. Each person addressed the impact of brain injury on themselves or a family member and many spoke to the process of recovery of self and acceptance of the changes brought about by brain injury. The Brain Injury Community works in powerful ways and can offer incredible support for its members. The comments this blog elicited heightened my awareness of the high importance of connection in the brain injury community. That connection can help you through the healing process.

    Thanks to all for sharing.

    Rolf B. Gainer, PhD
    Tulsa, Oklahoma

  8. Rolf Gainer March 15, 2016 at 11:01 am #

    We continue to receive responses to this blog on Brain Injury, Depression and Suicide. It is obviously a topic which is vitally important to people living with a brain injury and their loved ones. Some of the responses we receive are deeply personal and are an outpouring of the pain and suffering the person experiences as a result of their injury. We make every attempt to respond to those emails on a confidential, personal and timely basis and encourage the person to find help quickly. Other responses to this blog we post as we believe that there is much to be shared in terms of not feeling alone with the problem and, through that, to support an exchange of communication.

    Many people who have a brain injury experience depression and suicidal thoughts are not uncommon as people struggle with the changes in their lives and personal loss. We know that it is difficult to work through the changes caused by brain injury without support and professional help. That help and support is available through brain injury support groups in your community and now through some support groups in the on-line community. It is important that you not feel alone and reach out to others. There is help and hope available for you.

  9. David March 17, 2016 at 4:55 pm #

    I was in a car accident when I was a senior
    in College in Massachusetts… I was in a coma for 18-days.
    meningitis, bronchitis & pneumonia wth 4 months in hospitals.
    After I started & completed a stint with Sr ayor Kennedy & returned
    To college to complete my bachelor’s. I wrote for a newspaper
    & worked to get Ted Kennedy reflected ., but since then have
    Been married for 11years, but ended in divorce much to my
    Sorrow… Suicide has crossed my mind numerous tines but
    I have an 11-year-old daughter,

  10. Adam April 5, 2016 at 1:43 am #

    Hi my names adam. I suffered a brain injury durby drug overdose 6 months ago. I took 210 mg of pills and smoked ontop of it and ever since I haven’t been the same. I have no attention my brain just feels contested and I can barley think. My speech is slurred and it is very difficult sometimes just to conversation. I realize in my position now Im going to be alone for the rest of my life. Im only 18 and the whole rest of my life is ruined. I don’t know what to do now and I really want all the pain to end. Death seems to be the only answer. All I ever wanted was a pretty girl to call my own but it seems now this will never happen in my life and I will just be a lonely zombie the rest of my miserable existence. I used to love to talk and be with friends and now it’s just hard to be around them and try to be part of the group cause im so fried and I’ve been phased out because of my problems. Nobody wants to hang with a vegetable. Im planning on doing it when my friends go off to college. I just want out I realize im never going back to normal and I’ve just accepted im going to suffer for whatever time I have left. I just wish this didn’t happen but its my fault so I can’t do anything about it

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  1. Depression & Suicide Among Patients with Traumatic Brain Injuries | Debbie's Story - November 18, 2014

    […] Share on emailMore Sharing Services After a traumatic brain injury (TBI), patients experience a number of different challenges during the recovery process. In addition to the mental and physical difficulties, patients can experience emotional and behavioral changes. Though it may be difficult to talk about, a lot of patients may have feelings of depression or hopelessness, or even have thoughts of suicide. Feelings like these can be brought on by the stress of the injury and rehabilitation process, though damage to areas of your brain in charge of your emotional responses can also have an impact on how you feel. A recent report reveals that major depressive disorder (MDD) may be the most common and challenging mental health condition that patients encounter following a TBI—53.1% of TBI patients in the study experienced MDD at least once in the first year after their injury. Another study showed that suicidal thoughts and attempts are also common reactions to TBI—23% of the participants had thoughts of suicide, while 17% actually attempted suicide after their injury. These higher rates of suicidal behaviors may also be connected to MDD following TBI. Though these statistics may seem a little scary, it doesn’t mean that you have to be without hope when it comes to coping with these issues during recovery; a good TBI treatment center should recognize that addressing their patients’ mental health issues is a key component of the recovery process. […]

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