Following brain injury the presence of significant cognitive and communicative impairments increases the risk of the person experiencing elevated levels of anxiety in the context of many everyday situations e.g. when being assisted with personal care, at mealtimes, when meeting new people, in social situations etc.
Cognitive impairment may contribute to elevated levels of anxiety if the person:
- Is confused and disorientated (e.g. during period of post traumatic amnesia or in the context of persistent and significant memory impairment).
- Does not recognise the people around them or understand their roles.
- Is unaware of/lacks insight into their circumstances and their post brain injury difficulties.
- Experiences problems with information processing and maintaining attention.
- Struggles to ‘keep up’ with the cognitive demands placed upon them, resulting in them becoming easily overwhelmed.
Communication impairment may cause anxiety levels to be elevated if the individual:
- Does not understand what is being asked of them.
- Does not understand why something is being asked of them.
- Is unable to ask questions to resolve confusion and/or anxiety.
- Is unable to talk through their concerns and any associated distress.
- Is unable to manage the communicative demands that the environment places upon them.
Following brain injury there are other important factors which may have a significant impact upon the person’s cognitive and communication abilities also potentially contributing to elevated levels of anxiety e.g. fatigue and sleep disturbance.