Sustaining a traumatic brain injury can be a challenging experience. You probably felt angry, demoralized, helpless, and even hopeless in the days following your injury. For some people, these feelings eventually subside and disappear — but that didn't happen for you.
First, know that you are not alone: Up to 30% of concussion patients have long-lasting symptoms after their head injury. This is referred to as post-concussion syndrome (PCS) and may include symptoms such as brain fog, headaches, nausea, memory problems, and blurry vision.
Over 80% of our post-concussion syndrome patients report “personality changes” and mental health problems such as depression, post-traumatic stress disorder (PTSD), irritability, tearfulness, and more.
For some, the list of symptoms also includes suicidal thoughts. Suicidal ideation can be overwhelming and terrifying, or at the very least, unsettling. But it’s important to know that these thoughts don’t come from you; they are a side effect of your brain injury. The concussion you suffered can distort your thinking and emotions, so it becomes harder to see different solutions and find a way to move forward.
No matter how long you’ve had suicidal thoughts and feelings, this doesn’t have to be a permanent state. With the right help, you can improve, just like the many other brain injury patients who have gotten help before you.
The crucial point here is to find the right help to treat both your mental health and physical symptoms. Treating your brain injury will go a long way to make you feel better. In the meantime, it’s very important to address your suicidal thoughts.
Don’t let anyone tell you that you can get over these thoughts by simply wishing them away or “toughening up.” Depression and suicidal feelings can be treated by a doctor, just like diabetes or high blood pressure. Therapists, counselors, psychologists, and the treatment team at Cognitive FX can help you find solutions that otherwise may not be obvious to you.
In this article, we’ll explain what could be causing your suicidal feelings and putting you at a risk of suicide, as well as suggest ways to cope and move forward with the right treatment. We cover:
Over 80% of our patients have experienced emotional symptoms after a concussion. Many of those symptoms resolve shortly after treatment at our clinic (although serious mental health issues such as depression and anxiety can take additional therapy to resolve). If you’d like to learn more about how we can help you, schedule a consultation.
Note: Any data relating to brain function mentioned in this post is from our first generation fNCI scans. Gen 1 scans compared activation in various regions of the brain with a control database of healthy brains. Our clinic is now rolling out second-generation fNCI which looks both at the activation of individual brain regions and at the connections between brain regions. Results are interpreted and reported differently for Gen 2 than for Gen 1; reports will not look the same if you come into the clinic for treatment.
If you're feeling overwhelmed by suicidal thoughts and you have strong urges to take your own life, get help immediately.
Want to hear from another survivor? Anthony Loubet, an attorney and father of six, suffered from severe depressive episodes after his traumatic brain injury (TBI). His symptoms were so bad that he was afraid he’d never work again. After recovering, he’s able to work and feel fully present to his family. The experience gave him a new view on life, and he now takes more time to slow down, take care of himself, and enjoy each moment to the fullest.
These feelings only started after the head injury. Sometimes you may be able to ignore them, but other times they stick around in your mind. Many people before you have had suicidal thoughts at some point after a concussion.
For some, they’re just fleeting thoughts of falling asleep and never waking up, while others make intensely detailed plans. Studies show that having suicidal thoughts is seven times more common in PCS patients than in the general population.
There are many risk factors that contribute to these thoughts and feelings as a consequence of a brain injury, and it varies immensely from person to person.
A brain injury — especially if it has long-lasting consequences — can be emotionally traumatic. Difficulties often arise as patients struggle to adjust to their new reality, even if the concussion symptoms are just temporary.
Patients often feel helplessness and hopelessness, especially when their injury wasn’t their fault (or was an accident that could have happened to anyone). Being told that their issues are “all in your head” by friends or doctors can further compound these emotions.
A traumatic brain injury alters the way the brain works, making it difficult for survivors to do things they used to be able to do easily. This could include sports, hobbies, playing with their kids, and even communicating with loved ones.
To make things worse, issues such as losing a job or a change in family dynamics can create feelings of hopelessness, irritability, and frustration. Some patients react with mood swings and outbursts of anger, while others may become sad and withdrawn.
As these patients realize they’re unable to return to their pre-injury lifestyle, the added stress of coping with post-concussion symptoms such as headaches, dizziness, and cognitive issues put patients at increased risk for suicidal thoughts.
