My brother was 19 when he suffered a TBI. He’s made a lot of progress in six years. My family’s main concern right now is that he’s been talking a lot about conversations and events that clearly could not have happened or taken place. He’s also been talking to himself and gesturing like someone is with him — only there is no one around. The doctor has said she’s seen some TBI patients go into their own little world like this.
Our family is obviously very worried and concerned. We don’t want this to set him back especially since he’s come so far. Is this something that can happen to people with TBI and what suggestions might you have for us to help him?
Psychiatric issues, including hallucinations and delusions, are certainly more common after traumatic brain injury. The risk for new onset of psychiatric illness after a brain injury goes on for a long time and can be seen with any severity of traumatic brain injury. If these problem are new for your brother, a careful medical evaluation by a physician who has experience in treating patients with TBI is warranted. So the healthcare professional should take a close look at all of your brother’s medications. Some medications can increase confusion or cause hallucination or delusions. Stimulant medications such as Ritalin, Adderall, and Amantadine all have this potential side effect. Evaluation should also be done to ensure these symptoms are not related to seizures.
Loneliness and social isolation can also be contributing factors and should be considered as well.
If no medical or social issue is found and these problems are not bothering him or putting him at risk, I would be cautious about using any psychiatrically active medication. Neuropsychologic and group treatments can be helpful. Neurolpsychologists will evaluation his mood, insight, and judgment to establish if these are true hallucinations or a way of entertaining himself. Couseling can be useful in improving mood. Group therapy would give him a social outlet and can improve insight by seeing others go through similar challeges. If these symptoms worsen and he became a danger to himself or others, medications can be considered. These should only be prescribed by a practioner who has experience in evaluating and treating.
About the author: Brian D. Greenwald, MD
Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.
Comments (81)
Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.
Jenn replied on Permalink
I know this is an old post, but I am at a loss as to what to do and hoping maybe you can give me some insight. My mom is 78 and she took many falls, and still does, backwards and hits the back of her head. She has bad peripheral neuropathy in her feet and doesn't walk very well with a bad knee, but will not have surgery. She has an MRI done in 2/22 that showed front temporal lobe damage, and I guess they think it is front temporal lobe dementia. As this was all stared she began to pick at her skin thinking she had worms under her.skin and they tried different drugs but they did more harm than good. Years later she still see things and her arms are never totally healed. She started talking to one person specific who seems to be the main person, but then other people come into play, like a band and singers, once there was a little boy who was very sweet and then it will turn into people gossiping about her and lately she thinks she hears me, her daughter, and gets extremely angry because she thinks I am lying and all these people are trying to talk me into doing bad stuff. She keeps calling 911 and then they have a note to call me. I try to go to her and get her away from looking out the door or turn on the TV, but she gets so stubborn and just won't. She had a UTI, which they treated with oral antibiotics and my hope was that was to blame for all of this, and I don't think it is. At times I think maybe she has another one and am trying to get her to her doctor but they keep cancelling the appointments. I want to have her get another urine test. This is now almost a month and I don't know what to do. My fear is that since this has started and gone on his long that it is here to stay. She talks back to these voices and when she gets mad at me it's just too much. She doesn't have any friends, and neither do I at this point. We live together and I am here 24/7. Her friends all disappeared when all this started and I have just been engrossed with caring for her. My ex will come out and stay and try to give me a break. I worry that it's loneliness and isolation along with worry over money that may be contributing. I have two businesses I started from home trying to generate the income we need and I am starting to get income coming in, but then it leaves little time for her. As this has gone in years, the dementia like symptoms I have grown weary. When I go to sleep I really sleep and then sometimes I don't want to get up and face it all over again. I can't afford any help and my siblings won't talk to me or help. We can't afford to put her in a home. I feel like this is going to be my life and just drive me into the ground. Is this really it? Is this just how it goes? I can't believe that this is okay to have 2 people suffering like this, and yet it seems to be.
Anonymous replied on Permalink
Hi, my husband had a subarachnoid hemorrhage in 2018. Since then he can be completely rational one day and totally delusional the next day. Is this common and what causes this behavioral roller coaster?
