Kemmeter Column: U.S. still does little to treat TBI, PTSD
By Gene Kemmeter
After the U.S. killed the top Iranian general in an airstrike Thursday, Jan. 2, Iran responded on Tuesday, Jan. 7, with a missile attack on U.S. installations in Iraq, destroying barracks and bunkers.
U.S. officials initially reported there were no U.S. injuries. However, in subsequent days, those officials began reporting that more than 50 soldiers were transported to Kuwait and Germany for medical treatment after suffering from headaches and other brain injuries, possibly signs of traumatic brain injury (TBI) or Post Traumatic Stress Disorder (PTSD).
TBI and PTSD are separate conditions of brain injuries, but for persons living with a dual diagnosis, it can be hard to separate them. It is estimated that up to 35 percent of returning veterans with mild brain injury also have PTSD, as both exhibit symptoms related to memory, sleep, isolation, emotions, fatigue, depression, anxiety, talking about trauma, anger and substance abuse. Suicide is seldom used by TBI sufferers compared to those with PTSD.
Gen. Mark Milley, chairman of the Joint Chiefs of Staff and a veteran of combat in Iraq and Afghanistan, told reporters all of the casualties of the missile attack are categorized as “mild” injuries, but in some cases the troops will be monitored “for the rest of their lives.”
Combat commanders and veterans report that the brutality of wars evidenced by mangled dead bodies and physical wounds, such as the loss of limbs or burns, provide an immediate, lasting visual horror to participants.
But the traumatic brain injuries usually remain hidden and can take time to appear and be diagnosed. Soldiers in the Civil War exhibited signs of trauma, but the disorder became more readily identified in World War I as “shell shock,” when soldiers were subjected to massive bombardments by heavy artillery, as well as poison gas attacks.
“Shell shock” remained a popular definition after World War II, but problems began multiplying in the Korean War and the Vietnam War as the power of explosives and the sight of death and destruction increased in intensity.
The Department of Veterans Affairs (VA) says the full impact of brain injuries, both physically and psychologically, may not be evident for some time because studies have shown links between TBI and mental health problems usually associated with PTSD.
PTSD is diagnosed after a person experiences symptoms for at least one month as the result of a traumatic event. However, symptoms may not appear until several months or even years later, when the disorder is characterized by three main types of symptoms:
1: Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares; 2: Emotional numbness and avoidance of places, people, and activities that are reminders of the trauma; and 3: Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.
The VA reports that each year about 15 percent of Vietnam veterans exhibit symptoms of PTSD, 12 percent of Gulf War (Desert Storm) and 11 to 20 percent of veterans of Operation Iraqi Freedom and Operation Enduring Freedom.
Brain injuries were often dismissed at first because the problem wasn’t fully understood. In the early 1990s, because of the increase in brain injuries with increased deployments, the Pentagon established a head injury program that became the Defense and Veteran’s Brain Injury Center, researching links between severe TBI and behavioral issues such as suicide and alcohol abuse.
However, diagnosing those issues and symptoms and treating them is much more complicated than treating physical wounds. Remember members of your family, neighbors, friends or others in the community who periodically exhibited behavioral issues and symptoms of brain injury after they served in the military or lived in war zones.
Wars have consequences beyond victories and defeats on the battlefield. Research is showing nations haven’t yet found the ability to guard against or even treat brain injuries that caused TBI and PTSD. Governments have in the past just pushed aside claimants of those injuries by saying they are the individuals’ private mental illness to they don’t have to provide treatment.
Community members need to recognize that TBI and PTSD are legitimate, recognize the symptoms and support services that will successfully treat victims.