How traumatic brain injury impacts PTSD

Combat injury often includes traumatic brain injury (TBI), which understandably can be accompanied by psychological trauma. TBI resulting from combat or crime situations is different from TBI resulting from other causes (such as sports injury). The difference: TBI as a result of combat or crime is more likely to lead to PTSD.

When you have PTSD, recurring and intrusive memories in the form of flashbacks and nightmares can haunt you, and create the sense of re-experiencing the trauma as though it’s happening ‘right now’ instead of long ago.

Sleep routine is often disrupted by both TBI and PTSD, and this can impact your energy and mood. Substance use is a common but dangerous coping strategy. With TBI, alcohol and other substances can increase impulsiveness and outbursts, and with PTSD, it can compound problems with emotional numbing and impaired judgment.

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Post-Traumatic Stress Disorder (PTSD) and TBI connect in several ways, the first of which is the consequence of trauma, physical and psychological. TBI can range from mild to severe and doesn’t necessarily involve direct injury to the head. It can happen because of a concussion related to blasts, whiplash, or shaking of the brain that creates bruising.

Mild TBI, which might appear in the form of a concussion with minimal or no loss of consciousness, can resolve rapidly without formal treatment. But more severe TBI, such as direct injury to the head and brain followed by prolonged loss of consciousness is more challenging.

Many veterans who have TBI also develop PTSD. The symptoms overlap to some extent and can be hard to disentangle. Nearly a quarter of the injuries service members suffered during Operation Enduring Freedom and Operation Iraqi Freedom were to the brain, according to data from the Department of Defense. The combination of physical and psychological trauma, often from the same incident, make recovery more complex. This can be compounded by chronic pain and or substance use which may result in slowing down recovery.

When you have TBI, you may experience:

• Mental symptoms such as difficulty concentrating, memory loss and difficulty finding words

• Physical symptoms such as fatigue, headache, sleep disturbance, dizziness

• Emotional symptoms such as depression, mood swings, angry outbursts and anxiety

Getting care for TBI and PTSD takes a team of experts, from cognitive rehabilitation specialists to mental health counselors, and support from family and friends. It’s important to reach out and seek help, since delaying or ignoring symptoms can affect quality of life, relationships, and ability to take care of daily responsibilities.

Cuyler is chief clinical officer of Freespira, an FDA-cleared non-medication treatment that helps people with panic and PTSD manage their symptoms by learning how to regulate their breathing. - www.freespira.com

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