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PTSD, TBI, & Life After Combat courtesy of www.FamilyOfaVet.com Post-Deployment Alphabet Soup • Post-Traumatic Stress Disorder (PTSD) • Secondary Traumatic Stress (STS) • Traumatic Brain Injury (TBI) PTSD Post-Traumatic Stress Disorder The elephant in every post-deployment room. What is PTSD? • PTSD is clinically defined by five clinical factors: o The person has been exposed to a traumatic event (such as combat). o The traumatic event is repeatedly re-experienced in distress, nightmares, or other disturbances. o The person attempts to avoid or numb their responsiveness to the trauma through various methods such as avoiding thoughts, activities, or people that remind them of the trauma. o These symptoms are persistent and last for longer than one month. o These symptoms cause significant distress and/or impairment in social, occupational or other areas of functioning. Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994; American Psychiatric Association. And what does that REALLY mean? Essentially you’ve been in combat and have seen a lot of dead people, have been in situations where dying was a real possibility, had to kill combatants and been “on edge” for a long period of time. Your brain is struggling to “come back to normal”. Your brain doesn’t understand that you are back in a safe and secure situation and continues to overreact as if it were still in combat. PTSD Symptoms There are three kinds of PTSD Symptoms: o Psychological o Stuff going on in your head. o Behavioral o Stuff you are doing because of stuff going on in your head. o Physical o Physical symptoms a doctor can look at and analyze. Psychological Symptoms • • • • • • Depression Anxiety Guilt Avoidance/Lack of Emotion Intrusive Thoughts Hallucinations Behavioral Symptoms • • • • • • • • • Extreme rage Short fuse Isolating yourself Alcohol or drug abuse Always being “on guard” (Hypervigilant) Feeling numb Memory problems Lack of concentration Nightmares • Unable to fall asleep or stay asleep • Being easily startled • Low self-esteem • Feeling hopeless about the future • Not wanting to see/hear anything that reminds you of combat • Lack of appetite and/or overeating Physical Symptoms • Headaches o Constant or intermittent o Varying degrees from mild to migraine • Rapid Heart Rate o Especially when reminded of traumatic events or “for no particular reason”. • Sweating o Especially when reminded of traumatic events or “for no particular reason”. Crunch the Numbers • According to various studies approximately 20% (between 12-25%) or more veterans returning from combat operations have PTSD symptoms. • Based on the approximately 2 million soldiers who have deployed into Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn that means at least 400,000 PTSD veterans. • Less than half (200,000) of these will seek treatment. STS Secondary Traumatic Stress Because living with someone with PTSD can actually cause PTSD. Secondary Traumatic Stress STS (also called Secondary PTSD) is essentially PTSD caused by PTSD. It can affect: Spouses Children Parents Loved ones STS Symptoms • • • • • • • • • Depression Anxiety Frustration Anger Unable to Sleep Unable to Concentrate Irrational Behavior Crying An inability to cope with daily tasks Crunch the Numbers • Approximately 40% of those who care for someone with PTSD will develop STS. • Using our earlier PTSD number, if we consider only spouses, approximately 160,000 spouses will develop STS from their veteran’s PTSD. • Remember, this number just includes spouses, not other loved ones such as parents, children, and siblings. • Less than 10% of those who have Secondary PTSD will seek help. That means approximately 145,000 spouses are going untreated for STS. PTSD & Children Keeping PTSD from affecting our next generation. STS in Children Here are a few of the symptoms children can exhibit when they have Secondary PTSD: • Extreme mood changes, irritability; • Losing creativity and interest in activities they would typically enjoy; • Loneliness, withdrawal and pulling away; • Acting out more than a child should at their age; • Fighting and trying to harm siblings; • Attempting to take on more than they should at their age; • Suddenly getting into an unusual amount of trouble and taking place in violent acts. TBI Traumatic Brain Injury When blasts damage more than it may first appear. Traumatic Brain Injury (TBI) If you were ever exposed to a blast, TBI is a very possible problem. Symptoms include: o Headaches and/or neck pain that will not go away. o Difficulty concentrating, remembering, or making decisions. o Slowness in thinking, acting, speaking, or reading. o Getting lost or easily confused. o Feeling tired all the time – having no energy or motivation. o Mood changes (feeling sad and/or angry for no reason). o Changes in sleep patterns (Sleeping more or difficulty sleeping). o Lightheadedness, dizziness, and/or loss of balance. o Increased sensitivity to light, sound, and/or distractions. o Nausea. o Blurred vision or eyes that tire easily. o Loss of smell or taste. o Ringing in the ears. o Depression and/or anxiety. Crunch the Numbers • Approximately 22.8% of soldiers returning from combat are likely to have TBI. This number is relative. Sources have indicated numbers both above and below this ranging from 15%-30%+. • Based on our number of approximately 2 million deployed soldiers, that would mean over 450,000 veterans with TBI. • The vast majority of these cases are mild and likely to go untreated, especially if the blast was unreported to medical personnel. Should my vet be screened for TBI? The Veteran’s Administration uses these four question to decide if a veteran needs to be screened for TBI. If your veteran answers “Yes” to all four questions, he or she should be seen as soon as possible at your nearest military or veteran medical facility. 1. Were you exposed to a trauma or blast while in Iraq or Afghanistan? 2. As a result of the trauma or blast did you have a loss or alteration in consciousness (see stars, have bell rung, feel disoriented or confused)? 3. Did you develop problems with headache, insomnia, dizziness, thinking, or behavior immediately to soon after the trauma or blast? 4. Do you still have the problems with headache, insomnia, dizziness, thinking difficulties or behavior that you developed immediately to soon after the trauma or blast? How do I talk to my child about TBI? • Be honest. • Give age-appropriate information. • Watch for signs of stress. • Let everyone talk about their feelings. • Keep life as normal as possible. Recap 400,000 with PTSD 450,000+ with TBI 160,000+ with STS (just spouses) You are ABSOLUTELY not alone! Where Do We Go From Here? • Realize there is a problem. • Educate yourself about the symptoms and signs. • Actively encourage the veteran to seek help, • Courage is the key to seeking treatment. • Help each other by creating your own support network. Resources • • • • • • Mental Health Family Advocacy Military Family Support Group Chaplain www.familyofavet.com www.va.gov