Temporal Lobe Injury, Depression and SSRI

Number 3 SSRIs and Suicide: Traumatic Brain Injury [TBI} and Depression: More Dangerous Comorbid Conditions- Brain injury is often missed in diagnostic workup. Neuroscience, even more in the last several years, has confirmed that TBI is far more prevalent than expected [1 in 500 have TBI]. Three subsets of problems many miss when they see the obvious depression [I have missed all of these]:

1. Adult ADD
2. Traumatic Brain Injury
3. Chronic Metabolic Brain/Body Medical Challenges

Traumatic brain injury is often associated with depression and often with suicidal ideation and suicidal activity. TBI is dangerous, period. Three axiomatic clinical observations apply to brain injury:

1. Don't have to be unconscious to have significant brain injury.
2. MRI or CT scan can appear “normal” [SPECT, PET, fMRI will show the pathology]
3. Don't have to hit your head to have TBI, substantial problems even with whiplash

The big problem for this series of posts: RE: FDA, SSRIs and depression:

Brain injury with prefrontal cortical injury [common], and/or with temporal lobe injury [common], will often cause a catastrophic response with SSRI treatment: they can look really crazy, can become more depressed and feel overwhelmingly hopeless.

They can try to kill themselves! Symptoms are a challenge to understand.

Temporal lobe dysregulation will result in very unpredictable anger, mood changes, and the feeling by the patient: “I wasn't mad, didn't get mad, you have the problem.” Often they don't get it socially, miss the punch line, have trouble with words.

Clinicians will say the patient is “bipolar,” and miss the temporal lobe issues, the TBI, and just treat the depression. SSRIs should not be blamed for a missed diagnosis on the front end.

For two interesting stories with SPECT results and examples that confirm these observations go to wwwBrainPlace.com, item three at the bottom of this page.

Next: The third most frequently missed depression comorbidity [not in order of prevalence];
Metabolic Depression: bowel and liver problems that interfere with SSRIs and directly cause depression.

Happy New Year! See you in 07!