TBI and PTSD: Navigating the Perfect Storm

Marilyn Lash, MSW, Brain Injury Journey magazine
TBI and PTSD: Navigating the Perfect Storm

So often people talk about the effects of traumatic brain injury or the consequences of post-traumatic stress disorder as separate conditions — which they are. But for the person who is living with the dual diagnosis of TBI and PTSD, it can be hard to separate them.

Just as meteorologists predict “the perfect storm” when unusual and unprecedented conditions move in to create catastrophic atmospheric events, so can the combination of PTSD and TBI be overpowering and destructive for all in its path. The person with TBI and PTSD is living in a state unlike anything previously experienced. For the family, home is no longer the safe haven but an unfamiliar front with unpredictable and sometimes frightening currents and events.

While awareness of PTSD has greatly increased with recently returning service members and veterans, it is not new and nor limited to combat. Anyone — children, adolescents, adults, elderly — who is exposed to a life-threatening trauma can develop PTSD. Car crashes, shootings, floods, fires, assaults, or kidnapping can happen to anyone anywhere. But the rate of PTSD after brain injury is much higher in veterans than civilians due to their multiple and prolonged exposure to combat. According to O’Connor and Drebing, it is estimated that up to 35% of returning veterans with mild brain injury also have PTSD.

What’s unique about PTSD?

Symptoms of PTSD include:

  • Unwanted and repeated memories of the life-threatening event
  • Flashbacks where the event is relived and person temporarily loses touch with reality
  • Avoidance of people, places, sights, or sounds that are reminders
  • Feelings of detachment from people, even family, and emotional numbness
  • Shame about what happened and was done
  • Survivor guilt with loss of friends or comrades
  • Hypervigilance or constant alertness for threats.

Individuals with PTSD are at increased risk for depression, physical injuries, substance abuse, and sleep problems, which in turn can affect thoughts and actions. These risk factors also occur with brain injury.

PTSD is a mental disorder, but the associated stress can cause physical damage. TBI is a neurological disorder caused by trauma to the brain. It can cause a wide range of impairments and changes in physical abilities, thinking and learning, vision, hearing, smell, taste, social skills, behaviors, and communication. The brain is so complex, the possible effects of a traumatic injury are extensive and different for each person.

When PTSD and TBI coexist, it’s often difficult to sort out what’s going on. Changes in cognition such as memory and concentration, depression, anxiety, insomnia, and fatigue are common with both diagnoses. One basically feeds and reinforces the other, so it’s a complicated mix — it’s the perfect storm. It may help to consider and compare changes commonly seen with TBI and PTSD.

Memory

TBI: A period of amnesia for what went on just before (retrograde amnesia) or after (anterograde amnesia) the injury occurred is common. The length of time (minutes, hours, days, or weeks) of amnesia is an indicator of the severity of the brain injury. For example, the person may have no memory of what happened just before or after the car crash or IED explosion.

PTSD: In contrast, the person with PTSD is plagued and often haunted by unwanted and continuing intrusive thoughts and memories of what happened. The memories keep coming at any time of day or night in such excruciating detail that the person relives the trauma over and over again.

Sleep

TBI: Sleep disorders are very common after brain injury. Whether it is trouble falling asleep, staying asleep, or waking early, normal sleep patterns are disrupted, making it hard to get the restorative rest of sleep so badly needed.

PTSD: The mental state of hypervigilance interferes with slowing the body and mind down for sleep. Nightmares are so common with PTSD that many individuals dread going to bed and spend long nights watching TV or lying on the couch to avoid the night’s terrors. Waking up with night sweats so drenching that sheets and clothing are soaked. Flashbacks so powerful that bed partners have been struck or strangled while sleep battles waged.

Isolation

TBI: Many survivors of TBI recall the early support and visits of friends, relatives, and coworkers who gradually visited or called less often over time. Loss of friends and coworkers leads to social isolation, one of the most common long-term consequences of TBI.

PTSD: The isolation with PTSD is different as it is self-imposed. For many it is simply too hard to interact with people. The feeling of exposure outside the safe confines of the house is simply too great. The person may avoid leaving the house as a way of containing stimuli and limiting exposure to possible triggers of memories. As a result, the individual’s world becomes smaller and smaller.

