Brain injury and depression


Brain injury and depression


your avatar   Kathy (46 year-old woman)

I had a severe brain injury in 1975, and as I get older, things are getting more difficult for me. I have no energy, no motivation. I am what I have been told severely depressed, and I am on Celexa. I don't care about anything, and have no self-esteem. I don't like to be around people for long periods of time, I just like to be by myself. I have tried to be positive, but I just can't seem to make it work.

I would like it if you could give me some help as to what I could do. I have been in therapy; I don't feel like it has helped. Can you please help me? I have been suicidal also. Is it possible for a person with a brain injury and depression to be "normal"? My psychiatrist told me that since I had a severe brain injury that my depression is harder to treat. Is that true? I hope I get an answer!


    Bob Rich, Ph.D.

Dear Kathy,

It is impossible to give a specific answer to your question, because a lot depends on what parts of your brain were damaged. Some kinds of brain damage affect the areas responsible for emotion, and if this is the case for you, there is only one thing that you can do.

Yes, there is one thing.

Suppose that you had been a runner, and lost a leg. That would be the end of your career in running -- but as the recent Paralympics has shown, not necessarily in sport. And there are many other ways of constructing a meaningful life, even though you only have one leg.

The same is true for any other injury with permanent effects. WHATEVER the losses imposed on you by your injury, you can choose to respond in one of two ways:

  • Poor me, it's not fair, what's the point of living... OR
  • This is a challenge, and I will NOT buckle under.

    Please go to In the navigation bar on the left you will find a link to the story of the cover picture of my short story collection, Striking Back From Down Under. It tells you about my friend Lorraine, who is physically WORSE off than you are. She spent seven years in a nursing home, and kept asking the nurses to get a gun and shoot her. She is in constant pain, despite an implanted morphine pump. And yet, now she is happier than most people with no physical troubles.

    If she could achieve this miracle, then perhaps you can too. After you have read her story, you might want to send her an email -- she loves contact with other people who have physical problems. Email me for her address if you are interested.

    What I am saying is, even if the depression and listlessness are due to the brain damage, you can say to yourself, "I am not REALLY depressed, there is no real reason to feel this way. It's the injury, trying to get at me, and I refuse to let it." And you fight back.

    But, it is likely that the emotional centers of your brain are untouched. It is more likely that you feel down because you are grieving for your losses, for the aspects of your life that have had to change.

    Grief for a loss is inevitable. However, your injury occurred 15 years ago. You are now "stuck" in grief. If your therapist tells you that you are hard to help because of your brain injury, then... you need a new therapist. Find one nearby who practices "Narrative Therapy". To get an idea of what this means, go here, where I have a page describing Narrative Therapy, and the transcript of a speech about being stuck in grief. "How to change a habit" will also be useful to you.

    I am confident that you can beat this depression. You have already taken the first step, by questioning your therapist's judgment and deciding that you want better out of life.

    Good luck,

    Bob Rich

This question was answered by Dr. Bob Rich. Dr. Rich has 30+ years of experience as a psychotherapist. Dr. Rich is also a writer and a "mudsmith". Bob is now retired from psychological practice, but still works with people as a counselor.For more information visit:


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