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Mood Swings After Brain Injury: Causes, Signs, and Methods to Manage Emotions

woman with wide open eyes standing in front of purple background, dealing with mood swings after brain injury

Mood swings after brain injury can cause rapid, exaggerated changes in emotions. These emotional displays are often more extreme than what the person actually feels.

Today you will learn about the causes of mood swings after brain injury, plus different ways to cope with them. Let’s begin.

Causes of Mood Swings After Brain Injury

Extreme mood swings, also known as emotional lability, occur after damage to areas of the brain that regulate emotions. These brain regions help us control our:

  • Appropriate emotional response
  • Awareness of our own emotions and others
  • Ability to inhibit emotions

After a frontal lobe injury, patients can lose these skills. However, every brain injury causes different side effects. A brain injury to a different part of the brain could also cause emotional lability.

Also, it’s important to note that, while extreme mood swings might seem like a mental health problem, they are mostly physiological responses.

Signs of Emotional Lability

man yelling and experiencing mood swings after brain injury

©iStock/Brankospejs

If a person has emotional lability, their emotional response can either be out of proportion to what they feel or completely inappropriate.

For example, they might genuinely be happy, but once they start laughing they are unable to stop. Or they will express extreme sadness over a minor disappointment, such as missing a dinner reservation. They can also start crying even when they aren’t unhappy.

Other symptoms of emotional lability include:

  • Mixed emotional outbursts, such as crying that turns into laughing, or vice versa
  • Short outbursts that only last a few minutes
  • Laughing or crying at situations that are not funny or sad

People with emotional lability also can express their emotions too loudly in places where they previously would have been more reserved, such as in a church, a concert, or a library.

Finally, because a brain injury can affect a person’s self-awareness, the person might not even realize that they are over-reacting.

These behaviors can be troubling for both the person afflicted with the emotional lability and the people they are with. Fortunately, there are ways to manage mood swings.

How to Cope with Mood Swings After Brain Injury

While there is no cure for emotional lability, there are ways to keep it under control.

The following are some tips to help brain injury patients and their loved ones manage uncontrollable mood swings.

1. Identify triggers  

Most emotional outbursts are triggered by external or internal factors. If you can recognize what factors tend to make you emotional, you can take steps to avoid them.

Some common emotional triggers include:

  • Excessive fatigue
  • Stress or anxiety
  • Overstimulation or sensory overload
  • Discussing certain emotional topics
  • Movies or books that are very sad or funny

It might help to keep a journal to record your emotional outbursts to see if you can find a pattern. Have your family and friends keep one as well, that way you can compare notes.

2. Take a break

man closing eyes and breathing peacefully to avoid mood swings after brain injury

If you start to feel your emotions rising, take a break from what you are doing. Sometimes a short, brisk walk or even playing a game on your phone is enough to help you calm down.

You should also establish a code word or a signal that you can tell your loved ones so that they understand why you might need to abruptly leave a situation.

3. Ignore and change the topic

For family members, if the person starts to have an outburst, the best course of action is to pretend it isn’t happening.

Putting too much attention on the emotional lability can embarrass the person, which will only increase problems.

Instead, continue on with the conversation or activity as if nothing has changed, and encourage others in the group to do likewise.

If you think something about the situation has triggered the person, try to change the topic or engage the person with a different activity. Once again, only do so in a way that doesn’t bring attention to their reaction.

4. Educate others

friends laughing and giving high fives

Witnessing uncontrolled laughter or sobbing can be confusing and upsetting for other people if they don’t understand what is happening.

To avoid these situations, provide simple explanations such as “ever since my brain injury I cry a lot” or “my brain injury makes me laugh now whenever I get nervous.”

Make sure you also tell them what to do if an emotional outburst occurs. For example, you can say, “If you see me crying, it’s not because of you. Just ignore me and it will stop.”

This will help others be more supportive and understanding of your behavior.

5. Plan ahead

Once you identify the most common triggers of your emotional lability, you can plan to avoid problems.

For example, if loud, noisy places trigger you, try to go to a quiet environment instead. If you can’t avoid them, bring along noise-canceling headphones that you can put on when things start to feel like too much.

You can also plan to do more demanding activities when you feel the most rested or when you have the most energy, such as in the morning.

All of these preparations can help you avoid extreme mood swings.

Treating Emotional Lability After Brain Injury

Most cases of emotional lability will resolve on their own as the brain begins to heal.

If the mood swings are especially severe, you may need professional treatment. A cognitive-behavioral therapist can teach you helpful strategies to manage your emotions, such as:

  • “Thought stopping”
  • Guided imagery
  • Relaxation and breathing exercises
  • Using distractions

They can also help you come to terms with any unresolved feelings that could be upsetting you and making your lability worse.

Finally, if nothing else works, there are also some medications you can take to bring your emotions under control. The most common medications taken for emotional lability are:

  • Nuedexta, the only drug approved by the FDA to treat emotional lability
  • Low-doses of antidepressants

Make sure to only use these drugs under the close supervision of your doctor.

Dealing with Mood Swings After TBI

Mood swings after TBI are difficult to deal with and can make certain activities more frustrating.

However, it’s crucial to remember that they are not your fault. They are simply a symptom of brain damage, and once the brain heals, things will get better.

Even if your emotional lability doesn’t fade on its own, with the right coping methods and treatment, you can begin to gain back control of your emotions and resume living your life.  

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