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For most, the brain's limbic system activates “fight or flight” in response to intense emotions, then calms down. When triggered from trauma, those with PTSD remain in that activated state of hypervigilance. Over time those changes can affect sleep and mood disorders.

Originally, the Home Base program focused primarily on the brain injury, itself, of service members and veterans. With time, experience, and research, the program now approaches treating brain injury from a holistic method as other issues affect brain health—neurological, cognitive, and psychological functions—like sleep deprivation, chronic pain, or co-occurring substance abuse. Treating the whole person with an individually tailored plan has provided far better outcome.

There are several misconceptions around brain injury and it is important to dispel them. One is that someone with a TBI cannot get better. Not true; in fact, many, many people with TBI who are engaged in treatment get better and return to full lives. The second issue is the wishful thinking that there is one pill or technology that can cure a TBI. Not true; rather engaging in a series of evidence-based treatments and sticking to one’s treatment regimen is what helps people heal.

Home Base has been offering outpatient programs for 10 years and intensive programs for the last five, during which time they have learned two main lessons. The first is the importance of designing individual treatment plans for each person based on their biomarkers of injury, symptoms, and needs. Secondly, they learned the importance of follow through post-program—whether helping a service member or veteran learn the tools for self-management when ready or educating local practitioners to better help the military population with TBI and/or PTSD.

Oftentimes, a family member is the first to recognize symptoms of TBI and/or PTSD in their loved one who has returned from military service. At the Home Base program, veterans and service members are accompanied by a family member for part of the two-week intensive so upon returning home, the family knows better how to help their loved one understand their symptoms and aid with and ongoing treatments, interventions, medications, and general support.

Once upon a time, researchers and doctors treated all traumatic brain injuries the same, but they now know that the mechanism of injury plays a key role in diagnosis and treatment. There are many parallels for civilians and service members who sustain a traumatic brain injury, but the people are very different. Athletes who sustain a TBI most likely will not have the overlapping emotional challenges that service members may who sustained their injury in combat or in a more threatening setting. Helping service members and veterans often includes treating them for both TBI and PTSD simultaneously.

After sustaining a spinal injury as a teenager, Dr. Mary Alexis Iaccarino changed the trajectory of her future. She spent months and years in rehab for her neurological injury then went on to become a physiatrist who specializes in treating and rehabilitating people with the most clinically complex cases of sports concussion, traumatic brain injury, and repetitive head trauma. When she treats veterans and service members, she harkens back to her own experiences, encouraging them toward second careers and full lives even with a TBI.

Recently, Wounded Warrior Project funded a study with the Rand Corporation on the need to treat substance use disorder along with treating traumatic brain injury (TBI) and/or post-traumatic stress disorder (PTSD). The often co-occurring conditions must be treated simultaneously to be as effective as possible.

A traumatic brain injury or repeated brain traumas can sometimes lead to chronic traumatic encephalopathy, Parkinson’s, multiple sclerosis, astrogliosis, or other neurogenerative conditions. Since researchers are still learning about the progression of these diseases, which can stem from repeated TBIs, providers are currently trying to plan and address how to change their model of care to best help veterans and their families in the long term.

John, an Air force veteran, who sustained a TBI has benefitted greatly from almost all of the programs offered through Wounded Warrior Project. With help from community support specialists, life skills coaches, and other alternative treatments, John—and his wife—have turned some of their challenges into advantages and are now giving back to their community.

Wounded Warrior Project’s Independence Program case managers understand that when a service member has a TBI or other physical or mental health issues, the whole family is affected—in the short- and long-term. WWP case managers get to know their families intimately, checking on them weekly and helping them find the services and resources they need. They are always available to help families navigate through these sometimes-complex situations.

Wounded Warrior Project’s Independence Program does not have a protocol to work with service members and their families when they transition home from a clinical facility, but they do have a highly successful formula for independent programing that caters to the individual needs of their clients whether those needs arise from the vet’s neurological trauma or from emotional or psychological challenges that result from that trauma.