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Personality Changes After a Brain Injury or Concussion
Dr. Alina Fong PhD

By: Dr. Alina Fong PhD on January 6th, 2020

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Personality Changes After a Brain Injury or Concussion

Mental Health Support After a Brain Injury  |  Brain Injury Awareness  |  Education & Resources

Did you know personality changes are not uncommon following a traumatic brain injury? After all, how we think and process the world is so much of who we are. Our temperament is virtually the way our brain explains the world around us. With a brain injury, the way we process and understand information will be disrupted. So we should not be surprised that our personality can change after a concussion.

Personality changes can originate from two sources following a brain injury:

  1. Specific physiological changes in how the brain experiences, understands and expresses emotions. Making it hard to understand our feelings, or process them fully. 
  2. Emotional reactions are a natural response to the changes in your life brought on by a brain injury.

Brain injuries can damage connections that go from the cerebral cortex (the part of the brain that has a role in memory, attention, perception, cognition, and awareness.) to the limbic system (the part of the brain that supports functions like emotions, behavior, and motivation). These connections allow us to evaluate our emotional reactions, understand how important events are, and decide on a response that meets the demand of the situation. When these connections are injured, the emotional response differs from what it was before the injury, and are not always in sync with the current situation. 

The hippocampus is a part of your brain that is known for converting short term memories into long term memories. Your memories advise how you respond to your environment or the world around you, including determining your emotional response (Zhu et al. 2019). The hippocampus is one of those brain regions most often affected by a concussion. About 63% of the patients we see at Cognitive FX have abnormal regulation in one or both of their hippocampi.

These changes make it challenging, not only for those who are injured but can also for those who love and care about the person who is injured. It is never easy to watch as someone you love and care about go through something difficult, and personality changes after a brain injury are changes that occur without warning and can be beyond our control.  

Psychiatric Obstacles After a Brain Injury

image of a brain icon in happy sad okay worried and angry moods

A brain injury is emotionally traumatic. People can respond with frustration, anger, anxiety, and depression to their changed capabilities and life circumstances. It is normal to mourn the life you once had and to try to find ways to cope with a new way of life and personality. These responses are affected by the impaired connections described earlier and can result in extreme emotional reactions. In a recent study, students who have experienced a concussion have a higher risk of self-harm, depressive symptoms, attempted suicide, injury from attempted suicide, and overall poorer mental health outcomes (Yang et al. 2019).

Many times because the brain is also staying in fight or flight mode, it is hard to help your mind and body to relax, because your brain is trying to help you survive this injury and what has happened. This response is how the brain reacts even for even “mild” TBI or concussion. Any injury to the brain while it may not look severe on the outside, it should be taken seriously. In a recent study, the suicide rate was almost twice as high among individuals with TBI than those without a brain injury. (Madsen et al. 2018). Any damage or injury to the brain can impact your life in significant ways, especially your personality, and the way you process emotions. 

Furthermore, if someone who has struggled with depression in the past sustains a concussion, the battle might be even more difficult. In a study by Bombardier et al. (2010), he reports that prior history of depression among patients correlated with higher post-TBI rates of major depressive disorder and that the rate of depression post-TBI is nearly eight times higher than the general population’s rate. Multiple brain injuries also increase the risk for depression and suicide (Byran and Clemans, 2013). Suicidal thoughts should not be taken lightly, please seek professional help if needed.

What To Do With These Emotions

image of a woman helping a younger woman work through feelings by writing them down and talking about it

Recognize the Emotion: There are many injury-related reasons for a person who has a brain injury to have problems managing emotions like frustration, anxiety, and anger. There are plenty of understandable emotional responses to all of the changes, and challenges that come with recovering from brain injury.

It is also vital for the family members and caregiver’s to understand that the emotional response serves a purpose for the person experiencing strong emotions, even if he/she are not able to tell you the meaning.

Figure Out The Cause: Discover what happened in that specific situation or conversation that triggered the outburst to occur. For example, becoming overstimulated by the noises and smells in a busy grocery store (Walmart). Understand the behavior response to the trigger (the overwhelming environment at Walmart). When overstimulated, the brain injury survivor may shout and quickly exit the store, pushing aside anyone in the way.

Pick an Approach to Process The Emotions: Find a new process that better fits your needs and helps those close to you understand what is going on. Try out new ways of communicating and sharing your emotions with family members and caregivers. Try new ways to help you find a way to better express yourself.

Here are some of our ideas: 

  • Improve Communication with these new strategies.
  • Getting Exercise can also help your body to release frustration or anger.
  • Journaling can also help you put your feelings into thoughts and bring clarity to the emotions you are processing.

There is Hope 


We know it can be frustrating to recognize that you are not who you were before. We want you to know that there is hope. While going back to exactly who you were before may not happen, you can, however, make significant improvements in your recovery. Progress is possible even if other doctors have told you differently. You have already taken a new step in improving your quality of life by reading through this blog. 

We want you to know that your quality of life can improve after a traumatic brain injury, and it’s important to remember that your emotions are just that— emotions. You that are entitled to your emotions, acknowledge them, process them and let them go, in a way that works best for you. Many of our patients experience this adjustment in personality, and you are not alone.

At Cognitive FX, we want to help you understand what is going on in your head, both with your brain injury, and how to improve the regions that are injured to recover. Throughout EPIC Treatment, based on patient PCSS reports, our patients improved on average in the emotional category by 65%. Please do not lose hope, and please know that there are options available, and people who care about you and what you are experiencing. To schedule a complementary consultation and understand how EPIC Treatment could benefit you, click on the get started button below.


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About Dr. Alina Fong PhD

Alina K. Fong received her PhD in Clinical Neuropsychology with an emphasis in neuroradiology from Brigham Young University. She received the national American Psychological Association Clinical Neuropsychology Division 40 Graduate Student Research Award in 2004 for her research on "Cortical Sources of the N400 and 'The N400 Effect." Dr. Fong's interest in brain mapping soon turned to functional MRI, and since then, her research efforts have been focused on the clinical applications of fMRI.