PTSD, TBI, &PTSD, TBI, &Life After Life After Combat Combat

courtesy of

www.FamilyOfaVet.com

Post-Deployment Post-Deployment Alphabet SoupAlphabet Soup

• Post-Traumatic Stress Disorder (PTSD)

• Secondary Traumatic Stress (STS)

• Traumatic Brain Injury (TBI)

PTSDPTSDPost-Post-

Traumatic Traumatic Stress Stress

DisorderDisorderThe elephant in every

post-deployment room.

What is PTSD?What is PTSD?• PTSD is clinically defined by five clinical

factors:o The person has been exposed to a traumatic event (such as

combat).o The traumatic event is repeatedly re-experienced in distress,

nightmares, or other disturbances.o The person attempts to avoid or numb their responsiveness to

the trauma through various methods such as avoiding thoughts, activities, or people that remind them of the trauma.

o These symptoms are persistent and last for longer than one month.

o These symptoms cause significant distress and/or impairment in social, occupational or other areas of functioning.

Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994; American Psychiatric Association.

And what does that And what does that REALLY mean?REALLY mean?

Essentially you’ve been in combat and have seen a lot of dead people, have been in situations where dying was a real possibility, had to kill combatants and been “on edge” for a long period of time.

Your brain is struggling to “come back to normal”.

Your brain doesn’t understand that you are back in a safe and secure situation and continues to overreact as if it were still in combat.

PTSD SymptomsPTSD SymptomsThere are three kinds of PTSD Symptoms:

oPsychologicalo Stuff going on in your head.

oBehavioralo Stuff you are doing because of stuff going on in your head.

oPhysicalo Physical symptoms a doctor can look at and analyze.

Psychological Psychological SymptomsSymptoms

• Depression• Anxiety• Guilt• Avoidance/Lack of Emotion• Intrusive Thoughts• Hallucinations

Behavioral Behavioral SymptomsSymptoms

• Unable to fall asleep or stay asleep

• Being easily startled• Low self-esteem• Feeling hopeless about

the future• Not wanting to

see/hear anything that reminds you of combat

• Lack of appetite and/or overeating

• Extreme rage• Short fuse• Isolating yourself• Alcohol or drug abuse• Always being “on

guard” (Hypervigilant)• Feeling numb• Memory problems• Lack of concentration• Nightmares

Physical SymptomsPhysical Symptoms• Headaches

o Constant or intermittento Varying degrees from mild to migraine

• Rapid Heart Rateo Especially when reminded of traumatic events or “for no particular

reason”.

• Sweatingo Especially when reminded of traumatic events or “for no particular

reason”.

Crunch the NumbersCrunch the Numbers• According to various studies approximately 20%

(between 12-25%) or more veterans returning from combat operations have PTSD symptoms.

• Based on the approximately 2 million soldiers who have deployed into Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn that means at least 400,000 PTSD veterans.

• Less than half (200,000) of these will seek treatment.

STSSTS Secondary Secondary Traumatic Traumatic

StressStressBecause living with someone with PTSD

can actually cause PTSD.

Secondary Traumatic Secondary Traumatic Stress Stress

STS (also called Secondary PTSD) is essentially PTSD

caused by PTSD. It can affect:

SpousesChildrenParents

Loved ones

STS SymptomsSTS Symptoms• Depression• Anxiety• Frustration • Anger• Unable to Sleep• Unable to Concentrate• Irrational Behavior• Crying• An inability to cope with daily tasks

Crunch the NumbersCrunch the Numbers• Approximately 40% of those who care for someone

with PTSD will develop STS.

• Using our earlier PTSD number, if we consider only spouses, approximately 160,000 spouses will develop STS from their veteran’s PTSD.

• Remember, this number just includes spouses, not other loved ones such as parents, children, and siblings.

• Less than 10% of those who have Secondary PTSD will seek help. That means approximately 145,000 spouses are going untreated for STS.

PTSD & PTSD & ChildrenChildren

Keeping PTSD from affecting our next generation.

STS in ChildrenSTS in ChildrenHere are a few of the symptoms children can exhibit when they have Secondary PTSD:•Extreme mood changes, irritability;•Losing creativity and interest in activities they would typically enjoy;•Loneliness, withdrawal and pulling away;•Acting out more than a child should at their age;•Fighting and trying to harm siblings;•Attempting to take on more than they should at their age;•Suddenly getting into an unusual amount of trouble and taking place in violent acts.

TBITBITraumatic Traumatic

Brain InjuryBrain InjuryWhen blasts damage more

than it may first appear.

Traumatic Brain Injury Traumatic Brain Injury (TBI)(TBI)

If you were ever exposed to a blast, TBI is a If you were ever exposed to a blast, TBI is a very possible problem. Symptoms include:very possible problem. Symptoms include:

o Changes in sleep patterns (Sleeping more or difficulty sleeping).

o Lightheadedness, dizziness, and/or loss of balance.

o Increased sensitivity to light, sound, and/or distractions.

o Nausea.o Blurred vision or eyes that

tire easily.o Loss of smell or taste.o Ringing in the ears.o Depression and/or anxiety.

o Headaches and/or neck pain that will not go away.

o Difficulty concentrating, remembering, or making decisions.

o Slowness in thinking, acting, speaking, or reading.

o Getting lost or easily confused.

o Feeling tired all the time – having no energy or motivation.

o Mood changes (feeling sad and/or angry for no reason).

Crunch the NumbersCrunch the Numbers• Approximately 22.8% of soldiers returning from

combat are likely to have TBI. This number is relative. Sources have indicated numbers both above and below this ranging from 15%-30%+.

• Based on our number of approximately 2 million deployed soldiers, that would mean over 450,000 veterans with TBI.

• The vast majority of these cases are mild and likely to go untreated, especially if the blast was unreported to medical personnel.

Should my vet be screened for Should my vet be screened for TBI?TBI?

The Veteran’s Administration uses these four question to decide if a veteran needs to be screened for TBI. If your veteran answers “Yes” to all four questions, he or she should be seen as soon as possible at your nearest military or veteran medical facility.1.Were you exposed to a trauma or blast while in Iraq or Afghanistan?2.As a result of the trauma or blast did you have a loss or alteration in consciousness (see stars, have bell rung, feel disoriented or confused)?3.Did you develop problems with headache, insomnia, dizziness, thinking, or behavior immediately to soon after the trauma or blast?4.Do you still have the problems with headache, insomnia, dizziness, thinking difficulties or behavior that you developed immediately to soon after the trauma or blast?

How do I talk to my child about How do I talk to my child about TBI?TBI?

• Be honest.

• Give age-appropriate information.

• Watch for signs of stress.

• Let everyone talk about their feelings.

• Keep life as normal as possible.

RecapRecap400,000 with PTSD450,000+ with TBI

160,000+ with STS (just spouses)

You are ABSOLUTELY

not alone!

Where Do We Go Where Do We Go From Here?From Here?

• Realize there is a problem.

• Educate yourself about the symptoms and signs.

• Actively encourage the veteran to seek help,

• Courage is the key to seeking treatment.

• Help each other by creating your own support network.

ResourcesResources• Mental Health• Family Advocacy• Military Family Support Group• Chaplain• www.familyofavet.com• www.va.gov