Anonymous replied on Permalink
My wife went into Cardiac Arrest 7 years ago. she was down for 6-7 minutes and obviously lost oxygen to her brain. She has short term memory loss and also has personality changes. But one thing concerns me is that on days that she gets depressed or has anxiety or just a mood change or as we call it she is having an off day. On these days that she's off it also has the symptoms that she is drunk or out of it and she sleeps a lot. my question is the appearance of being off is this one of the Symptoms of having Hypoxic- Anoxic Injury
Bobbi HamiltonMD replied on Permalink
I mostly took care of working people ****So did not see a lot of subdurals
. I had one on Dec 2023 with a fall. My memory stops two hours after that and then only snippets for the next month. Now am having hallucinations for the first time and vertigo***is this usual??
Rosel geremia replied on Permalink
My father hit his head on the floor . After 3 weeks it seems that he is hallucinating.. but his head does not hurt..
Anonymous replied on Permalink
My brother fell 1800 feet from a hang glider 30 years ago and was in a coma for an extended time period. He is currently delusional about food topics, is somewhat anorexic and believes Covid 19 is not real. Some of this is a result of misinformation he read years ago that there are no "pathogens" and germ theory is incorrect. This places him at risk when he has a bacterial infection and needs meds. I am wondering how much of his delusional behavior could be a result of brain trauma and not conspiracy theories. He gets quite angry when challenged. I don't want to feed his delusions, but it doesnt seem to help to challenge him. He is pretty sure he alone knows everything about health and hygiene. And before the accident he was a liberal hippie. Now he is a right wing conservative.
Zuli replied on Permalink
My sister, who is 30, suffered an injury to the head in December 2019. Her vision became blurry and she was unable to focus on objects. She takes anxiety mEdication and also suffers from migraines and had to take a 3 month shot treatment. She also became very distant and anti-social. She recently started hearing voices in her head. What could be causing this?
Ben replied on Permalink
Anti anxiety medication is super dangerous and shouldn’t be taken for more than two weeks. It is not going to help. The withdrawl from it is just like a tbi.
Peter replied on Permalink
I also hear "voices" from a time to time when I'm alone for an extended period of time. She's probably entertaining herself, or maybe she's researching/trying occult methods. I'm sorry if this is weird to read but, it's how my life is too. I had a brain injury in 2017, right afterwards I started hearing voices. Spiritual outlets provided a pretty "logical answer" about these voices. Spiritual leaders actually encourage people as well as teach them new ways to communicate with these thoughtforms (voices).
Sometimes drawing or doing physical activities no matter how small they are, help reduce brain activity, and thus make her more grounded.
Anonymous replied on Permalink
My daughter aged 29 struggled with divorce of her parents and subsequent death of her mother 7 years ago. She is highly sensitive and suffered from anxiety and insomnia so was diagnosed Bipolar. She also suffered from an eating disorder that complicated matters. She abused Ritalin and finally in 2/2020 stopped breathing from overdosing on probably Zanex. She was not expected to live from her anoxic brain injury but did. She woke up finally and having brought her home to oversee recovery. She has done well and progressed nicely. Recently she became manic and started profusely journaling memories that previously were clouded in amnesia. After 3 sleepless nights, yesterday she wrote 4 hours straight about events and memories with particular focus on the "love of her life". She had been hearing his voice and he had proposed marriage, it was their wedding day, her sister was to do her hair and he was building a home on the coast for them to live in after the wedding. She has been 6 months off of all drugs, her eating disorder has resolved evidenced by 30 plus lbs., she is very focused on speech therapy and physical activities the promote healing and off all prescriptions for 6 months. This sudden change is alarming. Any suggestions?
Anonymous replied on Permalink
My daughter has TBI and sometimes she is hard to deal with.She thinks the neighbor has hacked her cell,tv and now somebody is walking on the roof gets bad at family because we don't do something about.Now is in trouble with law
.it's something all the time as a mother its worrying til it's on my mind most of the time.Any suggestions please
Constance Marcus replied on Permalink
With all due respect, is there a possibility she may have any access to drugs? I too, am trying to figure out what causes delusional behavior and certain other behaviors in someone I care about. Hoping MRI will shed some light. I hope it’s not the case but the one of the first questions asked. Good luck to you and your daughter.
