Emotional and behavioural effects of brain injury

Everyone who has had a brain injury can be left with some changes in emotional reaction and behaviour. These are more difficult to see than the more obvious problems such as those which affect movement and speech, for example, but can be the most difficult for the individual concerned and their family to deal with.

Personality changes

For many families, the worst consequence of brain injury is feeling as if the person who was once known and loved has somehow slipped away, together with their character and their individual ways. For the person with a brain injury, losing a sense of their own identity is traumatic and frightening. 

For this reason, experiencing brain injury can be similar to going through bereavement: the healing process is made up of grief, denial, anger, acceptance, and finally, resolution. However, this process can take many years to run its course, and the feelings experienced may not present in any particular order. 

Sometimes the impact of brain injury means that the individual remains unaware of what has happened to them and how they have been affected. If they are free from physical effects, other people may also fail to appreciate the ‘hidden disability’, such as the cognitive or personality changes that have taken place. This can leave both brain injury survivors and their families feeling very isolated.

It can be particularly difficult if the person with brain injury has children. While children are often surprisingly able to come to terms with changes in their lives, they may not be able to fully understand what has happened to their mum or dad and why they are different from before.

Mood swings or ‘emotional lability’.

The person may have a tendency to laugh or cry very easily, and to move from one emotional state to another quite suddenly.

Depression and sense of loss

Depression and sense of loss are common. Depression may be caused by damage to the brain’s emotional control regions, but can also be associated with the person gaining an insight into the effects of their own injury

After a serious accident or illness, many things that are precious to the individual may be lost forever. There may be much sadness, anger, guilt and confusion, surrounding this. There may be lost skills such as cooking, writing or sport; lost independence (getting dressed, going shopping, driving); lost lifestyle (friends move on and no longer include the injured person in their plans); lost career (most severe brain injury survivors are unable to go back to work); lost companionship (many brain injured people say that they feel very lonely).


Anxiety can be another consequence of brain injury. Life has been changed forever, and the future can look frightening. Anxiety can quickly lead to frustration and anger and needs to be identified and alleviated as early as possible.

Frustration and anger

Frustration can build up quickly, especially when things that were once so easy are now difficult or impossible. The resulting anger may be very difficult for the person to control.

Abusive or obscene language

This may be spontaneous and uncontrollable, and may be an outlet for the person’s anger and frustration. This behaviour can obviously be embarrassing and upsetting for those nearby.


There may be a loss of control over social behaviour, so that the person may behave in an over-familiar manner or may make sexual advances with the wrong people at the wrong time.


A person with a brain injury may tend to speak or act without thinking things through properly first.

Obsessive behaviour

For example, a person may be afraid that their possessions will be stolen, and may check their belongings repeatedly.