Switching from happy to angry and back again can occur very quickly. This process is known as emotional lability.

The issue is often the result of damage to brain regions that are responsible for managing emotions and behavior. Neurons deep in the brain, within the amygdala, process emotional information. Within this almond-sized structure, parallel neural pathways relay details of pleasant and unpleasant events.

Positive and negative emotions are managed by different nerve cells; another area involved in the process is the nucleus accumbens, a structure thought to be part of reward seeking behavior.

Patterns of Anger in Brain Injury Survivors

When intense emotions are observed in a patient, some distinct patterns may be observed. First, no specific statement or event may occur for there to be an emotional response. The outburst can happen spontaneously. For family members and other companions, this can spark confusion. Other people may feel like they said or did something wrong to upset the person, when in fact the patient’s response had nothing to do with them.

Brain injury survivors sometimes don’t respond according to how they feel. They may express laughter when they don’t feel particularly happy, or even laugh at something sad or negative. Also, one might cry in response to a positive feeling.

TBI and Anxiety

Damage to vital neurons can trigger anxious feelings. Also, individuals who have trouble concentrating or reasoning can easily become overwhelmed. The pressure of too many demands can inflict anxiety, which may manifest as anger. Crowded places, lots of noise, and traffic can create an information overload that can trigger an outburst.

As previously alluded to, anger can be a manifestation of other feelings. It’s often a way of communicating and/or dealing with strong emotions. Medical causes can include severe pain, a lack of sleep, headaches, reactions to medications, or difficulties hearing or seeing. However, survivors are often frustrated by a lack of independence, losses of skills, and not being able to process what’s going on.

How to Deal with Anger

Other people are best staying calm if an emotional outburst happens. It can help to move the person to a quiet area, give them a chance to calm down, and even talk about what they are feeling. Changing the topic or introducing a different activity can also be helpful. Time outs, physical exercise, focusing on the things one can do well, and writing out the methods one is using, as a reminder, are useful as well.

A behavior therapist can help, especially with techniques such as identifying a trigger, or antecedent; the behavior exhibited in response to it; and the consequence of the behavior that affects the chances of reoccurrence. Counseling can be an effective way to learn coping skills. Another strategy is medication for enhancing or stabilizing the person’s mood.