Hi, welcome to NeuroTalk.

In addition to being a TBI survivor, I have a son (age 31) who is a drug addict (marijuana, meth, opiates, bath salts, you name it) so my comments will be primarily from the perspective of the parent of an addict.

I suspect the paranoia and agitation are due primarily to the drug use since the TBI was in 2007 and this behavior has presented more acutely over the past year. My son also imagined people surrounding the house etc. Synthetic designer drugs (“potpourri”, “bath salts”, etc.) are well known to cause the paranoia and agitation you describe.

The brain is an incredibly complex organ with over 100 billion neurons, each connected by synapses to multiple others. It is very possible that his TBI is exacerbating the effect of the drug use, or vice versa. The ADD adds another level of complexity. That said, behavioral health professionals will be hard pressed to determine if the TBI is causing lingering symptoms when the drug use is still in the mix. The bottom line is he will need to find a way to get clean and sober for some time before the effects of the TBI can be assessed. Hopefully a psychiatrist or clinical psychologist at the TBI center can help sort through all this.

Regarding your wife and yourself, for your own sense of well-being, consider a support group for parents of addicts. A social worker at the center will likely have references to Al-anon or a similar support group.

I empathize with your situation and wish all of you the best possible outcome. Feel free to PM me if you wish.

Best to you all.