Ben replied on Permalink
The anti anxiety meds are most likely to blame. You can get hundreds of side effects when hitting tolerance or coming off of them. Psychosis isn’t nearly the worst symptom of anti anxiety medications. Many people loose the ability to walk and think. It can take years to heal from the damage they do. I know because it happened to me. I wasn’t on them long and didn’t take much.
Anonymous replied on Permalink
I got an acquired brain injury when I was 18 months old. I still suffer from the accident. I have problems with memory, concentration I have depression, anxiety and dissociative identity disorder ( multiple personalities) I hear voices 24 hrs a day. I also hear people talking about me on the radio or TV. At times I think I am microchipped and are being followed. I wish life was different
K replied on Permalink
I’m so sorry you experience this. And I bet the voices you hear have nothing good to say, they never do. Always talking about the one thing that would upset your or chattering away about things your afraid people may know or embarrassing things or even insulting you in ways that are very personal. To hear the chatter over the radio or especially when a fan or furnace is on...I can assume you experience this a lot of the time and your right to wish life was different. It’s a difficult existence and a lot of people don’t understand and don’t want to ❤️
Anonymous replied on Permalink
If you dont mind me asking, how old are you now. I Also suffered a major accident when I was around 2 years old. I am now 50 years old, and I am experiencing the same issues that you described. They started at the age of 35, and they seem to get worse and more difficult to deal with every day as I age. I also wish that my life was different. Thank you for sharing. It makes it a little easier knowing that I am not alone when it comes to experiencing these issues.
Anonymous replied on Permalink
Our daughter, who is now 36 and lives in a group home, was brain injured at birth with basically no right side and damage to the left and front. She has had her ups and downs, behaviors, episodes, you name it. A couple of days ago, she was screaming, tearing things up and staff stayed right with her. She apologized afterwards, and said a little man was on her shoulder. This is the first time she's said this. Hallucination? We have no idea.
Anonymous replied on Permalink
Hi there I too suffered a minor brain Injury. Side effects were Refractory depression, anxiety, insomnia etc. No meds worked. I nearly killed myself but I found 2 treatments that have recovered a lot of my brain health, one is I use a home PEMF (pulsed magnetic fields device) on my head / body, to heal the brain / reduce inflamations. And also instead of ECT I use the Alpha Stim device - a more advanced version of CNS (Cranial nerve stimulation) That taps alpha waves into your ears to balance out severe depression and mood changes.
The results have been life changing. I would be happy to let you know some more, and best wishes to all :)
Anonymous 83 replied on Permalink
Hi i hope you receive this msg. My brother suffered a blow to the back of his head and had other trauma on top of it. Losing girlfriend, house burnt down and he turned to drugs to try deal with life. He now hears voices and really believes he has been microchip in his body and believes these voices which he can tell me whom they are, are controlling his everyday life and can feel see everything he does. I'm desperate to help him. He does nothing but eat and sleep now. Believes his everyday life is obstructed by the voices and he can not do anything because the voices do not stop. I have suggested frequency to lisen to frequency's to try over ride the voices and promote healing. He will not give it ago. So this device you are talking about? Do you think it could help with this kind of injury and trauma? Because I would like to get a natural healing for him. Thankyou for your time and awaiting your response.
Lynn replied on Permalink
I would like to hear more........please
Concerned wife replied on Permalink
Can you please tell me where I can get the home pemf and cns from? I have tried so many different medication for my husband and they don’t help. It’s been over three years. Thank you
Anonymous replied on Permalink
I first started having hallucinations because of a brain cyst but after it ruptured and caused nerve damage that 2yrs later is still not healed. I see demons crawling on my skin and dust like things floating in the air and coming straight for me. I am a devote Christian and i believe God is in control and is working behind the scenes. It is scary from time to time but i believe God is bigger than this problem. Hang in there everyone!!
