Traumatic brain injuries (TBI) can lead to mental health issues. However, injury to the brain and mental illness are two very different diagnoses, which are easily confused. Misdiagnosis of either condition may lead to serious complications. Understanding each of these conditions individually, in addition to where they overlap, can prevent damaging decisions and misconceptions.

Key TakeAways:

1) TBIs occur when the brain is forcefully bumped

2) Mental illness includes an array of conditions negatively impacting cognition, behaviour and mood.

3) TBIs can be the root cause, unrelated or exasperating factor for mental illness.

4) Mental health practitioners must be notified if their client has experienced a brain injury.

5) Understanding the differences and overlaps between TBIs and mental health can lead to increased awareness, decreased stigma, in addition to accurate support and treatment plans.

What is a Traumatic Brain Injury?

Traumatic brain injuries occur when an external force bumps up against the brain. A non-threatening TBI may cause a mild concussion, while a more serious TBI could result in a coma or even death. There are two types of TBIs, penetrating, when the skull is broken through, and non-penetrating when the head is bumped without the skull breaking.

What are the Common Impacts of a Traumatic Brain Injury?

Physical Symptoms:

When your brain takes a hit, your body often pays the price. TBIs can mess with nearly every system, making everyday tasks feel like climbing a mountain.

• Nausea and Vomiting: Feeling queasy? That’s often an early warning sign that something’s not right in the brain, especially if it’s paired with dizziness or confusion.
• Headaches: These aren’t just your average “I didn’t drink enough water today” headaches. We’re talking persistent, pounding pain that can last for months—or even years—after the injury. Some people even develop migraines triggered by light, sound, or stress.
• Dizziness and Balance Issues: Suddenly feeling like the ground is shifting beneath you? TBIs can throw off the brain’s ability to process spatial awareness, making walking a straight line or even standing still feel like a challenge.
• Muscle Weakness or Paralysis: Some people experience full-body fatigue, while others might struggle to lift an arm or move a leg properly. In severe cases, TBIs can lead to partial or total paralysis in certain body parts.
• Loss of Coordination: Buttoning a shirt, holding a spoon, or even signing your name can become frustratingly difficult when the brain’s motor functions are affected.
• Seizures and Convulsions: TBIs can increase the risk of seizures, sometimes appearing months or even years after the initial injury. In some cases, they can lead to long-term epilepsy.
• Vision Problems: Blurred vision, double vision, and trouble focusing are common. Some people also develop sensitivity to light, making it painful to be in bright rooms or outside on sunny days.
• Tinnitus (Ringing in the Ears): That annoying ringing that won’t go away? TBIs can disrupt the auditory system, leading to constant buzzing, difficulty hearing, or sensitivity to certain sounds.
• Fatigue and Sleep Disturbances: Some people with TBIs find themselves sleeping all the time, while others struggle with insomnia. Either way, energy levels take a massive hit, making recovery even harder.

Cognitive and Emotional Symptoms:

The brain is the command center of our thoughts and feelings, so when it’s injured, emotions and cognition can go haywire.

• Memory Loss: Forgetting where you put your keys is one thing, but with a TBI, entire chunks of your life might be missing. Some people struggle to remember events before the injury, while others have trouble forming new memories.
• Difficulty Concentrating: Reading a book, watching a movie, or even following a simple conversation can feel exhausting. The brain has to work overtime just to keep up.
• Slowed Thinking: Many describe it as feeling like their brain is running in slow motion—processing thoughts, making decisions, and problem-solving all take way longer than they used to.
• Mood Swings: One minute you’re laughing, the next you’re in tears. TBIs can wreak havoc on emotional regulation, making feelings unpredictable and intense.
• Increased Irritability and Aggression: Patience wears thin quickly. What used to be minor annoyances—like a noisy room or a slow internet connection—can now trigger full-blown frustration or even outbursts.
• Depression and Anxiety: The combination of physical pain, cognitive struggles, and lifestyle changes can lead to deep emotional distress. Many people with TBIs feel isolated, misunderstood, or frustrated with their new reality.
• Reduced Impulse Control: The brain’s ability to hit the “pause” button before reacting can be compromised, leading to risky decisions, inappropriate comments, or sudden emotional outbursts.
• Lack of Motivation: Tasks that used to be effortless—like getting out of bed or going for a walk—can feel like monumental challenges. Some people with TBIs struggle to find interest in anything at all.
• Hallucinations or Paranoia: In severe cases, TBIs can cause people to see or hear things that aren’t there or develop irrational fears and suspicions.

