Traumatic brain injuries can be caused by motor vehicle accidents, falls, other accidents, and firearms. Such injuries can cause a wide variety of cognitive issues. In addition to cognitive problems, if you’ve experienced a brain injury, you may also develop symptoms consistent with one or more forms of mental illness including obsessive-compulsive disorder (OCD). Adults over the age of 65 are at a high risk of TBIs due to accidental falls. Statistically, men are more likely to get TBIs than women. TBI is often classified according to the severity of the injury—mild, moderate, or severe. Common symptoms of TBIs include a persistent headache, vomiting or nausea, lack of coordination, and increased confusion. According to the Centers for Disease Control, TBIs were responsible for more than 64,000 deaths in the United States in 2020. The most common causes of TBIs are falls, firearm-related suicide, motor vehicle crashes, and assaults.

Mild TBI Symptoms

Symptoms of a traumatic brain injury vary depending on the type of injury, the severity of the injury, and the area of the brain that is affected. Some symptoms may appear immediately, while others may not become apparent for days or even weeks. Symptoms of a mild TBI can include:

Bad taste in the mouthBehavior or mood changesBlurred visionChanges in sleep habitsConfusionDizzinessHeadacheLoss of consciousnessNausea or vomitingProblems with memory, attention, or thinkingSensitivity to light or sound

Moderate to Severe TBI Symptoms

A moderate or severe TB may lead to symptoms such as:

An inability to wake up from sleepConvulsions or seizuresEnlargement of the pupils or loss of visionLoss of consciousnessNumbness in arms or legsSlurred speechVomiting and nauseaWorsening headache

Changes Caused by Traumatic Brain Injury

If you have experienced a TBI you may also notice a change in your cognitive functioning. After a TBI, your performance on everyday tasks requiring memory, language, and spatial or verbal ability may be negatively affected. This can be either temporarily or permanently. If the TBI affects motor centers within the brain, mobility may also be impaired, and you may need a mobility device like a wheelchair or help with day-to-day tasks. TBI can also affect your behavior, causing changes in your personality. It is possible, after a TBI, that a previously calm person may become impulsive or aggressive. Likewise, an outgoing individual may become shy and withdrawn.

Causes

When you experience a traumatic head injury, your brain may undergo significant changes that can cause symptoms like confusion, headaches, and sensitivity to light and sound. With milder injuries, these changes will go away eventually. But with more severe TBIs, the injury can cause brain swelling, which can lead to further symptoms. A person may experience increased hostility, aggression, or inappropriate emotions (i.e., laughing during a sad moment). Inappropriate emotions may arise as a result of the part of the brain that controls “executive functions” in the brain, such as emotional regulation and impulse control, being affected by the TBI. In many cases, these symptoms resolve themselves in the months after a TBI is sustained, depending on the severity of the TBI.

OCD and Traumatic Brain Injury

In addition to changes in cognitive function, behavior, and mobility, TBI can trigger symptoms of OCD including obsessions and compulsions. OCD following a TBI usually occurs soon, if not immediately, after the event has taken place. However, there have been reports of TBI-induced OCD being diagnosed months after the initial injury. In each case, localized brain damage may or may not be present when viewing a brain scan. Research has indicated that OCD following a TBI is usually accompanied by symptoms of major depression. Whether this depression is a result of the TBI, the psychosocial stress caused by the injury, the onset of OCD, or a combination of these factors is unclear.

If you developed OCD after a traumatic brain injury, your doctor may recommend selective serotonin reuptake inhibitors such as Prozac (fluoxetine) or a tricyclic antidepressant such as Anafranil (clomipramine). Psychotherapy for OCD following a TBI may also be helpful. However, since cognitive impairment is common among those with TBI, cognitive-based therapies may not be the best option for everyone and should be evaluated on a case-by-case basis. If you can, choose a supportive therapy that assists you and helps you cope with both the practical and emotional challenges associated with TBI and OCD.