Lots of things change after a traumatic brain injury, not only for the person that has suffered the injury but for their friends and family. A good sup­port system of friends and family is important to the recovery of an individual who has sustained a traumatic brain injury. Unfortunately, a lot of friends and family struggle with how to help and how to understand what is happening to a loved one who has sustained a life-alter­ing traumatic brain injury. The focus of this article is to assist with that understand­ing, suggestions for social interactions, and to provide resources for more in depth assistance.

Emotional Stages following a Traumatic Brain Injury

Many individuals who sustain a traumatic brain injury lose friends and family because of the emo­tional changes and personality changes that come with a traumatic brain injury. It is important to understand that there are many common emotional stages that people with a traumatic brain injury go through. Below is a sampling of stages summarized from Glen Johnson, Ph.D.

First, there is confusion and agitation. The injured individual may not understand or track con­versations or may become aggressive and swear at family members. This stage is frightening for family and friends who are helping the injured individual. While this is a struggle for many family members who may think this stage may never end, practi­tioners report that 99{f8270180bd013a86e8a7bdc2029d331e433a151f411edd98c48642ec5f8162bf} of patients move on from this stage.

Second, is the denial stage. Oftentimes, people who sustain a brain injury do not know or under­stand the full extent of their injury and the way their brain has been affected. Oftentimes, the med­ical system contributes to the denial by telling tell people “Go home, relax, in a couple of weeks you will be better.” While most brain injuries do resolve with time, not all of them fully resolve and there are resid­ual symptoms. As a family member and friend, it is important to observe the deficits the injured individual is suffering from, and help them to under­stand what it is they are capable of and assist them with recognizing what is going on to help them get treatment.
Third, denial begins to break down when the same problems happen over and over and over again, which leads us into the third stage, anger and depression. In this stage, people are often self-deprecating stating things like “I’m no good” and “I’m a failure.” They also may look back and state “I just want my life back” or “If I had only left my house five minutes later, I would not be in this mess.” They may not see people as being sup­portive or understanding the brain injury and what they are going through. You may notice anger that comes extremely quickly and then goes away just as quickly. It is important to understand that this is coming from the brain injury and emotional chal­lenges facing the injured individual. This is difficult for the injured individual and a struggle for family members and friends. It is important to remain sup­portive and understanding through this process and assist them in getting the help that they need to combat the depression and anger.

Traumatic Brain Injury

Fourth, after there is a period of recovery and improvement in thinking abilities, injured individuals go through the testing phase. In this phase, they test themselves to determine their limits with their brain injury and symptomatology. For example, they will try to spend the weekend doing things with friends and stay out too late or be too active, and then they pay for it with overwhelming fatigue for several days after. This is a struggle for the injured individual in that they often have significant fatigue when they try and do too much. During this phase, the injured individual often asks “Why can’t I be the way I used to be?”
Fifth, once the testing phase is complete, the final stage is uneasy acceptance. This is when injured individuals learn what their limits are and what they have to do to cope. This is where the injured individuals let go of the “old me” and work towards accepting the “new me.” As friends and family, help the injured individual find and accept the “new me” and accept them for the current capabilities and limitations.

Social Interactions

One of the struggles throughout all stages of a traumatic brain injury for the injured individuals and their friends and family are the changes in social interactions. Oftentimes, a traumatic brain injury can lead to emotional changes, fatigue, trouble sleeping, and diffi­culty concentrating — all of which affect ones social interactions. For example, their personality may have changed and they may have flat­tened or dulled emotions or a different sense of humor. Conversa­tions may go differently than they used to because it requires signif­icant attention and concentration that they may be struggling with. They may not have a filter and will blurt things out in conversation that they should have kept to themselves.

Therefore, just because your injured friend or family does not want to interact in social settings, it is not because they do not want to spend time with you. Rather it is difficult for them to interact in the way they used to. It is better to meet earlier in the day as the fatigue will not have fully set in. It is also better to meet in small groups of two or three as it is hard for the injured individual to focus and concentrate in large social settings. Do not take it personally if they have to reschedule set plans. Injured individuals have good days and bad days which affect their energy levels and they may have to reschedule plans. Finally, as a friend and family member be patient and encourage the injured individual to work on his or her rehabili­tation and recovery.


There are several resources available for those individuals who have sustained a traumatic brain injury and their friends and family. These resources offer great tools in the form of education, assis­tance, and support groups.

· Brain Injury Alliance of Colorado: www.biacolorado.org
· Rock Mountain Human Services Brain Injury Support: www.rm hu ma nservices.org/program/brain-i nju ry-support
· Colorado Kids Brain Injury Resource Network: www.cokidswithbraininjury.com

The websites additionally offer National and other resources available. Don’t be afraid to seek out the help of one or more of these orga­nizations. The support that these organizations offer can be truly beneficial and give injured individuals and their friends and family a platform to be educated and also speak in an open forum about their struggles and frustrations.