Emotions

TBI: When the areas of the brain that control emotions are damaged, the survivor of a TBI may have what is called “emotional lability.” This means that emotions are unpredictable and swing from one extreme to the other. The person may unexpectedly burst into tears or laughter for no apparent reason. This can give the mistaken impression that the person is mentally ill or unstable.

PTSD: Emotional numbness and deadened feelings are a major symptom of PTSD. It’s hard for the person to feel emotions or to find any joy in life. This emotional shutdown creates distance and conflicts with spouses, partners and children. It is a major cause of loss of intimacy with spouses.

Fatigue

TBI: Cognitive fatigue is a hallmark of brain injury. Thinking and learning are simply harder. This cognitive fatigue feels “like hitting the wall,” and everything becomes more challenging. Building rest periods or naps into a daily routine helps prevent cognitive fatigue and restore alertness.

PTSD: The cascading effects of PTSD symptoms make it so difficult to get a decent night’s sleep that fatigue often becomes a constant companion spilling over into many areas. The fatigue is physical, cognitive, and emotional. Feeling wrung out, tempers shorten, frustration mounts, concentration lessens, and behaviors escalate.

Depression

TBI: Depression is the most common psychiatric diagnosis after brain injury; the rate is close to 50%. Depression can affect every aspect of life. While people with more severe brain injuries have higher rates of depression, those with mild brain injuries have higher rates of depression than persons without brain injuries.

PTSD: Depression is the second most common diagnosis after PTSD in OEF and OIF veterans. It is very treatable with mental health therapy and/or medication, but veterans in particular often avoid or delay treatment due to the stigma of mental health care.

Anxiety

TBI: Rather than appearing anxious, the person acts as if nothing matters. Passive behavior can look like laziness or “doing nothing all day,” but in fact it is an initiation problem, not an attitude. Brain injury can affect the ability to initiate or start an activity; the person needs cues, prompts, and structure to get started.

PTSD: Anxiety can rise to such levels that the person cannot contain it and becomes overwhelmed by feelings of panic and stress. It may be prompted by a specific event, such as being left alone, or it can occur for no apparent reason, but the enveloping wave of anxiety makes it difficult to think, reason or act clearly.

Talking about the Trauma

TBI: The person may retell an experience repetitively in excruciating detail to anyone who will listen. Such repetition may be symptomatic of a cognitive communication disorder, but it may also be due to a memory impairment. Events and stories are repeated endlessly to the frustration and exasperation of caregivers, friends, and families who have heard it all before.

PTSD: Avoidance and reluctance to talk about the trauma of what was seen and done is a classic symptom of PTSD, especially among combat veterans.

Anger

TBI: Damage to the frontal lobes of the brain can cause more volatile behavior. The person may be more irritable and anger more easily, especially when overloaded or frustrated. Arguments can escalate quickly, and attempts to reason or calm the person are often not effective.

PTSD: Domestic violence is a pattern of controlling abusive behavior. PTSD does not cause domestic violence, but it can increase physical aggression against partners. Weapons or guns in the home increase the risks for family members. Any spouse or partner who feels fearful or threatened should have an emergency safety plan for protection.

Substance Abuse

TBI: The effects of alcohol are magnified after a brain injury. Drinking alcohol increases the risks of seizures, slows reactions, affects cognition, alters judgment, interacts with medications, and increases the risk for another brain injury. The only safe amount of alcohol after a brain injury is none.

PTSD: Using alcohol and drugs to self-medicate is dangerous. Military veterans drink more heavily and binge drink more often than civilian peers. Alcohol and drugs are being used often by veterans to cope with and dull symptoms of PTSD and depression, but in fact create further problems with memory, thinking, and behavior.

Suicide

TBI: Suicide is unusual in civilians with TBI.

PTSD: Rates of suicide have risen among veterans of OEF and OIF. Contributing factors include difficult and dangerous nature of operations; long deployments and multiple redeployments; combat exposure; and diagnoses of traumatic brain injury, chronic pain, post-traumatic stress disorder, and depression; poor continuity of mental health care; and strain on marital and family relationships. Veterans use guns to commit suicide more frequently than civilians.

Summary

There is no easy “either/or” when it comes to describing the impact of TBI and PTSD. While each diagnosis has distinguishing characteristics, there is an enormous overlap and interplay among the symptoms. Navigating this “perfect storm” is challenging for the survivors, the family, the caregivers, and the treatment team. By pursuing the quest for effective treatment by experienced clinicians, gathering accurate information, and enlisting the support of peers and family, it is possible to chart a course through the troubled waters to a safe haven.

