Brain Injuries and Dependencies

Following a traumatic brain injury, the survivor may be left with various dependencies. They may be emotional in nature or based on a substance abuse. Whatever dependency is involved, it can lead to difficulties in recovering from the injury.

Some of the emotional problems that can lead to dependency are a result of lack of initiative; lack of motivation; planning and problem solving difficulties and lack of self-esteem. All of these things can lead to feelings of powerlessness. And for this reason they will often become emotionally dependent upon someone close to them. There is another type of dependency called learned helplessness or learned dependency which will sometimes come about when someone helps beyond the point where help is actually needed.

With frontal lobe injuries there may also be a difference in emotional intelligence post-injury versus pre-injury. This is quite different from intellectual intelligence. Emotional intelligence relates to emotional self-awareness, the ability to recognize others’ emotions, taking responsibility for their own feelings, empathy, self-confidence, self-control, feelings of independence, and getting along with others. Difficulty in these areas can lead to dependency on others, particularly a caregiver.

Another dependency may be that of substance abuse. Sixty-seven percent of those with brain injuries have a history of substance abuse pre-injury and fifty percent of those will return to using alcohol following their injury. However, substance abuse can often be a result of boredom and loneliness also. With the use of alcohol and drugs after a brain injury, there is an increased risk of seizures as well as the risk of sustaining further brain injuries.

But there are many others who will fight for their independence. i.e.: they will drive before they have been given the ‘go ahead’ to drive; will refuse to go to therapy appointments; will feel increased anger if they are personally, socially or financially limited, as well as if they are deprived of privacy. Also those who need help physically may resent the help they receive if they think they should be able to do it themselves.

Regardless of whether they have become dependent or are fighting for their independence, it is important to remember that there are no two brain injuries that are the same and each person will react differently to their circumstances.