Mood changes in the wake of a traumatic brain injury are common and include the full spectrum from depression to mania.
The management of depression after brain injury can be difficult as one has to deal with not only the physiological mechanisms which may alter brain circuits involved in mood regulation (such as limbic system, amygdala, anterior frontal lobe) after trauma, but also the psychological consequences of loss of function and disability.
Patients may develop ’emotionalism’ in which there is uncharacteristic crying or laughing, sometimes inappropriately, with minor trigger.
Other patients can develop symptoms of mania, with characteristic signs such as elation, loss of sleep, hyperactivity, increased sexual energy, disinhibition, and recklessness, sometimes with aggression.
Careful psychopharmacological treatment from an experienced neuropsychiatrist is essential.