References:

O’Connor, M. & Drebing, C. (2011). Veterans and Brain Injury. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Ehde, D. & Fann, J. (2011). Managing Depression, Anxiety, and Emotional Challenges. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Posted on BrainLine March 7, 2013. Reviewed July 26, 2018.

Marilyn Lash, MSW has more than 35 years experience working with individuals with disabilities and their families in medical, rehabilitation, educational, and vocational settings. Her primary focus is supporting families and developing community programs along with user-friendly publications for families, educators, and clinicians. She is a founding partner of Lash & Associates. Marilyn recently joined a team of specialists who facilitate retreats for wives of wounded warriors, which take place near military bases around the country. She is a former chair of the Board for the Brain Injury Association of North Carolina and former chair of the Brain Injury Advisory Council for North Carolina. She continues to share her insights as a keynote speaker at many brain injury conferences.


Used with permission from Brain Injury Journey magazine, issue #1, Lash & Associates Publishing/Training, Inc.

Comments (98)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I served my country, I loved my country but my country has abandoned me.
I lost friends, blood, now my life. I have tried to hang in there but no more. I was shot, stabbed, run over, fell 700 feet woke up over 12 hours later, the military doctors never checked my head, my back was broken but at time no one checked.
Now they see where I had a server head injury, they see where my broken back healed now they want to try to help
I have others with same thing. Va wants to stop pain meds. We made a mistake the last time va did that my brothers in arms killed themselves. No more we are talking to one another and we are soldiers of more than 10,000 that has had enough.

I was actually really excited to read this article because it said navigating the perfect storm. I did not learn any tools to get through this. I was hoping for a solution to what happens when my husband gets upset. And his brain goes to fight mode automatic every time.

Good afternoon noon so my question after reading this tell me that it is very hard to put both of these issues in one group and they should be treated as such so how is it that the Veterans Administration is doing this to all veterans

I have PTSD and TBI and chronic pain.
PTSD IS FROM military , I held the hand of a soldier dying from being cut in half from a machine gun, another ran over by a tank, soldiers heads blown off next to me, I saw over 100 men die,crying for their mommies as the life left them.
I have been shot, blown up, fell over 500 feet. My PTSD AND TBI. AND all of my surgeries and pain has made life not worth living. I have went through all the pain treatments. Injections,all non pain meds, acupuncture, all types of meds.
The sad thing that help a little was oxycodone 5 a day. It will not take pain away but help function a little. For 16 years I went to work and took care of my family but, opinoids scare came and there are people who do not need meds but got them anyway. Now they want to as they say cut me off. It is unreal. I was a functional person now they have disable me and said don't work. Now I still have pain and stay home and thinking everyday of ending it.
During my time in the military I did my job. Never spent christmas with my wife and child to protect america. While a lot of Americans were with their families I was killing people so they could go to the mall. I did not sleep for several days so I could catch the enemy. To make sure Americans can could Christmas shop go for coffee,go eat while I went days without food.
This is what some soldiers do so Americans can eat turkey.
Now it seems everyone gets PTSD from politics.
When you have your buddy's brain matter sprayed on your face and all over you then you might have PTSD. PLEASE PLEASE remember soldiers are the PTSD people the shell shock people. I do know people have went thru bad things and they will have PTSD. BUT not football players. So please help the soldiers live.

I have PTSD but mine was from a wreck and childhood trauma. My battle was not fought in a war but I battle wars in my head is how I explain my situation to people. I have constant flashbacks. I can't sleep without waking up every 2 hours. I have night sweats, my memory is slipping. The list goes on. I've seen a lot of animal disasters than people compared to you though. I'm sorry for your loss. I hope things get better for you.

Can you have PTSD and TBI after mental abuse (without life threatening?) I have all symptoms of PTSD and TBI, although was not in mortal danger etc, just 3years in absolutely extreme stress to the border of suicidal thoughts. Without support, but with need of supporting other people. Over ten years later, practically all symptoms still last. Ruining forever my work, "career" and everything else.

