Angry outbursts are often short-lived and will calm quickly. On some occasions they may last for longer periods of time, particularly with someone who also has difficulty with perseveration. It is perfectly acceptable to validate the patient’s upset mood. However, attempting to reason with or explain the situation to someone who is already angry is unlikely to be an effective strategy.

Psychosocial Considerations

• Identify triggers and avoid if possible, or be prepared to manage outbursts when they arise
• Set rules for communication such that it is not acceptable to yell, threaten, or hurt others
• Ensure patient is not a threat to himself/herself or others
• Give the patient space and time to calm down
  • Refuse to talk to the patient until he/she is calm
• Attempt to redirect patient to another activity or topic.
• Encourage use of coping/relaxation strategies
  • Deep breathing
  • Muscle tension exercises
  • Meditation
• Refer to neuropsychologist experienced with traumatic brain injury

Medical Recommendations

• Antidepressants