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What Causes Depression Following A Brain Injury?

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Posted on Wed, 10 Aug 2016
Question: hello.

I was injured 4 years ago, ,concussion, simple, no fracture or bleed. was in NICU for several days, in intensive rehab about 2 weeks. then regular rehab for 5 weeks. by the time I went home, still could not dial a phone, talk, add or subtract, get online. lost all my education: 5 languages, physics, math (even arithmetic) ability to read with XXXXXXX do have partial complex sz and this reminds me a lot of unmedicated self then.
I guess I am worried about how empty my whole life is: most of the things I loved are gone. I can do simple arthmatic now and periods where I can remember differential calculus, then it goes away. and I recall that in my whole life have never even used it. good brain exercise for brain, tho.
does this seem like an acceptable course or should I jump up and down and demand more workup.

will write from psyc hospital, where I'd probably end up if I jump and down. moot anyway: polio and in chair. btw, I am 75 but have an awful long time to live like this, with everythikng I love gone.

best,
XXXX XXXXXXX
doctor
Answered by Dr. Alexander H. Sheppe (23 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Traumatic brain injury (TBI) can result in a complicated clinical course. Everything you describe is consistent with TBI. I don't think any further workup is indicated. Retraining lost function is the best way to regain those functions. However, I am worried you may also be depressed. Depression is common in TBI. You may benefit from an antidepressant, or from psychotherapy. I encourage you to speak with a psychiatrist about either of those options.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (2 days later)
dear dr. sheppe,

thank you so much for your note. I would like to correspond with you: not many docs here seem to feel that losing my 'mind' is old age or a function of earlier probs. here is a truncated list of stuff which might be contributing. let me know if you want to see the whole shooting match:

-PTSD with depression/insomnia/flashbacks/nightmares, everything. due to severe and brutal child abuse with scars both in and out. of all the things I have ever dealt with it is the worst) take paxil, Ativan and minipress r nightmares. lse too) and mini-press for nightmares (2mg. very elegant VA discovery which works reasonably well. was in therapy for a number of years, most recent lady lost her XXXXXXX it was free and that is what I need. very little money). great shrink, double boarded in psychiatry and IM. also very nice and respectful. understands the hell of PTSD, is also concerned about 'very severe major depression' on her charts. she is very attentive. she doesn't want me to commit suicide, which is something I have never understood from anyone.y imagine how lonely my little cat would be, with no love. no friends left after postpolio attacked (big surprise). they just all bailed out.
aside from friends, I had to quit my job as a respiratory therapist. was past retirement time (30 yrs) but still loved it. was also a ballet dancer for many years and loved it but couldn't even walk. was a volunteer in homeless shelter clinic and did tons of educational speeches to med. folks all over XXXXXXX started the ethics committees for carilion system. was clinical resource for house staff and attending. hiked, ate, partied, movie-ed with my large circle of friends, who are now gone.
there are other medical probs but the worst is bad CHF, time-consuming to monitor it.

so I guess the real problem could be just called LOSS. I never had stability or love so I made my own. now all that is gone and I am lost.

############################################

a question from me: re: PTSD. I have been working on controlling it for many years but the trouble is once in a flashback, cannot get out & nightmares warp reality. some times in a big way, they overflow each other. the hiking and dance and clinical stuff were very valuable because I had worked for them and they were mine and I was SUPERB at them. (well, I was!!!) well also I have FUCHS and am losing my vision rapidly. at my age and money sitch, no treatment. that's a loss on major proportions..

so what is your recommendation for PTSD. I realize I am a psychiatric train wreck, but if my last years could be more peaceful, that would be a boon. hmmm. just realized I have been giving stuff away. I think more as approaching natural death. some are in my family for literally centuries, want my daughter to have them.

this is what happens to a person who talks to her cat all the time and cat communicates well but not in English. long yakky letters to people I don't even know.

thank you.
my best,
XXXX
doctor
Answered by Dr. Alexander H. Sheppe (3 hours later)
Brief Answer:
Followup

Detailed Answer:
Thank you XXXX for giving me the opportunity to know you better. I really enjoyed reading about your history and it helps me understand you.

As far as PTSD goes, medications are generally not that helpful, with the exception of prazosin which you are taking for nightmares which often works wonderfully. There is some evidence antidepressants are of some help. But the best treatment for PTSD is called prolonged exposure therapy. It involves a 12-14 session treatment of exposure to traumatic memories. I recommend talking to your VA doctors about starting it if you can find a therapist who does it.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Alexander H. Sheppe (23 hours later)
hello dr. sheppe,

am still having problems getting to your link. keep getting linked-up.
am distracted now and pc is also. so I go to healthcaremagic.com. then what?
very sorry. I am actually pretty good at online stuff, but lost a bunch with concussion.
did research on TBI, does sound about right. mine seems to be pretty bad, but have had a number of head injuries, starting in early childhood. maybe cumulatlive?

the idea of doing the reliving method of PTSD treatment just creeps me out. have spent all my life trying to avoid those feelings. as to the actual events, easy to get, in shallow graves. the feelings were devastating. I am afraid I would never stop crying and screaming, somehow would get stuck in the past experiences and unable to get out. I know this is childish but I have always walked a wavery path, for as long as I can remember. always preparing myself for more abuse should it reappear. and it did.

I will ask my shrink about it. my feeling is that I am too fragile, have been hospitalized many times, all messed up. and several dead serious suicide attempts from which I was saved. great for docs, bad for me.

thank you so much. hope I can track down your private URL.

XXXX
doctor
Answered by Dr. Alexander H. Sheppe (8 minutes later)
Brief Answer:
Followup

Detailed Answer:
To reach me directly, type the following into the address bar of your web browser:

www.tinyurl.com/DrSheppeAnswers

or you can try this longer one:

https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684

Thanks,

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Alexander H. Sheppe (2 hours later)
found it. money again.
thx
doctor
Answered by Dr. Alexander H. Sheppe (2 hours later)
Brief Answer:
Followup

Detailed Answer:
Hope to hear from you soon!

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Alexander H. Sheppe (5 hours later)
wish I could go to private email but ,the cost is too high for me, ,now. lots ,of expenses ,now. fortunately not possible for anyone ,to garnish or come grab stuff. I don't own anything.

still very depressed. was thinking about the exposure ,method for ptsd and began to ponder ,what all happened. might be able to do this. if I get mad enough instead of scared, ,could be very empowering to look stuff right in the ugly face, ,feel the feelings and let them go.
meanwhile i'll read Shakespeare and listen to wagner, ,2 things I promised myself I would do in my old age. still sounds as uninteresting as it always has.

thanks. do you think I have a grip on the ptsd tx?
feel a lot more patient about concussion damage. I figure that someone taught me all the stuff I've lost, I can damned well teach myself now. or just wander around with a partially blank brain for another 10 yrs.

babbling,
XXXX
and thanks again.
doctor
Answered by Dr. Alexander H. Sheppe (9 hours later)
Brief Answer:
Followup

Detailed Answer:
Exposure therapy is the best treatment available for PTSD. You might be able to manage without it, but I would strongly consider it.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers


Above answer was peer-reviewed by : Dr. Prasad
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Depression Following A Brain Injury?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. Traumatic brain injury (TBI) can result in a complicated clinical course. Everything you describe is consistent with TBI. I don't think any further workup is indicated. Retraining lost function is the best way to regain those functions. However, I am worried you may also be depressed. Depression is common in TBI. You may benefit from an antidepressant, or from psychotherapy. I encourage you to speak with a psychiatrist about either of those options. Please remember to rate and close this answer thread when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers