Can Head Injuries Lead to Mental Illness? the Risks

Q: Can Head Injuries Lead to Mental Illness? the Risks

Hello Mr. <br>Stephen： Generally speaking, if there is no loss of consciousness, no anticoagulant use, or obvious local hematomas, head trauma is mostly mild. <br>You mentioned that "a few months later, your brother developed a high fever and experienced symptoms of epilepsy," wh

Can a head injury lead to mental illness?

When my brother was in the second year of junior high school, we were playing basketball, and in a moment of anger, I pushed him while he was in the air.
This caused him to fall face-first onto the ground.
At that moment, he had facial bruising and a nosebleed.
We later went to a clinic, and since there were no significant issues, we thought everything was fine.
A few months later, my brother caught a cold and developed a high fever, during which he exhibited symptoms of seizures (twitching of the limbs).
He then went to a hospital in Taipei for a brain examination (I can't recall the specific tests), and the results showed no problems.
After that, he did not experience any further seizure symptoms, and we gradually stopped worrying about it.
However, after he entered high school, his previously good academic performance plummeted; he went from being in the top three of his junior high class to being at the bottom of his high school class.
He also began to contemplate strange questions (for example, whether he was the only real person in the world and everyone else was a figment of his imagination).
Consequently, our family took him to see a psychiatrist, and he started medication for depression, which he has been on until now (at age 21).
At 21, he still asks bizarre questions, such as whether the talisman drawn for him by a temple priest could affect his destiny, or whether not returning a female classmate's call years ago could lead her to commit suicide (exaggerating situations), among other delusional behaviors.
My brother had good grades when he was younger, but although he started playing video games in junior high, his academic decline has been drastic, as if he suddenly forgot how to study.
This year, he took an IQ test and scored only 90.
What is particularly distressing are his absurd, seemingly delusional statements, which leave us unsure of how to respond.
He has become depressed due to constantly thinking about these nonsensical issues.
I have started to wonder if I am responsible for my brother's condition and feel guilty about it.
Therefore, I would like to ask the doctor: Is it possible that the incident where I caused my brother to hit his forehead hard on the ground during junior high could have led to a decline in his IQ and resulted in mental health issues (such as depression and delusions)? What is the likelihood of this happening? Additionally, our mother has symptoms of bipolar disorder and is very strict with us, often scolding my brother.
Could this high-pressure environment also contribute to the possibility of my brother developing a mental illness?

Stephen, 20~29 year old female. Ask Date: 2023/07/30

Dr. Jiang Junyi reply Neurology

Hello Mr.
Stephen: Generally speaking, if there is no loss of consciousness, no anticoagulant use, or obvious local hematomas, head trauma is mostly mild.
You mentioned that "a few months later, your brother developed a high fever and experienced symptoms of epilepsy," which may be a separate event.
Hallucinations can be a symptom of schizophrenia; since mental disorders often become more difficult to manage under stress, regulating psychological stress can help stabilize the condition.
The exact causes of mental illnesses are still not fully understood, but it is believed that biochemical substances in the brain are affected.
Changes in these biochemical substances can lead to symptoms such as hallucinations, delusions, and other thought disorders.
Clinically, there are case reports indicating that repetitive transcranial magnetic stimulation (rTMS) can be used to adjust neural plasticity.
It has shown some enhanced effects for conditions such as insomnia, chronic pain, anxiety disorders, obsessive-compulsive disorder, panic disorder, addiction, post-traumatic stress disorder, and auditory hallucinations in schizophrenia.
Thank you for your question, and feel free to discuss any related issues further! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2023/07/30

More Info

Head injuries can indeed have a significant impact on mental health, and the concerns you have regarding your brother's situation are valid. It's essential to understand the potential consequences of head trauma, particularly in younger individuals whose brains are still developing.
When a person experiences a head injury, especially one that results in a loss of consciousness or significant trauma, there is a risk of various neurological and psychological issues. These can include cognitive impairments, mood disorders, and even the development of conditions such as post-traumatic stress disorder (PTSD). In your brother's case, the incident during basketball, where he fell and hit his head, could have contributed to some of the cognitive and emotional challenges he is facing now.

Research indicates that head injuries, particularly those involving the frontal lobe, can lead to changes in personality, cognitive function, and emotional regulation. The frontal lobe is responsible for executive functions, which include decision-making, impulse control, and social behavior. Damage to this area can result in difficulties with concentration, memory, and even the emergence of psychiatric symptoms, such as depression or anxiety.
In your brother's case, the decline in academic performance and the emergence of unusual thoughts and behaviors could potentially be linked to the head injury he sustained. While it is difficult to establish a direct causal relationship without comprehensive medical evaluation, it is plausible that the trauma he experienced could have contributed to his current mental health challenges.
Moreover, the family environment plays a crucial role in mental health. You mentioned that your mother has bipolar disorder and that she manages your brother with a strict approach. High levels of stress and conflict within the family can exacerbate mental health issues, particularly in individuals who may already be vulnerable due to genetic predispositions or previous trauma. The pressure and emotional turmoil from a high-stress home environment can lead to increased anxiety and depressive symptoms, which may further complicate your brother's mental health status.

It is also important to consider that mental health conditions such as depression and anxiety can manifest in various ways, including obsessive thoughts or irrational fears, as you described with your brother's concerns about his fate and the impact of past actions. These symptoms can be distressing and may require professional intervention.

Given the complexity of your brother's situation, it would be beneficial for him to continue receiving support from mental health professionals. A psychiatrist or psychologist can provide a thorough assessment and develop a treatment plan tailored to his needs. This may include therapy, medication, or a combination of both to help manage his symptoms and improve his quality of life.

In conclusion, while it is difficult to definitively state that the head injury caused your brother's current mental health issues, it is certainly a factor that should be considered in the broader context of his health and family dynamics. Encouraging him to seek ongoing support and understanding the interplay between physical and mental health can be crucial steps in his recovery journey.

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