Defining Post-Concussion Irritability:
Post-concussion irritability can be thought of as persistent difficulty controlling emotions or experiencing strong mood swings. The feeling has been described as “an emotional roller coaster ride” where an individual’s emotions shift swiftly from happy to sad and then angry. These emotions change quickly and can be brief.
Why Does Irritability Occur?
Post-concussion irritability can be attributed to several factors. The primary explanation postulates that irritation occurs due to an injury induced disturbance to the areas of the brain that control emotional expression. However, alternate theories explain irritability as the result of difficulties faced in everyday life following a concussion. They suggest that the pain, exhaustion, memory difficulties and overall changes to one’s lifestyle can worsen the emotional toll of a concussion.
A recent study on post-concussive symptoms in adolescents suggested that irritability may also be a potential indicator that an individual is not recovering well. If irritability arises as a symptom in the subsequent months following a concussion, it may be the body’s way of conveying a larger issue.
How Does Irritability Affect Everyday Life?
A 2012 study revealed that 15-20% of individuals who suffer from a concussion experience irritability 3-12 months post-injury and 30% struggle with irritability past the 1-year mark. Many of the individuals who participated in the study said that irritability and aggression were among the top reasons for delaying returning to work, failing to achieve optimal levels of performance, stress in the home, and feeling a loss of independence.
When the families of these individuals were studied, they notably reported instances of irritation more frequently than the concussed individual themselves. Irritability was recognized on a scale of annoyance to verbal aggression, and quite often the concussed individual was not self-aware of these heightened emotions. This was congruent with prior studies which found that post-concussive patients may suffer from an impairment of self-awareness.
It can become challenging to mediate post-concussion irritability, when the individual and their family are perceiving different scenarios. For the concussed individual it may feel like you are isolated, depressed or misunderstood and for the family it may result in aggravation or frustration, especially when it seems as though the concussed individual is not understanding the impact of their actions. Post-concussion irritability forces both the concussed individual and their family to restructure their attitudes and responses, in order to get through everyday life.
What Can Be Done About Irritability Problems?
The most viable strategy for dealing with post-concussion irritability is utilizing self-calming strategies, relaxation and communication methods; tools rooted in anger management treatment. Working with a psychologist or mental health professional may also be an asset. In some instances, medication may also help to minimize the deleterious effects of post-concussion irritability.
It can also be beneficial for post-concussion patients to have support and understanding from their loved ones.
Loved ones are advised to:
- Refrain from arguing with the concussed individual during an outburst; the emotion will likely pass quickly, if given a moment to cool down.
- Establish ground rules for efficient communication; the concussed individual should understand what is and is not acceptable behaviour.
- Following an outburst, discuss what might have triggered the irritability.
References:
Dan, Y. H. D., Combs, H. L., Koehl, L., Camargo, F. C., & Mattacola, C. G. (2017). Irritability and aggression in persistent youth concussions. British Journal of Sports Medicine, 51(11), A17-A17.
Emotional problems after traumatic brain injury. (n.d.). Retrieved February 25, 2021, from https://msktc.org/tbi/factsheets/emotional-problems-after-traumatic-brain-injury
Kim, S. H., Manes, F., Kosier, T., Baruah, S., & Robinson, R. G. (1999). Irritability following traumatic brain injury. The Journal of nervous and mental disease, 187(6), 327-335.
Yang, C. C., Hua, M. S., Lin, W. C., Tsai, Y. H., & Huang, S. J. (2012). Irritability following traumatic brain injury: divergent manifestations of annoyance and verbal aggression. Brain injury, 26(10), 1185-1191.