My husband of 39 years had a severe TBI injury back in 1997 while he was in the military. A helicopter landed on him and his buddy while trying to attach a hook for pallets to be deployed out to the field. He sustained frontal lobe damage and spent 1-1/2 years at Walter Reed. Also, he has PTSD due to the Gulf War and Afganistan.
Since retiring from the military, he tried to go back to school for Architecture, the workload was too trying for him so changed his focus to teaching. Unfortunately, he missed passing the Praxus by 5 points and instead of taking it again, he went into a deep depression. During his internship, he was an amazing teacher to underprivileged students, so I was disappointed he didn't want to try the test again.
Then he tried to drive a semi and dump truck, VA took away his license because of his TBI. So he has been continually spiraling down into deeper and deeper depression.
Since then he stays in bed all hours of the day, stays up all night, won't eat with his family, won't spend time with us, has no sexual interest in me, won't talk to me. I can't help him, only try to show compassion and love. But I'm overwhelmed with responsibilities, I'm the sole financial provider, maintaining our household, maid, cook, and keeping our family together.
Recently in 2019/2020 at the age of 55, I battled a severe illness due to infected mesh from a hernia repair. I had 7 surgeries and numerous hospital visits due to the infection. Finally, in November 2020, I had the final surgery and recovered fully.
During the time of my illness, my husband had an emotional affair with a younger woman. It wasn't a physical affair only because his body couldn't. My first reaction was to end the marriage because of hurt. My second reaction was to pray and give it to GOD. I did tell my husband that I love him but I would not live like this anymore. He wanted to work on our marriage one last time.
So, for me, I talked to my primary care physician for personal consulting. Asked my husband, who had always refused to tell his Neurologist and primary care physician about needing help coping with his emotional, sexual, and psychological conditions and depression, to seek help. This week was the first week he saw a therapist.
I know this is going to be a long road to any semblance of recovery and healing. Is there any forums for family members, who are dealing with similar issues.

So very true. Does anyone know of any great in patient programs in the United states that does a good job treating both issues? I can find programs that deal with PTSD but don't seem to be appropriate for people who are also trying to heal from a brain injury at the same time.
Mostly I'm just finding excessive exposure programs. Not ideal when needing to avoid stress.

I'm a Vet. and been dealing with the drug pushing doctors and what they call PTSD while I was hit by a car in 1983 now 36 years later it is an untreated TBI has now become the perfect storm and not only government not listening my congress men can't help.

Thanks. Great information. Unfortunately I'm suffering from both TBI and PSTD. My injuries are from a 30 foot fall off a two story roof. Because it happened at work, the healthcare has been terrible. My love ones don't understand my pain or suffering. Feel alone beside myself most days.

Dear Reader,

Thank You for the phrase "perfect storm" that is the best description I have heard for my TBI & Complex PTSD. Yes, finding proper help has been a nightmare. Your descriptions are spot on.

Thank You

I've suffered several mild/moderate TBIs due to multiple motor vehicle accidents. I am a shell of the person I used to be. Some days are better than others, but it's a struggle just to get out of bed everyday. I've given up. Had to quit my job because of crippling anxiety/panic attacks and unpredictable emotional states. Speech is becoming more and more difficult. I feel empty and apathetic. I don't want to die, but I am not truly living - I simply exist. I feel hopeless. I am no longer able to plan anything. I do not care to socialize with anyone. I don't want to leave my home. I cannot motivate myself to do anything. I'm exhausted all the time. Sleep is never refreshing and is riddled with nightmares. I hardly recognize myself anymore. Family and friends don't understand. I just wish this misery would end.

I feel exactly the same. I am a husk of my former self. I am of the walking dead.

HI JAY
I have multiple motor vehicle accidents with tbi and whiplash. How long since you last accident?
My experience has been it will take every one a diffrent amount of time to get back to felling like yourself. Please understand what worked for me has taken many years for meto see there is life after TBI and PSTD. I would say one of the thing that help me was to talk with a cousler who has training in dealing with TBI.

All you can do is to place on step in front of the other . This may sound outof place but from that one step come the next step and so on.

