Traumatic Brain Injury & Concussion

Traumatic brain injury (TBI), also called acquired brain injury or simply head injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, from whiplash, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. These are the typical “post-concussion syndrome” signs and symptoms.

Apart from the many cognitive effects of a brain injury, individuals may find themselves struggling with emotional effects as well.

The key parts for understanding peoples’ experience of emotional illness include ‘distress’, ‘impairment of functioning’ and ‘increased risk’.

It is also clear that there may be a physical basis to an individual’s psychological problems following a traumatic brain injury. Understanding the relationship between a person’s physical health and psychological well-being becomes particularly important for people with acquired brain injury where misunderstandings about the cause of symptoms are common.

There may be a relationship between a person’s emotional  and  physical health following a brain injury:

  • An individual with a brain injury may have a history of pre-existing psychological problems that is made worse by their injury;
  • Emotional illness can develop as a direct result of the brain injury due to damage of specific areas of the brain;
  • An individual can develop emotional illness in reaction to the traumatic stress associated with an accident or ongoing negative experiences in life;
  • An individual often experiences other traumatic and stressful life events subsequent to acquiring the brain injury.

Therefore, an individual with an acquired brain injury who suffers from emotional illness requires a high level of understanding and support. As previously discussed such individuals are often significantly distressed and at an increased risk of suffering, pain, disability and loss of freedom, or even death.


A very common type of emotional illness experienced by people with acquired brain injury is depression. The symptoms of depression may include a sad mood for most of the day, loss of interest, poor sleep, negative self-concept, low energy and recurrent thoughts of death or suicide. For people who think about ending their lives, suicide may represent an answer to what they feel is an otherwise unsolvable problem. The choice may appear preferable to other circumstances such as enduring emotional distress or disability, which the person may fear more than death. It is worth noting here that the suicide rate of people with acquired brain injury is two to nearly five times higher than the general population.

Dual Diagnosis

There are several types, or combinations of disabilities that come under the heading of ‘dual diagnosis’, one of which is acquired brain injury and emotional illness. The people who fall into this group experience many difficulties.

People can be affected physically by a brain injury, but mostly, there are no obvious outward signs. They describe themselves as “I’m not the same person that I used to be,” and may undergo pronounced changes in their personality.

A person’s behavior following a brain injury may be different to what it was before, or the injury can exaggerate previous behavioral traits. Perhaps the most troublesome changes for the individual and those around him or her are depression, low frustration tolerance, poor impulse control, and aggressive tendencies such as explosive verbal and/or physical outbursts towards others.

Seeking psychiatric help after a traumatic brain injury can alleviate many of these signs and symptoms and in many cases can restore a person to their pre-injury level of functioning. Dr. Kehr is recognized as an expert on the neuropsychiatry aspects of traumatic brain injury.

Meet Bruce Alan Kehr, M.D.


“If you are in emotional pain, I’d like to help. My philosophy is to treat the whole person, by meticulously identifying and treating the underlying biological, psychological, social, and life-stage causes of emotional distress, persistently striving to help you achieve a full recovery. My approach may include innovative laboratory and genetic testing; coordination with other medical specialists, family doctors, psychotherapists and nutritionists; medication management; and nutrition and lifestyle modifications. I also provide caring and empathetic psychotherapy for individuals, couples and families. Learn more about my approach to treatment at”

Bruce Alan Kehr, M.D. is the Founder and President of Potomac Psychiatry. Dr. Kehr is passionate about helping patients with anxiety, depression, obsessive compulsive disorder, life adjustment issues, and bipolar disorder. He treats adolescents, adults, and the elderly in psychotherapy, and with medication management when needed. Through his collective expertise and experience in business and psychiatry, he specializes in helping top business executives lead more balanced, symptom-free lives. He is also the author of Becoming Whole: A Healing Companion to Help Untangle Your Heart, to be published in late 2017 by Greenleaf Book Group. Read more about Becoming Whole at

Dr. Kehr has been voted one of the area’s “Top Doctors” by Washingtonian Magazine from 2012 to 2017, after polling more than 10,000 randomly selected physicians in the DC area, and asking them where they would send their patients and family members for treatment. Dr. Kehr also serves on the Board of the Institute on Aging of the University of Pennsylvania, where he served as Chairman from 2006 to 2009; and was selected as one of the “100 Most Inspiring and Influential Leaders in the Life Sciences Industry,” by the readers and editors of PharmaVOICE in 2007.

Dr. Kehr received training in psychotherapy at the Boston Psychoanalytic Institute, where he also completed his training in psychoanalysis; and has continued his psychoanalytic training in the Washington, D.C. area. A forensic consultant in neuropsychiatry and traumatic brain injury, Dr. Kehr is also the inventor of sixteen issued patents in the United States, Europe, Japan, and Canada, as well as issued and pending trademarks and service marks, in the field of medication adherence software, hardware and communications technologies.

Dr. Kehr writes a weekly blog, and has frequently lectured on many aspects of psychiatry and psychotherapy; medication adherence, where he is recognized as an expert; and on the neuropsychiatric aspects of traumatic brain injury. He received his BA from the University of Pennsylvania, followed by an MD from the Georgetown University School of Medicine. He is Board Certified by the American Board of Psychiatry and Neurology.

View complete curriculum vitae for Dr. Bruce Kehr.

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