Brain Injury and Schizophrenia: How to Deal

For victims of a traumatic brain injury (TBI) and their families, side effects such as bipolar disorder and memory loss are tragic, but well known and well understood. But in the last decades, scientists have begun to study another serious side effect of brain damage that may go undetected: schizophrenia.

What is Schizophrenia?

Schizophrenia (Greek for “shattered mind”) is a psychotic disorder that affects behavior, mood and thinking. The term was originally coined as “the schizophrenias” because of the wide variety of symptoms characterizing the condition. A misperception that all schizophrenics hear voices is actually untrue. It is a symptom in some suffering from schizophrenia but not all. Psychologists break symptoms of schizophrenia into three categories:

. Positive symptoms are behaviors that are not present in normal individuals. Other symptoms include hearing things, delusional though as well as sporadic thought.

. Negative symptoms are symptoms showing loss of normal abilities. They include loss of ability to show or feel emotion, lack of motivation and trouble with speaking.

. Neurocognitive defects are problems with brain function in areas such as memory, problem-solving, attention and social functioning.

Schizophrenia Related to Brain Injury in Patients

Scientists have established that psychiatric conditions such as bipolar and anxiety disorders are more common in patients who have suffered from traumatic brain injuries. Schizophrenia itself has been associated with individuals who have previously suffered brain damage regardless of family history. But it is only since the early 1990s that researchers have begun to explore in depth that connection between brain damage caused by traumatic brain injury and schizophrenia.

Schizophrenia and Brain Injury: Recent Studies

. Among the findings of those studies:

. TBI-associated schizophrenia is true schizophrenia, not another disorder with similar symptoms, according to a 2001 study by Columbia University. Schizophrenia and TBI are now being associated as hand-in-hand illnesses, one usually occurs in the victim of the other.

. Another study in the same year at the University of New South Wales in Australia discovered that TBI patients with schizophrenia-like psychosis had more widespread brain damage and cognitive impairment than TBI patients without psychosis. It also suggested that a family history of schizophrenia and the severity of the brain damage sustained during TBI increased the risk of schizophrenia.

. Scientists at the Hawaii State Hospital found in 2002 that it took an average of four to five years after a traumatic brain injury for psychosis to manifest, with most cases arriving within two years. Psychosis may be the result of trauma and blunt force to temporal and frontal lobes, for which researchers are attempting to determine.

While the complex nature of schizophrenia makes its cause unclear, as the last study suggests, there is evidence to believe that brain injury directly causes schizophrenia, by damaging the areas of the brain that control higher functions. There is also evidence that a traumatic brain injury may cause psychosis indirectly. Scientists believe that schizophrenia is caused by a combination of genetic susceptibility to the disease and an emotionally or physically traumatic experience that triggers this susceptibility. Researchers are finding that TBI and the trauma that can occur can actually trigger schizophrenia.

Many physicians know a traumatic brain injur may cause neurocognitive disorders such as trouble with speech, and psychiatric problems like bipolar disorder, but not all are aware of the growing evidence linking schizophrenia with brain damage. It is imperative that after a TBI accident, that a victim consult a psychiatrist to ensure that they return to normal behavior. In addition, brain injury patients and their families should consult an experienced brain injury attorney as they seek to recover costs for expenses such as lost wages, current medical costs and future medical care.

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5 Responses

  1. […] 18, 2008 in Personal Experiences with TBI I found an interesting post over at Lawyers Attorneys: Brain Injury and Schizophrenia: How to Deal For victims of a traumatic brain injury (TBI) and their families, side effects such as bipolar […]

  2. A number of things came to mind when I read this:

    * Okay, so does it mean I’m going to lose my mind, because I sustained a TBI? Am I headed for a psychotic break?

    * If head-injured folks are given proper treatment, rest, nutrition, and time to heal after their injury, will that help prevent a later development of mental illness?

    * How is that these symptoms are ascribed to schizophrenia:

    . Positive symptoms are behaviors that are not present in normal individuals. Other symptoms include hearing things, delusional though as well as sporadic thought.

    . Negative symptoms are symptoms showing loss of normal abilities. They include loss of ability to show or feel emotion, lack of motivation and trouble with speaking.

    . Neurocognitive defects are problems with brain function in areas such as memory, problem-solving, attention and social functioning.

    I don’t know nearly enough about schizophrenia or other forms of mental illness, but it seems to me that calling a neuro-physical condition a psychological one not only makes it difficult to properly diagnose, but also makes it difficult, even dangerous, to treat.

    Approaching an actual physical condition (or a neurological one) with a psychological approach might actually do more harm than good — convincing the specialist and the patient that there’s something wrong with them rather than something wrong with their bodily system.

    Might this not actually make matters worse? I personally become highly stressed when “solutions” don’t work, and if a TBI survivor is prone to violent outbursts gets stressed and acts out, might the psychologically based “treatment” actually be endangering both the patient and the therapist?

    I think psychotherapists and psychiatrists really need to think this through — familiarize themselves with TBI and its effects and realize what neuro-physical issues might truly come up along the way that mask themselves as psychological issues, and realize that they might be barking up the wrong tree.

    There was a great article in the Boston Globe not long ago about TBI being mis-diagnosed as PTSD in returning veterans. I think its points apply here.

  3. Broken, your argument is valid and well written. I agree with many of the points posted in your thread.

    “Approaching an actual physical condition (or a neurological one) with a psychological approach might actually do more harm than good — convincing the specialist and the patient that there’s something wrong with them rather than something wrong with their bodily system.”

    Whether it be misdiagnoses or believing their is actually something wrong psychologically will absolutely do more harm than good.

  4. I had a TBI in 1998. I had other multiple injuries as well. I self Medicares for about 5 years after being prescribed loratab. I got on methadone for 9 years…quit cold turkey and had a scizophrenic episode. I am now on suboxone but continue to deteriorate with memory problems anxiety depression and had been diagnosed bipolar. I take geodon and clonidine. I make rash decisions and tried to quit suboxone in 2 weeks with help of geodon valuim and clonidine but all I cry all the time all day over everything. I told my Dr. I couldn’t do it. He called in 12 Mg per day which helped but didn’t give me enough to last til my next visit. When I called the office the nurse said she told me to take 1. I was like why call in 1 1/2? They got rude told me not to let it happen again. I don’t know what I did wrong. I need to know what medicine is gonna help me? Do I need a new Dr? I have lost my insurance and dont know what to do. Any suggestions?

  5. Sp. Medicated

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