I am not sure where you are in your journey but undersatand you are not alone

I have been diagnosed with both my ptsd was cause from tbi this happened 30 years ago when I was struck by a moving vehicle I received little or no treatment no rehab anyway my life is nothing but 1 argument after another my poor wife and kids I’m sure they would be better off without out me I’m currently suspended from my job for arguing with supervisors that everyone hates but I can’t help telling them what I really think and or threaten them most of the time they provoke me cause the know of my problems just to get me disciplined cause they are intimidated because I have way more experience and knowledge about construction ( the only thing I’m good anymore) they do life is always going downhill

I was in the hospital for 4 months woke up can't remember anything daily living is ridiculously hard my point is I had no idea what to do or how to do it no direction at all than I stumbled on here and it gave me hope again just wanted to say thank you

I love the article but also disagree with a few points. That being said many of the comparisons are with a mass event tbi...as opposed to an mTBI. For instance, the effects of depression and rates of suicide are vastly different for those with mTBI because they often go undiagnosed for so long. As well both tbi and mtbi lead to other disorders and even cte.

This was a concluded study. Its the same thing over and over. sxs are all the same in every write up.

This is the worse summery I have ever read in my life why even right a sentence I have both and this was a waste of time all you have done is put info nation readily available side by side, this will contribute to my ptsd from all you people farming suffering and and pretending you have something to offer

I have been having nightmares for most of my life they are always different but kinda the same I'm always running and hiding from some one and they always end up the same with me being killed last night I was running for my life and it was different because I had another person to protect I've been reading you're articles and I've figured out that I may have an old injury or something I don't want to be around people and several of the issues with TBI well all of the symptoms I have I'd like any help I can get I'm so alone going threw this life

I have what they are refering to now as complex ptsd mixed with that ive had over 20 concussions in my lifetime. I am a civilian and am 32 y/o. No one ever explained to me what a concussion was or what it felt like until i was 29. The perfect storm is correct. The intertwining of these two diagnoses makes it difficult if not impossible to prove whether it is a correlation or causation of the symptoms that i have. And bc of the lack of medical care we dont know what came first the PTSD or the PCS. My most recent concussion has turned my life upside down and rideside up all at the same time. For me my PTSD already had a dissociative aspect as far as we know so the memory loss and forgetting days conversations and names has all mingled. My hypervigilance is so bad i can scream simply by a word i often slap or hit punch 3x when scared and my speech has been effected as well. The other day i screamed at my own hair out of the corner of my eye. I think humor is important and thats what gets me through. The other day i was reading aspartame off a soda bottle to check ingredients guess what part my mind got stuck on and repeated. Some days are drastically better than others and i pray some day there will be more research done. Ive found research itself is easy its funding and bureaucracy that makes it difficult. I wish luck to all those looking to find answers and thank you for your time.

Jgirl86
I feel so alone.

:(

Remember, we are never alone, when you feel alone close your eyes, think of nothing , breathe in and out , relax, I am there with you , keep breathing , slowly, in hale count to three , ex hale , count to four , then in hale repeat , each time adding a pause, you are never alone , believe me and have faith . I am always there . Much love always ME

You are not! The God of the universe knows right where you are at and is with you even if you can’t feel or see Him! I promise!! If you want to talk to Him, he’s ALWAYS listening!!! Praying for you now! You do matter. You are loved more than you know and you are perfect just the way you are and you are not alone! Just read the other posts here. We know you exist!!! You matter!!!

Thank you

you are not alone, everything is a stage and we will adapt to changes. Wishing you always the best!!!

I know how you feel. Try to find empathic people to surround you and support groups through veteran councils and disability resources. I know you're feeling so well, so know that you are not the only one who struggles and that there are people who care.

Interested to read all of your stories and don't feel so alone now. My situation is still something of a mystery to me. I am still unsure whether to believe the specialist as to my diagnosis. It doesn't make any sense to me. In 1997 I was diagnosed as an adult with amnesia about a serious incident that apparently occurred in my home as a child. I have no memory whatsoever of any such incident. I was in disbelief and so shocked to be told this that I developed both PTSD and TBI as a result. Just like that. The therapist tried to press me to remember to 'work through it' but I would get so stressed in the sessions that my mind would just shut down and I would 'fall asleep' right in the session. I have never recovered, 22 years later. I used to be a high achiever with a geat family but I lost all that. I have never been able to get my mind to function enough since to be able to work at any kind of a job. I get angry that my life has been wasted over something I don't even remember

