ABI – The Invisible Injury

The devastation of physical injuries after a brain injury is very obvious.  Yet it is not apparent to the eye. Visible injuries such as not being able to move an arm or leg, when a person’s eyes are out of alignment, when their vocal cords are impaired (and/or more) are injuries that are easily seen.

However, the most longstanding issues and even more devastating are the psychosocial complications that can continue even decades after the injury.  Other terms for these problems are “the walking wounded” or “invisible injuries.”

Anxiety can be a longstanding issue for some people with brain injuries. They may worry about their loss of control over their lives (e.g., can’t work, can’t drive, and maybe can’t even make it to the restroom in time).  In busy or noisy situations, they may become overwhelmed by their inability to keep up with everything.  Sometimes the anxiety can be extremely intense in the form of a panic attack.

Depression is another long-term complication after brain injury. Some sadness and frustration is normal following such a life-changing event.  However, some people with brain injuries develop longstanding symptoms of depression which may be both situational and biological. Some people with depression may express the wish to not want to live life any more.

After a brain injury, mood swings and anger outbursts are another potential long-term complication. One minute the person is happy and laughing, the next minute they may be crying uncontrollably.  Everyone gets mad, whether they have a brain injury or not. Most people without a brain injury are able to control their anger.  After a brain injury, the person may not be able to stop themselves from yelling, cursing, or physically attacking others (even those they love).

Fortunately, all of these psychosocial complications are treatable and some level of improvement can be obtained.  Research suggests that early detection and intervention is recommended. In some cases, medications may be helpful as well as cognitively-structured forms of counseling.  The best treatment appears to be a holistic rehabilitation approach including any necessary modality specific therapies (e.g., physical therapy, occupational therapy, speech therapy) along with Neuropsychology and cognitively-structured activities and counseling.

Research references available upon request.

Kier Bison, Ph.D.