Whether traumatic brain injury stems from a disease such as multiple sclerosis or Parkinson’s or from the effects of aging, an accident, or an assault, many of the emotions a victim may feel will be similar. He or she may be plagued by anger at the unfairness of it all, wondering why such a situation had to befall him or her. Why not someone else, or no one at all?

Fear is also very common, not only about the future but even as a response to whatever trauma may have caused the injury. Coping with the threat of the unknown, with all it encompasses, can be extremely overwhelming for anyone. When that person has been dealt a blow to his or her ability to communicate or function normally, that trepidation can be amplified many times over.

A third reaction, less common but still quite frequently seen, is denial. The patient may refuse to believe that his symptoms are as severe as doctors or other professionals or family members claim them to be. He or she may also refuse to entertain the idea that recovery will not be quick and total. Finally, the brain injury patient may feel sadness and even despair. Life has changed irrevocably, as have relationships and the outlook for the future.

Now consider what would happen if that patient, already struggling to deal with the concrete effects and the emotional fall-out of the injury, also became clinically depressed. The inability to concentrate and remember that often occur in a depressed person who is not otherwise injured would be all the more devastating for someone whose cognitive processes had been recently compromised by trauma. The feelings of hopelessness that often immobilize the depressed patient would put huge roadblocks in the way of successful rehabilitation of the brain-injured person. Considering that the course of rehabilitation approved by insurance companies is often finite, the pressure to succeed on a timetable is often great. To expect a clinically depressed traumatic brain injury patient to adhere to this schedule is often unrealistic.

Another factor is the bitter disappointment that many patients may feel if they are not able to function as well as they had hoped. Throughout therapy, many bolster their own confidence by telling themselves repeatedly that if they just keep on trying, they will accomplish anything. That is, after all, the work ethic that many people subscribe to in their everyday lives as well. When those principles collide with the unpleasant reality of insurmountable limitations, there is often a great deal of grief and anger. It is at this time that a patient is most susceptible to suicidal thoughts or actual attempts.

Assisting the patient through physical and occupational therapy and language consultation after he or she has sustained traumatic brain damage is vital. However, it is of equal importance to take into consideration and monitor the patient’s emotional health and well-being throughout the rehabilitation process. In addition, attention should be given to ensure that care-givers are provided with information and support about the reactions they are having and the emotions they feel. These aspects of recovery, while more subtle, are essential to the well-being of patient and family as they move toward acceptance and healing.