For Military and Veterans Military & Veterans

Blast Injury and Mental Health

Daniel P. Perl, MD
Related Content: 
The Anatomy of PTSD
Blast Injury: What We Have Learned Since the Days of "Shell Shock"
As a Psychologist, Do You Treat TBI and PTSD Together or Separately?

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.
(Photo: Official Marine Corps photo by Sgt. Mark Fayloga/Released)

Comments (1)

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.

DeAnne J Armstrong replied on

My son shows all signs of TBI & was released from the Army as "personality disorder". He is coping with the many issues by a very strick diet.