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Changes After a Brain Injury

Social and Emotional Changes after a Brain Injury

Behaviour and Personality

Sometimes, personality traits may become exaggerated or more intense after a brain injury. For example, the quiet person may become even quieter; the assertive, active person may become aggressive and even more outspoken. The opposite can happen too, where a normally quiet person becomes very outgoing or outspoken.

Brain injury can cause the person to have poor emotional control. This can be seen by mood swings that often don’t seem to be related to what’s happening. There may be strong emotional outbursts triggered by minor frustrations. Or he may seem demanding, self-centred, irritable, or impatient. Even a person with a mild brain injury can be irritable and impatient while his brain heals. Finally, a person with a brain injury may lose interest in hobbies or activities he used to enjoy.

Mood Swings and Managing Anger

Being irritable and having trouble controlling anger are common personality changes seen in a person after a brain injury. There are several reasons for this. It could be due to the areas of the brain that were damaged.

He will often get frustrated very easily. Where he may have been able to keep quiet in a situation before the injury, he may now have trouble doing so. He may blurt out angry words before he knows it or before he is able to stop himself from saying hurtful things.

Sometimes a person is irritable after a brain injury because he’s frustrated because he can’t do things as easily as he could before the injury.

As a result, he may become angry over things that don’t seem like a big deal to us. Like anyone else, the person with a brain injury may direct the anger he feels towards himself or those who are closest to him. Don’t take it personally.

Don’t blame him for his short temper or to tell him that if he only tried harder he could control his temper.

Strategies that can help to manage mood swings and angry outbursts

  • Stay calm when he’s having an outburst.
  • After he calms down, ask him to write down what happened to make him angry, what he thought and did when he was angry, and what happened after he was angry. In this way he will have a record of what happened. He can then look back at his written notes, alone or with someone else and see more clearly what is happening and what can be done about it.
  • Respond right away to ideas that aren’t appropriate and stay focused on the original topic.
  • Suggest other ways he could behave. Praise and reward the behaviour you want to see.
  • Have him take a “time-out” when he starts to get angry or frustrated. When he starts to feel like he might be getting angry, he can say “I am beginning to feel angry and I would like to take a time-out.” He can then go for a walk or sit somewhere quiet until he isn’t as angry or frustrated.
  • Listen to him and let him know you want to understand what he’s feeling.

Family and friends need to be told ahead of time that the he may need to take a time-out to help prevent anger outbursts. Time-out is not a sign of weakness, nor is he trying to run away from his problems. Time-out is a way of preventing angry outbursts. When he’s calm, the problem that made him angry can then be dealt with more reasonably.

Other ways of reducing chances of anger outbursts include:

  • making sure he gets enough sleep
  • avoiding drinks with caffeine or alcohol
  • telling yourself that “this isn’t the end of the world” or “it’s not worth fighting about”
  • identifying situations that seem to lead to anger and calmly change or avoid them

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