Unveiling the Hidden: Recognizing Personality Changes After Mild Traumatic Brain Injury 

March is National Brain Injury Awareness Month. According to the Centers for Disease Control and Prevention (CDC), approximately 1.5 million Americans experience a traumatic brain injury each year, with mild traumatic brain injury (mTBI) comprising a substantial portion of these cases (CDC, 2022). 

Many of us working in the healthcare field have dealt with individuals with physical and cognitive challenges after a traumatic brain injury. However, one concern that often flies under the radar but is crucial for us to understand and address is personality changes following an mTBI. Often, these are the ones that walk away after a fall to the ground or some impact to the brain and have no apparent physical impairment. They return home, to work or school, to their regular daily routine, but something is off. 

Let’s explore why these changes matter and why they might slip through the cracks of our care. 

What exactly do we mean by personality changes? They can manifest in various ways, from alterations in mood and emotional regulation to shifts in social interactions and cognition. Think of it as a subtle yet significant transformation in how the individual perceives and engages with the world around them. 

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These changes can be missed easily and often misdiagnosed as psychiatric disorders or go untreated. One reason is that they can be subtle and gradual, making them less conspicuous compared to the physical symptoms typically associated with mTBI, such as headaches or dizziness. Moreover, the individual might not recognize or report these changes, attributing them to stress or other factors. 

Additionally, personality changes following mTBI can be masked by overlapping symptoms of other conditions, such as depression or anxiety, further complicating the diagnostic process. As care providers, we’re often juggling multiple tasks and responsibilities, and it’s easy to overlook these nuances amidst the hustle and bustle of our healthcare settings. 

Recognizing and addressing personality changes is essential for comprehensive care following mTBI. These changes may not be apparent right away and can significantly impact the person’s quality of life, relationships, and overall well-being. From increased irritability and impulsivity to social withdrawal and apathy, they can disrupt daily functioning and hinder rehabilitation efforts. 

Mild TBI represents a significant public health concern with far-reaching implications for individuals, families, and communities. Nurses, case managers, and healthcare professionals stand at the forefront of addressing this challenge, armed with knowledge, compassion, and a commitment to excellence in care delivery. It starts with adopting a holistic approach to assessment and care. Beyond conducting standard cognitive evaluations, we must also screen for emotional and behavioral changes and make appropriate neuropsychologist referrals.   

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Furthermore, fostering open communication with the individual with the injury and their families is paramount. Encourage them to share any concerns or observations regarding changes in personality or behavior, no matter how small they may seem. Educate them about these changes so they understand that the unwelcome behaviors may be due to the mTBI and not the person. Remember, our role isn’t just to treat symptoms; it’s to support the whole person on their journey to recovery. 

Incorporating multidisciplinary collaboration is another key strategy. By working closely with neuropsychologists, psychiatrists, and other specialists, we can gain valuable insights into the complex interplay between brain injury and personality changes, facilitating tailored interventions and support strategies. 

Not everyone with a mTBI exhibits personality changes. When these changes happen, it is more than just a footnote in a person’s medical history – they’re integral pieces of the puzzle that deserve our attention and care. By sharpening our awareness, enhancing our assessment skills, and fostering collaborative partnerships, we can ensure that no personality change goes unnoticed, misdiagnosed, or untreated.  

To learn more about TBI and related conditions, please refer to our catalog on Brain Injury. 

CareerSmart® Learning knows the value of a well-supported, well-educated, well-prepared healthcare workforce. We maintain various accreditations by professional licensing and certification organizations and offer CE or contact hours to Nurses, Certified Case Managers, Certified Rehabilitation Counselors, Certified Disability Management Specialists, and Social Workers nationwide.

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