Depression is a common sequela of head trauma. Approximately half of all individuals with a cranial injury will experience depression within the first year, regardless of the severity of the injury. The ailment is characterized clinically as a mood disorder, often associated with intense feelings of sadness. However, depression is more complex than mood disorders, as many mental and bodily complaints—such as insomnia, fatigue, anxiety, appetite changes, aches and pains, and lack of interest in previously enjoyable activities—are associated with depression. These intense feelings, particularly when combined with despair and hopelessness, can lead to suicide, a dreaded potential complication of depression.

Recent studies of traumatic brain injuries have identified specific biochemical and structural factors that can cause depression. From a biochemical standpoint, a brain injury can trigger changes in key neurotransmitters, such as serotonin and dopamine. In addition, head trauma can cause structural damage to certain vulnerable brain circuits linked to depression. Pre-existing issues of depression, substance abuse, and head trauma augment the potential of a depressive mental illness following a traumatic brain injury.

When handling a brain injury claim involving depression, lawyers must understand that being “depressed” is not the same as being “sad.” The primary source of depression is loss, and those who have sustained a brain injury have experienced the most overwhelming loss of all—the loss of his well-being. These cases can be expensive and require a degree of expertise in understanding these problems. Lawyers must obtain records to ascertain the individual’s functional status both before and after the traumatic event. Still, defense counsel can take solace in the general treatability of acute depression; most patients react positively to proper care.

This Article provides a medical analysis of how depression develops following a brain injury. Further, it offers a legal discussion on depression and brain trauma by examining how lawyers should approach such cases and by reviewing recent court cases on this subject.