After a brain injury, a person may behave in new or different ways and may have personality changes and emotional or behavioral problems. They may become agitated or aggressive, and these mood changes may be disturbing. Some people 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. People with TBI are less likely to be aware of changes in behavior and executive function. 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 the health care team. A number of treatments are available that may be helpful for improving quality of life.
Care 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.
Reducing agitation
A person with a brain injury may pass through stages of agitation and aggression. The care team 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 care team. Or team members may take turns staying with the person. The doctor may recommend medicine. As a person becomes calmer, the team may:
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Point out when a behavior is not proper. Then they'll explain what the person could do instead.
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Redirect agitated actions such as pacing.
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Divert the person from tasks that are upsetting.
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Reduce stimuli such as TV, phones, and frequent visitors.
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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, and they may be more self-centered. 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.
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Stay calm.
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Don't hold a grudge.
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Don't always give in to demands.
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Try to follow a consistent daily routine.
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Help them eat a healthy diet and get a good 8 hours of sleep each night.
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Avoid anything that can delay healing, like alcohol and drugs.
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Let them do one thing at a time. This can help them gradually resume daily activities.
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Ignore outbursts of anger. Direct the person toward a task they can do.
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Don't cringe, frown, roll your eyes, shake your head, or clear your throat.
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Make contact. Hug, hold hands, and offer a gentle touch of reassurance.
