Depression After Brain Injury: What You Need to Know

“Late at night, I cried. When I thought about who I used to be and what I used to be able to do, I felt frightened and alone. Then the self-pity would kick in, and that made me feel ashamed,” writes author Kara Swanson. After her brain injury, Kara experienced significant bouts of depression, especially early on in her recovery. But over time, she learned to manage it, to accept who she was now, and to create a fulfilling life for herself.

What exactly is depression?

Depression is sadness than can last a few days or weeks, or a long time. It can also manifest as a loss of enjoyment in life, even in the activities that once gave a person great joy and sense of self. It is characterized by feelings of sadness, despair, and discouragement. It often follows a personal loss or an injury, like TBI. When someone’s life has changed drastically, it’s normal to feel depressed. It is not a sign of weakness, nor does it represent a moral failure. It is definitely not something to be ashamed of.

Depression can result from the chemical changes in the brain itself. It can also be a symptom of post-traumatic stress disorder. If the depression becomes extreme and affects the way you live your life, it may become pathological. Seeking help early is crucial.

Signs and symptoms

When recognized early, depression is easier to treat. Family members — and individuals with brain injury — should watch for these common signs:

• Feelings of worthlessness, guilt, or loss
• Loss of concentration
• Decreased energy
• Loss of appetite
• Sleep problems
• Slowed thinking or movement
• Diminished desire to participate in social or recreational activities
• Thoughts of suicide

Strategies

Depression can sometimes be a double-whammy. While depressed, you don’t have the energy or confidence to do what you need to do to try to feel better. Here are a few strategies that people with post-TBI depression have suggested:

• Set up a routine for your day and try to stick with it.
• Stay involved in life. Find activities that give you pleasure — ones you used to enjoy or new ones.
• Give yourself credit; acknowledge your improvements.
• Be open to the support of others. Healthy relationships with family and friends are healing.
• Have faith and hope.

Treatment

For Kara and others with brain injury, the good news is that depression after a brain injury often goes away on its own or can be treated successfully with medication or non-traditional means like yoga or meditation.

Depression is usually treated with medication and/or counseling by a trained professional, but without treatment the symptoms can last longer and may return. Chronic depression can cause low self-esteem and poor quality of life. Treatment is usually quite successful, so there is little reason to delay seeking help.

“One of the most important steps in recovering from any traumatic event,” wrote Kara, “is realizing that you need help — that you can’t always make it by yourself  — and then finding the strength to seek it out.”