Acquired Brain Injury System Navigation of Southeastern Ontario

Mental Health

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When Mental Health and Brain Injury Overlap

Although the presentation of some mental health issues can be difficult to differentiate from the effects of an ABI, the two are not addressed the in the same way.  While issues relating to brain injury remain generally stable or improve over time, mental health symptoms may have a onset that post-dates the injury, or display symptoms that come and go depending on mood.  Those living with an ABI are often more vulnerable than the general population to mental health disorders such as anxiety, post-traumatic stress disorder, and depression (   It should be noted that the severity of the ABI is not correlated to the likelihood of a concurrent mental illness.  Many individuals who have sustained what would be deemed a mild brain injury face their first onset of depression in the days that follow.

Causes & Diagnosis

Often this is most noticeable to those closest to the person with an ABI; family, friends, and support workers.  Sometimes these comorbidities pre-date the injury, at other times the brain changes may trigger issues which did not previously exist.  The trauma, loss of ability, and social connection many face following an injury can also trigger symptoms of anxiety and depression.  The injury often places a strain within family systems, causing stress, fear, or tension.  Changes to the brain can trigger biochemical changes and difficulty with the regulations of body systems such as the endocrine system, which left untreated, can manifest themselves in mental health issues.

Complaints may include that the individual is not able to cope as they had at an earlier time, or have noticed changes in behaviour or abilities.  By asking the right questions and looking to the root of the issue and not the presentation, it is often possible to distinguish with some probability whether a mental health issue should be considered.


Questions to Ask the Survivor and Family Members, If Possible:


  • Were there mental health or addictions issues prior to sustaining the brain injury?
  • Have you noticed changes in your ability to do things you had been able to do since the time of injury?
  • Have there been any behavioural concerns or irritability?  What were the triggers?
  • Have you noticed  changes in: grooming, appetite, sleeping habits, pain, concentration, attention, or memory? (Consider that the although these areas may be impacted as a result of the injury they are still subject to change in the event of a mental health issue)
  • Have you been able to engage in activities you enjoy at home, or in the community?  Assess for feelings of loss related to injury.
  • Has the injury affected your family members?  How well do you feel you are supported and understood?
  • Have you experienced recurring thoughts of the accident or fears that something similar could occur again?



It is generally recommended that a biopsychosocial approach be taken in the treatment of mental health issues in the ABI population.  Medications should be considered where appropriate, while accompanied by supports to engage the individual in the community and activities as much as possible.  Counselling is advisable not only to the affected individual, but their family members as well, to enhance coping abilities within the family unit.  Finally, steps should be taken to maximize the individuals’ physical health through balanced diet and regular exercise, as these factors have been demonstrated to impact positive outcomes.

Additional Resources

Many resources are available which provide further education on brain injury for physicians and caregivers.  Please visit our Research and Learning Links section or contact us directly to request a consultation.


ABI System Navigation of Southeastern Ontario

303 Bagot Street LaSalle Mews, Suite 401 Kingston, Ontario K7K 5W7


Michelle Pangilinan,
ABI-SEO System Navigator

613-547-6969 ext. 165
[email protected]

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