A New Understanding of TBI and Mental Health

March 17th, 2025

By P. Casey Arrillaga, LCSW, LCDC

NOTE: This is the second post in our series on TBI. The
first post was on “TBI and Addiction”, released on 3/3/25.

Traumatic Brain Injury [TBI] used to be considered as either
as life-threatening condition when it was moderate or severe, or it was largely
considered benign when it was mild. In recent years, it has become more and
more apparent that TBI can have profound and long-lasting effects on mental
health conditions that have not been previously recognized. This post explores
what we know so far and what we can do to help.

What We Know So Far

Traumatic Brain Injury (TBI) is a serious medical condition
that occurs when an external force injures the brain, such as in a car
accident, a bad fall, high-impact sports, or military combat trauma. The
severity of TBI can range from mild concussions to severe brain damage. One of
the most significant yet often overlooked consequences of TBI is its impact on
mental health. When the brain sustains an injury, it can struggle to regulate
emotions, thoughts, and behaviors the way it used to. The person with TBI may
or may not notice the changes, but those closest to them often see differences
in personality, such as increased impulsivity or anger.

One of the most concerning mental health impacts of TBI is
an increased risk of suicidal thoughts and behaviors. The combination of
cognitive impairments, depression, social isolation, and loss of independence
can create feelings of hopelessness.

Related to this is that individuals who suffer from TBI are
at a significantly higher risk of developing depression. This may be due to any
combination of changes in brain chemistry, damage to areas controlling mood
regulation, or the psychological distress caused by life-altering impairments. One
such life change is that many people with TBI see themselves as lacking enough
social support due to changes in functioning and personality, leading to more
loneliness, and then depression. Symptoms of depression, such as persistent
sadness, fatigue, and loss of interest in activities, can in turn make recovery
from TBI even more challenging, creating a negative cycle.

Anxiety disorders are another danger from TBI. Those who have
been hurt may develop generalized anxiety, panic attacks, or PTSD, particularly
if the injury was caused by a traumatic event such as an accident or combat
exposure. The fear of re-injury, difficulty coping with changes or struggles in
thinking, and uncertainty about the future can all contribute to heightened
anxiety. This can lead to avoidance behaviors, social withdrawal, and increased
stress, further complicating recovery.

Additionally, TBI can lead to mood swings and emotional
instability. People with TBI may experience sudden outbursts of anger,
frustration, or crying for reasons they can’t explain or understand. This can
occur because the parts of our brain responsible for emotional control, such as
the frontal lobe, may be damaged. This can puts further strain on personal
relationships, making it difficult for individuals to maintain social
connections and support networks, which are crucial for mental well-being.

How Do We Use This Knowledge to Help People?

At Windmill, we not only screen every client for TBI as part
of our thorough assessments, every client is also given an EEG shortly after
arrival, which allows us to directly see if there are effects of concussion and
TBI. Through this process, our clients, team, and family members can then move
forward armed with objectively accurate information. When we find evidence that
someone has had TBI, we have cutting-edge tools including validated
psychometric tools and individualized Transcranial Magnetic Stimulation [TMS], as
well as some of the best trauma therapy available to help people not only
manage their lives, but also directly reduce the effects of TBI, thus giving
them a much greater chance of recovery from both the TBI and any mental health
struggles.

Given the social challenges that many people with TBI
experience, we use as social approach in working with each client to make sure
they have the resources to continue building their network and their
understanding of the support available to them. This includes our strong alumni
program for both clients and their families.

In addition, we offer specialized services for active-duty
military, military veterans, and first responders. We have what it takes to
overcome combat trauma, other military trauma, and first-responder trauma, both
physical and psychological, including any TBI effects.

The Bottom Line

Traumatic Brain Injury (TBI) can result from accidents,
falls, sports, or combat, and its effects range from mild concussions to severe
brain damage, often impacting mental health by altering emotions, thoughts, and
behaviors. TBI significantly increases the risk of depression, anxiety, mood
swings, and even suicidal thoughts due to cognitive impairments, social
isolation, and personality changes. At Windmill, every client undergoes thorough
TBI screening and gets the help they need. If you or anyone you love has been
affected by TBI and/or mental health struggles, reach out for help now.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.