Mood and Anger Issues After Severe Brain Injury

Mood and Anger Issues: Ian Part Nine

In far too many cases, the biggest problem that interferes with a good recovery after a severe brain injury is the breakdown in relationship’s that comes from the survivor’s inability to control his or her temper. The mood and anger issues are particularly intense with men. My first three or four clients with severe brain injury were not personal injury clients, but divorce or criminal clients because of their mood and anger issues caused by brain injury. The reason they needed a lawyer was they had been arrested because of domestic disputes, clearly attributable to the inability to control temper when returned home from rehabilitation. Ian’s mood and anger issues are not that extreme, but do appear to be one of his biggest ongoing problems. I asked Ian what things made him irritable and that he may have mood and anger issues with:

Loud noises. It – to me I just – or I shouldn’t say loud noise; more like a high-pitched sound. For some reason it just irritates me.

Does background noise trigger your mood and anger issues?

That doesn’t really bother me.

None of, none of the noise, background noises in this room are triggering your mood and anger issues?

No.

Do restaurants and crowded places trigger your mood and anger issue?

That really doesn’t bother me.

Are you able to screen out the things that you don’t want to hear?

Somewhat.

Where do you have trouble with your mood and anger issues?

Actually in the house; with the kids, the wife, for some reason they’re always – it seems to me like they’re always screaming and in my ears and it’s like, no, I’m trying to get away from that type of noise.

Is it the that sound or the things they’re asking you that trigger your mood and anger issues?

A little bit of both.

What is it that triggers your mood and anger issues in terms of what they’re asking; for you to do things?

Not so much do things; it’s getting to listen to yourself. That isn’t how you ask a question, and things like that. Or dad, take me here. Dad, I want this. Dad, I want that, you know. Most people with teenagers will know what that’s all about. But the way he does it, though, it’s – or he’ll come and say, “You know what I want.” And it’s like –

Is it frustrating for you that your family sometimes forgets how hard it is for you because of your brain injury mood and anger issues?

I think so. And what really makes a hamper on it is both my sons are autistic and the one has ADHD, Turrets and bipolar mixed in with it. So he’s – so I’ve got one kid that, he’s basically a good kid. He’ll do dishes, laundry, vacuum and put stuff away and everything. He’s kind of like the neat freak so to speak. And then the other one is just the total opposite. He screams, he throws things, punch holes in the wall; I mean that’s the one that’s got the bipolar in him.

How do you isolate yourself from that stimulus at home to curb your mood and anger issues?

I either try to go to a friend’s house, go trap shooting. What really is weird is both kids are in Special Olympics and I go with them, take them and let them play and have fun. And after that then it seems to calm things down.

Ian talks about his irritation coming from noise, but his explanation points to additional triggers of his mood and anger issues. His parents add significant perspective to his mood and anger issues. I asked his Dad what was the biggest change in Ian since his accident with his mood and anger issues:

Angry. Get’s red in the face. Upset real fast. If I’m there I can calm him down a little bit and say hey don’t worry about it let’s go outside. But if he’s there alone I don’t know.

Mom agreed with the change in his mood and anger issues:

He get’s angry.

I don’t know if he said anything but Monday, Tuesday and Wednesday I usually go over to his house and some days he’ll get up and he’ll be fine. Other days he’ll get up and he has an attitude. He gets very angry. Nothing has been said. Nobody is there except him and I. The kids are there but they’re not up yet. And for whatever reason he’s angry. And if I say something to him he starts getting very loud and he gets this attitude like it’s your fault.

And I said to him you know if you’re going to talk to me that way I can leave. So I said whatever is bugging you, you either let, talk to me about it or back off. And I haven’t seen him throw anything but he does get angry and likes to, for a while there he would slam doors and drawers and stuff because he didn’t know what else to do.

They have been at our house, something would trigger him. He’d be angry and he won’t say anything to anybody and first you know he has disappeared. What he does is he starts walking home. We live about two miles from where they live. And he’s done that on different occasions. Or he’ll just, he can be home and he’s done it, pick up, get in his car and start driving.

Does it help him to isolate himself when he’s upset to prevent mood and anger issues?

Not always. Sometimes. He’s, he’s been known to come to our house and he’ll be sitting in the backyard. We went home one day and there he was. Why are you here? I can’t handle it at home, I don’t know what to do. Well is there something you can tell us so we can kind of help you? No. So he has a short fuse some days and other times not.

You say he always had a bit of an attitude with his mood and anger issues caused but his brain injury. How’s the attitude different?

Well before when it was just a regular teenage attitude, you know, I’m not doing that kind of thing. Now it’s I’m angry attitude that – How can I say it? He could be just sitting there doing absolutely nothing and it just – there it is.

Ian’s Friend reports a bit more success dealing with Ian’s moods and anger issues than his parents. He states that Ian will still listen to him when he tries to tell him to get it together.

Yeah. I just did it ten minutes ago. Well, I was telling him he needs to walk, and he’s trying to tell me, “I can’t. Every time I go to do something, somebody calls me.” I said well then you call them and say you’re going to be doing this and you’ll be back then. “No, then it’s my wife and she’ll call me and I was going to walk at the mall, and she’ll call me and my son’s throwing things, slamming the doors, you got to come home.”

And by the time he gets back home, the kid’s in the shower, everything’s cooled off. You know, I said here you wasted a half an hour. You drove there from the mall, drove back home and now you’re going to have to drive back to the mall again just so you can do your walk. And he’s making excuses of why he shouldn’t go out for a walk.

I told him, you need to set up a schedule, and if you need someone to walk with you, I’ll walk with you. I also caught him on, he was trying to, I was telling him about the anger thing I was telling you about just a little while ago, and he was trying to cut in and I said: No listen. You just shot off at me out of nowhere. You were mad at me just out of the blue. You know and that’s not right and you have something inside you, it may be subconscious that’s pissing you off and you need to get it out, because you have, the last 2, 2 1/2 months, he has been really, really bad.

Does his temper come out of nowhere?

Yeah. Ian was, lives in a household that does a lot of yelling, between him, his wife and his oldest son, and they all grew up in that.

When the accident happened and Ian was in the hospital, that Ian was in the hospital, his wife picked up taking over the, the bills, and she needed to buy a new bed, and I helped her with that. Her car was breaking down. Ian, and Ian always worked on vehicles. Well he can’t work on them. He’s not going to be able to work on them for six to eight months. So, with Ian’s brother they got a different car for her.

When Ian got out of the hospital, he’s pissed off because they went out and bought a car, that they could have fixed the old one and they spent this money and that, and that’s just one thing for him to keep harping on.

I told him, you know, you got to let this go. But if his wife is sleeping in the chair, she works, she was working 4:00 in the morning until about 100:00 and she’s tired when she comes home, so she falls asleep most of the time in the chair. He will go, just for no reason, wake her up and then start yelling at her, and it’s why are you doing that? Let her sleep. Leave her alone.

The most important relationship for a survivor to maintain is that with his or her spouse. In too many cases, that is the one person the survivor has the hardest time listening to. Like Ian, it is often a parent, a close friend who can intercede, say the calming words of advice. Finding better ways to cool the intensity of anger at home is one of the greatest challenges facing any TBI household. It must be a bigger priority in discharge planning and ongoing treatment.

Next in Part Ten – Importance of Family After TBI