Posttraumatic mood symptoms

Discussion of post-traumatic mood symptoms

After a traumatic brain injury, psychiatric and mood effects are common but often overlooked symptoms. Changes in mood are often hard to diagnose, and the frustration resulting from limitation after a traumatic injury masks direct effects on mood. Being the predominantly affected area in traumatic brain injuries, frontal lobe circuits become dysfunctional. As a result, the circuits regulating anxiety, depression, motivation, and frustration are often direct recipients of the concussive forces that result from TBI.

 

Individuals with a  traumatic brain injury experience a range of changes in behavior and emotions. Behavioral changes include but are not limited to difficulty with self-control, risky behaviors, and general difficulty in social situations. These changes can be accompanied by emotional changes including mood swings, anger, insomnia, irritability, depression, and/or anxiety.

 

The stress involved with an acute injury often results in a picture of post-traumatic stress disorder.  The symptoms of intrusive thoughts and memory of the trauma, anxiety regarding eventual recovery, and negative changes in thinking and reactions to mood require accurate identification and proper treatment including psychotherapy, cognitive behavioral therapy, and pharmacotherapy.

 

Mood symptoms including depression and anxiety are common after traumatic brain injury.  Of those suffering from a traumatic brain injury, 45.8% of participants without a history of TBI and mood disorders were observed to exhibit mood disorders. Moreover, previous mood symptoms are a significant risk factor, and it estimated that of individuals suffering a traumatic brain injury, 75% of those with a past history of mood disorder will suffer mood symptoms (Gould et al., 2011). 

 

Treatment for post-traumatic mood disorder

 

  • Referral for cognitive behavioral therapy

    • Mindfulness exercises

    • Referral to Psychiatry

    • Referral to Psychology

    • Start medication’s

      • Trintellix

      • Zoloft

      • Prozac

      • Lamotrigine

 

Treatment of depression following a mild TBI is similar to the treatment of individuals with no history of depression. Studies have shown that the use of selective serotonin re-uptake inhibitors (SSRIs), such as sertraline, is associated with a decrease in “symptoms of depression, psychological distress, functional disability, and post-concussive symptoms” (Fann et al,m 2000). 

 

In addition to medication use, the use of psychotherapy, mindfulness exercises, and cognitive behavioral therapy have been shown to improve and manage mood symptoms such as anxiety and depression. Scientific studies have revealed that a variety of mindfulness exercises, including meditation, hypnosis, and yoga, have been shown to improve symptoms of depressive and anxiety disorders (Saeed, 2019). 

At Los Angeles Brain Science Project, we have curated this document including mindfulness resources we find most effective in improving mood and cognitive symptoms in traumatic brain injury patients. 

 

 

References

Fann JR, Uomoto JM, Katon WJ.  103 Soo C, Tate R. Psychological treatment for anxiety in people with traumatic brain injury. Cochrane Database Syst Rev 2007 (3):CD005239.].

Fann JR, Uomoto JM, Katon WJ. Sertraline in the treatment of major depression following mild traumatic brain injury. J Neuropsychiatry Clin Neurosci. 2000 Spring;12(2):226-32. doi: 10.1176/jnp.12.2.226. PMID: 11001601.​

Robert S. Traumatic brain injury and mood disorders. Ment Health Clin. 2020 Nov 5;10(6):335-345. doi: 10.9740/mhc.2020.11.335. PMID: 33224691; PMCID: PMC7653730.

Saeed, Sy Atezaz et al. “Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation.” American family physician vol. 99,10 (2019): 620-627.