My husband returned from Iraq 10 years ago and was so angry and vulgar that I didn’t quite recognize him. The years passed and his anger was all that I was subjected to. He verbally abused me every chance that he had, and I am not a quiet or meek person. I told him he needed help repeatedly for years, to no avail. As it turns out, he was addicted to porn and was cheating on me for 5 years with multiple women. One in particular for 5 years. After I figured out what he had been doing I was ready to walk. Surprisingly on the same day he wanted to talk and began telling me about his time in Iraq. Everything came out and it has been almost a year. I truly don’t understand how this can be so as he excelled at his job and was always helpful and courteous to everyone around him except for me. No one believes that he could be so verbally abusive. Everything that I read says people don’t function with ptsd, but he did. The other weird thing is that the since the day everything came out, he has felt no anger, pain, or need to even watch porn, and continually tries to make it all up to me. I have read nowhere that someone with ptsd can just come out of it like that. I am trying to figure out my future, but the confusion of it all has me spinning.

My husband was brutally attacked 10 years ago.
Last year I too found out about sex addiction.
He’s since had mri for brain damage but they didn’t find anything but said unlikely to this much further on and the mri didn’t pick up all signs of damage anyway. So that’s inconclusive.
He had cbt for PTSD after the attack but now although not diagnosed, they think its likely he still has.
He’s been diagnosed with depression the whole time.
Just hard not knowing for sure whether it’s tbi and PTSD and how best treat it.
Started cbt but they now looking at alternative poss more specific trauma therapy.
I suppose this would be cbt / other for psychological trauma following attack as opposed to therapy for tbi , as read this be two seperate services and as tbi not proven.

I wrote before
I was a special operation soldier
I fought hard to keep my country safe I love my country
Now my mind and body is fighting me I found out my brain is having my body relieve all the injuries in the military
My injuries are
Falling 700 feet with a total parachute failure unconscious for 13 hrs, seeing 17 comrades killed around me , holding the hand of a soldier dying after being cut in half from machine gun fire, a woman having her head blown off from a sniper.
I had over 15 surgeries and 3 months at walter Reed hospital.
People tell me I am lucky to be alive . Now I tell them no I wished I had died. The pain is intense it bends me over , I fall down alot. I scream in silent so my wife can't hear me and this is with my 4 oxycodone a day my zoloft 1 aday. I chose this low dose 10 years ago I only wanted as little I could stand .
A doctor told me to take responsibility for my pain because I chose special operations.
Now the USA has an epidemic on pain meds.
I am tired I keep going but no pain meds i will not.
I love my country why won't my country love me back.

My heart to you Brother. I can not comprehend living after that fall, I was an AirMedevac Specialist (that's Paramedic in a Helo for Civies) or the excruciating pain as a human and man I've got some pain. But I do completely understand not being loved back by our country, denial of pain meds because of somebody slamming H. I am physically and mentally broken, but I did it willingly for my country,Constitution and her people. But this complete disregard to my pains by the govt, VA and people's is not what I expected. Vietnam guys at least got told they were unloved. Now it's our words of love mask the true apathy of our nation. Do you know the population of persons who are the highest represented in Clinical Trials? Veterans, still serving except now we're the Nation's Crash Test Dummies.John I love you and wish you peace. I send my posative prayers into the universe for and about you.
Sic ut aliorum vivimus.

I’m so sorry. You are not alone. I do not know what you are going through but God loves you sooo much and Jesus gave up His life so we could be free of all of this one day for those of us who believe in Him and ask Him into our hearts. I promise He’s real!!! Don’t give up hope! Stay focused on what’s ahead. For we are not seeking the approval of man or working for earthly things, but for God and for what is u seen. He is real, heaven is real, and KNOW that God has a bigger plan in all of this, even if you can’t see it or feel it. Ask Him to reveal Himself to you and I’m praying the God of peace surrounds you with His unexplainable peace right now!!! Thank you for your service. I’m so sorry you are going through this. You do matter and there are a more people who love and care about you than you probably realize.

Yes, my head "almost" went through a windshield. That is, it created a bubble in the windshield in the shape of my head. Police and ambulance there, not one person asked whose head did that! I walked home, two miles from the accident. Parents yelled at me for being late. Told them, they didn't think to take me to the hospital. Had headaches for years, every time I bent down, head would throb. Have serious memory problems, feel stupid all the time. Married a psycho woman who treated me like dirt and I thought I was doing something wrong so I kept trying to change to appease her. Now realize I always think I'm the problem, attract narcs have serious trust issues, paranoia and hypervigiliance, always thinking someone is plotting against me (like my Ex) or someone has a problem with me. Over-react, under-react, react in the wrong way, not sure what to do when. Got divorced, now I hate the government, don't trust lawyers. Broke, think of ending it every day.

