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We answer all types of Neurology/Neurological questions about the brain, spinal cord, and peripheral nerves. Include your age, sex, current meds, and known diagnoses, upcoming/completed appointments, tests, or procedures. We are not physicians. We help explain medical terminology and give support.
Can head trauma cause behavior changes?
aacnl5 posted:
I have looked all over the website looking for answers and have come up empty handed. My husband seems to just not "care" about things, he also has this mean streak in him and lashes out verbally at people and even says hurtful and embarrassing things im public and doesnt even seem to realize his behavior is rude. He knows people dont like him because of it, but doesnt even seem to care about that. Our marriage has been in shambles because of things like this and he never wants to talk about the issues. His mother says he didnt used to act like this. Over the week we finally had a real heart to heart where he admitted that it was a generic exuse but truely felt that his personality and anger has been caused by a car accident he was in two years before we met. I have heared about this accident before and know he had to be flighted to metro health here the only hospital here specializing in that kind of trauma. He was dischared not long after and no discussion of brain trauma was ever discussed. Is it possible that this could be the cause behind his personality and if so is there help for this? Can it ever be reversed? thank you.
RedBear2005 responded:
Yes, it is ABSOLUTELY possible that head trauma can be associated with apparent personality and behavior changes. Given the length of time that has unfolded since the trauma, however, a real assessment of such changes may be difficult to establish. I would recommend that your husband be seen first by a head trauma specialist for a survey and evaluation of post-incident behavior changes (possibly with you in attendance at the appointment, to assist and encourage full disclosure). Then it may be in order for your husband to be treated with some type of anti-depressant medication, under supervision by a psychiatrist who is specifically trained in the delayed effects of head trauma.

If your husband refuses to engage with a process of evaluation, you may find yourself facing some very tough choices. You can always schedule an appointment for consultation with a trauma specialist, on your own. That can help you to understand your options as well as your husband's. Or you can joint an internet-based mutual support group for the spouses and significant others of trauma patients (I believe Brain Talk Communities has such a support group). Ultimately, however, you may find it necessary to decide how much undeserved anger and personal embarrassment and abuse you are willing to tolerate before saying something like "ENOUGH! Either you engage with a program of behavioral therapy or I am OUT OF HERE!"

I would not encourage this latter course of action as a first response, of course. But it is one of the options that you should face squarely and prepare yourself emotionally to embrace if you must.

I wish you well in a difficult process,

Go in Peace and Power
Red Lawhern, Ph.D.
Master Information Miner
aacnl5 replied to RedBear2005's response:
Thank you so much, You answered my question to the fullest. I will relay this info to my husband.
RedBear2005 replied to aacnl5's response:
Feel free to come back with further questions or simply to vent. There are good people at WebMD, some of them in this small forum. A lady named "Life's" has been dealing with debilitating spinal pain and the dismissal of many people in the medical community, for several years.If she responds to your posts, try to take on board anything she has to offer. She is GOOD with patients and understands their concerns Another of our "residents" named Susie Margaret is also a long time pain patient, who meticulously researches and documents Internet sources for a wide variety of pain and neurology issues -- even when she is not personally familiar with some of the disorders involved. The site itself also offers extensive resources.

If you wish to talk privately rather than in a public forum, I can be reached through my personal website: "Giving Something Back"

Go in Peace and Power
qwkslvr replied to RedBear2005's response:
I would have to say that without a doubt that brain injury can and will cause personality changes. My son was assaulted in 10/08 resulting a 3 large brain bleeds. He was a great kid before had alot going for him. Now he has been diagnosed with bi-polar, depression,anxiety, ptsd, short term memory issues, congnitve issues and drug addiction. All this is new to us and we are struggling with the issues from the traumatic brain injury (TBI). When the doctors told us that he "may" have some personality changes we had no idea how bad things could and would have gone. Also finding with right doctor has been difficult. He has lost hope and that is where the drug use comes in to play. He would rather be a drug addict than mentally ill. It is a pretty sad situation. He needs to go to a dual diagnosis inpatient treatment program but he can not afford one. We keep trying to get him on track.

