Blast Injury and Mental Health
Dr. Perl discusses the importance of looking at physical and mental impacts of blast injury together.
A significant part of the symptoms that our
blast-exposed service members come home with are behavioral in nature. And there are large variety of these with
significant overlap in what has been referred to as PTSD. And there has been this, I guess you could
call it debate in terms of how much of blast injury is physical damage and how much is
a mental health issue in terms of the mind’s response to this problem. And it’s very clear that when one has experienced
blast injury, particularly severe blast injury, that the response of the individual to this
involves one’s behavior in terms of mental health issues. And sorting out what is a mental health issue
and what is an actual physical injury to the brain has been a difficult thing. We really don’t have the tools for this
and I think that some of our findings are going to provide some of those tools, but
up until now this has been a very difficult problem. And I don’t want our findings to be misinterpreted,
we’re not saying that there aren’t mental health issues here, there are. There are significant ones. But with that is actual physical damage to
the brain. And that needs to be taken into account in
terms of diagnosis and in particularly in terms of treatment. And for the most part the treatment of mental
health issues has been involved in a variety of, if you will, talk therapy and to a certain
extent, you know, psychiatric, psychoactive drugs. And we’re not saying that that isn’t appropriate,
we think it is appropriate. And can be helpful. But in the same way as the patient with cancer
can suffer from severe depression related to that diagnosis, the cancer patient with
depression can be helped significantly by seeing a mental health worker and talking
about and dealing with the depression. And they can feel better about the diagnosis
and the prognosis and the underlying condition. But that therapy, the mental health worker
therapy is not going to have any significant effect, we don’t believe, on the cancer
cells. They’re still there. That’s the underlying physical problem that
needs to be dealt with. And I think it’s a good analogy here in
terms of what we’re dealing with. And I think that at times the discussion gets
very polarized. It’s a mental health problem. End of story. Or it’s an organic problem. End of story. I think these are overlapping conditions. They are superimposed on each other and we
have to dissect out what’s what using data, using evidence, rather than just the discipline
one comes from.
Posted on BrainLine December 13, 2017.
Dr. Perl is a Professor of Pathology at USUHS and Director of the CNRM's Brain Tissue Repository, where he has established a state-of-the-art neuropathology laboratory dedicated to research on the acute and long-term effects of traumatic brain injury among military personnel.
(Photo: Official Marine Corps photo by Sgt. Mark Fayloga/Released)