Traumatic Brain Injury and Depression: Understanding the Link

Researchers and health care providers recognize that traumatic brain injury victims often experience depression. Symptoms of depression or other mental illness occur because of brain damage or the life-changing consequences following a dramatic event.

If you or someone you care about is battling depression after a brain injury, it’s more common than you might think, and it’s not something you have to go through alone. At the Brain Injury Law Center, we know that the emotional damage can be just as painful as the physical injury.

Get in touch with an experienced TBI lawyer from our firm today by filling out our online form or calling (757) 244-7000.

How Common Is Depression After a Traumatic Brain Injury?

Depression is one of the most common mental health challenges people face after a traumatic brain injury (TBI). It doesn’t just affect a few people, but something many deal with, whether the injury was mild or severe. Understanding how often this happens can help you or a loved one know what to expect and when to seek support.

Here are some important facts and figures about depression after a TBI:

• Around 27% of people with a TBI are diagnosed with major depression or ongoing mild depression (dysthymia).
• About 38% experience symptoms of depression that are serious enough to interfere with everyday life.
• The average rate of major depression is 16% in people with mild TBI or concussion, and 30% in those with severe TBI.
• People with a history of TBI are nearly 8 times more likely to have major depression than those without a TBI.
• The risk of depression is highest in the first 5 years after a brain injury and may decrease slightly over time.
• More than 50% of people with TBI who have depression also struggle with anxiety.
• One study found that 56% of people showed signs of depression just 10 weeks after a TBI.
• Even after a concussion, up to 22% develop depression within 6 months.
• In teens, a history of concussion raises the risk of depression by more than 3 times.
• In older adults, a past concussion doubles the risk of depression.
• People with 3 or more concussions are up to 3 times more likely to develop depression than those with fewer than 3.
• Factors like the severity of injury, the number of injuries, and age at the time of the TBI all play a role.
• Overall, people with TBI are almost twice as likely to experience depression compared to those without a brain injury.
• Another study, examining post-combat effects of Iraq and Afghan veterans in the state of Virginia, concluded that out of those individuals who sustained brain injury, 66% exhibited MDD or major depressive disorder.

These statistics underscore a concerning reality: TBI and depression are not just common but nearly expected. It is one of the many unfortunate and long-term effects of TBIs.

How Can A Brain Injury Cause Depression?

Scientific studies indicate that brain damage-related depression and other mental illnesses occur in one of two ways: direct physical brain damage and psychological responses to life changes resulting from the injury.

Physical Brain Damage and Depression

The physical impact of traumatic brain injury on brain tissue can directly trigger depression through:

• Direct trauma to emotion-regulating brain regions: When areas of the brain that govern behavior and emotion, particularly the frontal and temporal lobes, sustain damage, mood regulation can be severely compromised. Brain tissue injury occurs when a person experiences direct trauma along with subsequent swelling and fluid accumulation.
• Neurochemical changes: TBI often disrupts the brain's delicate balance of neurotransmitters like serotonin, dopamine, and norepinephrine. These chemicals are critical for mood regulation.
• Neural pathway disruption: Communication pathways between different brain regions may be damaged, affecting emotional processing and response.
• Post-Concussion Syndrome: Even without loss of consciousness, individuals may experience mood disorders as part of Post-Concussion Syndrome, which can persist for months or years.

The type of behavioral and mood symptoms depends on the nature and severity of the injury, in addition to the location and size of the traumatized region.

Life Changes After TBI Contributing to Depression

Understandably, victims of traumatic brain injury experience depression due to many life-altering circumstances. Depression occurs from the loss of cognitive, sensory, or physical abilities.

Beyond direct brain damage, many TBI survivors develop depression due to the profound life changes and complications following their injury:

• Loss of abilities: Cognitive, sensory, or physical limitations can dramatically impact independence and self-image.
• Chronic pain: Many TBI victims experience ongoing pain that can significantly affect mood.
• Frustration with recovery: Slow or incomplete recovery can lead to feelings of helplessness.
• Financial stress: Job loss and mounting medical bills create enormous pressure.
• Relationship changes: Family dynamics often shift as caregiving needs increase. People may feel they are unjustly burdening loved ones.
• Loss of identity: Many survivors struggle with their new limitations and changed life circumstances. The TBI might prohibit individuals from participating in once loved family or recreational activities.
• Social isolation: Physical limitations and communication difficulties can reduce social engagement.

The combination of these neurological and psychological factors explains why depression is so prevalent following traumatic brain injury.

