Depression: A Common Head Trauma Symptom

Many suffer from depression after head trauma

Depression is a very common symptom experienced after traumatic brain injury from direct head trauma. It’s estimated that close to half of moderate to severe head trauma survivors suffer from depression. Even mild traumatic brain injury, or concussion, can lead to depression.

Depression is in part related to changes in brain chemistry, so it’s not something the depressed person can “just get over”.

It often begins within a year after the head trauma, but may also take years to manifest. Medical intervention that addresses the root cause of the depression is often needed.

Depression Symptoms

Depression is described as experiencing feelings of hopelessness or despair that get in the way of living one’s life. It does not improve on its own over time. Some common symptoms of depression include:

  • Losing interest in normal activities
  • Feeling guilty or worthless
  • Having a difficult time concentrating
  • Appetite changes
  • Changes in sleep patterns
  • Fatigue
  • Not wanting to be around others
  • Having thoughts of dying or suicide

When depression is experienced more than a couple times a week, or for two weeks straight, it needs to be evaluated and managed by licensed mental health professionals. A referral to a mental health specialist can be provided by one’s primary care provider.

What Causes Brain Injury Related Depression?

A variety of factors affects one’s risk of developing depression after traumatic brain injury.

These include genetics, coping mechanisms, emotional responses, and structural changes to the brain itself.

  • Genetics: Individuals with a prior history of depression, or whose family has higher rates of depression, are often more likely to develop post head trauma depression.
  • Emotions and Coping: There are a variety of emotions related to dealing with brain injury. Loss of one’s sense of self due to no longer being able to work, or inability to do the same work, affects self-esteem. Engaging in in social activities may also feel challenging. If one’s role in the family has changed, such as no longer being able to provide financially, this can lead to depression. Adjustment to life after head trauma takes time and often has an emotional toll on both the person suffering from brain injury and their family.
  • Physical Brain Changes: Chemicals in the brain, also called neurotransmitters, help regulate emotions. An injury can affect the areas of the brain that secrete these chemicals. Injury can also stop chemical signals from effectively traveling through the brain.

Medications for Traumatic Brain Injury Depression

According to the research, some of the most effective anti-depressants after head trauma belong to a class called Selective Serotonin Reuptake Inhibitors or SSRIs. Another class of antidepressants called Serotonin-norepinephrine Reuptake Inhibitors, or SNRIs have also shown themselves to be effective.

The benefits of anti-depressants can take several weeks to be experienced. It’s important to take the anti-depressant medication every single day, and also continue it after the depression gets better, or goes away. Working directly with the prescribing provider to adjust medications or change the treatment plan is necessary so there are no unexpected side-effects. Adolescents react differently to anti-depressants and may be at a higher risk for suicide, so close medical management is essential.

Counseling for Head Trauma Related Depression

There are a number of therapeutic approaches available to help those suffering from TBI learn how to manage the cognitive, behavioral and emotional symptoms of head trauma.

Cognitive Behavioral Therapy and Behavioral Activation Therapy have both demonstrated good results in the brain injury population.

Addressing other causes of stress such as pain, limited mobility, isolation and fear about the future is also very helpful. If a realistic plan for the future is developed, and goals toward achieving that plan are met, hope and confidence begin to return.  There are excellent therapists trained in managing head trauma depression who can help.


Rapoport, M. J. (2012). Depression Following Traumatic Brain Injury Epidemiology, Risk Factors and Management. CNS Drugs, 26(2), 111-121.

Resilience, Traumatic Brain Injury, Depression, and Posttraumatic Stress Among Iraq/Afghanistan War Veterans. (2015). Rehabilitation Psychology, 60(3), 263-276 14p. doi:10.1037/rep0000050

Tsaousides, T., Ashman, T. A., & Gordon, W. A. (2013). Diagnosis and Treatment of Depression Following Traumatic Brain Injury. Brain Impairment, 14(1), 63-76. doi:10.1017/BrImp.2013.8

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