Sensory and Neurological Impacts:

Because the brain processes every sensation, TBIs can cause the world to feel… different.

• Sensitivity to Light and Sound: Bright lights feel blinding, and loud noises become unbearable. This can make shopping malls, concerts, or even watching TV overwhelming.
• Altered Taste and Smell: Foods you once loved might taste bland—or worse, disgusting. Some people experience phantom smells, sensing odors that aren’t actually there.
• Speech Difficulties: Finding the right words, forming clear sentences, or even speaking without slurring can be a daily struggle.
• Pupil Dilation or Unequal Pupil Sizes: This can be a sign of serious brain damage and should be checked out immediately.
• Fluid Leakage from the Ears or Nose: If clear fluid is coming out of these areas, it could be cerebrospinal fluid—a red flag for a skull fracture or severe brain trauma.

Social and Behavioral Impacts

Life after a TBI isn’t just about the physical and mental changes. Relationships, independence, and daily life all take a hit.

• Difficulty Maintaining Relationships: Friends and family may struggle to understand the changes in personality, mood, and behavior, which can strain even the closest relationships.
• Social Withdrawal: Conversations become exhausting. Many people with TBIs start avoiding social situations, either out of frustration or fear of saying or doing something embarrassing.
• Inability to Handle Stress: What used to be minor inconveniences can now feel like the end of the world. Small challenges often lead to overwhelming emotional breakdowns.
• Loss of Independence: Depending on the severity, people with TBIs may need help with everyday tasks, from cooking meals to driving to work. That shift can be incredibly frustrating and difficult to accept.

What is a Mental Illness?

Mental illnesses impact thinking, behaviour, in addition to emotion or mood, and include a wide range of conditions. When struggling with a mental illness, individuals may face distress and challenges in relation to social, family or work activities and functioning. Mental illness is not uncommon, for instance, in the U.S. more than one in every five adults has a diagnosable mental disorder. However, mental illnesses are treatable and the majority of individuals living with a mental disorder continue to function effectively from day to day. Healthy relationships, excelling in productive activities such as school or work, as well as the ability to adapt to change and manage adversity, are commonly the result of good mental health.

How Can They Overlap?

TBIs can either be a separate issue to mental health – where a mental illness is developed due to the struggles of having experienced, or having to continue living with, a brain injury. These challenges may even worsen an already existing mental illness. It can also be the root cause of a mental illness due to the damage sustained to the brain.

3. These overlaps can occur because all behavioural, psychological, emotional and cognitive skills originate in the brain. Both mental health issues and brain injuries are linked do dysfunction in the brain. Memory, planning and attention can be impacted by both mental illnesses and brain injury. Similarly, how an individual reacts, thinks, works and relates to the world can also be impacted by either, or both, mental health and injury to the brain.

All of the above factors if caused by brain injury can put people at a higher risk of developing a mental illness due to increased difficulty managing stress, emotions and relationships. Injury to the brain, such as TBIs, puts individuals at higher risk of depression and suicidal actions or thoughts.

Why This Matters?

By understanding the differences and overlaps between mental illness and TBIs, stigma can be countered and enhanced support offered. Treatment plans aimed at mental illness may be ineffective if the individual has sustained a brain injury.

As the client may need to see a neuropsychologist and receive brain scans, mental health practitioners should always be informed if their client has experienced a brain injury.

Conclusion

• understanding how traumatic brain injuries (TBIs) and mental illness can overlap is super important. While they’re two different things, they can mess with each other in ways that make things complicated. Recognizing the signs of both is key to getting the right diagnosis and treatment. If someone’s had a brain injury, mental health pros need to know so they can provide the best care. It’s not just about treating the symptoms—it’s about understanding the root cause. If you or someone you care about is going through this, don’t wait to get help. With the right support, recovery is absolutely possible.