No products in the cart.

Understanding the Link Between Brain Injury and Depression: Causes & Treatment Methods

man extending arms in gratitude after overcoming brain injury and depression

After sustaining a traumatic brain injury (TBI), survivors may feel blue, tired, or sad, which are all common symptoms of depression. However, it’s important to understand the link between brain injury and depression to identify the signs and seek proper treatment.

While depression may be caused by other contributing factors, a TBI can increase the risk of developing it. This effect can interfere with daily activities and life as a whole, but fortunately there are ways to overcome it. 

This article will discuss the connection between brain injury and depression, exploring the causes, symptoms, and most effective treatments.

What Causes Depression After Brain Injury?

Depression is characterized as a major mood disorder that can negatively impact your daily activities and quality of life overall.

Brain injuries, from mild concussions to more severe trauma, can all increase the risk of developing depression. In fact, studies show TBI survivors are two to fives times more likely to get depression than non-TBI individuals.

While the exact cause of depression after brain injury depends upon the unique circumstances of every survivor, scientists have identified a few contributing factors, which include:

  • Physical changes in the brain. When the frontal lobe, an area of the brain responsible for regulating emotions, sustains an injury, it can result in post-TBI depression. This is due to a disruption in the balance of neurotransmitters, or chemical messengers.
  • Emotional struggles. Depression may also arise from a survivor’s mental and emotional struggles, especially when adjusting to life after brain injury, which may involve adjusting to limited abilities.
  • Genetics and other factors. Individuals with a family history of depression may be at a higher risk of developing depression after TBI.

It helps to work with a medical professional to obtain a proper diagnosis and better determine if the cause of depression is TBI or other contributing factors.

Common Signs and Symptoms of Depression After Brain Injury

An adequate diagnosis of clinical depression usually has two requirements: at least two weeks feeling sad or apathetic, and experience four or more types of symptoms including:

  • Extreme fatigue
  • Speaking or moving more slowly
  • Decreased concentration or indecisiveness
  • Loss of interest or pleasure in usual activities
  • Insomnia or excessive sleeping
  • Significant weight loss or weight gain (about 5% percent or higher in a single month)
  • Motor agitation (unintentional or purposeless motions)
  • Excessive crying or irritability
  • Feelings of worthlessness or guilt
  • Suicidal thoughts or death

The National Suicide Prevention Lifeline provides free and confidential emotional support 24/7 to everyone in the United States. If you are having thoughts of suicide, please call the suicide hotline at 1-800-273-8255.

Sometimes, depression symptoms may look similar to other conditions such as adynamia, or lack of motivation. However, these are two different effects of TBI that are treated separately, according to the causes they stem from.

One noticeable difference in differentiating between depression and other conditions is the loss of interest in your most favorite activities. 

It’s understandable, after having sustained a brain injury, to not enjoy loud or crowded places as much, especially if the brain is sensitive to noise. However, when participating in activities that you once enjoyed seems like a drag or you’re simply not interested, it may be a sign of depression.

How to Cope with Depression Post-TBI

There are several methods to help treat depression after brain injury. Two of the most popular treatments include antidepressant medication and psychotherapy.

The following are some of the most effective types of medication and therapy to help treat depression.


antidepressants used to treat depression after brain injury

Antidepressants are amongst the most common medications given to individuals with depression. It helps regulate the level of neurotransmitters in the brain. They can be taken for a few months, depending on the severity and your doctor’s recommendations.

Everyone may react differently to antidepressants so it’s important to keep track of any side effects you may experience and consult with your doctor or psychiatrist.

There are also several classes of antidepressants that can create a different impact on the brain. Two common types are selective serotonin reuptake inhibitors (SSRI) and selective norepinephrine reuptake inhibitors (SNRI).

SSRIs are one of the safest and most effective medications for TBI survivors. These tend to have minimal side effects and may even help improve cognitive function. For example, two popular antidepressants prescribed to treat depression are Fluoxetine hydrochloride (Prozac) and Sertraline (Zoloft). Fluvoxamine (Luvox) can also help treat depression as well as OCD, another potential secondary effect from brain injury.

Sometimes SNRI are used to treat depression after brain injury such as Venlafaxine (Effexor), which is also used to treat anxiety and panic attacks. However, because SNRI are newer drugs their side effects are still undergoing research.

Certain classes of antidepressants such as monoamine oxidase inhibitors (MAOI) should be avoided when possible because they can cause sedation and worsen cognitive function.

Cognitive-Behavioral Therapy

psychotherapist sharing with survivor ways to overcome the effects of brain injury and depression

Psychotherapy, also known as talk therapy, is one of the best approaches to treating depression and other mental or emotional difficulties after TBI. While there are various forms of psychotherapy, the most effective treatment for brain injury survivors is cognitive-behavioral therapy (CBT).

One of the goals of CBT is to get to the root of cognitive and behavioral difficulties after brain injury based on three core principles: 1) beliefs create feelings, 2) feelings dictate behavior, and 3) behavior reinforces beliefs. Many treatments focus on helping survivors become more aware of their mental state and uncover unhealthy thinking patterns.

