Traumatic brain injury: Addressing long-term effects

  • After a car accident, my mom developed a TBI that changed her moods, memory, and personality.
  • I often found it difficult to navigate her impulsiveness, outbursts, and tensions with other family members.
  • Therapy and creative outlets helped me cope and support my mom as she worked to manage her symptoms.

A head-on car crash in 2000 left my mother with scarred legs and a permanent limp. Most obvious to me, however, were the lasting effects of her traumatic brain injury (TBI)—unpredictable moods, memory problems, and other changes in her personality.

I didn’t know until later that many TBI survivors experience these exact same symptoms.

Each year, approximately 1.5 million Americans survive a TBI. Some people with mild TBI experience only short-term symptoms lasting several weeks or months. However, people with more severe TBIs, like my mom, can experience lifelong effects.

Frontal lobe injuries like my mom’s can affect personality, behavior and judgment, says Dr. Philip Blum, a neurologist at Memorial Hermann Mischer Neuroscience Associates.

Family members of TBI patients often report that their loved ones are “not the same” — but they may not always realize that these changes are related to the brain injury, which can add to their confusion and frustration.

Here are five of the changes I noticed in my mom following her TBI and how I dealt with them.

1. Short-term memory problems

The anterior temporal lobe is an area of ​​the brain that plays a role in your ability to remember and understand information about people, words and objects. Injuries to this area can cause difficulty storing short-term memories in your brain, according to Blum.

says Bloom. “A person can remember something for a second, minutes or hours, but have difficulty recalling days later.”

After my mom’s car accident, I noticed that she had a tendency to forget things I told her, like the date and time of an upcoming choir recital or the location of the next softball game.

When she accused me of neglecting to keep her informed, I often became defensive, hurt, and frustrated because I assumed she just hadn’t heard me.

She also sometimes had trouble remembering where she put things — including her keys, phone or wallet — which made walking out the door a stressful experience.

“It’s like deep down I’m storing what you told me in some hidden part of my brain, but I can’t access or download the information,” my mom explains. “But once you start telling me the second time, it often comes back to life.”

As I noticed with my mom, however, this symptom can improve over time — and both memory exercises and expert support can make a difference.

2. Difficulty focusing

Before the accident, my mom and I would often spend hours watching movie marathons on a gloomy Sunday afternoon, and she never had a problem following complex stories.

But after the TBI, I noticed that I had to keep replaying scenes or clarifying events in the film.

He also seemed to have difficulty concentrating during long conversations or conversations with several people.

Many people with TBI have similar trouble focusing. It may take longer for their brain to process information, which can make it difficult for them to understand and respond to different situations.

At first, I felt annoyed when I had to keep explaining things to her — but once I realized it wasn’t her fault, I developed more patience and compassion. I also learned that eliminating background distractions, such as turning off the TV during conversations, helped her understand what people were saying.

3. Impulsivity

Image of Rebecca Strong with her mother smiling at the camera.

Rebecca would feel annoyed with her mother’s forgetfulness or impulsiveness, but eventually found ways to accept these changes in her mother’s personality.

Rebecca Strong



After her TBI, when my mom wanted to do, say, or buy something, she did it—with little planning or consideration of the consequences.

For example, he might start painting a wall in our house, but stop in the middle of the process to start a new project. She also had a tendency to buy expensive items that were out of her budget. Over time, he accumulated extensive credit card debt due to these impulse purchases.

Poor impulse control affects about 55% of people with moderate to severe CSD — and experts have linked a lack of impulse control to behaviors like compulsive shopping.

People with TBI may also appear to lack a ‘filter’ for their thoughts or actions and may make inappropriate comments in a social setting.

For example, when my mom first met my ex-boyfriend, she made a joke about his puffy eyes not knowing it was a symptom of Grave’s disease. We all laughed about it later, but at the time I was red with embarrassment.

4. Outbursts of anger

Speaking of impulsive behavior — after the TBI, my mom’s anger came out very suddenly and very strongly. Even just wearing my shoes in the house could throw her off.

Once at a local salon, she was frustrated with the time it took to dry her hair. He got up from the chair, went down the stairs and started yelling at the receptionist.

When she would have these kinds of tantrums at me, I felt afraid – not sure when they would end or what would calm her down. When he directed them to others, I felt humiliated, like I wanted to run and hide.

My mother’s uncontrollable anger also confused her. She has since expressed to me how confused and ashamed she felt after passing.

“I felt this intense rage that I had no explanation for — it was like I was in a blackout, where I didn’t even know what I was saying or doing,” she says.

5. Relationship trends

Fortunately, most of the changes my mom experienced were manageable and did not compromise her ability to work or lead a generally fulfilling life. But she also experienced relationship problems, like 17% of people with moderate to severe TBI.

At various times during my teenage and teenage life, my mother’s siblings, parents, and friends cut off contact with her intermittently after she assaulted them. This left me in the difficult position of either trying to smooth things over or losing those connections myself.

But TBIs can also have a lasting effect on loved ones’ psychological well-being, often in the form of anxiety, stress, and depression. And it’s true, I often felt like I was “walking on eggshells” around her, worried that the slightest thing might throw her off.

As a result, I developed a fear of confrontation and people-pleasing tendencies. I also resorted to hiding things from her or telling lies to avoid her potential wrath.

How did I last?

Rebecca Strong and her traumatic brain injury mother dress up for a fancy night out.

Rebecca found that creative pursuits like journaling and acting helped her cope.

Rebecca Strong



I haven’t joined any support groups in person, but Blum suggests finding an in-person or virtual group. Since people in these groups also have loved ones with TBI, they can share potentially useful information from their own experiences.

Instead, I focused a lot on getting comfortable with setting healthy boundaries to protect myself whenever her problematic behavior came up. Now, when my mom occasionally has a temper tantrum, I know I can lovingly remove myself from the situation and invite her to engage with me again when she calms down.

Creative pursuits like songwriting, acting, and journaling have also given me an outlet for my sadness, anxiety, and frustration—emotions that I struggled to express to my mother.

After trying several forms of therapy, I found cognitive behavioral therapy (CBT) to be the most helpful. In particular, I have learned to challenge some of the false beliefs that contributed to my fear of angering others.

Working with a therapist was beneficial for my mom as well. Through therapy, she’s learned healthy coping mechanisms for anger—and as a result, she’s finally getting back on good terms with all of her loved ones.

“CBT skills such as breathing exercises for relaxation and replacing negative thought patterns with positive ones have been shown to greatly help patients manage their symptoms and speed their recovery,” says Kosofsky.

Occupational therapy also helped my mom deal with cognitive issues related to learning, memory and attention and adjust her lifestyle accordingly.

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If you have a loved one with TBI, you may notice changes in their mood, cognitive abilities, and behavior. Try to keep in mind, however, that these symptoms are not your loved one’s fault.

Another important thing I want people who have relatives with TBI to know: There is hope.

Many cognitive and behavioral symptoms improve over time, says Dr. Barry Kosofsky, a neurologist at Weill Cornell Medicine — particularly with social support, occupational therapy, and psychiatric and psychological care.

In short, your understanding and support can give your loved one an even better chance of overcoming the difficulties they face as a result of TBI.

Growing up with a mom who had a TBI may have had its challenges, but it ultimately helped me cultivate empathy, patience, and resilience.

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