Healing after a brain injury is rarely a straight path. When progress feels slow or doesn’t come at all, it’s easy to feel like you’re failing. Many people carry heavy feelings of guilt, stress, or even shame, especially when they can no longer work or keep up with everyday life.

Some people with depression do improve over time as their brain heals. But others continue to struggle. For some, symptoms may even get worse as time goes on. If your symptoms are worsening or you feel like you need someone who truly understands what you are going through, the Brain Injury Law Center is here for you. Reach out to us today online or by calling (757) 244-7000.

What Does Depression Look Like Following a Brain Injury?

Depression after TBI is more than just sadness or "feeling down." It's a serious medical condition characterized by persistent changes in mood, thinking, and behavior that can significantly impact recovery and quality of life.

Those struggling with a traumatic brain injury and depression may experience:

• Persistent feelings of sadness, emptiness, or hopelessness.
• Loss of interest in previously enjoyed activities.
• Sleep disturbances (insomnia or excessive sleeping).
• Fatigue and loss of energy.
• Changes in appetite and weight.
• Difficulty concentrating or making decisions.
• Feelings of worthlessness or inappropriate guilt.
• Recurrent thoughts of death or suicide.

What makes post-TBI depression particularly challenging is that some symptoms overlap with common TBI symptoms, making diagnosis complex and often delayed. Symptoms resulting from frontal or temporal lobe injuries include:

• Aggression
• Impulsivity
• Anger
• Increase or decrease in sexual desire
• Anxiety
• Mood swings
• Agitation
• Paranoia
• Disinhibition and reckless behavior
• Sadness
• Emotional outbursts
• Sleep disorders, from lethargy to insomnia
• Irritability
• Violence

Treatment Options for Traumatic Brain Injury and Depression

Traumatic brain injury victims suffering depression for neurological or non-neurological reasons receive similar treatment.

Health care providers specializing in TBI may prescribe medications, including:

• SSRIs (Selective Serotonin Reuptake Inhibitors) are often the first choice for treating depression after a TBI. Sertraline (Zoloft®) and citalopram (Celexa®) are SSRIs that may cause fewer side effects and can also help improve thinking and memory.
• SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) are another type of antidepressant that may work well for some people with TBI. Venlafaxine (Effexor®) and duloxetine (Cymbalta®) may be helpful, especially if the person also has chronic pain or anxiety.

Other TBI patients may engage in therapy to deal with depression after a TBI. Counseling or psychotherapy can be a powerful tool for managing depression:

• Cognitive Behavioral Therapy (CBT) helps people notice and change unhelpful thoughts, feelings, and behaviors. It can help improve mood, reduce anxiety, and build a more positive self-image.
• Behavioral Activation Therapy (BA) focuses on helping you get back into activities you enjoy or find meaningful. These small steps can boost mood and give life more structure.
• Acceptance and Commitment Therapy (ACT) teaches you how to accept difficult thoughts or feelings without letting them take over. It encourages living in line with your values, even when things feel hard.

Many patients may rely on a combination of medication and therapy, but it’s important to remember that every TBI case is different.

Furthermore, some patients experience symptomatic relief after participating in an aerobic exercise program. Other TBI patients turn to alternative treatments, including biofeedback, hypnosis, or relaxation therapy.

Legal Action Is Available for TBI And Depression Victims

If you or someone you love suffers from TBI, you know that therapies and treatments for the injury and associated emotional problems are costly. When traumatic brain injury and subsequent depression result from someone else's negligence, victims may be entitled to significant compensation, including:

• Medical expenses: Including specialized mental health treatment.
• Rehabilitation costs: Physical, occupational, and cognitive therapy.
• Lost wages: Both current and future earning capacity.
• Pain and suffering: Including emotional distress and diminished quality of life.
• Long-term care needs: For those requiring ongoing assistance.

Why Hire the Brain Injury Law Center

At the Brain Injury Law Center, we see the pain behind the statistics. That’s why we’re here: to fight for justice, financial relief, and the dignity every survivor deserves. Our team has secured over a billion dollars in verdicts and settlements for clients whose lives were turned upside down by brain injuries.

Our founder, Stephen M. Smith, has dedicated nearly 50 years to helping people with TBI, earning national and international recognition for his work. If you’re living with depression after a brain injury and you feel lost and don’t know where to start, we’re here to help.

Call us at (757) 244-7000 or fill out the form on this page for a free, no-obligation consultation. It costs nothing to ask questions. It could mean everything to get the help you need.