Every family has an emotional reaction when a spouse, sibling, child, or other relative has a traumatic brain injury. Each family has learned ways of coping from previous experiences with stresses, losses and changes in their lives. Some methods of coping have been productive for families in the past and helped ease not only their levels of stress and anxiety, but helped them problem solve and prepare for the future. Other ways of coping may not have been as productive for families. Some may have learned from this and changed how they cope with stress or change, while others may be stuck repeating negative patterns.

Why do many persons with brain injury have trouble developing and maintaining relationships? It may be due to changes in their ability to read and express emotions. This is essential for communicating and connecting with other people and for sustaining close relationships. Research into the expression and interpretation of emotions by survivors is examining new areas for brain injury treatment and recovery.

John Richards never expected to be a brain injury survivor. As a rehabilitation professional, president of a brain injury residential program, and Board of Directors member of the Brain Injury Association of New Hampshire, he was a well known service provider and advocate for persons with acquired brain injuries. The day he was found unconscious next to his bicycle on the road changed all that.

Update on acquired brain injury among prison inmates describes limited treatment for prisoners with neurological issues and acquired brain injury. Many have unidentified brain injuries and head trauma despite histories of unconsciousness, concussions, hospital admissions and physical trauma or abuse.

As a volunteer and support group leader in jail and prisons, John Simpson describes unidentified head trauma and TBI, physical abuse, childhood brain injuries, multiple brain injuries and alcohol abuse among prison inmates. As a case manager, he discusses the impact of head trauma on social behavior, alcohol use and troubled relationships.

Pituitary hormone deficiency may result from traumatic brain injury, head trauma or subarachnoid hemorrhage (stroke). Symptoms of hormone deficiency can mimic other effects of traumatic brain injury and delay diagnosis. Physical and psychological effects of hormone deficiency are described.

Alcohol and drug use after traumatic brain injury increases risks of another brain injury. Use of drugs and alcohol after TBI can worsen recovery, impair cognition, balance and problem solving. The body’s tolerance level can change after brain injury. Drinking one alcoholic beverage may be equivalent to six drinks.

Emotional reactions after traumatic brain injury include depression, boredom, loneliness and. Music increases dopamine levels associated with positive affect and feelings of well-being. Music therapy can help persons with TBI express feelings, concentrate, and participate in community events. Rehabilitation programs and families at home can use music therapy to help survivors with physical skills and coordination as well as social and cognitive skills.