For example, a survivor struggling with depression after TBI may have negative beliefs, such as worthlessness or guilt, fueling certain feelings. A CBT therapist might then try to help the survivor dig and search for underlying feelings that are triggering depression. Two common approaches to help survivors achieve this are cognitive restructuring and behavioral activation.

Cognitive restructuring is a technique that helps survivors learn how to identify “automatic” or irrational thoughts, and address them before allowing them to take over their actions. This can help survivors interpret thoughts with a more neutral, positive approach.

Behavioral activation is another technique that helps survivors initiate and plan positive activities to improve their mood. This can include simple activities such as going for a walk or meditating. Behavioral activation can also help target harmful behaviors that can enhance symptoms of depression or other disorders such as social isolation or inactivity. This technique is especially attractive for brain injury survivors struggling with adynamia, or low motivation.

While there are various treatments for brain injury and depression, some survivors may benefit from a combination of methods to enhance improvement. Consult with your doctor or psychotherapist to find the best approach(s) for you.

The Benefits of Positive Psychology After TBI

woman writing in gratitude journal to help cope with brain injury and depression

In addition to medication and talk therapy, another method used to help with depression after brain injury is positive psychology

Unlike traditional psychology, positive psychology focuses on forward-thinking and expanding on positive, therapeutic processes. It aims to help survivors create positive thoughts and feelings, like gratitude, and improve overall mood by rewiring the brain through neuroplasticity.

Neuroplasticity is the brain’s ability to rewire itself and improve certain functions. It can be summarized by the phrase “you are what you repeatedly do.” Positive psychology aims to harness neuroplasticity by training your brain to focus on positive thoughts and boost positive feelings.

The most simple yet effective positive psychology practice is writing in a daily gratitude journal. At the end of each day, write down three good things that happened to you, or write three things that you are grateful for. This will help train your brain to seek out and notice things that are positive.

Overcoming Depression After Brain Injury

There are many secondary effects survivors may experience after brain injury and depression can be one of them. Fortunately, there are just as many ways to overcome these effects and improve function and quality of life overall.

Consult with your doctor or therapist first to learn how to identify the symptoms of depression or other disorders and obtain a diagnosis, if any. Your medical team can create a treatment plan most suitable for you, which can include a combination of medication, cognitive-behavioral therapy, and positive psychology.

With the proper treatments and techniques, you may be able to overcome the effects of brain injury and depression and soon return to your most favorite activities.

Keep it going: Do you know these 15 essential TBI recovery tips?

If you like our content, you’ll love our ebook and newsletters! Get instant access to our TBI recovery tips ebook with 20 pages of helpful advice by signing up below.

You’ll also receive our emails that share survivor stories and more useful TBI recovery tips, which you can opt out of at any time. (We know you’ll love them, too.)

We will never sell your email address, and we never spam. That we promise.

More Ways to Recover with Flint Rehab:

Download Free TBI Recovery Tips!

15 Things Every TBI Survivor Must Know

Discover Award-Winning Neurorehab Tools

You're on a Roll: Read More Popular Articles on TBI Recovery

Do you want to sharpen your cognitive skills after a TBI?

Time with a speech therapist is extremely valuable during recovery, especially if you struggle with communication, critical thinking, or memory after brain injury. Insurance typically covers speech therapy for a fixed amount of time. But once it’s over, recovery is in your hands.

That’s why two speech therapists came together to create the CT Speech & Cognitive therapy app. It contains over 100,000 cognitive exercises that are all available right from your phone or tablet. 

This app is the perfect fit if you want to improve your speaking, memory, or general mental sharpness. Best of all, it’s affordable at just $29.99/month.

Click here to learn more about the CT app »

See what Miriam said about the CT Speech & Cognitive Therapy app:

“For the past 6 months, my son has used the app about three times a week. The app is like a virtual therapist, it’s very easy to use, and it gives him immediate feedback.

He now understands things faster, can make decisions with less hesitation, has improved recognition of words, and his confidence is higher. I also find it easy to get in touch with customer service; they pleasantly help out. The whole experience has been great.”

— Miriam

It’s like having a virtual speech therapist available anytime you want

With the CT App, you can get the guidance you need right from your phone or tablet. You can use it on your own or in between sessions with your speech therapist.

Whether you struggle with aphasia, memory loss, or critical thinking, the CT Speech & Cognitive Therapy App can help.

“The CT app has helped me gather my confidence by building on and reinforcing old forgotten skills. It helps to see my percentages increase, and work harder when they decrease. It’s very self-motivating.” -Kathryn

We are confident that this app will help improve your speech and cognitive function after brain injury. Like our recovery tools, the CT App is also covered by our 30-day money-back guarantee.

15 Things Every TBI Survivor Must Know

Do you know these 15 TBI recovery tips?

Get a free copy of our ebook 15 Things Every TBI Survivor Must Know. Click here to get instant access.