Jarrod replied on Permalink
I got a brain injury in 2018
And I have been having this same problem I see dust like things and sometimes when my eyes are closed I see hands grabbing my soul it's freaky then 7 weeks ago I had a poltergeist run at my throat
Lisa Long replied on Permalink
Following a traffic accident - tremendous impact - I suffered hallucinations for days. Seeing insane images that appeared completely real. Some nice (Koala Bears, kittens)
some terrifying (Talking heads without bodies). Could go on and on, but won't.
I have tremors and confusion.
Five months after now, I still consider myself unable to function.
Mike schwan replied on Permalink
I have a tbi from 3years ago. Couldn't do my job. I quit my job. General math became very hard for me. Trying to put it together or away out. I also have 2brain anurisms before my accident. I try to not think about it I hope things turn out ok. Thanks for listening
Anonymous replied on Permalink
Hi Mike would you mind sharing your social account? Need to talk about something.
Will replied on Permalink
I fainted outside and hit my head ever since then I've been visually and auditory hallucinating every min of the day sleep is impossible. I get tremors can't sit still. Tried ZZZquil and melatonin to 100mg seroquel
Drink a lot of Alcohol to help me pass out. I can't stop thinking about it its like OCD anxiety with Psychotic depression on roids. My doctor said its sounds like a severe concussion. Didn't get a Ct Scan Yet its been don't know why its been over a week and Ive been in the ER all I wanna do is sleep now I officially dubbed myself insane.
Em replied on Permalink
I've read about hallucinations occurring from TBI but I've never come across an occurrence, the hallucinations, the hallucinations of seeing dead bodies must have been frightening? When it was over did you know that you had a hallucination?
When I first woke up, I was not aware that I was in the hospital, and the only distinct thing I can remember is getting mad that they wouldn't let me use the toilet and I couldn't understand why. It might have been drug induced because I was getting Haldol, IV fentanyl & dilaudid. After 6 months of being home, I developed this grandiose sense of self and I was convinced that I was going to be famous. It's so weird that I had such high confidence, 6 years later and I feel ugly and it feels like the TBI ruined me. but as of Now I'm always paranoid and expecting the worst. My TBI was a intraventricular hemorrhage, brain swelling and edema. I hope that you're able to recover from the hallucinations eventually, seeing bodies would cause more PTSD then the car accident itelf.
Sseniotto replied on Permalink
I developed psychosis and delusions after I was hit by a car and the. Eventually I got admitted into a psych hospital and was put on lithium and latuda and then ECT I think the whole experience is Unfair and not clear at all. I’m not sure if the delusions were amphetamine induced or from the car accident or both
Kathy replied on Permalink
Did you find that the ECT was successful? We have a situation in our family where a relative had a brain bleed, and then has completely gone into psychosis with out rages delusions and severe depression now… We’re almost resorting to ECT now because we don’t know what else to do in medication isn’t helping.
Carolyn replied on Permalink
My sister had a TBI and has experienced hallucinations and delusions ever since the accident. Typically, the diagnosis for her symptoms would be Schizophrenia, however, when caused by a TBI, isn’t the diagnosis different? Or more specific or have a secondary diagnosis of TBI?
Renee replied on Permalink
Yes, I'm personally going through the same thing. Typically, hallucination and sort come back if you stop taking meds, which I'm on month 4. Plus, I never had any medical problems until after my car accident. It is very frustrating because help is so hard to find.
Anonymous replied on Permalink
Jennifer replied on Permalink
Yes, they can actually see and hear you whether you are there or not. My Mom has front temporal lobe damage and constantly thinks she hears me and others talking to me trying to get me to do horrible things, and when I say it's not me she calls me a liar. There is no talking her out of it. I don't know what to do and am out of ideas, but I wanted you to know that yes, that is totally possible, and more than likely happening if he thinks that, and it's not you doing it. I wish I could tell you how to fix it, but I just don't know.
Will replied on Permalink
Just let him know that you'll always be his bro regardless.
Best friends are a bond like family.
His family sounds like they abused him and they need mental help also.
Ann thomas replied on Permalink
What can you do if a person refuses to accept the voice he hears is not real. My son had head injuries 20 years ago (front temporal lobe damage) was in induced coma for 3 weeks. He has, for the lady few years, been accusing neighbours of shouting things at him (even "neighbours" who do not exist) Will not see doctor as all this is real !!!