Take Care, P
Lifes responded:
I've read the other replies and I'd just like to add a couple things.

People with brain injury often say it feels like their brains "hurt", like it's almost too hard to think or think very easily. Brain tiredness often brings out frustration and lashing out, partly because the person doesn't have a quick way to spell out what's happening. Like, hubby wouldn't be as quick to say, "Now honey, my brain's hurting tonight. Your words aren't making sense or it's irritating me and I don't know why I feel like this. Maybe I'll feel better later but right now..." No, that's analytical and in the moment, people don't process what exactly is going on. He may not have that kind of clarity anyway.

But, emotions are easily expressed. Yelling, being mean, nasty, etc. are all quick to come out. If nasty feelings could speak, they'd say: "Leave me alone!" Isn't that what rage says?

But people with brain injuries need to consciously connect the rage to whatever the physical feelings are... like, "All I know is I'm tired and your voice seems like nails on a chalkboard right now." OR, "I don't understand what you are trying to say. I feel confused and just not quite right. But I can't explain it to you or to myself. So I yell at you."

If hubby could start to verbalize the physical sensations or problems, it might help so that both of you become aware of when he needs a brain rest. You could come up with a few solutions. Ask him if when he physically feels (whatever) if he could just say, "I need to sit in my chair quietly for 20 minutes; then, we'll try to talk again."

His physical symptoms could be anything from brain tiredness, brain freeze (i,e. forgetting), inability to say a specific word, some kind of physical pain, etc.

As a couple examples, my friend had a probable TIA last June. When SHE can't think well, she gets so nasty. I stopped her one day and asked her how her head /brain felt. She said it HURT to think and she felt very tired. We agreed that anytime she feels that way, she'd just say it hurts to think and those days, we do "mindless" and non-stressful things. Things she doesn't have to think about. Example: She helps me add up my bills. On a bad day, I will never ask her to do math or talk about my finances. We save that for a good day.

Another example about overall pain. I can hurt so badly that I just can't use my brain except to do basics: breathe, move, eat, drink water, go to the bathroom. On those bad pain days, I can get snappy if anyone does anything irritating. I have had to learn to stop myself and at least tell people, "I hurt really bad today so please don't (tap your pen...or crinkle that bag..or talk during the TV show... or whatever).

If your hubby really thinks his behavior relates to an old head injury, it doesn't mean he can't become conscious of what he feels and work on a way to reduce his nastiness. But he has to verbalize WHAT it is - what sensations or problems he feels at those moments so that the 2 of you can work together.

Also, be cautious with docs. Docs don't have patience, knowledge, or understanding about "emotional problems." They are more apt to diagnose depression and prescribe a pill, rather than find out what symptoms your hubby feels at those times. It may help more to see a neuro-psychiatrist or just to work together to figure out a few things that will help the situation. But BOTH of you have to do it, not just you. Your hubby HAS to be willing to stop, analysize a little, decide on something that could help (like a 20 minute quiet time), and actually work on using his own restraint. The solutions don't rest just with you doing something different to avoid his wrath or belittlement.

Sorry I can't be more help; I'm not in a great place tonight myself.

RedBear2005 replied to Lifes's response:
I completely concur with the additional details of approach that Life's has suggested.

I'm sorry you were having such a not so hot evening, Life's. Have you taken any further steps to talk with an orthopod or neurologist about possible spinal compression factors in your bladder problems?

