Emotional effects

Brain injury can change the way you experience or express your emotions. You may have less or more intense feelings, or you may feel and act in ways that are out of character for you.

For example: you might have been called really cheerful in the past, and you might have felt that way. But after your brain injury, you might feel sad or angry more frequently. We get to know ourselves pretty well as we grow up, so this might feel really strange/unlike you. And that can be distressing, which further impacts how you feel.

Being a teenager by itself can be really emotional sometimes. Your hormones and brain are changing, and you’re starting to be in more intense social situations [1]. Brain injury plays a role in your emotional wellbeing too. You may experience emotional changes because of the physical damage to your brain and/or your recovery journey.

Let’s talk about:

Anger/irritability

We talk about anger and frustration in our section on behaviour and brain injury – but these behaviours start with how we feel.

It’s common to experience these emotions more often after a brain injury or to feel these emotions well up inside you faster. These episodes of anger or irritability can be caused by:

  • Confusion
  • Frustration with a task that is harder than it used to be
  • Feeling overly tired
  • Misunderstanding another person’s intentions
  • People telling you what to do or pointing out mistakes
  • Too much stimulation (for example, too much light, noise, or movement)

Sometimes, you might not even be fully aware of why you’re angry, which can make you more angry! When you’re angry, you may:

  • Shout
  • Say negative or hurtful things
  • Make loud noises (like slamming doors)
  • Refuse to engage in conversation (sometimes this is called giving others the silent treatment)

It’s okay to feel angry sometimes. But how we handle our anger is an important part of our emotional health. We want to be kind to ourselves (and to others) as much as possible, and that means finding ways to cope with our anger. If you’re experiencing periods of anger or irritability, try some of the following coping methods:

  • Do an activity that makes you feel calmer. This could be listening to music, reading, drawing, or something else.
  • Practice deep breathing.
  • Remove yourself from the situation and go to a more calming location.
  • Work with a doctor who is familiar with acquired brain injury on self-calming methods and communication strategies. Being able to communicate what you’re feeling to others can be extremely helpful when it comes to emotional situations.

Anxiety

Anxiety stems from feelings of worry and fear. This could be related to recovery, going back to school, socializing, relationships, and other aspects of your life. When you feel anxious, you might be feeling a lot of things like worry, fear, sadness, and other emotions.

Anxiety can play a big role in mental health, so we cover that more in our mental health section.

Depression

Adjusting to your new self and your experiences is difficult and can result in a lack of motivation and feelings of sadness, loneliness, and even despair. This is pretty normal when there are big changes. However, if they don’t go away, that could be a symptom of depression.

Before you keep reading

When we talk about depression on this website, we’re talking about diagnosed Major Depressive Disorder. There is a difference between some saying they feel depressed to describe feeling sad and unengaged and having a mood disorder. Only a health care professional can diagnose Major Depressive Disorder.

Depression can affect anyone and is a complex health condition. It’s more than bad feelings – it can impact your ability to do things, maintain your friendships, and find enjoyment in things you love.

We cover depression in more detail on our page on depression and mental health.

Keep in mind: if you have any questions about your mental health, depression, or other emotional health concerns, you should talk to an adult.

Emotional control

Sometimes we feel really strong emotions (like intense sadness, happiness or anger), and we act on those emotions without really thinking it through. Our ability to listen to our emotions but still be able to think through our next steps (whether it’s saying something or doing something) is called emotional control. It sometimes goes hand-in-hand with impulse control, which we talk about in our section on behaviours. A brain injury can impact emotional control, meaning you may not consider the outcome/consequences of what you say or do. You just act based on how you’re feeling. This can lead to potentially risky or dangerous situations.

For example: You’re feeling really down today, and you’re playing a game on your smartphone that is making you happy. In order to keep playing, you need to make an in-app purchase. You may not think about the money – you may just be focused on the fact that this game equals you feeling happy. You may not be able to think through the consequences of you continually spending money on this game.

Emotional control doesn’t mean you have to block out your emotions and never access them – it’s good to feel your feelings. But it’s important to work on recognizing when your emotions are making decisions instead of you. If you do have a decision to make, even a simple one, it can be helpful to:

  • Pause: Don’t instantly say yes or no, or make a move. Take some time to stop, so you can move onto step two.
  • Think: How will this affect me? How will this affect others around me? Will this have consequences in the future? Is there something different I should be doing? Once you have some of these answers, you can make your decision.
  • Ask: You’ve paused. You took some time to think. Now you may be ready to act. But if you aren’t, you can ask a parent/guardian or someone you trust for help. They may be able to share with you some information you’re not seeing right now.
  • Act: You’ve taken the time to acknowledge your emotions and think about what decision will be best for you.

Sometimes it’s helpful to write down a decision-making process like the one above to have with you. Or there may be other methods that help you navigate a balance between your emotions and making informed decisions (such as taking some deep breaths). It will take some time to figure out what works best for you: don’t be afraid to ask someone for help with that.

Grief

Grief is something we feel mostly when something changes or we lose something/someone. It’s a common (and very human) experience.

For example

  • You may have had to say goodbye to someone in your family when they passed away
  • You may have moved when you were younger and lost touch with friends
  • You might have lost a beloved pet
  • You may not have made a team or club that you really wanted

Now we recognize that these are all really different situations and that some are more serious than others. But they all can result in grief. This might feel like:

Some common emotions often experienced intertwined with grief can include [2]:

  • Shock
  • Sadness
  • Anger
  • Loneliness, helplessness, and guilt
  • Fear and anxiety

A lot changes in the days and months after a brain injury, and these changes can be difficult. You might feel grief over:

  • Changes in your independence
  • Loss of opportunities (for example, getting your license when you’re 16)
  • Changes in friendships and other relationships
  • Disruptions to your routines and abilities

Grief can feel big and overwhelming some moments, and smaller and more in the background at other times.

