Behavioural effects of brain injury While people can make a good recovery after brain injury, many people have long-term behavioural effects.

Emotions and behaviour are closely linked, with behaviours often reflecting an internal emotional state. However, after a brain injury, some behaviours become more common or difficult to control.

Learning to use techniques that help with managing behaviour can sometimes be beneficial, as well as using equipment or adaptations for other effects of brain injury that may be causing the difficult behaviour.

Living with the effects of brain injury may cause many people to feel like they are ‘living life in the slow lane’ and this can be upsetting or difficult to adjust to. Quality of life, relationships or sense of identity can be affected by the behavioural effects of brain injury. Speak to your GP, neurologist, or neuropsychologist about any behavioural effects of brain injury that you are struggling with, as they may be able to provide a referral to a specialist that can help.

Explore the sections below to find out more about the behavioural effects of brain injury.

What are the behavioural effects of brain injury?

Click through the list below for information on some of the common behavioural effects of brain injury.

Post-traumatic amnesia (PTA)

PTA is the time after a period of unconsciousness when the brain injury survivor is conscious and awake but is behaving or talking in a bizarre or uncharacteristic manner. The survivor has no continuous memory of day-to-day events, including what happened a few hours or even a few minutes ago. They may fail to recognise family members and close friends, attempt to leave hospital, swear, shout, or take off their clothing. Alternatively, the survivor may be very quiet, docile, extra-loving and friendly, clinging, or childlike.

PTA can be a very distressing and frustrating time for relatives and friends, but it is important to remember that it is a normal stage of the recovery process, and it is temporary. It can take minutes, hours, days, weeks or even in rare cases months to improve. Behavioural effects that continue for longer are not considered to be PTA anymore, but a longer-term impact of the brain injury itself.

Disinhibition

A brain injury survivor may become uninhibited with what they say or do. They may behave in a way that is considered to be socially or culturally inappropriate. Common examples of disinhibition include using crude or abusive language, making tactless remarks (such as commenting on a stranger’s weight in public), laughing inappropriately and being overly familiar towards others. A major area of difficulty is that of sexual behaviour – making inappropriate sexual advances or remarks. Disinhibition can often cause others around the survivor to feel embarrassed or upset.  

Impulsiveness

The ability to weigh up information before making a decision can be affected so that a survivor becomes impulsive with their actions. They might spend money without thinking about bills that need to be paid first or may make spontaneous plans that they are unable to carry through.

Irritability and aggression

Brain injury survivors may have difficulties managing their anger, which can result in irritability or aggressive behaviour. This can include shouting, swearing, using threatening language or being physically aggressive or violent. There may in some cases be remorse after the outburst of anger. However, some survivors might not recognise their behaviour as problematic, or may not remember the event at all.

If a brain injury survivor’s anger becomes violent, abusive or causes a risk of harm to themselves or others, there may be a need to seek intervention through a safeguarding team, domestic abuse services or the police.

If you are in immediate danger, or you are in an emergency, call 999.

Perseveration

Survivors may continuously repeat certain behaviours, actions, or words, for instance repeating things that they have already said several times. They may find it particularly difficult to switch from one activity to another, becoming seemingly ‘stuck’ on what it is that they are thinking, doing, or saying.

Egocentricity

Survivors may appear to be self-centred and as though they are not considering the feelings or needs of family and friends. It is common for people to focus on their own needs in difficult times, but this can be greatly exaggerated for a person with brain injury. Cognitive impairments may mean that they are oblivious to or unable to understand others’ points of view, and they may be unaware of the needs of others. These sorts of issues can cause problems in relationships.

Personality change

A brain injury survivor’s personality may change for many reasons after their injury. The combination of the effects of brain injury and the consequences of their changed life can affect their personality. For example, someone who was usually calm before their brain injury may become agitated and struggle with managing their anger after the injury. Or someone very shy before their injury may become outgoing afterwards.

Personality change is often noticed by the survivor’s relatives and their wider network. Sometimes the survivor may not understand how their personality has changed, while for others who do understand, this can be a very difficult thing to adjust to.

Where can I get help with the behavioural effects of brain injury?

It is a good idea to start by speaking to your GP about any issues you are having as they may be able to refer you to an appropriate service that can help. If you are under the care of a neurologist or rehabilitation team, they may be able to help with managing some of the behavioural effects of brain injury.

Clinical neuropsychologists and clinical psychologists with experience in brain injury can often help with the behavioural effects of brain injury. They will often begin by interviewing brain injury survivors and their families to get an understanding of what issues the survivor is experiencing. Rehabilitation can be recommended to help cope with the behavioural effects of brain injury.

Other professionals with experience in brain injury may also be able to offer help in coping with the behavioural effects of brain injury.

Talking therapies such as counselling may help to cope with some of the emotional effects of brain injury that are underlying the behavioural effects. Other forms of therapy offered by psychologists exist to help with emotional issues, such as cognitive behavioural therapy and compassion-focused therapy. Therapists will be able to advise which type of therapy is best suited depending on the emotional effects experienced.

How do I cope with the behavioural effects of brain injury?

Coping with the behavioural effects of brain injury will depend on the types of effects you have. For some types of behavioural effects, good support and understanding from family and friends can help. Share information from Headway with your loved ones to help them with understanding the effects of brain injury and how best to support you.

There may be psychological techniques that therapists can recommend and help you work through to redevelop behavioural skills.

It is a good idea to start by speaking to your GP about any issues you are having as they may be able to refer you to an appropriate service that can help.

In some cases, a survivor may be unaware of their behavioural effects and lack insight into inappropriate behaviour being displayed. Headway’s Brain Injury Identity Card can help in these instances.

Our series of publications cover many of the effects of brain injury and can offer detailed information on coping tips. For more information, visit the Information Library.

When will I recover from the behavioural effects of brain injury?

Behavioural effects from post-traumatic amnesia (PTA) tend to improve within days, weeks or in some rare cases, months. Behavioural effects that continue for longer are not considered PTA anymore, but a longer-term impact of the brain injury itself.

Other behavioural effects of brain injury may not be as obvious in the early days of injury and may be more apparent once the brain injury survivor has returned home. They may therefore take longer to understand and adjust to than some of the other effects of brain injury. Behaviour may also change as the survivor begins to understand the impact that their injury has had on their life.

While therapeutic intervention and good support from families and friends can sometimes help, behavioural effects can last for weeks, months, or even years, or be lifelong and may require adaptations to cope.

No two experiences of brain injury are the same, so there are no rules about when you will recover from the behavioural effects of brain injury. Receiving support from suitably qualified professionals can help with the recovery process while learning new ways of coping can help to readjust.


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