Behavior Changes After Brain Injury

After a brain injury, a person may behave in new or different ways and may have personality changes. They may become agitated or aggressive, and these mood changes may be disturbing. Some may curse, laugh, or cry out of context. Others may show increased or decreased sexual interest. Judgment may be altered. This can have financial and legal implications.

Behavior changes may be caused by damage to the brain. Or they may result from the person’s increasing awareness of what has happened. Such changes may be linked to frustration, anger, or grief.

Not all changes in behavior are caused by a brain injury. For instance, if a person is addicted to drugs or alcohol, going through withdrawal will be linked with a change in behavior. Other health issues such as reactions to medicines are linked to agitation and behavioral changes.

Handling feelings

Many people with brain injuries have extreme mood swings. Others show no change in emotions. As a person becomes more aware, depression may set in. Signs of depression should be brought to the attention of healthcare professionals. A number of treatments are available that may be helpful for improving quality of life.

Team members address the person's feelings and behavior. A team member may ask an angry person to “calm down.” If the person does, they are praised for using self-control. Then the person may be asked how they were able to handle the emotion. If they know, the technique can be used again.

Controlling agitation

A person with a brain injury may pass through stages of agitation and aggression. A healthcare professional needs to ensure that there is no physical, medical, or psychiatric cause for the agitation. If the person's safety is a concern, restraints may be used. If this happens, be sure to contact the healthcare team. Or team members may take turns staying with the person. The healthcare professional may recommend medicine. As a person becomes calmer, the team may do the following:

• Point out when a behavior is not proper. Then explain what the person could do instead.

• Redirect agitated actions such as pacing.

• Divert the person from tasks that are upsetting.

• Reduce stimuli such as TV, phones, and frequent visitors.

• Try to stay away from situations that may trigger agitated or aggressive behavior.

Regaining social skills

After a brain injury, some people see only how matters relate to themselves. They may not be aware of how their actions and words affect others. Group rehab helps people with brain injuries learn to deal with others. It also improves speech. Playing games helps people link ideas and increase hand-eye skills.

You can help

Try to act in ways that teach good behavior. Also, let the person know they are still needed and loved. Try the tips below.

• Stay calm.

• Don't hold a grudge.

• Don't always give in to demands.

• Ignore outbursts of anger. Direct the person toward a task they can do.

• Don't cringe, frown, roll your eyes, shake your head, or clear your throat.

• Make contact. Hug, hold hands, offer a gentle touch of reassurance.