I feel your pain brother

I am so sorry this is happening to you. Hope you are alive and well and can read this. Please ask for help from friends, family hotlines. Whatever it takes

Hang in there JM I know how do you feel! Keep fighting!! Just letting you know you are not alone.

Dear J.M.,

I'm so sorry that you're going through this and that you don't feel understood. You may think no one has ever experienced what you’re going through and that no one can help you. I'm here to say that you can get through this.

Have you expressed what you’re struggling with to your family or to a friend? If you’re not comfortable talking with them or feel they're unable to understand, please consider reaching out to one of these confidential resources:

National Suicide Crisis Line (24/7)
1-800-273-8255

When you call you will hear a message that you’ve reached the crisis line, there will be brief hold music while you’re connected. Then a skilled, trained crisis worker who works at the Lifeline network crisis center will answer the phone. This person will listen to you, understand how your problem is affecting you, provide support, and share any resources that may be helpful.

Crisis Text Line (NAMI)
Text HOME to 741-741
to connect with a trained crisis counselor to talk via text message.

When you text HOME to 741-741 the first two responses are automated. They tell you that you're being connected with a Crisis Counselor, and invite you to share a bit more. It usually takes less than five minutes to connect you with a Crisis Counselor. When you’ve reached a Crisis Counselor, they’ll introduce themselves, reflect on what you’ve said, and invite you to share at your own pace. You’ll then text back and forth with the Crisis Counselor. You never have to share anything you don’t want to.

Hi my name is Connie. I am on my second bout of PTSD. And have had multiple concussions. The first @ 18yrs old a car crash where my head was caught between the roll cage and concrete I was drug 50ft before expelled from the vehicle. It scapled me. A year of surgeries I looked normal on the out side. Not one dr then told me I had TBI or PTSD. My whole family was called in to say goodbye. I made it navigating on my own with family to help. I never really remembered the car wreak even years later. 10yrs I suffered. Then in between I had many more concussions. I always was rough on my self. Then my brother shot and killed my dad and tried to kill my mom. I was a thousand miles away. My husband is in the military. I have never felt so helpless my whole life. Now im three years into battling my second round of PTSD. All I feel is empty or like im drowning at the same time. I feel guilty about everything. And Rage but control is what is killing me slowly. I agree with all said above. I am all that and more. My saving grace has come from a stellate ganglion block. I am at war with my self internally at all times. The block helps there need to be more people discussing this block it helps like nothing else. There is hope.

ACA Adult Children of Alcoholics and or Dysfunction.
It's miraculous, it may help. If you don't have a group near by join a phone group. I wish you well. I'll keep you in my prayers.

I was diagnosed with Complex-PTSD and had severe closed head injuries due to a motor cycle accident. Is there any specialists in or near Indianapolis, IN

Wow. I thought I was a special kind, then I read that is common for those who isolate with PTSD. So, I decided to let that go. Then I read the first few sentences in this article. I am a special kind of hopeless. Like, should have been gone hopeless.

U have suffered 10-12 serious traumas equivalent to one that caused be on of my TBIs. Someone tried to murder me with a baseball bat (according to doc). My brain became bloody applesauce. Four weeks afterwards, in the hospital, I had the first cognitive thought since the assault "I am still alive". 11 months later a serious car accident delivers another serious tbi and offers up extended, if not permanent eye focus problems. Shit, the shattered skull severed my hearing nerves, now I am losing eye sight? Yep. Truth is there. In these words there is horrific truth. I never want to see you suffer. I suffer so alone. It is the only safe place I have. In bed. Alone. On my back. Nothing behind me but a bed.

My daughter was beaten to near death by an ex-boyfriend Dec. 30, 2015. This informative article has answered most of the questions I had about TBI & PTSD, she has symptoms of both minus the violence. We had to relocate her due to the constant threat of the abuser, away from her family and support system, because law enforcement would not revoke his probation and put him in jail. Through your website I was able to find a facility that treats both of these and the whole person. Thank you so much.

