New Research Offers Hope for Preventing Depression After Brain Injury

Author: Dr James Woolley, Consultant Psychiatrist and Group Medical Director, Schoen Clinic UK. 27 May 2025.

Many of us are aware of the visible, physical challenges that follow a serious brain injury due to an accident or stroke. However, the invisible mental health consequences, particularly depression, are incredibly common yet often receive less immediate attention. Research suggests that around half of all individuals hospitalised with a brain injury will experience depression within the following year.

This isn't just a fleeting sadness; post-injury depression can profoundly affect a person's recovery, influencing their relationships, ability to return to work or education, and overall quality of life. The impact extends beyond the individual, with the broader societal costs of brain injury in the UK estimated at over £15 billion annually, a figure exacerbated by challenges like depression.

Traditionally, medical focus after a traumatic brain injury understandably prioritises surgical interventions, physical rehabilitation, and managing immediate physical symptoms. While crucial, this can sometimes mean that emerging mental health difficulties, like depression, are addressed much later. For some, it can take a year or more to access the right support and medication for their mental health.

Fortunately, there's growing recognition of this issue, and new research is exploring proactive approaches. A significant UK trial is currently underway across nine trauma centres in England, investigating whether a common type of antidepressant – Selective Serotonin Reuptake Inhibitors (SSRIs) – could help prevent severe depression if administered in the weeks following a brain injury. This builds on smaller studies suggesting such early intervention might be beneficial.

While the exact mechanisms are still being explored, one theory is that SSRIs might do more than just treat established depression. There is evidence linking severe depression to inflammation in the brain after an injury. It’s thought that SSRIs could potentially trigger an anti-inflammatory response, thereby offering a protective effect against the long-term development of depression.

The implications of this research are substantial. If we can find effective ways to prevent depression from taking hold after a brain injury, we can significantly improve long-term outcomes for patients, support their rehabilitation more effectively, and potentially reduce the overall burden on individuals, families, and the NHS. As healthcare professionals, we understand that mental health is integral to overall health and recovery.

This ongoing research represents a hopeful step forward in how we care for individuals who have experienced traumatic brain injuries. It highlights the critical importance of considering mental well-being from the very early stages of recovery. If you or someone you know is recovering from a brain injury, remember that support for mental health could be just as vital as physical rehabilitation.

Contact the team at Schoen Clinic Chelsea for specialist mental health support.

Dr James Woolley, Consultant Psychiatrist & Group Medical Director, Schoen Clinic UK

About the author: Dr Woolley

Dr James Woolley is a highly experienced Consultant Psychiatrist at Schoen Clinic Chelsea, with particular expertise in treating mental health conditions that overlap with physical illness.

Trained at the Maudsley Hospital and Institute of Psychiatry, he combines evidence-based medication with psychological therapies such as CBT.

Dr Woolley also holds Fellowships with both the Royal College of Psychiatrists and the Royal College of Physicians, and has published widely in leading scientific journals.

References:

Jorge RE, Acion L, Burin DI, Robinson RG. Sertraline for Preventing Mood Disorders Following Traumatic Brain Injury: A Randomized Clinical Trial. JAMA Psychiatry. 2016;73(10):1041–1047. doi:10.1001/jamapsychiatry.2016.2189 Available at: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2548277 [Accessed 27 May 2025]

Wall, J., 03/04/2024. Have you heard of traumatic brain injury depression? [online] King’s College London. Available at: https://www.kcl.ac.uk/have-you-heard-of-traumatic-brain-injury-depression [Accessed 27 May 2025].

ISRCTN Registry, 23/12/2022. Trial of sertraline to prevent post-traumatic brain injury depression [online] Available at: https://doi.org/10.1186/ISRCTN17518945 [Accessed 27 May 2025].