Evelyn Radcliffe replied on Permalink
I've had brain surgery was in a EXTREMELY abusive relationship ..was put on oxycodone to deal with aftermath I don't know myself if it's the brain surgery or oxycodone but whatever it is. Is so REAL ITS scary SOMTIMES .
Mike S replied on Permalink
Hang in there. We have to. God Will help you. He's helped many times. I'm living proof of that.i don't even remember my accident at all.
Holly replied on Permalink
I've had the same thing happen to me. The people and conversations within were very realistic. I take abilify which just allows me to know what i hear isn't real. The voices and people really never went away.
Claudia replied on Permalink
What to do after having a concussion for 4 months and seeing things that are not there
Cathey replied on Permalink
I hope you are better now, please let me know how things have progressed for you. This is my third month after a fall and hard blow to my forehead. I have chronic headaches. When I get very tired I see things briefly that aren't real, and it only takes me seconds to understand that it was a mild hallucination. I truly hope you are better. If you could share your experiences, it might help me or others. Thanks,
Peace and Health to you
Will replied on Permalink
I think were gonna be in the seams boat. Look up Post Concussion syndrome. It can take months up to a year my luv
Corey P Pollock replied on Permalink
I was involved in a auto accident about a year ago and have a TBI. I'm having Hallucinations, Ringing in my Ears, Head Aches, speach problems including stuttering! Some of my symptoms have gotten a little better. My Ears never stopped ringing and I'm still having Hallucinations! Do you know if and when these symptoms will go away?
Matthew Peter Swet replied on Permalink
My life ,career, fiance, are all gone . I was hit from behind at work by a truck in 2014 and got a diffused- axonal head trauma without breaking my skull. I have developed the same symptoms. Fir a while my family and doctors said I was very psychotic. Because of the areas affected I was put on a huge dose of Prozac. I couldn't stop shaking or hallucinating neon mushrooms growing on everything in my house . I even thought that i was the King of England at one time. I couldn't sleep. They took me off Prozac and on Lexapro. No more shaking or hallucinations but I have many other things that won't go away such as isolation, anxiety, paranoia, crippling gast headaches that stop me in my tracks. Lso my eeg showed no obviously seizures but I smell thing that aren't there a lot plus I can't drive in heavy traffic & although there's no documented reason to take my licese away Ionly drive on small country backroads .my neurologist said that really nothing can help me since I won't recover the dead areas in my head.. and nothing can help me after 9yrs. I've lost most of my friends and have a hard time understanding the world. My mom has to help me with my paperwork and disability will go farther if I move home so at 48 im selling everything and going back to live with my family.. I still have my dogs &I'm not suicidal but I pray God will just take me in my sleep sometime soon
Philip replied on Permalink
I had a hard knock on the head, and for 3 days had hallucinations. then they went away. do I still need medical help? I feel fine now.
Scared immensely replied on Permalink
Hi I can completely understand unfortunately for us but am glad to know I’m not crazy and my loved one isn’t out to get me (maybe). I was in a car accident on September 9th 2019 and had a TBI plus an open head wound on forehead. My entire head and face bruised badly. At first I had virtigo non stop. Now I’m having hallucinations and hearing things. It’s VERY REAL TO ME. Everyone tells me I’m crazy it’s not real no one is there and no one said anything. I feel like I’m losing my mind and it’s causing me lots of problems. I’m scared to tell my neurologist but now after reading everyone’s story I feel safe to tell my doc and that I should. Thank you and God bless
Jade replied on Permalink
I went through the same thing a year ago with all the same symptoms after a car accident. Got a coup-contrecoup brain injury and extensive bodily injuries inside and out. I also developed chronic migraines and persistent post-traumatic headaches for several months afterward. Several ruptured discs, sprains, strains, bruised liver and ribs. Right after the accident, I had trouble talking, like I was myself in my head, but just couldnt make the words come out, forgeting words, losing words. I remember the impact knocking the wind out of me, the feeling of mt brain hit the inside of my skull and what I can only describe as my soul being thrown out of my body as I watched myself from outside the car until I regained consciousness.
