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Acquired brain injury (ABI) accounts for more than 355,000 hospital admissions a year, according to Headway. This is a 12% increase since 2005. Males are 1.5x more likely to be admitted to hospital with a head injury but there has been a 28% increase in hospital admissions for females since 2005. These statistics show an alarming rise in ABIs in a short time and include a spectrum of factors like non-superficial head injuries, encephalitis, brain tumours, stroke and other conditions. With so many ABIs, it’s obvious that more support will be required to deal with the emotional and psychological impacts. Knowing causes and types of ABIs is important for understanding their impact.
Unlike congenital brain disorders, ABIs can stem from diverse causes and result from medical conditions or trauma. Traumatic brain injuries (TBIs) are a type of ABI that occur due to falls, accidents or sports injuries. Non-traumatic injuries are those that derive from infections, tumours, oxygen deprivation and stroke.
Examples of ABIs
Here are some examples of types of acquired brain injury. This list isn’t exhaustive.
| Traumatic Brain Injury (TBI) | Cause: A sudden, external force to the head. They occur due to falls, car accidents, sports injuries or physical assaults. Characteristics: Severity can range from mild (concussion) to severe. There can be long-term cognitive, physical and emotional impairments. Symptoms: Headaches, memory loss, confusion, dizziness, mood changes and loss of consciousness. |
| Stroke | Cause: A disruption of bloody supply to the brain, either due to a blood clot (ischaemic stroke) or bleeding (haemorrhagic stroke). Characteristics: Damage in the affected area of the brain, resulting in a range of physical and cognitive deficits. Symptoms: Sudden numbness or weakness, difficulty speaking or understanding speech, severe headache and vision problems. |
| Anoxic Brain Injury | Cause: A lack of oxygen to the brain due to suffocation, drowning or cardiac arrest. Characteristics: Damage to brain cells due to deprivation of oxygen. Symptoms: Cognitive impairment, memory loss, difficulty concentrating, coma or persistent vegetative state. |
| Hypoxic Brain Injury | Cause: Similar to an anoxic injury but involves reduced levels of oxygen rather than complete deprivation. Characteristics: Brain damage due to insufficient oxygen. Symptoms: Cognitive deficits, changes in behaviour and motor impairments. |
| Infectious diseases | Cause: Certain infections like encephalitis or meningitis can cause inflammation and damage. Characteristics: Cognitive deficits, seizures and neurological impairments. Symptoms: Headache, fever, stiff neck, altered mental state and neurological symptoms. |
| Brain tumour | Cause: Abnormal growth of cells in the brain. Characteristics: Damage by pressure on surrounding brain tissue. Symptoms: Headaches, seizures, changes in personality or behaviours, cognitive impairments and neurological deficits. |
| Aneurysm | Cause: Weakening of a blood vessel wall, leading to a bulge that can rupture and cause bleeding in the brain. Characteristics: Damage to brain tissue and impairments depending on extent and location of bleeding. Symptoms: Sudden, severe headache, nausea, vomiting and neurological deficits. |
Emotional challenges faced by survivors
Acquired brain injuries disrupt more than the physical function of the brain. They also have an impact on the emotional wellbeing of the person affected. Survivors often have to deal with emotional challenges and each one poses unique obstacles to recovery.
Depression
One of the most common emotional challenges faced by those with an ABI is depression. The alterations in brain function as well as the potentially life-changing consequences of the injury itself can trigger feelings of hopelessness, sadness and isolation. Coping with changes to lifestyle or ability can seem overwhelming. This contributes to the development of symptoms of depression.
Anxiety
Another common emotional hurdle is anxiety. The uncertainty surrounding recovery, fears of complications and adjusting to a new normal can cause anxiety to heighten. Cognitive deficits resulting from the injury can also lead to difficulties in information processing. This can intensify feelings of apprehension and unease further.
Grief and loss
ABI survivors often have feelings of grief and loss as they mourn the life they used to have. The loss of cognitive abilities, independence and even relationships can evoke strong emotions. Coming to terms with profound life changes requires support and understanding. This also extends to their loved ones supporting them through these changes.
Mood swings
Mood swings are common in ABI survivors. There can be irritability and emotional liability due to neurological changes caused by the brain injury. These mood swings can pose challenges in relationships and managing them with understanding is crucial for recovery.
Self-esteem problems
Changes in cognitive abilities, functional independence and even physical appearance can impact on a person’s self-esteem. Survivors of ABIs often struggle with self-identity and self-worth as they face challenges to accept their new reality.
Recognising and addressing the emotional challenges of ABIs is integral to a comprehensive approach to recovery. Psychosocial interventions, counselling and support groups can be crucial in aiding survivors to understand their emotions and build resilience as they adjust to their new circumstances.
Psychological effects and coping strategies in acquired brain injury survivors
ABIs have psychological consequences that often affect cognition and personality. Understanding the effects of these is important for tailoring rehabilitation and supporting survivors to regain function or a sense of normalcy in their lives.
Cognitive changes after ABIs
After an ABI, there can be several cognitive impairments that affect memory, attention, thinking and problem-solving. It can be common to struggle to process information, maintain focus and organise thoughts. Rehabilitation that includes strategies to develop cognitive skills is important.
Memory impairments
A common psychological effect of ABIs is memory deficits. This could be an impairment of short-term or long-term memory loss both of which can impact the person’s ability to learn and their daily functioning. Memory aids, external reminders and mnemonic devices (acrostics, acronyms, rhymes, etc.) are some of the memory rehabilitation tools used to compensate for acquired impairments following a brain injury.
