When doctors treat brain injuries they generally focus on physical trauma and mental issues, but depression can develop as well and be just as disabling. A new study shows high rates of depression in the first year following a brain injury.
Traumatic brain injury (TBI) can happen to anyone. It can be caused by a car crash, a fall or a sporting accident.
Many American survivors of armed conflict have suffered brain damage from explosions.
The injury disrupts normal function of the brain and can lead to permanent damage.
Before suffering a brain injury, Zachary Lystedt used to play football. Now he would just like to walk again.
TBI can lead to physical disabilities as well as changes in mental ability, personality and behavior. Doctors are also finding it can lead to serious depression.
Shane Diel suffered a brain injury three years ago.
"I'm sore," said Diel. "I'm tired a lot, probably more depressed than I was, but that's all getting better though."
Psychologist Charles Bombardier and Dr. Jesse Fann from the University of Washington studied more than 500 hospitalized traumatic brain injury patients for one year.
"Fifty-three percent of the individuals we studied had at least one depressive episode during the year following Traumatic Brain Injury," said Bombardier.
The number of patients suffering depression was about 8 times greater than expected.
"Even among those with no history of major depression prior to their injury, 41 percent experienced an episode of depression in the year following their injury," said Dr. Fann.
The researchers discovered that medical care did not routinely include treatment for depression.
"We found that only 44 percent of the people who had been depressed received any kind of treatment, only about 40 percent received anti-depressants and only 20 percent received psychotherapy," added Bombardier.
The researchers say the reported rates of major depression are probably conservative and that the problem is likely greater.
They say if mental health care is included in standard care for patients with traumatic brain injury, it could improve their outcome.
The study was published in the Journal of the American Medical Association.