Chiropractic Meridian ID Depression After Brain Injury

Did your brain injury cause your depression or are you depressed because of the injury and how it impacts your life?

Depending on who you ask, you are likely to get different answers. The answer you are given will dictate the treatment you will receive.

So what is the answer, I think the truth is often a mix. One side of that question may be more true compared to the other depending on your
unique situation. With that being said, I’ve rarely seen it where someone is solely depressed because of how the injury impacts their life.

We are going to discuss the complexity of depression after brain injury.


BRAIN INJURIES

The human brain is an incredibly complex and resilient organ, but like any part of our body, it isn’t impervious to damage. In the aftermath of a brain injury, individuals often grapple with numerous visible physical symptoms — headaches, dizziness, loss of balance, and difficulty in speech, to name a few.

However, there’s another side to this story: the invisible wounds of brain injuries, such as depression, anxiety, and irritability, that often lurk beneath the surface.

Understanding these unseen effects is crucial not only for the brain injury patients but also for their caretakers and health professionals tasked with  their recovery. To truly help those recovering from a brain injury, we must examine this link between brain injury and depression.


THE PREVALENCE OF DEPRESSION POST BRAIN INJURY

Each year millions of brain injuries occur. These are split into traumatic and non-traumatic. Traumatic brain injuries are diagnosed as concussion, mTBI, and TBI. Non-traumatic injuries are from stroke, anoxic injuries, hypoxia, and infections. To prevent too much confusion we will put everything underneath the umbrella of brain injury as there is a lot of overlap between these two and for the sake of this article it will not take away from it.

Depression is a very common symptom that many experience following a brain injury. A study found the odds of developing depression post brain injury is 11x higher than that of the general population (1). Other studies show the risk of depression doubles (4). Needless to say, the risk of developing depression after a brain injury is higher. It should be noted this can occur immediately after the injury, but can also take time to develop.


THE NEUROLOGICAL CONNECTION

The connection between brain injuries and depression goes beyond just statistical correlation — it has roots in our neurobiology. Again, depression is a complex neurological issue. Brain injury can damage parts of the brain responsible for emotional regulation, including the prefrontal cortex and the limbic system. Some new research suggests there is a difference in the brain in those who suffer with depression as a result of a brain injury versus depression without the injury (2). If damage to the brain which results in depression isn’t enough, most with brain injuries will battle a variety of symptoms.


Emotional Impact of the Injury

Apart from the neurological changes, the emotional impact of living with a brain injury can be immense. It doesn’t take a severe injury that results in paralysis, difficulty walking, or having to learn to talk again.

Any of the injuries that have historically been considered as minor can forever change someone’s life.

We will start with the minor injuries, with concussion being the most common. This is an invisible injury where routine CT and MRI scans are going to be normal. How frustrating is it to have a provider tell you nothing is wrong because imaging is normal?

Unfortunately it doesn’t stop there, as this gets communicated to family and friends. The patience and understanding shown at the beginning is usually short lived because your imaging was normal and it has now been 3 months and you aren’t better. They don’t know why you aren’t back to yourself. If you are like most of my patients, this creates an immense amount of frustration.

Now severe injuries routinely have findings on imaging. So that frustration isn’t an issue for this group.

No matter what group you fall into, one of the biggest problems is that you are no longer who you were. It is one thing if you believe you will be back, but as months go on and improvement is slow then feeling down and depressed is an expected by product.


RECOGNIZING AND TREATING DEPRESSION AFTER BRAIN INJURY

Depression before a concussion or being on psychotropic medications are two very strong predictors of someone who doesn’t recover (3). This means that what was going on before the brain injury matters.

When receiving treatment for depression following a brain injury it is important to understand why the depression is there. Is it due to damage to the brain, how the injury impacts your life, or was this something going on before the injury occurred.

Any evaluation should start with a comprehensive history to identify factors that set you up for a difficult recovery from the injury or predisposed you to depression.

Next, you need to know how your brain is functioning. Since we are looking at function it is important to have testing that looks at function. Routine MRI and CT scans don’t look at function, but are meant for structure.

When looking at function some of the best ways to do this are using balance, eye movement, cognitive, and brain wave testing. With this information you are able to know which parts of the brain aren’t functioning properly as a result of the injury.

Now you can take all of this information and have a unique plan put together for you. This may include specific brain based therapies to improve function of the brain, nutritional supplements, normalizing brain waves, and supporting a healthy environment for the brain to improve and heal.


GETTING HELP FOR DEPRESSION AFTER BRAIN INJURY

Depression and brain injury often go hand in hand. Each case is unique and there isn’t one best treatment. There is an approach we see that routinely works.

We help you understand how your brain is functioning and what will prevent it from doing so at the highest level. We stack the latest therapies to allow for results that therapies when used in isolation aren’t able to achieve. Contact our office today and see how we can help.


REFERENCES:

1. Choi, Y., Kim, E. Y., Sun, J., Kim, H. K., Lee, Y. S., Oh, B. M., Park, H. Y., & Leigh, J. H. (2022). Incidence of Depression after Traumatic Brain Injury: A Nationwide Longitudinal Study of 2.2 Million Adults. Journal of neurotrauma, 39(5-6), 390–397. https://doi.org/10.1089/neu.2021.0111
2. Siddiqi SH, Kandala S, Hacker CD, et al. Precision functional MRI mapping reveals distinct connectivity patterns for depression associated with traumatic brain injury. Sci Transl Med. 2023;15(703). Published online July 5, 2023. doi:10.1126/scitranslmed.abn0441
3. Theadom, A., Parag, V., Dowell, T., McPherson, K., Starkey, N., Barker-Collo, S., … BIONIC Research Group (2016). Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand. The British journal of general practice : the journal of the Royal College of General Practitioners, 66(642), e16–e23. doi:10.3399/bjgp16X683161
4. Yeh, T. C., Chien, W. C., Chung, C. H., Liang, C. S., Chang, H. A., Kao, Y. C., Yeh, H. W., Yang, Y. J., & Tzeng, N. S. (2020). Psychiatric Disorders After Traumatic Brain Injury: A Nationwide Population-Based Cohort Study and the Effects of Rehabilitation Therapies. Archives of physical medicine and rehabilitation, 101(5), 822–831. https://doi.org/10.1016/j.apmr.2019.12.005