Depression Linked to Traumatic Brain Injuries

Study Shows 30% Risk of Depression for TBI Patients

A recent study from Vanderbilt University, authored by evidence-based Practice Center co-direct Melissa McPheeters and Division of Trauma and Surgical Critical Care assistant professor Oscar Guillamondegui, found a high risk of depression for Traumatic Brain Injury (TBI) patients. Their study focused on blunt force causes of brain injury such as car accidents, falls, athletics injuries and assaults.

Depression Linked to TBIs

Scope of the Problem

Emergency rooms see approximately 1.2 million patients for TBI every year. Roughly one quarter of those patients require hospitalization. The study found that 30 percent[1] of TBI patients suffered depression following traumatic brain injury, compared to 10 percent of the overall population.

Depression Medications May Not Be Safe

Doctors worry that depression medications may harm patients rather than help them. The study brings up concerns for the well being of those with brain injuries who become depressed. Traumatic brain injuries change the brain’s chemical processes, and few studies exist to test the effect of commonly prescribed antidepressants on brain-injured patients.

Special Concerns for Mild TBI

Co-author Melissa McPheeters expresses great concern over the problem stating, “It’s unacceptable, with so many people sustaining TBIs – both in combat and civilian life – that we know so little about treating depression in this population.” She worries that depression may go undiagnosed for those with mild traumatic brain injuries. Many such patients never seek medical treatment. “Patients and their families…need to know what to look for because they are the ones who will see the changes first.”

At Risk Populations

An additional concern is the prevalence of traumatic brain injury in susceptible teen and young adult populations. These individuals are more likely to suffer brain injuries and face greater risk of serious side effects from antidepressants. Many such medications carry FDA warnings about the heightened risk of suicide in teens and young adults.[2]

Medication Concerns May be Unfounded

Although few studies exist on antidepressants and brain injuries, one recent study shows that the medications might actually help those with brain injuries recover faster. University of Rochester Medical Center neurosurgeons recently studied mice, looking at the number of neurons present four weeks after injury. They report a 70 percent[3] increase in the number of neurons for mice given the antidepressant imipramine. Although the study only looked at one antidepressant, there is reason to be hopeful.

Cause of Depression Remains Uncertain

There remains a question whether the heightened rate of depression comes from the emotional difficulties brought on by brain injury or other causes. The rate of depression did not change over time, even after patients had reached maximum improvement. Therefore, it seems likely that depression arises because of chemical changes brought on by the brain injury, rather than the frustrations of coping with neurological disabilities.

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