Depression and Alcohol after Brain Injury: FAQs

 How Depresssion and Brain Injury Interact

By DeAnna Frye, Ph.D.

What is the relationship between brain injury and depression?

Depression is the most common psychiatric diagnosis after brain injury.  Individuals may experience symptoms immediately after their injury or not until several years post injury.  Individuals with depression after brain injury have poorer rehabilitation outcomes, poorer quality of life, less social and recreational activity, greater caregiver burden and poorer subjective well-being.  As a result, it is important that individuals receive treatment for their depression.

The preferred form of treatment for individuals with depression following brain injury is psychotherapy.  Medications can also be beneficial but caution should be taken as individuals with brain injury are more likely to experience side effects from these medications.

Since her discharge home from the hospital my daughter has been telling us that she wished she hadn’t survived the accident.  This really upsets us, as it is a miracle that she is alive today.  How should we respond when she says this to us?

Your daughter may be expressing feelings of grief over the significant changes in her life as a result of her injury.  This is a normal part of the grief process and you should encourage your daughter to talk with you and a counselor about her feelings of loss.  While most individuals who recover from a brain injury experience similar feelings, it is also important to make sure that your daughter is not clinically depressed and suicidal.  While it is common for individuals to express feelings that they wished that they had not survived their injury, this does not mean that they currently wish to die. An individual who is expressing a desire to end their life needs immediate medical attention to ensure their safety.  If your daughter is expressing suicidal thoughts, you should call her psychologist or doctor immediately and alert them to the situation.

The holidays are approaching.  How much alcohol is a safe amount to drink after a brain injury?

Research has shown that there is no “safe” amount of alcohol after a brain injury.  Important factors to consider include interactions with any medications the individual is taking as well as history of alcohol abuse or dependence. Individuals also may react differently to alcohol after a brain injury, which may place them at greater risk for additional injury.

Why does my treatment team tell me not to drink alcohol now that I have had a brain injury?

It is important to realize that alcohol is a neurotoxin – in other words, it kills brain cells. After a brain injury, alcohol can interfere with the healing process.  Alcohol can also cause seizures.  While this is pretty rare for healthy individuals, your risk for seizures is higher after a traumatic brain injury.  Drinking alcohol increases that risk even further. Individuals who drink to the point of intoxication also demonstrate changes in their cognitive skills, with judgment being one of the first skills affected.  As a result, intoxicated individuals may do things that put them in situations where they may be harmed and perhaps sustain another brain injury.

Some individuals turn to alcohol as a means of coping with their loneliness, depression or anger.  Research that has been conducted to look at safe alcohol consumption for individuals with traumatic brain injury has concluded that there is no safe amount.

Dr DeAnna Frye has a B.S. in Psychology, M.S. in Counseling Psychology, Ph.D. in Counseling Psychology. She is currently employed by Neurology Neuroscience Associates of Akron. Her special interests are psychotherapy and counseling to patients with neurological disorders with special expertise in brain injury. She is a founding member and the current co-chair of the Summit County Traumatic Brain Injury Collaborative located in Akron, Ohio.
Many individuals struggle with depression after brain injury. This Tool Kit helps individuals, families and clinicians recognize symptoms and triggers ranging from mild depression to effects of PTSD.

For more information, see:

The Depression Tool Kit after TBI

Many individuals struggle with depression after brain injury. This Tool Kit helps individuals, families and clinicians recognize symptoms and triggers ranging from mild depression to effects of PTSD.


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9 responses to “Depression and Alcohol after Brain Injury: FAQs”

  1. Dear Neil,
    Unfortunately a high percentage of traumatic brain injuries involve alcohol and your friend’s history of alcohol use makes him a high risk for substance abuse again. It’s a common saying in the brain injury community that the only safe amount of alcohol for a brain injury survivor is none. Because of changes in the brain due to the trauma, alcohol can have different effects – it often takes less alcohol for person for the person to feel high and the effects can be more intense. So having a 2 or 3 drinks can feel like 5 or 6. When you add this to the depression that many experience after an injury, it is a bad combination. Drinking increases the chance of another brain injury due to poor judgment and impulsive actions. I encourage your friend to consider counseling with someone experienced in brain injury and substance abuse.

  2. Neil Perkins says:

    Howdy, just want to ask if there is a big effect if a person had TBI was an alcoholic before because my wife and I have a friend who is an alcohol addict and went to care center drug rehab in Texas. He completes the 30 day treatment programs but he was not able to maintain his sobriety. He experience relapse due to anxiety because he lost his job. Then unfortunately he had an accident because of drunk driving. As a result he is suffering from TBI and at the same time with substance abuse problem. His wife always talks to us about his husband’s problem and we don’t know what to do because his husband doesn’t want to seek help.

  3. Kara Terna says:

    I’m depressed that my brother, doesn’t know how to read blogs and for those people out there who are suffering from addiction.

  4. Amy says:

    James, I thought I was totally fine too, this is brand new for me. I guess I got promiscuous when I drank, even with my husband right there. One of the things I read about people with TBI’s, they do things and don’t really think about how it affects the people around them. (Although everyone is different). I feel so ashamed of how I’ve been, but I was 16 at the time of my TBI., I was still growing up.
    Oops, I lost my train of thought. And my memory is pretty much gone. The things I remember are from my childhood, so now I need to ‘grow’ up.

  5. Amy says:

    I come from a family of alcoholis, so it is already part of me. I had a head trauma 25 years ago, but I also have epilepsy. I love to drink. My husband finally read all about head trauma’s, and how drinking effects those that have had a one. Now I am forbidden to drink. I guess it’s for the best, but he drinks, my son drinks, and I can’t?
    I also suffer from depression, so drinking was my release. What is my release now?

  6. James says:

    How sad:(. I have had a pretty severe tbi about 13 years ago and I feel
    Totally fine. I am an every day person and I have fully recovered. I have tried all sorts of alcohol in the last few months. Many, many time I have tried alcohol and I have been intoxicated all night nervous times and I have never seen any issues with drinking. I feel normal and I am completely normal who is to say I should not be drinking??? I have the taste in my mouth and I’m not craving it all the time. Is it wrong to drink every once and awhile? If I had ten drinks of different alcohol at this very moment I would be fine. I would not be able to drove but why can’t I have any? Should this be something to keep to myself or try and avoid? I can’t really avoid it because I hate being told I can’t do something. I am 25 and male. How do I tell the people around me to just let me be? I will be fine if I drank I promise. Any advice?

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