|Joseph's case highlights several key points with Posttraumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). First, the head trauma is often missed during the medical assessment of the initial injury. About 15% of people with mild TBI have symptoms that persist for a year or more. TBI occurs as the result of the forceful motion of the head or impact causing a brief change in mental status (confusion, disorientation or loss of memory) or loss of consciousness for less than 30 minutes. It sometimes can be referred to as post concussive syndrome. The most commonly reported symptoms of TBI are:
- Irritability and mood disturbances
- Visual disturbances
- Memory loss (especially short term memory)
- Poor attention and concentration
- Sleep disturbances
- Dizziness and loss of balance
- Feelings of depression
- Suicidal thoughts
Other Symptoms Associated with Mild TBI
- Loss of smell
- Sensitivity to light and sounds
- Mood changes
- Getting lost or confused
- Slowness in thinking
These symptoms may not be present or noticed at the time of injury. They may be delayed days or weeks before they appear. The symptoms are often subtle and are often missed by the injured person, family and doctors. Despite not feeling or thinking normal, the person otherwise looks normal. Therefore the diagnosis is more challenging to recognize. Others, such as family and friends often notice changes in behavior before the injured person realizes there is a problem. Frustration at work or when performing household tasks may bring the person to seek medical help. The inability to describe how and why they are suffering may create barriers to these veterans receiving proper care.
What can families do to help?
Learn about PTSD and TBI. Get your loved one to professional help, but go with them to assist good communication about the behaviors and symptoms. Collaborate with health care professionals in the treatment plan. Good care requires a multidisciplinary team. Following is an example:
Psychologist/Neuropsychologist: Evaluates the extent of the head injury and PTSD on the individual's functioning. Provides psychological treatment approaches such as cognitive therapy, narrative therapy, teaching coping skills and healthy life style changes.
Speech Therapist: Provides cognitive rehabilitation techniques.
Physical Therapist: Provides specific therapy and help for balance and hearing problems.
Psychiatrist: Provides medications to relieve symptoms.
Neurologist: Evaluates and treats seizures
Internal medicine: Treats overall health conditions
The treatment of PTSD and TBI requires a comprehensive approach. The treatment team must collaborate and coordinate their treatment efforts. PTSD and TBI are treatable. It is important that veterans and their families are persistent to request the appropriate care and treatment for their needs.
For more information on TBI and PTSD:
Comorbid TBI and PTSD Conditions
Dr. Angie Panos is a psychologist and a board certified expert in traumatic stress with 25 years of experience. She is the mother of a daughter who is currently serving in the military. Dr. Panos is on the Chaplain Training Committee and trains volunteer chaplains for Intermountain Health Care and Primary Children's Hospital. She is on the Board of Directors of Gift From Within, a nonprofit organization that provides education and resources for trauma survivors and mental health counselors. For more information contact www.giftfromwithin.org
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