Depression After Traumatic Brain Injury (TBI)

Key Statistics

53% develop depression within 1 year (JAMA Psychiatry 2023)
Peak onset 6-12 months post-injury
40% better outcomes with combo therapy

Neurobiological Connection

TBI disrupts key depression-related pathways:

Prefrontal cortex dysfunction
Serotonin production ↓ 30-40%
Hippocampal volume reduction

Clinical Presentation

Emotional

Anhedonia (87% cases)
Emotional lability
Suicidal ideation (22%)

Cognitive

Executive dysfunction
Rumination cycles
Attention deficits

Somatic

Psychomotor retardation
Insomnia (78%)
Appetite dysregulation

Evidence-Based Treatments

CBT-Adapted

Memory aids integration
Shorter sessions (25 mins)
Caregiver involvement

Pharmacology

SSRIs first-line
Stimulant adjuvants
Therapeutic drug monitoring

Neuromodulation

rTMS protocols
tDCS applications
VNS options

Long-Term Management

Annual neuropsych testing
Cognitive reserve building
Family psychoeducation

24/7 Crisis Support

988 Suicide & Crisis Lifeline

Phone/Text: 988
Chat: 988lifeline.org/chat

24/7 confidential support for suicidal crisis or emotional distress

Veterans Crisis Line

Phone: 988 (press 1)
Text: 838255
Chat: veteranscrisisline.net

Specialized support for veterans and their families

Brain Injury Association

Toll-Free: (800) 444-6443
Local: (703) 761-0750
Website: biausa.org

Crisis Text Line

Text: HOME to 741741

Free, confidential 24/7 text support

Disaster Distress Helpline

Phone/Text: 1-800-985-5990

Crisis counseling for disaster/trauma survivors

All services are confidential