Executive dysfunction
Executive functions are responsible for impulse control, decision-making and planning. These may be compromised by an ABI. Cognitive rehabilitation helps improve executive functioning through exercises and strategies. These could include breaking down tasks to make them more manageable, for example.
Personality changes
ABIs can cause alterations in behaviours and personality traits. Survivors can show increased irritability and impulsivity or have less inhibition. Coping strategies include psychoeducation, support groups and counselling to help the person and their families to understand the changes and learn how to adapt.
Adjustment disorders
When a person is forced to adapt to life following an acquired brain injury, this can trigger an adjustment disorder. These are characterised by behavioural and emotional difficulties. Psychotherapy like cognitive behavioural therapy (CBT) can help people to address maladaptive thought patterns to foster healthier coping mechanisms.
Coping strategies
There are many coping strategies to support rehabilitation available to individuals following ABIs. These include:
- Rehabilitation programmes: These comprehensive programmes work to address both the physical and mental aspects of ABIs. They are supervised by a multi-disciplinary team to improve functional abilities and promote independence.
- Psychoeducation: This teaches survivors and their loved ones about ABIs and what to expect from their specific injury. It will detail the psychological effects and the resources available to support their recovery. Psychoeducation empowers survivors to participate in their own recovery and rehabilitation.
- Counselling and psychotherapy: Individual therapy as well as family counselling can help people to navigate the psychological challenges associated with an ABI. These activities provide a safe space where individuals can explore their emotions and develop coping strategies to help them adjust and recover.
- Support groups: These help many survivors to connect with others who have experienced similar challenges. This provides a sense of community and understanding. Sharing coping strategies and stories in this way can be beneficial.
- Mindfulness and relaxation techniques: Incorporating mindfulness exercises like meditation and deep breathing can help survivors to manage the stress and anxiety associated with their acquired brain injury. It also helps improve their overall wellbeing.
The role of support systems and therapy
Acquired brain injuries present complex challenges. Those who acquire these injuries need robust support systems in place to aid their recovery and help them to adjust to their life post-ABI. This support system should include family and friends as well as healthcare professionals. The networks play an important role in providing the necessary emotional, psychological and practical support throughout the process of rehabilitation and beyond.
Emotional support
Support from family and friends is crucial for ABI survivors. Dealing with the aftermath of a brain injury includes a huge range of emotions. These include frustration, grief and anxiety. A supportive network of people who understand and validate emotions is needed. This emotional support speeds up the recovery process.
Practical assistance
In the early days following the ABI, less support is needed as the person recovers in hospital. However, individuals are likely to need support systems that offer practical assistance once they return to their own homes. Support with daily activities, tasks and transportation is likely to be needed, depending on the nature of the ABI and individual circumstances. Practical assistance helps survivors maintain a sense of independence and, if delivered correctly, reduces the burden associated with transitioning to life after an ABI.
Rehabilitation
Healthcare professionals like physiotherapists and occupational therapists are an integral part of the support system needed after an acquired brain injury. Collaborative efforts between healthcare professionals, survivors and their families help improve outcomes for patients. Working together to develop and implement comprehensive rehabilitation that addresses the physical, cognitive and psychological aspects of recovery is crucial.
Counselling and psychotherapy
Mental health professionals contribute significantly to support systems following an ABI. Interventions in mental health help survivors and their loved ones to navigate the emotional side of recovering from an ABI. They help people to develop adaptive coping strategies and build resilience.
Education and advocacy
People’s support systems are often the ones who take a leading role in advocacy for survivors. It’s important they receive all of the necessary information and resources so that survivors have appropriate arrangements. Through education, friends, family and the wider community can learn more about ABIs and so adapt to be more understanding and inclusive.
Peer support
The importance of support from other survivors cannot be underestimated. When other survivors share their experiences, it can be invaluable to those who are just at the start of their recovery. Mutual understanding in support groups creates a sense of community, thus reducing feelings of isolation and providing practical insights into coping strategies.
Planning for the long term
Most ABIs require support for recovery long term. Support systems are critical in this regard. Long-term planning includes consideration of ongoing medical care needed, vocational rehabilitation and the development of strategies to address changing needs during recovery and rehabilitation.
Final thoughts: Resources for individuals affected by acquired brain injuries (ABIs)
Recovery from an ABI requires comprehensive support. For those navigating the challenges presented by an ABI, here are some resources for further assistance and information:
- Headway: This brain injury association is a charity supporting those directly affected by brain injuries, including their carers. They have a support line, online communities, an emergency fund, local groups and branches, and offer legal advice and care to those affected by brain injuries.
- The Brain Charity: This charity provides practical help on living with a brain injury. They also offer emotional support like counselling, phone befriending and group therapy. There are also social activities too. The charity is based in Liverpool, but its support extends throughout the UK.
- Brainkind: This is a charity helping people thrive after a brain injury. They offer rehabilitation and ongoing support to ensure life after injury is as good as possible. Brainkind has a network of services, including supported living centres and residential care.
- Brain Injury Group: This is an organisation helping people bring brain injury claims and manage compensation.
- Brain Injury is BIG (B.I.G.): This organisation helps carers who look after people with severe brain injuries. There is an online discussion forum and helpline.
- Brain & Spine Foundation: This is a charity providing support to those affected by brain and spine conditions, including ABIs.
- UKABIF: This is the United Kingdom Acquired Brain Injury Forum, which is a membership organisation and charity promoting the understanding of ABI. There are regional support groups too.