Hello.
When I was 17; I was beaten, tortured and dumped south of town. It left me with PTSD and TBI. I haven't been able to find help beyond pills that don't work. There is a place that offers help near me. But it's too expensive. My doctor keeps offering me meds but I am tired of them not working. I have. A good diet and exercise that is very important to living this way.

I really don’t like how this is written. If family and friends of the person who has PTSD keep reading about how it makes the person violent and add in domestic violence they will assume this is the case. When I’m facg most of the research has been done with sufferers of PTSD from violence related to war. So for these sufferers they may be violent if they feel threatened as this is how they protect themselves in war. If the trauma did not come from this type of violence the sufferer may not be violent. I’m tired of seeing this about people with PTSD being violent and the research being mainly from veterans. It leaves family and friends thinking everyone with PTSD is violent. This of course is not true.

While I understand your point completely, that not all PTSD suffers are violent, it IS a common response for people to have emotional disturbances that cause them to be, what might seem, irrationally angry. It also mentions in the article that PTSD does NOT cause violence right off the top, and TBI patients due often have frontal lobe damage that causes these kinds of symptoms so that is part of what they are trying to get across. It's an effort to get people who are uneducated to understand that patients are not choosing to act the way they do and have little control over it the way a diabetic would over their insulin levels. It's not meant to stigmatize but to inform so that people are informed, prepared and non-judgemental in order to help people recover and live with the symptoms, instead of blaming them.

I too agree with this my ptsd came from traumatic bereavement and no not violent but complete opposite infact...

I understand where you are coming from with this concern.

PTSD goes hand in hand with feeling SAFE. There should be more empathy and understanding. People who care about those who suffer from PTSD should always work to make their loved one feel SAFE. It is something PTSD sufferers deal with every day. We react so seriously because we perceive a threat which puts us in fight or flight mode.

You must understand this about PTSD survivors. As a veteran once said: a bag of trash is just a bag of trash to everyone else, but to someone who has served and seen soldiers blown apart, it’s not just a bag of trash. Have some empathy here - it’s a reality for I have PTSD from several traumatic events one of which was a home invasion. I am so suspicious of anyone coming to my home uninvited. I had some people who came to my front door right after my mom had come in. They were pretending to be needing oil for their car. I overheard my mom talking to this person. When I came into the living room to intervene I threatened them and ran them off. I chewed my mother out for standing there with door open talking to these people. I pulled photos from my critter cam and called police. Another guy in their group was at their car while the officer talked to me. I told the officer I was nearly taken from my home and take threats like this very seriously. I then turned to the other guy and told him that if they ever stepped foot in my house I’d be ready. I do have a permit to carry, but I prefer to avoid problems as best I can instead. I call police if I have a suspicion.

Trying to be aware of your daughter's deficits and how she can learn to identify them can help. For example, I know I tend to chat and get too personal with strangers not realizing they may not be safe. I’ve run into situations as a result, so I now try to have a “circle of trust” of guy friends and non-emergency law enforcement to help.

These comments and the body of evidence that has grown to help us understand the complexities of issues each PTSD/TBI sufferer faces gives me HOPE! Through my own challenges and discoveries, I hope my experience one day can be a beacon for veterans as civilians like me.

I was not given assistance or rehab. As a typical severe TBI victim, I lived for 30 years never realizing my injury and subsequent injuries affected my life. I constantly struggled and still do. I had tutors in school and used academic support services to graduate with a Doctoral degree finally.

I am finally seeking accommodations at work because I am so afraid of losing my job that I have started looking at my needs seriously. I always knew something was wrong since the gruesome accident, but I had poor self-awareness. My family is military, so there was no support for an injury like severe TBI that had no visible signs after the initial swelling and unconsciousness. My head was swollen like a pumpkin, but luckily the CT scan showed I was ok back in 1987. S

Rather than be angry that I’ve suffered, I try so hard every day to believe that my experience, my life is not for naught. Sometimes I feel that nothing would be for meaningful to me, more healing for my soul than to help others because I have some insight. I understand how important it is to preserve the DIGNITY and autonomy of PTSD/TBI victims.

Every case is complex, but there is overlap that can help support many related conditions -autism, anxiety, victims of abuse and neglect. I hope nothing here is offensive to anyone. My intentions are to share in our struggle, believe and hope for a life of safety, compassion and healing.

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