Causes of Depression
The normal, healthy brain is brimming with abilities and is well-equipped to spearhead the overcoming of any number of challenges that may occur in a patient’s life. Unfortunately, however, a brain that has been diminished in functioning either because of violence, accident or degenerative disease may not have the same aptitude for creativity and resilience. Take, for example, the case of an individual dealing with the consequences of a gunshot wound to the head. He or she will be forced to grapple with the physical and functional results, and may also be burdened with overwhelming and severe depression brought on by the circumstances of the accident or its fall-out. Ironically, the brain that may once have held in abundance the tools of resilience and innovation that could have assisted the patient in fighting the depression, is often too debilitated to take on that role.
Although encased in the skull and surrounded by protective layers of fluid, the brain is far from immune to injury. Whether penetrated by an external object or skull fragment or severely shaken and bruised through banging against the skull, the brain can be severely and permanently compromised, causing marked changes in physical, perceptual, language, and behavioral abilities. It is safe to say that, in most cases of serious traumatic brain injury, a patient’s life has been irrevocably changed, as have been the lives of family, friends, and others who may give care to the person. As a patient struggles with the multiple physical and emotional challenges that confront him or her in the weeks and months after sustaining a traumatic brain injury, depression can often become yet another burden that saps the patient’s energy and ability to succeed.
Traumatic brain injury can be sustained in any number of ways, each of which brings with it challenges to the patient in terms of preventing and overcoming depression. In situations where violence or assault has occurred, the patient may become depressed because of the nature of the situation and/or the person who committed the assault. In accident situations, anger or self-blame may be catalysts for depression. When a person’s injury is instead due to a degenerative disease such as multiple sclerosis, Parkinson’s or Huntington’s disease, other depression-eliciting factors may arise. Professionals and care-givers must remain aware that the patient may be grappling with questions such as “why is this happening to me,” “how can I cope with a downward spiral in my ability to function ,” and “what will happen to my family if I can no longer take care of them anymore.”
Traumatic brain injury can be quite devastating to a person’s way of life and functioning. When accompanied by the added weight of debilitating depression, recovery can be further threatened. It is vital that the patient, his or her treatment team, and care-givers all remain vigilant about the possibility of depression, as well as committed to taking steps to treat it if it should arise. By accepting depression as just another obstacle to overcome on the road to rehabilitation, much of the fear and stigma surrounding this condition will be removed.
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