and its name is you

Traumatic brain injury (TBI) is incredibly complex. The long-term effects of a TBI include a wide array of symptoms. Each injury is different, and some people can completely recover rather quickly while others can become permanently disabled, even for seemingly "minor" injuries. What I'll cover here isn't a definitive representation of the experiences of all those who have long-term effects from TBI, nor do I speak for everyone with brain damage.

Here are some long term symptoms relevant to this post:

Alexithymia (inability to process and name emotions)

Inability to process and name physical perceptions

Mood swings and emotional regulation difficulties

Communication difficulties

Social impairment

Apathy about caring for oneself

Lack of motivation

Alexithymia and inability to process physical perceptions

This one is rather obvious. While Mithrun is shown to feel emotions and have physical sensations (for instance, describing his location when he gets lost in the dungeon as "a cold place"), he is also apathetic to how this affects him. This means that his physical and emotional perceptions are reduced in some way. He says that becoming lord of the dungeon will leave someone "empty", showing he is aware of his dulled emotional state.

A good example of this is can be seen here in a bonus comic where he doesn't give much of a reaction to burning his mouth on hot food.

(I love these two a lot, by the way. Pattadol is really under appreciated.)

He is also not able to recognize bodily signals, such as hunger or when he is tired. Despite collapsing from exhaustion and not eating for long periods of time, he still insists he is not tired or hungry.

Mood swings

Mood swings in combination with alexithymia can be an especially disorientating experience. Those who struggle to perceive their own emotions can still feel them even if they don't know how to recognize it.

Individuals with brain injuries often experience drastic mood swings, particularly anger. To those around them, they can appear to go from 0 to 100 in an instant.

This is more speculation/headcanon on my part, as the strongest emotion Mithrun has for most of his appearances is anger. However one could interpret this as being unrelated as he is seeking revenge for a traumatic experience.

Communication difficulties and social impairment

Not only can naming personal experiences be incredibly difficult with a brain injury, but other areas of communication are often affected as well.

Mithrun is not able to set boundaries for himself even if someone is doing something he would not actually want them to do, which can leave him in a vulnerable position.

People with brain injuries can sometimes have a paradoxical experience when it comes to communicating with others. They can go from being very quiet to speaking at length about one topic, seemingly without regard for the importance of each bit of information. (I see it like Newton's first law of motion. It is hard to start speaking and it can be just as hard to stop.)

I really like this aspect of Mithrun's characterization. Usually, he is very quiet because he has no reason to speak. However, once he starts talking he is shown to be overly specific and goes on for long periods of time. Kabru has to spend multiple days figuring out his story.

In a side comic, Kabru tells Mithrun he should condense some of the personal details that Kabru finds irrelevant to the topic of the dungeon.

Mithrun shares many details about himself because his desire not to do so is gone. This mirrors the experience of many people who have brain damage to overshare and not understand how their words will come across to others. Sometimes they say or do things that are insensitive or inappropriate for the situation.

Caring for oneself and motivation

In the dungeon, Mithrun becomes reliant on others for self care. He also seems especially incapable of motivating himself to take care of his body when he is particularly focused on his goals.

In these panels, thus far he had been fairly receptive of Kabru trying to take care of him. However, he could sense that the demon was close and was too focused on that to care to eat.

Refusal of care and treatment is often an effect of traumatic brain injury. This can be for seemingly no reason, even if the person knows that this will help them. Sometimes people will lie about receiving treatment or doing things to take care of themselves, either so they can avoid it or avoid having someone take care of them.

He knows that eating regularly and not pushing himself too much will help him - he's been told multiple times on-screen - but he still has to be continuously told by others to give him that motivation to take care of himself. He's very apathetic to his physical state, even if it seems his only desire is for revenge and he should be doing anything he can to achieve that.

Other things of note

I wasn't sure where to put this, but while Mithrun's sense of direction is speculated by Kabru to be left over from his time as lord of an ever-changing, confusing dungeon, having poor sense of direction in the way he does could also be indicative of brain injury as well.

While the dungeon is confusing and illogical, he is known to have a poor sense of direction and to get frequently lost by those around him, even trying to exit an entrance he just came through. He is shown to be very intelligent, but memory is greatly impacted by brain injuries which affects a person's sense of direction and location.

Something that really stands out to me about Mithrun is how much the things that help him are particularly helpful to those with brain damage. He is physically capable of performing tasks, but he needs an outside source to remind him and get him started. He relies entirely on routine, and when that regularity is taken away he shows extreme difficulty taking care of himself.

Sometimes, the care that some people need is simply someone else to encourage them or to tell them when to do things. The care that he needs is pretty consistent with a person with a brain injury who does not need a full time caretaker and would prefer to have some independence.

Also, healing magic is specified to not work with brain injury unless the person is killed and revived. Mithrun had not been revived after his injuries, so it is entirely possible for him to have sustained a TBI. I don't think this matters that much because one is still allowed to have headcanons even if there is a magical explanation or isn't really possible in canon, but I thought it was an interesting detail.

In conclusion

Because of all this I don't believe that his lack of self care is due solely to mental illness. While mental illnesses like depression or PTSD can cause a decline in self care, the reasons why the affected individual is avoidant of these tasks differs. These disorders can also cause cognitive difficulties and emotional regulation issues, but not to the same extent or in the same way that brain damage would. I think that he does have both depression and PTSD (both are common after a TBI) but those are not his only disabilities.

And on a personal note, I just think that having a character with brain damage is really cool. Most of the time I've seen it the characters are not given very much respect and they are treated as comic relief and a joke. Regardless of whether you agree with this post or not, it is still nice to see a character with a disability like this.

Thank you if you read all of this. I hope it was easy to understand and I did not ramble too much. I don't have anything else to say but I've been wanting to write this out for a while.