My mom's traumatic brain injury changed her personality — here's what I noticed and how I coped

• After a car crash, my mom developed a TBI that changed her moods, memory, and personality.
• I often had trouble navigating her impulsivity, outbursts, and tensions with other family members. 
• Therapy and creative outlets helped me cope and support my mom as she worked to manage her symptoms.

A head-on car collision in 2000 left my mother with scars on her legs and a permanent limp. Most obvious to me, however, were the lasting effects of her traumatic brain injury (TBI) — unpredictable moods, memory problems, and other changes in her personality. 

I didn't know until later that many TBI survivors experience these exact same symptoms. 

Every year, about 1.5 million Americans survive a TBI. Some people with mild TBIs only experience short-term symptoms that last for several weeks or months. Yet, people with more severe TBIs, like my mom, can experience lifelong effects. 

Frontal lobe injuries like my mom's can affect personality, behavior, and judgment, says Dr. Philip Blum, a neurologist with Memorial Hermann Mischer Neuroscience Associates. 

Family members of TBI patients often report their loved ones are "not the way they used to be" — but they may not always realize these changes relate to the brain injury, which can add to their confusion and frustration.

Here are five of the changes I observed in my mom following her TBI, and how I coped with them.

1. Short-term memory problems

The anterior temporal lobe is an area of the brain that plays a role in your ability to remember and understand information about people, words, and objects. Injuries to this area can cause difficulties with storing short-term memories in your brain, according to Blum.

Blum says. "A person may remember something for a second, minutes, or hours but have trouble recalling days later."

Following my mom's car accident, I noticed she tended to forget things I told her, like the date and time of an upcoming choir recital or the location of my next softball game. 

When she accused me of neglecting to keep her in the loop, I often became defensive, hurt, and frustrated because I assumed she just hadn't listened to me.

She also sometimes had trouble remembering where she put things — including her keys, phone, or wallet — which made getting out the door a stressful experience. 

"It's like deep down I stored what you told me in some hidden part of my brain, but I can't access or download the information," my mom explains. "But as soon as you start telling me the second time, often it all comes back."

As I observed with my mom, however, this symptom can improve over time — and both memory exercises and support from specialists can make a difference.

2. Difficulty focusing

Before the accident, my mom and I would often spend hours snuggled up watching movie marathons on a gloomy Sunday afternoon, and she never had trouble following complex storylines. 

But after the TBI, I noticed I perpetually had to keep rewinding scenes or clarifying events in the movie. 

She also seemed to have trouble concentrating during long conversations, or conversations with multiple people.  

Many people with TBIs have similar trouble focusing. It may take their brains longer to process information, which can make it challenging for them to understand and respond in a variety of situations. 

At first, I felt annoyed when I had to keep explaining things to her — but once I understood this wasn't her fault, I developed more patience and compassion. I also learned eliminating background distractions, like turning the TV off during conversations, helped her hone in on what people said.

3. Impulsivity

After her TBI, when my mom wanted to do, say, or buy something, she just did it — with little planning or regard for consequences. 

For instance, she might start painting a wall of our house but stop in the middle of the process to start a new project. She also tended to buy expensive items that were outside of her budget. Over time, she racked up extensive credit card debt due to these impulsive purchases.

Poor impulse control affects about 55% of people with a moderate to severe TBI — and experts have linked a lack of impulse control to behaviors like compulsive shopping.

People with a TBI may also seem to lack a "filter" for their thoughts or actions and may blurt out inappropriate comments in a social setting. 

For instance, when my mom met my former boyfriend for the first time, she made a joke about his bulging eyes without knowing it was a symptom of his Grave's disease. We all later laughed about it, but in the moment I turned red from embarrassment.

4. Angry outbursts

Speaking of impulsive behavior — post-TBI, my mom's anger came on very suddenly and very intensely. Even just wearing my shoes in the house could set her off. 

One time at a local salon, she became frustrated with how long it was taking to dry her hair. She got up from the chair, stomped down the stairs, and began yelling at the receptionist. 

When she directed these types of angry outbursts at me, I felt afraid — unsure of when they would end or what would calm her down. When she directed them at others, I felt humiliated, like I wanted to run away and hide.

My mother's uncontrollable anger perplexed her, too. She's since expressed to me how confused and ashamed she felt after it passed. 

"I felt this intense rage I didn't have any explanation for — it was like I was in a blackout, where I didn't even know what I was saying or doing," she says.

5. Relationship tensions

Fortunately, most of the changes my mom experienced were manageable and didn't compromise her ability to work or live a generally fulfilling life. But she also experienced relational problems, like 17% of people with moderate to severe TBIs.

At various times throughout my adolescent and teenage life, my mother's siblings, parents, and friends intermittently cut off contact with her after she lashed out at them. This left me in the difficult position of either trying to smooth things over or losing out on those connections myself.

But TBIs can also have a lasting impact on the psychological well-being of loved ones, often in the form of anxiety, stress, and depression. And it's true, I did often feel like I was "walking on eggshells" around her, worrying the littlest thing might set her off. 

As a result, I developed a fear of confrontation and people-pleasing tendencies. I also resorted to hiding things from her or lying in order to avoid her potential wrath.

How I coped

I didn't participate in any support groups personally, but Blum suggests finding an in-person or virtual group. Since the people in these groups also have loved ones with TBIs, they can share potentially helpful insight from their own experiences.

Instead, I focused a lot on becoming comfortable with setting healthy boundaries to protect myself whenever her problematic behaviors came up. Now, when my mom occasionally has an angry outburst, I know I can lovingly detach myself from the situation and invite her to re-engage with me when she's calmed down.

Creative pursuits like songwriting, acting, and journaling have also given me an outlet for my sadness, distress, and frustration — emotions I had trouble expressing to my mother. 

After trying several forms of therapy, I found cognitive behavioral therapy (CBT) the most helpful. Specifically, I've learned to challenge some of the false beliefs that contributed to my fear of angering others. 

Working with a therapist has been beneficial for my mom, too. Through therapy, she learned healthy coping mechanisms for anger — and as a result, she's finally back on good terms with all of her loved ones.

"CBT skills such as breathing exercises for relaxation, and replacing negative thought patterns with positive ones, have been shown to greatly help patients manage their symptoms and accelerate their recovery," says Dr. Barry Kosofsky, a neurologist at Weill Cornell Medicine. 

Occupational therapy has also helped my mom cope with cognitive problems related to learning, memory, and attention and adapt her lifestyle accordingly. 

Insider's takeaway

If you have a loved one with a TBI, you may notice shifts in their moods, cognitive abilities, and behavior. Try to keep in mind, though, that these symptoms aren't your loved one's fault. 

Another important thing I want people who have relatives with TBIs to know: There is hope. 

Many cognitive and behavioral symptoms do improve over time, Kosofsky says — particularly with social support, occupational therapy, and psychiatric and psychological care.

In short, your understanding and support may give your loved one an even better chance of overcoming any difficulties they experience as a result of the TBI.

Growing up with a mom who had a TBI may have had its challenges, but ultimately it helped me cultivate empathy, patience, and resilience.