Coping with Depression
While much research still needs to be done about depression and its relationship to traumatic brain injury, it is clear that this condition is both prevalent and dangerous in the population. Whereas one out of ten people in the regular population experiences serious depression at some point in their lives, six out of ten brain-injured people do. Once it occurs, depression compounds the difficulties brain injury patients experience, making rehabilitation more problematic, reducing the patient’s ability to perform activities of daily living, increasing failure and stress, making unemployment more likely, increasing divorce and the burden to family members, minimizing a person’s enjoyment of social/recreational tasks, causing sexual problems, and leading to a generally lower quality of life. There is also evidence to suggest that brain injury increases the incidence of suicidal thoughts among patients.
Obviously, depression must be addressed as soon as it is recognized. The first step is for the patient to acknowledge that there is a problem. At this point, a medical professional or trusted member of the clergy should be consulted. Then, the patient must actively seek to alleviate the symptoms by avoiding destructive behaviors such as substance abuse, cut out negative self-criticism, stay away from so-called toxic people. Ultimately, it makes sense to seek treatment from a professional knowledgeable not only about depression, but also about traumatic brain injury. During the first meeting, the patient and professional will determine if the depression is stable, getting better, or worsening. They will also discuss the patient’s emotional state and difficulties, both before and after the brain injury. A decision will eventually be made as to whether the depression will be treated with medications, therapy, or a combination of the two.
If the depression is being treated with medications, there are three important things the patient should remember. First, he or she should remain in regular communication with the doctor. Second, the dosage should not be changed without consulting the medical professional. Finally, the patient must create a system to help him or her remember to take the medications regularly. Although this is true for any patient, it is particularly vital for a brain-injured person, who is often more susceptible to memory lapses.
If psychotherapy is chosen as a treatment modality, the patient will meet with a psychologist, psychiatrist or social worker, either one on one or in a group setting. During sessions, he or she will talk about concerns, take time to mourn and grieve for the loss of functioning brought on by the brain injury, envision what he or she wants to be like in the future, process feelings regarding people’s reactions to him or her as a newly disabled person, and develop strategies to cope with adversity in a healthy way. The goal of therapy should be to aid the patient in thinking more flexibly, encouraging compensatory strategies such as memory aids, and addressing unacceptable behaviors. In some cases, role playing can be used to model more appropriate coping methods.
In the end, the overarching priority is to assist the patient in minimizing or totally alleviating the debilitating symptoms of depression, symptoms which can make coping with brain injury exceedingly more difficult.
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