Asked by David Kershaw, United Kingdom
Can traumatic brain injury cause a person to develop a mental health problem or trigger an underlying problem not yet discovered, which then causes the person to create a fantasy world while in a coma, which, when they awake they are adamant is real?
Mental Health Expert
Dr. Charles Raison
Emory University Medical School
The quick answer to your question is "yes, absolutely." The more complicated, but more accurate answer is "yes, sometimes but it depends, and lots of time the brain injury is a red herring." Let me explain.
I don't know anything about your situation other than what you've described in your single sentence question, so I can't say anything specific about your case, but let's consider some possibilities. I can't tell you how often over the years I've seen young adults who have developed a psychotic disorder such as schizophrenia who have a history of head trauma. The family will invariably suggest that the bang on the head is what set off the psychotic disorder. This is certainly possible, but almost always when I dug deeper I'd discover that the person was showing abnormal thoughts or behaviors even before the head trauma, and that therefore the head trauma was likely a "red herring," meaning an event that appears to explain something but in fact doesn't.
It is human nature to grasp at understandable causes for complicated, tragic affairs such as the development of a severe mental illness. Head trauma is such a memorable, obvious event that people tend to want to link behavioral changes to it, even in cases when careful inspection of the facts don't support this.
On the other hand, it is absolutely true that head trauma -- when severe -- can completely change a person's ability to think, feel and accurately perceive reality. If I had 5,000 instead of 500 words for this blog, I could disturb you at great length with the terrible things I've seen over the years in this regard. I'll give you one famous example.
I'm not sure if you are old enough to remember the young man who shot a bunch of people from atop the University of Texas tower in 1966. He was a top student and all-around solid citizen who mysteriously changed and became angry and bizarre. Before climbing the tower, gun in hand, he left a note asking doctors to perform an autopsy on his brain after he was dead. He felt sure that something must have gone wrong with his brain to account for the change in his views and feelings. After he was shot by law enforcement, his request was honored, and lo and behold, he was right: A tumor was growing throughout the "rage center" of his brain.
In terms of your question: If the person you are thinking of was completely normal before the head trauma, had serious head trauma and has been out of touch with reality ever since -- which is really the definition of psychosis -- then it is extremely likely that the head trauma is the cause of the problem.
Here is a very important point: If the person is psychotic on an ongoing basis -- that is, acting and thinking bizarrely throughout most aspects of his or her life -- then it is of utmost importance to get that person treatment. Fortunately medicines that work on psychotic symptoms from an illness such as schizophrenia also work for psychotic symptoms arising from brain trauma.
A final point. I have extrapolated a great deal from your question, which is really about someone who had bizarre experiences while "in a coma" that he or she still believes are real. If the only problem is that the person is convinced of the reality of these experiences, but doesn't have any other ongoing psychotic experiences or behavior, I'd consider him or her a fairly lucky person and let the issue alone. It is very common for people to continue believing that what they experienced was real without this in itself causing them much further trouble. What matters most is that a person is functioning normally now and into the future.
CNN Comment Policy: CNN encourages you to add a comment to this discussion. You may not post any unlawful, threatening, defamatory, obscene, pornographic or other material that would violate the law. All comments should be relevant to the topic and remain respectful of other authors and commenters. You are solely responsible for your own comments, the consequences of posting those comments, and the consequences of any reliance by you on the comments of others. By submitting your comment, you hereby give CNN the right, but not the obligation, to post, air, edit, exhibit, telecast, cablecast, webcast, re-use, publish, reproduce, use, license, print, distribute or otherwise use your comment(s) and accompanying personal identifying and other information you provide via all forms of media now known or hereafter devised, worldwide, in perpetuity. CNN Privacy Statement.
The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.