It’s normal to go back and forth between feeling helpless and feeling hopeful, because grief is not something you experience in a straightforward way. Some days you may not want to face what has been lost (for example, your independence). Other days you may be able to acknowledge that you’re feeling grief. And other days, you may not feel it. This is called the dual process model of understanding grief. It helps you find a balance between the reality of loss and moving forward after it [3].

It’s normal for grief to be with us for a long-time. It’s also normal to feel alone or that you can’t cope with the grief you’re experiencing. But while you may have good days and bad days with grief, there are some ways you can navigate it.

The Canadian Mental Health Association recommends trying a few of the following strategies [4]:

It’s completely normal to feel a bunch of emotions when coping with grief. In one moment, you may feel happiness when a nice memory comes to mind; the next, you may feel a swell of sadness. You may even feel relieved that something is behind you. That’s okay! Accept your feelings as they come, realizing that they may come and go along the way. And as time passes, you’ll probably find that the difficult feelings become easier.

You may be wrestling with positive and negative thoughts and feelings. Instead of keeping those inside, you may find it helpful to express yourself through things like:

  • Journaling
  • Creative writing
  • Drawing/painting
  • Playing an instrument
  • Singing
  • Talking it out
  • Engaging in an activity

Grief might make you feel lonely and isolated, or that no one can understand how you’re going. But if you talk about what you’re feeling with others, it can really help. You can help nurture your own wellbeing and your relationships by being honest.

Sometimes people who are grieving think they shouldn’t find things funny or enjoy themselves. But allowing yourself to laugh when something’s funny and engage in humour can actually help make you feel better. Whether it’s watching your favourite comedy or sharing a joke with a friend–laughter can be part of the healing process.

It’s probably pretty hard to find the positives when you’re grieving. And we’re not saying that you have to force yourself to feel happy when you don’t – it’s important to be honest about that. But in your recovery, what have you learned? What are some of the things you have gained? What are some kind things you can say about yourself? Asking yourself these kinds of questions may be helpful in navigating grief.

It can be hard to take care of your physical health when you’re feeling bad. But not eating well, exercising to the best of your ability and/or poor sleep will make you feel bad physically. And that can make you feel bad emotionally (and so on so on). It’s important to work with your parent/guardian and other people in your life to make sure that you do what you can to care for yourself. You can learn more on our page about physical health.

Mood swings

Sometimes there is an obvious reason why your emotions suddenly change. For example, you’re watching a sad movie or listening to a sad song. Mood swings (also called emotional lability) are when you go from one emotion to another quickly, often for short periods of time, and there may not be any obvious reason.

For example: You’re laughing or crying a lot even if you don’t feel particularly happy or sad.

Long story short, this can be wildly confusing not just for other people but for you as well.

Mood swings are common when the parts of the brain that control emotion are injured. They can also be unrelated to a situation or the way you feel–they just happen. Whenever you do experience mood swings, don’t be too hard on yourself. And if you’re struggling to cope with mood swings, you could try:

  • Calming activities
  • Deep breathing
  • Distracting yourself from the thing that is making you laugh or cry more than you want to
  • Speaking with your doctor: they may be able to help with mood stabilizing medications and tools

If you do take medication, remember that it may not work right away and you will need to work closely with your doctor to find the right medication and dosage. You should never take medication for your mood that hasn’t been prescribed by a doctor.

Over time, many people find their mood swings happen less and less.

Self-image loss

Self-image is how we see and think about ourselves. After a brain injury, you might not feel like yourself. There are lots of changes happening, and that can be really emotional. It can get even more emotional if you don’t feel connected to who you are today.

If you aren’t sure about your self image, you can ask yourself:

  • Do I feel like myself?
  • Have I thought about myself positively today? How about in the past week? The past month?
  • If someone asked me to describe myself, what would I say?

These questions can prompt you to think more deeply about how you see yourself and how it’s changed. You may recognize that you don’t have a great self-image right now and find it difficult to break the cycle of focusing on the past instead of the present. It’s important to work on doing just that – breaking that negative cycle and working towards a new sense of normal and what that means to be you. Some tips to help find a sense of positive self image include:

  • Asking a parent/guardian, sibling, or caregiver for help
  • Celebrating your successes
  • Finding new hobbies that bring you joy
  • Returning to an activity you loved or finding ways to adapt it for your new abilities
  • Being patient. It will take some time to adapt to your new normal
  • Identifying the ways that you have NOT changed (i.e. I am still considerate of others; I still enjoy classical music, etc.)
  • Keeping a positivity journal: at the end of the day (or as they happen), write down the good things that happened to you

[1] Study on puberty from 2022

[2]   Coping with loss and grief. Centre for Addiction and Mental Health (n.d.). Retrieved June 22, 2023, from https://www.camh.ca/en/camh-news-and-stories/coping-with-loss-and-grief

[3] Stang, H. (2020, April 19). The Dual Process Model of Grief: Navigating the spiral. Mindfulness & Grief: Meditation for Life After Loss. https://mindfulnessandgrief.com/dual-process-model-of-grief/

[4] Understanding and Coping with Loss and Grief. Canadian Mental Health Association (n.d.). Retrieved August 2, 2023, from https://ontario.cmha.ca/documents/understanding-and-coping-with-loss-and-grief/Information sourced in part by My Health Alberta and sourced in part from Model Systems Knowledge Translation Center (MSKTC)