I had auditory issues, and
I recently learned that I have moderate hearing loss on my left side, the same side with the tinnitus. I had auditory hallucinations, and I still do except I have always known they weren't real, I maintained insight, but still scary. I still have trouble processing sound, but it was so bad that I couldn't interpret what I was hearing. My ears worked, but the sounds didn't make sense...I would lay down at night and then suddenly the room would sound like a crowded cafeteria of people talking. Everything got worse at night.
I had nightmares, sleep-paralysis
It started with insomnia where i woke up like clockwork every 2 hours for 2 months. Then it turned into near narcolepsy where I'd sleep for 16-20 hours per day and had sleep-attacks. I had bad hypnopompic and hypnogogic hallucinations to the point I would bolt out of the house in my underwear, running around the yard screaming for my son because I hallucinated that I heard him running toward the highway, calling my name.
The auditory issues affected everything, then i thought I could read people's minds and communicate telepathically via writing in a notebook. I filled several notebooks with that, as well as deeply philosophical and psychological ramblings. Some of them still kinda make sense, but woah. At the time I felt I was having a constant conversation with God and now I kinda miss that feeling. I always knew my thinking was bizarre, so I hid it, which tbh, was probably a smart move.
Ironically, stimulant medications helped me regain order and organization in my life and in my thoughts. I felt everything getting out of control, like i had so many thoughts and things to process that it was totally random. I would not have recovered with as much function as I did without the stimulants, which is odd considering I was definitely having psychotic drifts...
I also found that getting botox shots and spinal steroid shots helped immensely for pain, particularly the head and neck.
As of today, i continue to have auditory processing issues, hearing loss, tinnitus and auditory illusions. I am not lost inside of myself anymore, and no longer having unusual beliefs/delusions or hallucinating. I think some of the changes are permanent, i still have word-finding difficulties and speech hiccups that only I seem to really notice, but I think this is as good as it will get.
Hope that sharing my experience is helpful at all. Good luck.
Mary replied on Permalink
I have had many of the same experiences that you have had. I suffered an accident that left me with a TBI, difficulty with speech, extreme virtigo, extreme depression, critical memory loss, and then around 7 months later I went into psychosis and started having constant audio hallucinations. They started as religious hallucinations but now may be about anything. I thought I was better for a while and only heard myself thinking but now hear several voices all the time. Since much of what is talked about to me references actual things in my life sometimes it is believable. I have tried latuda but had a very bad reaction and am now taking a low dose respiradone which doesn't seem to be helping. Can someone provide feedback on medications that actually work with fewest side effects?? I have been desperate to have someone to talk with that has actually experienced the same thing. I was and still am a very intelligent person but my life feels shattered. I am single and feel that no one will ever except me. Would appreciate a good person experiencing the same thing to talk with. The doctor's tell me I'm not schiprenic but that my audio cortex and frontal lobe was damaged.
Magical Lady replied on Permalink
I never really suffered with speech problems or studdering. Unless I was a little nervous about something like maybe public speaking. I noticed for a while after my concussion and later a 18 wheeler truck crashing into my rear end. I noticed that I was studdering and sometimes my speech would even slur. Your comment just helped me realize what was going on that it could've been related to TBI.
Ricky replied on Permalink
My girlfriend and I are about to celebrate our 8 yr anniversary, and 7 of those have been bliss. I live in a part of the country where violence on some level is an everyday occurrence, and it touches all who live here. My girlfriend is no exception. She has been in a couple of bad relationships where she was often abused and one ex made it a point to target her head when angry. On top of that, she's been in numerous car wrecks where she was concussed but sought no treatment. About two years ago she was attacked by a woman who hit her in the head with a rock as well.
A year ago her personality changed and she started hearing voices, has mild headaches for days and just isn't the same. I'm extremely worried about her and I don't know what to do! She refuses to see a doctor bc she is afraid she will be labeled as crazy.
Is it possible these numerous head injuries caused this? What can I do to help her? I'm getting desperate and I know she can't continue like this.
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