NEWSLETTER: June 17, 2026

FROM THE NESTIssue 9 | Robbins Nest Alliance

It was just a bus.

We went to a golf tournament last week. Beautiful course, beautiful neighborhood, something we both looked forward to.

We parked fine. Got on the shuttle with everyone else. We were among the last to board, so we walked toward the back through a full bus. Loud. Crowded. Unfamiliar. Every seat taken, people with their gear, no clear path.

We got about halfway down the aisle when the driver pulled out.

Most people grabbed a seatback and steadied themselves. Minor jostle. Nobody thought twice. But Rob was already navigating a moving, crowded aisle with compromised balance and a nervous system running at full alert. That jolt landed differently. I grabbed him before he went down, which spared him the fall, but the damage to his sense of control was already done.

By the time we got off the bus, he was angry. He told the driver. Not kindly.

From the outside, it probably looked like an overreaction to a non-event. From inside his nervous system, it was something else entirely.

Heather's Translation

What happened on that bus has a name: emotional dysregulation, and it is one of the most misunderstood symptoms families deal with after brain injury.

The frontal lobe controls the brain's ability to modulate emotional responses. It functions as a regulatory layer between a perceived threat and the reaction to it, essentially filtering "how big does this response need to be?" After brain injury, that filter is damaged. The amygdala (the brain's threat-detection system) can fire a full alarm for stimuli that would register as minor to an uninjured brain.

What happened in that moment was not a personality flaw. It was not a bad attitude. The bus driver did nothing wrong, and Rob knew that. He said so himself later. He said if he had been the driver, he probably would have done the same thing. But knowing that in hindsight and being able to regulate his response in the moment are two completely different neurological events.

The research on this is clear. A 2019 review in Neuropsychological Rehabilitation identified emotional dysregulation as one of the most persistent and functionally disabling outcomes of acquired brain injury, affecting relationships, community reintegration, and quality of life far beyond the acute phase. It is not a phase. It does not reliably resolve on its own. And it is not proportional to how serious the original injury looked from the outside.

For caregivers, this is the part nobody prepares you for. You can manage a mobility device. You can manage medication schedules. Managing a reaction that comes out of nowhere, in public, in front of other people, while also making sure your person doesn't hit the ground, is something else.

We found the veteran tent about an hour in and stayed there most of the day. Quieter. Fewer bodies. His own space to decompress. He watched golf. His shoulders came down. We were fine.

But we were fine because we found an exit ramp. Not every outing has one.

Rob's Corner

I knew the driver wasn't wrong. Buses run on a schedule. People were fine. But I couldn't stop being angry about it, and I couldn't explain it in the moment in a way that made sense.

That's the part that's hard to describe. I understand what happened. I understand it was a minor thing. And I was still furious. Those two things were both true at the same time. The understanding doesn't turn off the reaction. It just makes you feel worse about having it.

One Thing Worth Knowing

The Dysexecutive Questionnaire (DEX), developed by researchers Wilson, Alderman, Burgess, Emslie, and Evans, is a validated assessment tool used by neuropsychologists to measure frontal lobe dysfunction, including emotional regulation difficulties. If your person has never been formally assessed for dysexecutive syndrome following brain injury, this is worth raising with their neurologist or neuropsychologist by name.

One Resource

The Brain Injury Association of America's caregiver resource pages include specific guidance on behavioral changes after brain injury: biausa.org​

Robbins Nest Alliance provides free, peer-reviewed education for caregivers, veterans, and families navigating neurological injury and illness. If someone in your life needs this, forward it.

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