Monday, October 31, 2011

Traumatic Brain Injury (TBI) or Post Traumatic Stress Disorder (PTSD or PTS)

First and foremost, I will make the disclaimer that I am not a medical professional.  I am not trying to act like one.  I believe that my experiences and the fact that I survived a Moderate Traumatic Brain Injury gives me a voice to express thoughts in this subject.  The purpose of this article is to create a healthy and respectful discussion.

Many times, in the military, I hear the terms Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD or PTS) forced together in a phrase or a sentence.  It is implied that TBI and PTSD are "kind of" the same thing and that the treatment for one works on the other.  As many of you know I sustained a TBI in Iraq. It is expected for me to have PTSD.  Well... I am PTSD free.  My symptoms are 100% neurological that resulted from the TBI.  

I have heard that PTSD and TBI are comorbid.  I am sure that in many cases both conditions are present.  But according to the definition of comorbid, one does not exclude the other.  Not because they can coexist means that one will be treated and the other should be taken care by itself (which I have heard many times).  The American Heritage Medical Dictionary defines comorbid as coexisting or concomitant with an unrelated pathological or disease process. 

Rarely, I hear "amputee and PTSD" on the same line.  The amputee receives treatment and rehabilitation for the loss of a limb. If there is PTSD present they receive care for that as well.  Two separate injuries, two separate treatments.  But when it comes to TBIs, commonly I hear it side by side with PTSD.  Rarely I hear TBI by itself.  I believe talking about these two different conditions so attached to each other brings misconceptions, dismissal, downplay, and widens the room for error.  

The National Institute of Health defines Traumatic Brain Injury as: a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.  Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.   A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.  A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.

Clearly, TBI and PTSD are two separate and very different conditions that should require two separate and very different approaches. One is a physical injury to the brain whereas the other is not.  In my opinion, the care team should include different specialists for each of these conditions.  I am not a medical professional and I can see the difference.

I have heard that many of the behavioral issues after a TBI are due to a frontal lobe injury. defines the function of the frontal lobe as: The frontal lobes are considered our emotional control center and home to our personality.  

A question comes to mind: How many PTSD are frontal lobe injuries? Or, how many frontal lobe injuries are taken as PTSD?

Bottom line: TBI and PTSD are obviously two separate and very different conditions.  

I leave you all with the question:  Why are these two conditions are being forced to be "married"?


  1. In our book (Wilson, Evans Gracey Bateman,2009, Neuropsychological Rehabilitation. Cambridge University Press) there is a short history of some of this story that date back to Goldstein 1959 and subsequent authors. The concept of the catastrophic reaction that understandably happens when a person experiences a threat to their identity - we have found to be helpful in planning for successful therapy.
    Great blog, thanks for writing it.

  2. I work in the hyperbaric oxygen therapy industry and I have personally seen the miracle that this therapy can do for someone who has suffered from a traumatic brain Injury. I myself suffered a significant head injury shortly after the first of the year. I had bleeding in my frontal lobe and my brain had four contusions plus swelling. Hyperbaric therapy helped me to one, suppress the horrible constant headache I had and two, to accelerate my healing time and return me to my normal self. Hyperbaric therapy helps the brain begin to function normally by saturating the blood with oxygen through permeation and osmosis. This helps the vascular system (veins and arteries) to start creating new capillaries thus helping the brain to fix itself and possibly return to normality. There is a website that lists centers and facilities nationwide to help people find the help they need. If you are wanting to have a chamber in your own home go to I personally used the home portable chambers.

  3. My Dearest Soldier

    My dearest soldier, I remember when you would have died for me,
    Why then oh why, is suicide the only option you can now see?

    I sit here alone and wish I knew how to call you up on the phone.
    I wish I knew who or where you were so I could make sure you aren't alone.

    I wish you would send me your email so I could just drop you a line,
    The real truth is, I want some guarantee that you will eventually be just fine.

    But wars hurt and mame and the warriors never come home quite the same.
    You all have paid such an ultimate price and life in this world can get insane.

    If I could scream at you I would say just wait a little longer until you want to again live.
    But I know that with PTSD, brain trauma, wheelchair’s, and all the rest, your feeling you must have nothing else to give.

    But if you will take just a moment to listen to a friend, I promise with time the heart can again mend.
    If you listen close I’ll tell you the truth, even with a battered body or mind, you still have something special you can give a friend.

    Make sure someone gets you some access to a phone and a computer,
    Because I am excited to see what you can all do if You choose to live until the future.

    There will be hope again in your life, I Promise!

    With Loving Regards,
    Debbie Wilson 12-26-2011

  4. Thanks for posting this informative post. I like the content because its very easy to understand. And the topic captures my attention. Keep on posting like this and more power!