And hopes of attracting girls were dashed by the confused, suspicious, frightened, and wary reactions of others to his slowed speech and awkward gait. Mary lamented about the tremendous effort required to appear bright, cheerful, and engaging with coworkers and family, while privately struggling to fend off an enveloping shroud of bleakness and self doubt. Rick discussed his inability to provide financially for his wife and children. And he felt ashamed and inadequate that he could no longer sexually satisfy his wife. Dealing with depression that results from the neurological and psychological consequences of brain injury is one of the greatest challenges facing survivors, their families, and health care providers.
Depression occurs in fifteen to twenty-five percent of brain injury survivors.
It may manifest itself as sadness and low mood, but can often present as agitation, irritability, lack of enjoyment, or impaired cognition. I believe that if the necessary resources are available, each of the brain injury survivors described above would benefit from psychotherapy and adjustment in social milieu. Psychotherapy could address the methods in which the survivors cope with intense feelings of disappointment, frustration, anger, guilt, shame, etc. Survivors and family members could find more adaptive ways to deal with these painful feelings, maintain a sense of self-worth, and derive satisfaction from life. Through the process of therapy they could understand how their current condition often resonates with and revives intense, painful feelings from earlier life situations which are unconsciously experienced as similar.