It’s important to note that you’re feeling like this because your brain is trying to protect itself. Our brain has two systems to control how we react with the environment around us: the behavioral activation system, and the behavioral inhibition system.
Under normal circumstances, the behavioral activation system is more prominent. It helps us feel rewarded for learning a topic or enjoying a new activity.
However, the behavioral inhibition system also monitors everything we do, particularly if we experience a loss or a negative emotion. If the losses start adding up — as it may happen in the aftermath of a brain injury — it can block the behavioral activation system.
And once the behavioral inhibition system is in control, it stops you from feeling any pleasure or reward from something you used to enjoy before the injury, in an effort to protect you from further losses. As a result, you can feel like you’ll never get better, which then triggers suicidal thoughts.
We often have patients surprised at how they can’t feel anything — even toward their children — and how everything post-injury becomes so robotic.
If you want to find out more about these two systems, we’ve written about them in more detail here.
Suicidal thoughts may also result from a direct impact on the areas of the brain that control emotions, memory, and executive skills. Studies have shown that concussion patients who go on to develop depression and suicidal thoughts are much more likely to experience damage to the hippocampus (which plays essential roles in emotion and behavior), and to the orbitofrontal cortex (a region involved in the cognitive process of decision-making).
We have seen this first hand. For example, about 63% of the patients we treat at Cognitive FX have abnormal fMRI scans in at least one of their hippocampi. We know this damage occurs because brain injuries disrupt normal blood flow within the brain.
As a result, some parts of the brain — such as the hippocampus — don’t receive enough oxygen to complete a particular task, such as forming a long-term memory or knowing how to behave in a social situation. Other parts of the brain may try to compensate, but it’s often not very effective. This is known as neurovascular coupling dysfunction and is one of the root causes of post-concussion symptoms, including suicidal thoughts.
Recent evidence shows that concussions may also affect the brain’s functions by inducing an inflammatory reaction.
Researchers in the UK found signs of neuroinflammation in depressed patients with suicidal thoughts, but not in depressed patients who weren’t suicidal. The most dramatic changes were observed in an area called the anterior cingulate cortex, where mood regulation happens — which may explain the suicidal feelings. These results raise hope for a potential target for treatment in the future to keep these feelings under control.
Hannah was feeling suicidal after four concussions and 10 years of dealing with post-concussion syndrome. Her symptoms got a lot worse after the fourth injury, and Hannah started experiencing constant headaches, a rage that she could not control, and suicidal thoughts. Hannah noticed massive improvements in how she felt almost immediately after her treatment and believes that getting treated for post-concussion syndrome was the best investment she could have made for herself.
So far, we’ve mentioned the higher risk of suicidal thoughts due to a head injury in patients with no history of depression or suicidal feelings.
However, there is another aspect of the story that’s worth considering: suicide attempts as the cause for the brain injury, not just the result. Sadly, patients experiencing depression or other mental health disorders can obtain a brain injury as a consequence of their suicide attempts. In this situation, addressing the patient's mental health alongside treating the brain injury is paramount for recovery.
Treating a traumatic brain injury can be challenging by itself, and adding these feelings will only make this process even more difficult. However, it’s important to remember that it’s not impossible. Your suicidal thoughts can be addressed during recovery by working with your healthcare provider to build a well-rounded approach to your treatment.
Note: Over 80% of our patients have experienced emotional symptoms after a concussion. Many of those symptoms resolve shortly after treatment at our clinic (although serious mental health issues such as depression and anxiety can take additional therapy to resolve). If you’d like to learn more about how we can help you, schedule a consultation.
While it may seem that these suicidal thoughts are going to stay with you forever, they are usually not permanent. With the proper treatment, you will feel better again.
In the meantime, here are some ways to help you cope with your feelings.
Each patient with a brain injury is different. This makes treatment complex and challenging, to say the least. Many programs use the same two to three types of therapies for every patient, which works for some but not others.
At Cognitive FX, we follow a different approach. We know that concussions can have an impact on different parts of the brain. Knowing which areas are affected means we can customize treatment for each patient.
That’s why we start our patient evaluation with a fNCI scan. This particular type of scan permits us to identify which areas are affected by a brain injury so we can tailor treatment accordingly.
During our EPIC treatment (short for Enhanced Performance in Cognition), we use a combination of exercise and multiple types of therapy, including cognitive, neuromuscular, occupational, and sensorimotor therapy, to name just a few.