Regards and best,
aacnl5 responded:
Thanks for all of your help and advise. Much of what all of you has had to say actually sounds a lot like my husband. With that said I think it is easier for me to believe that this may truely be real explanation and not just some phoney exuse. I still think it needs to be looked into though. I really hope my husband will talk to the doctor about this and start to explore some options. He did say he had tons of cat scans and MRI's after the accident, but nothing ever showed up. I can only assume thought that they never really know for sure what the long term damage can end up being.
P- I am so sorry for what has happened to your son. As a parent, I can only imagine how hard it must be to watch your child go from being happy and successful to miserable and confused. It must be just heartwrenching. Please stay stong and you will be in my prayers as well.
Lifes- Im am glad you wrote. I will be sure to be more aware of his signals. He complaines of a lot of headaches and body aches in general. A lot of what you said is very character for him. We will talk and he wont seem to comprehend a thing I say somedays, or things will be fine and out of no where he gets frustrated and angry over silly little things and just fly off the handle. Those are usually the times when he gets really mean and starts name calling and blaming for all sorts of things. Im always shocked at these moments because they tend to come out of no where.
RedBear- Being an everyday person...:) how would I find a head trauma specialist? What would we need to tell them to get the ball rolling. I supose Im not sure where to start other than our family physician.
Thank you guys so much for your help. This really means the world to me. We are getting ready to take our kids on vacation so I am kind of sitting on the information right now, but when we get back he and I are going to have a talk and see where we can start and hopefully get him some help, which in return is help for me and our family too.
RedBear2005 replied to aacnl5's response:
Your family physician isn't a bed choice for a place to start looking for a head trauma specialist. If your doc doesn't happen to know the local area well enough to make a referral, then I'd suggest that you call the patient affairs and referral office of the largest hospital in your area, and ask where they send head trauma patients for follow-up case management. If they come up empty, then the next step would probably be the nearest branch of a major regional treatment center such as Mayo Clinics.

Life's may be able to add something here...

Go in Peace and Power, Danielle,
goggy526 replied to Lifes's response:
Hi, I have brain trauma. It actually happened when I was a child. It probably would have healed but I am a product of child abuse, where my head has not healed. My soul and spirit yes but head no. What you described how a person feels with brain trauma is totally correct.
I have been married for 14 years and it is very hard for my husband to deal with me sometimes. It takes a lot of patience and understanding. But still it gets very frustrating for both of us going through this. Because one of the effects is also thinking you said something one way but actually said it another way or get confused on word meanings. Which can totally blow an argument :)
I finally found cymbalta works for me with getting what I call a cloud lifting off my head. I still have all you describe but I'm able to deal with it better. Thank God! Just whoever does end up reading this it isn't easy for either one of you and counseling doesn't mean- failure.
It actually means coping- WINNING.
I hope this has help whoever reads this.
brainfog61 responded:
HI aacn

Some very helpful replies but there are more things that can be said in reply to your original letter. People with brain injury can get agitated when their brains are tired. Try and remember you are seeing an injury rather than a 'mean streak.' He will be dealing with something he cant control as much as he wants to and does not understand. With better management and training and support he could be a lot better, though it is unlikely he will be cured. Before you get to the point of saying 'enough' and demanding action, these pieces of information might help. he wont want to 'talk about the issues,' because he cant do it so easily that way any more. He might seem not to be listening because his brain cannot link to abstract statements or jump to 'step 6' solutions. He needs to be spoken to at a time when he is rested, and talk about only one specific thing at a time, starting at the beginning, concretely and specifically, and then dont pressure him to respond quickly. Maybe talk about it over a few days. Dont try to pressure him and make him do it now. Think of the way this site is up and you can only look at one at a time, and sometimes it might be slow to load, thats how it works. It may still all be in there, just need these new ways of understanding and management.
Finally, a person can seem intelligent but still have a brain injury and problems with function.
Secondly, medical people and x rays will only give limited information. Neuro Psychologists or neuro psychiatrists are the specialists in diagnosing brain injury. MOST brain injuries are diagnosed by the tests of these people and do not show up on an MRI. As someone with a brain injury myself I want to say dont give up on your guy. It might not be able to be completely reversed, but it should be able to be better managed and therefore seem to improve a lot. Slow, step by step, compassion, is what I would urge.Taking the pressure off might help a bit, just try it, and try and get support from others for a bit. education helps. he might not be able to 'care' or have a lot of empathy in the moment, but with more time and if things are explained more specifically, he might be able to more. I am like that. I do wish you the best.

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