Spinal Cord Injury Journal

Traumatic Brain Injury: 5 Emotional & Mental Stages to Recovery

Written by Carley Dole | October 18, 2018

Traumatic Brain Injury (TBI) survivors not only go through physical changes but also mental and emotional changes throughout their recovery. Although everyone’s recovery is different, most survivors will transition through five emotional stages including but not limited to:

  • Confusion,
  • Denial,
  • Anger & Depression,
  • Testing Phase,
  • and Uneasy Acceptance.

Confusion

Confusion and agitation is the first stage many survivors will experience and this phase usually occurs right after the original trauma. During this phase, survivors experience confusion about everyday life as well as the conditions of their injury. A person’s ability to pay attention and learn stops, preserving energy for the brain to begin to heal- often times causing confusion and frustration. This stage can last for the first few days, weeks or months after impact.

Denial

After confusion subsides, denial takes its place. Some survivors experience one or both types of denial depending on the initial accident and severity of the injury. Emotional denial occurs when the individual is scared or upset and doesn’t want to deal with the recovery or results of the initial injury. The other type of denial is caused by chemical changes in the brain. The brain will sometimes refuse to process certain information. Typically, TBI patients believe “there’s nothing wrong with me,” making recovery difficult for both the survivor and their families. It’s important to note that when someone is in denial, they benefit from being given consistent feedback on their injury, mental state and who they have become. 

Anger & Depression

Eventually, denial will subside and a break down into further recovery will begin. Because many survivors have limited awareness about what’s going on around them and in return what’s going on in their own recovery, many become frustrated/angry and depressed. Many survivors experience both. It’s important to keep in mind that this is completely normal. Parts of the brain that control emotions have been injured. When realizing you have become “different” or are struggling to take part in things you once enjoyed, it can be difficult to comprehend. In addition, many survivors are trying to keep up with the constant changes they are experiencing. This is a crucial step in recovery and is often times not a one-time phase. Many times survivors will go back and forth throughout their recovery. 

Testing Phase

After experiencing improvements and new attributes, many survivors will experience a “testing phase.” Understanding they are really close to the person they were before their injury, survivors are excited to start “testing” their abilities. In most head injuries, survivors will develop fatigue disorders experiencing tiredness easily. However, during the testing phase, everything is thrown out the window and anything is fair game. Often times, patients will push beyond their limits to prove to others that they have “recovered.” In reality, most patients will overdo it and go beyond their abilities, spending several days paying for it. This can be a very painful and difficult stage to comprehend for both survivors and family members. 

Uneasy Acceptance

When patients begin to learn their limits, they experience uneasy acceptance. Survivors have learned through failures, therapy, and fatigue that they can only handle a limited number of hours of work, school or social activities. They've learned the importance of keeping a consistent schedule and find that it becomes helpful to stick to that schedule. Often times survivors in this phase begin to use words like "the old me" and "the new me." Many of their old friends are no longer with them but they've found new friends. They've moved on to new relationships, new schools or maybe even new work. When they do, they begin to accept the challenge of acceptance and healing. 

Healing is no easy task for TBI survivors or their families. It can be a very daunting challenge at times but given proper treatment and time, many people will see improvements. One of the most difficult things to handle is that many TBI survivors won’t have scars or physical problems but will suffer from the emotional recovery of the brain. Often time’s people who seem fine to the outside world have greater emotional problems. These emotional phases may not reflect everyone’s experiences but have a powerful correlation between TBI survivors and head injury recovery.