Patients also meet with a psychologist at least twice during treatment, and for those showing signs of depression or suicidal thoughts, further appointments may be scheduled.
The therapist conducts a psychological assessment to establish what may be causing your suicidal thoughts and any emotional symptoms, along with recommendations for how you can keep recovering after treatment.
At the end of the treatment period, patients get a second scan to find out how their brains improved. On average, we see improvements of over 75%, and if patients follow their homework, they experience further improvements at home.
During our EPIC treatment, we primarily focus on resolving brain dysfunction. For some patients, treating their post-concussive symptoms (such as headaches or sleep issues) has a significant impact on how they feel. In this case, it’s likely their feelings were the result of physical changes to the brain caused by the injury, and addressing these changes is enough to eliminate any mental health symptoms relatively quickly.
For other patients, recovery is not so straightforward. Treatment of post-concussion symptoms is still a step in the right direction, but these patients may need additional therapy to work through their feelings. In this case, we can refer you to a psychologist in your area to help you with any problems you may be having.Unlike friends and family, psychologists can show you effective and practical strategies for addressing suicidal thoughts, depression, anxiety, and any other mental illness over time.
Antidepressants, anti-anxiety and antipsychotic medications, as well as other medications for mental illness are often used to reduce symptoms, which can help patients feel less suicidal.
However, this may not be the best option if you also have to contend with a brain injury. For example, with antidepressants, there is still some division amongst scientists as to whether they should be used or not: Some studies say they’re effective, while others suggest they’re not. The use of antipsychotics to treat a brain injury is also controversial. Studies suggest they cause excessive drowsiness, exacerbate cognitive deficits, and inhibit neuronal recovery.
Each case is different, and use of medication should be considered carefully between you and your doctor. It may work for some patients but not others. If we had to make a general recommendation, it would be to see medication as a last resort after you’ve undergone treatment for your post-concussion syndrome and tried psychotherapy. If you decide to go down this route, it’s important to find a doctor that understands your post-concussion syndrome and can distinguish between PCS symptoms and side effects from the medication.
Some patients see marked improvements after EPIC treatment, while others may take a little longer. If that’s the case for you, suicidal thoughts may not go away immediately, and you need to be prepared to deal with them during your recovery.
Here are some of our suggestions to help you during this period:
Click here to watch Cayci’s story: According to her mother, Cayci started developing concussion symptoms, but they couldn’t pinpoint exactly when the injury occurred. Their best guess was from a very mild bump in the car, but it caused no symptoms at the time. Months later, Cayci was struggling with life and started to think it wasn’t worth living. The young woman found Cognitive FX through a friend and started feeling improvement almost immediately during her EPIC week.
For some, recovering from a head trauma can be overwhelming, while others may see it in a more positive way. Everyone is different, and there is no “normal” recovery journey.
However, whether your loved one is feeling apprehensive or a little more upbeat, it’s crucial you support them during this period. This can be anything from helping with shopping trips, to being a patient listener, to providing financial support while they get back on their feet.
Learn to adapt to what they can do. A concussion doesn’t mean they stop enjoying activities you did together, but you may just have to do things differently for a while.
Above all, if they open up to you, don’t brush off their feelings or ignore what they’re saying. This is particularly important if you’ve noticed any behavior or personality changes that may indicate they’re having suicidal thoughts. This could include, for example, having dramatic mood swings or engaging in reckless and impulsive behavior.
Even if you’ve been fighting with suicidal thoughts for a long time, you are not alone.
Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) for 2019 showed that 12 million Americans seriously thought about suicide, and 3.5 million even had a plan.
Most people who have suicidal thoughts do not actually act on these feelings and never attempt suicide, but nevertheless, these should never be ignored. Many people before you have gone through the same difficulties and were able to recover and improve their quality of life.
Remember, suicide is an irreversible solution to a temporary problem. It may be difficult to see it at the moment, but the feelings you have now are short-lived. With the right medical attention, you won’t always feel like this.
Note: Over 80% of our patients have experienced emotional symptoms after a concussion. Many of those symptoms resolve shortly after treatment at our clinic (although serious mental health issues such as depression and anxiety can take additional therapy to resolve). If you’d like to learn more about how we can help you, schedule a consultation.
Everyone’s experience is different. Anyone experiencing a concussion or TBI has a different story, different outlook on life, and different symptoms, their experience of EPIC Treatment is going to be...
