Changemenets Emotionels

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A brain injury can affect the areas of the brain that control emotions.  The following are common emotional problems for a person with a brain injury and suggested ways to help.




Problem: Difficulty controlling emotions



  • Mood swings ranging from anxious to sad to angry
  • Inappropriate laughing or crying
  • Lower tolerance for frustrating situations


What to do:

  • Expect the unexpected.
  • Remain a model of calm assurance and confidence if an emotional outburst occurs.
  • Take the person to a quiet room or area for time to calm down and regain control.
  • Provide feedback gently and supportively after the person regains control.
  • Avoid comparing past and present behaviours.
  • Gently redirect behaviour to a different topic or activity.
  • Recognize that the person may use negative
  • comments or refusal as a means of control.
  • Understand that brain
  • injury often prevents the individual from feeling
  • guilt or empathy.
  • Recognize your emotional reactions to the person with brain injury.

Problem: Intermittent distress (comes and goes)



  • Unhappiness and irritability
  • Cries easily
  • Responds angrily for no apparent reason


What to do:

  • Acknowledge feelings.
  • Give the person a chance to talk about feelings.
  • Listen and express your desire to understand those feelings.
  • Encourage behaviours that have helped cope with stress in the past.

Problem: Grief



  • Tearfulness
  • Restless sleep
  • A change in appetite


What to do:

  • Remind the person that grief is a healthy and normal response.
  • Explain that coming to terms with the loss of some abilities may take time.
  • Offer whatever support you can provide.
  • Seek guidance from a professional.



Feelings of sadness, frustration and loss are common after a brain injury.  Such feelings often appear during the later stages of recovery, when confusion decreases and self-awareness improves.  However, if these feelings become overwhelming or interfere with recovery, the person may be suffering from depression.


Depression can arise as the person struggles to adjust to temporary or lasting disability caused by a brain injury.  Depression also may occur if the injury has affected areas of the brain that control emotions.


Being depressed is not a sign of weakness, nor is it anyone’s fault.  Depression is an illness.  A person cannot get over depression by simply wishing it away, using more willpower or “toughening up.” Depression after brain injury may result from biochemical and structural changes in the brain.  Fortunately, medication and other therapies can help most people who have depression.


These are symptoms of depression:

  • Persistent sadness
  • Irritability, moodiness
  • Anxiety
  • Loss of interest or pleasure in life
  • Neglect of personal responsibilities or personal care
  • Changes in eating habits or sleeping patterns
  • Fatigue, loss of energy, lack of motivation
  • Extreme mood changes
  • Feeling helpless, worthless or hopeless
  • Physical symptoms such as headaches or chronic pain that do not improve
  • Withdrawal from others
  • Thoughts of death or suicide


If the person with brain injury has symptoms of depression, his or her health care provider should be consulted.  Effective treatments are available, including individual and group therapy, medication or a combination.  Early treatment can help prevent needless suffering.  If your loved one expresses suicidal thoughts or threatens self- harm, immediately call your local emergency services provider.


Self-esteem is a person’s assessment of self-worth and is often adversely affected by brain injury.  A problem may be more significant if the person with brain injury has had a mild to moderate injury or a severe injury with good self-awareness.  The more aware the person with brain injury is, the more likely are changes in self-esteem.


What to do:

  • Focus on the positives.
  • Allow the person to express feelings.
  • When necessary, redirect conversation to positive or neutral thoughts.
  • Express your concern and desire to understand the person’s feelings.
  • Point out the person’s successes, even partial successes.
  • Encourage as much independence as possible.
  • Do not criticize.
  • Give caring, realistic feedback.
  • Help the person plan ahead to maximize opportunities for success.
  • Choose activities and tasks that the person can successfully complete.


Challenges vary among people with brain injury. Be aware of how you reference the person with brain injury. Avoid labelling, categorizing or stereotyping a behaviour or communication skill that was altered by the injury. Learning as much as possible about brain injury and exercising patience and compassion are good steps toward understanding and nurturing the self-esteem of the person who has brain injury.