Brain Injury and Psychiatric Symptoms
Abstract: Clients who are thought to have psychiatric illness, like depression or problems with concentration, may have traumatic brain injury. Psychiatric treatment may relieve some symptoms but there may be over riding issues that need to be addressed to assure that appropriate treatment is being provided.
I just read in the January 7,2006 USA today, about a soldier in Iraq who suffered a concussion after a bomb explosion. It was the third time in his life that he had suffered a concussion. The article quotes Deborah Warden, who is the director of the Defense and Veterans Brain Injury Center, which is part of the Department of Veterans Affairs and the Pentagon as saying that although mild brain injuries may not cause severe damage, repeated injuries could cause permanent damage. The article reports that symptoms of brain damage are: “slow thinking, headaches, memory loss, sleep disturbance, attention and concentration deficits and irritability”.
This article brings to mind client that I evaluate from time to time. One particular client, a 28 year old male, who was divorced from his wife, walked in asking for a psychiatric evaluation. He said he was sad. He lives in the area but reports that he is continually confused, he has memory problems, is slow thinking and acts bizarrely. He just wanted to feel happy again.
He is well noted in the clinic, because a young female case worker was attempting to assist him with obtaining health benefits and the patient asked her out and when she told him she couldn’t because it would be inappropriate, he persisted, to the point where I needed to intervene. During his evaluation I learned that the patient suffered a head injury when he was a child and was struck in the head with a back hoe when he was working in construction a few years ago. Then, his symptoms appeared to become much more severe when he was in a car accident and struck his head on the wind shield. These separate events were evaluated and the patient reports that he was never advised that his injuries had caused mental defects. When his father came in for a follow up evaluation; the father was surprised that the patient was being considered for psychological testing and a neurological evaluation. The father told me, “He’s always so sad and angry, but we just thought he was depressed.”
Summary: Psychiatric professionals should evaluate for any history of brain injuries when evaluating clients. All to often, I find that due to a variety of issues, questions about brain trauma, head aches and seizures are not asked and this could be a serious dis-service to the client. It could result in inaccurate or inappropriate treatment.
I just read in the January 7,2006 USA today, about a soldier in Iraq who suffered a concussion after a bomb explosion. It was the third time in his life that he had suffered a concussion. The article quotes Deborah Warden, who is the director of the Defense and Veterans Brain Injury Center, which is part of the Department of Veterans Affairs and the Pentagon as saying that although mild brain injuries may not cause severe damage, repeated injuries could cause permanent damage. The article reports that symptoms of brain damage are: “slow thinking, headaches, memory loss, sleep disturbance, attention and concentration deficits and irritability”.
This article brings to mind client that I evaluate from time to time. One particular client, a 28 year old male, who was divorced from his wife, walked in asking for a psychiatric evaluation. He said he was sad. He lives in the area but reports that he is continually confused, he has memory problems, is slow thinking and acts bizarrely. He just wanted to feel happy again.
He is well noted in the clinic, because a young female case worker was attempting to assist him with obtaining health benefits and the patient asked her out and when she told him she couldn’t because it would be inappropriate, he persisted, to the point where I needed to intervene. During his evaluation I learned that the patient suffered a head injury when he was a child and was struck in the head with a back hoe when he was working in construction a few years ago. Then, his symptoms appeared to become much more severe when he was in a car accident and struck his head on the wind shield. These separate events were evaluated and the patient reports that he was never advised that his injuries had caused mental defects. When his father came in for a follow up evaluation; the father was surprised that the patient was being considered for psychological testing and a neurological evaluation. The father told me, “He’s always so sad and angry, but we just thought he was depressed.”
Summary: Psychiatric professionals should evaluate for any history of brain injuries when evaluating clients. All to often, I find that due to a variety of issues, questions about brain trauma, head aches and seizures are not asked and this could be a serious dis-service to the client. It could result in inaccurate or inappropriate treatment.
posted by Eric Malz at 3:40 AM
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