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Changes After a Brain Injury

Depression and Lowered Self-Esteem


Feelings of sadness, frustration, and loss are common after a brain injury. These feelings are often seen during the later stages of recovery, when confusion decreases and self awareness improves. However, if these feelings become too much or affect recovery, he may become depressed.

Depression can happen while the person tries to adjust to a temporary or lasting disability caused by a brain injury. It can also happen if the injury was to parts of the brain that control emotions (changes in the brain's structure or chemistry).

Being depressed is not a sign of weakness, and it’s not anyone’s fault. Depression is an illness. Depression doesn’t go away just because you want it to, or if you use more willpower, or “toughen up”. Fortunately, medicine and other therapies can help most people with depression.

These can be symptoms of depression:

  • a feeling of sadness that doesn’t go away
  • irritable, anxious, moody, or big mood swings
  • not interested in things anymore or don’t feel pleasure
  • eat or sleep more or less
  • feel tired, no energy, no motivation
  • feel helpless, worthless, or hopeless
  • physical symptoms such as headaches or chronic pain that don’t get better
  • want to be by yourself
  • thoughts of death or suicide

If the person with brain injury has symptoms of depression, please let his healthcare provider know. There are very good treatments that can help.

If he says he wants to die or says he’s going to hurt himself, call 911!

Lowered Self-Esteem

How a person sees himself (self-esteem) is often affected by a brain injury. The more aware the person with a brain injury is, the more likely there will be changes in how he sees himself.

Don’t label, categorize, or stereotype a behaviour or communication skill that was changed by the injury. Learning as much as possible about brain injuries and being patient and kind are good steps toward understanding and helping raise the self-esteem of someone with a brain injury.

Tips to help with lowered self-esteem

  • Focus on the positives—don’t criticize.
  • Re-direct conversation to positive or neutral thoughts.
  • Let him express his feelings. Give caring, realistic feedback.
  • Tell him you are concerned and want to try to understand what he’s feeling.
  • Point out his successes, even partial successes.
  • Let him be as independent as possible.
  • Help him plan ahead to help him be as successful as possible.
  • Choose activities and tasks that he can do well.​

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