Discussions By Condition: I cannot get a diagnosis.

Possible Brain Damage

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: Gaille
  • October 28, 2010
  • 06:23 PM

My 19 year old son sustained a nasty head injury a couple of years ago. He was basically attacked with a baseball bat and hit on the back of the head. He was knocked out for several minutes, taken to hosptial, had his head stitched up and then discharged himself. Typical of a 19 year old male. Three years on he now has an alcohol and drug problem, so hard to tell if the blow to the head has caused the damage or the damage is a result of his addictions problems or both.

He has severe anger management problems, real short term memory problems, and is very much a jekyl and hide now.

He recently lost the plot and smashed up ,my home, wrote off his car, smashed up his younger brother and can remember various bits of this traumatic event. When he recalls this time he says it felt like he was up above himself looking down on what was happening. He obviously no longer lives at home with me and we have struggled to get a physciatrict evaluation done but he is seriously worried that he has a mental health problem. Maybe he does but I think that he must have sustained some level of brain damage as a result of the blow to his head. His younger brother sustained several smashed bones in his forearm during the same attack so there must have been similar damage done to my son's brain surely.

The problem I now have is that health professionals won't look beyond the addicition issues so it is making it even harder to get a diagnosis on whether or not there is any brain damage.

Any suggestions please:(

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  • My 19 year old son sustained a nasty head injury a couple of years ago. He was basically attacked with a baseball bat and hit on the back of the head. He was knocked out for several minutes, taken to hosptial, had his head stitched up and then discharged himself. Typical of a 19 year old male. Three years on he now has an alcohol and drug problem, so hard to tell if the blow to the head has caused the damage or the damage is a result of his addictions problems or both. He has severe anger management problems, real short term memory problems, and is very much a jekyl and hide now. He recently lost the plot and smashed up ,my home, wrote off his car, smashed up his younger brother and can remember various bits of this traumatic event. When he recalls this time he says it felt like he was up above himself looking down on what was happening. He obviously no longer lives at home with me and we have struggled to get a physciatrict evaluation done but he is seriously worried that he has a mental health problem. Maybe he does but I think that he must have sustained some level of brain damage as a result of the blow to his head. His younger brother sustained several smashed bones in his forearm during the same attack so there must have been similar damage done to my son's brain surely. The problem I now have is that health professionals won't look beyond the addicition issues so it is making it even harder to get a diagnosis on whether or not there is any brain damage. Any suggestions please:(Physicians can choose from a number of drugs for reducing the rage attacks that often result from traumatic brain injury (TBI). But there is no guarantee any given medication will do the trick. Different drugs work or don't work with different patients, so your doctor must do some experimentation -- basically, a carefully controlled process of trial and error -- to find the most effective drug for controlling your son's problem.A neurologist specializing in epilepsy should determine whether he has a form of that disease in which seizures present as fits of rage. If so, anticonvulsant medications should obviously be tried first. But even if your son does not have epilepsy, anticonvulsants can sometimes help. Other classes of medicines -- including antidepressants, anti-anxiety agents and beta blockers -- have also been used to ease the episodes of rage induced by TBI.An advantage of such drugs is that they have relatively mild side effects and enable a patient to function reasonably well. In the "old days" -- that is, until about a decade ago -- patients being treated for explosive rage were heavily sedated, with powerful tranquilizers or antipsychotic drugs, so the fits of rage were replaced with a soporific state. No anger, but not much function either. These practices are still sometimes pursued by those not in the know, so it is important that your son's doctor, or at least one of his doctors, be a physical medicine and rehabilitation (PM&R) physician, a behavioral neurologist, or a neuropsychiatrist, any of whom will likely be trained in addressing his kind of problem.Drug treatment is only one part of the solution; the other is behavioral counseling -- a family affair involving you, your spouse and your son. The goal is to identify the things that trigger his anger or that reinforce it, and to develop strategies for preventing or dealing with them. For example, he may regularly fly into a rage when told he cannot do something, such as drive the family car, when he has expressed the wish to do so. But the rage can be minimized, or prevented, by the parent's tone of voice and method of presentation. A gentle "Remember what the doctor said about your driving the car?" helps alter the parent's image as the bad guy, and a sincere offer of an alternative -- such as "May I take you someplace?" -- helps make you a good guy.For those rage-inducing situations that cannot be avoided, he should learn some relaxation techniques. Breathing exercises, shooting some baskets, or taking a brisk walk, for example, allow him to focus on more peaceful and adaptive responses. To employ such solutions your son and other patients with TBI need support from a "significant other" such as a parent or sibling. While patients' cognitive impairments often prevent them from acting effectively on their own to quell the impending rage, over time constructive responses can become more of a habit.As with medications, developing specific behavioral interventions for your son will probably be a careful process of analysis and trial and error to find approaches that work. This process should be done in consultation with a rehabilitation neuropsychologist who is experienced in working with people with brain injury.One-on-one psychotherapy is not a useful option here, though group therapy -- in which all members of the group are patients with TBI-related rage problems -- can help. Participants tend to accept feedback from individuals they identify as their peers; and as with people without TBI, they often give better advice to others than they do to themselves.-- James F. Malec, Ph.D., Psychiatry and Psychology, and Allen W. Brown, M.D., Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minn.On the other end of the spectrum...There can be more to the anger iceberg than just feelings. Often when seek help for anger management issues and are assessed for the reason behind the anger, they have extensive alcohol or other drug use. In cases where drinking or other drug use is present, anger is often the symptom of the drug’s attack on the brain. Often, the more and more a person uses drugs, the angrier he or she becomes. There are many reasons this results in anger, namely the withdrawal once a person runs out of drugs, the family problems stemming from the drug use, the drug user’s guilt, and the chemical attack on the brain as a direct result from the use.I want to stress that anger management is usually ineffective for a person who is angry and frequently using alcohol or other drugs. You can do anger management with such a person until you are blue in the face—and it will not work. Drugs are often the cause for anger, and this type of client should be referred to a substance abuse program. Occasionally, there is a need for anger management once the substance abuse program has been completed and the client has remained clean and sober. A 12-step program, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) is an excellent long-term program that helps many to stay clean and sober and it does not cost a dime.Another cause for anger can be a brain injury. The frontal lobes of the brain, located behind the forehead, are responsible for controlling impulses, such as anger. A simple injury, such as a car crash, falling and hitting your head, or other accident can turn a rather mellow person into someone full of rage. Actually, it is rather scary how easily one can damage his/her brain and become easily angered.Looks like you got some work to do, mom. Good luck.
    keanhe 86 Replies
    • October 29, 2010
    • 08:04 AM
    • 0
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