PTSD, TBI Or Both?

May 15, 2007

One challenge that military healthcare providers are facing with soldiers returning from Iraq, is the challenge of differentiating between PTSD and Mild Traumatic Brain Injury. Both can have similar symptoms, so at times, it can make distinguishing between the two very difficult. Both are signature problems that are seen coming out of Iraq and Afghanistan. In the past, it was thought that one could not suffer from both PTSD and TBI. While that is normally true in the general population, however with the types of situations our troops are faced with and the injuries that they are succeptible to, it is a common to see both together in military personnel returning from the warzone.

PTSD is an emotional injury in response to a traumatic event. Many of the symptoms are emotional in nature. However, there are a variety of cognitive problems as well. Problems such as forgetfulness, inattention, a sense of being overwhelmed with even very simple tasks and clouded thinking. These symptoms can also been seen in patients who experienced a Mild Traumatic Brain Injury. MTBI results from a relatively mild blow to the head that causes just enough of a physical injury that normal brain functions of memory, attention, mental organization and logical thinking can be compromised. Thus making it difficult at times for the healthcare provider to be able to distinguish the difference. Especially when the person may in fact be suffering from PTSD, but has also suffered from a blow to the head.

One thing that can help the healthcare provider is having a full and complete history of the event that caused injury. Amnesia about the event that caused the injury, is one of the key diagnostic criteria for a brain injury of any kind. With our troops, many seeing traumatic situations multiple times and the possibility of them receiving a TBI as well, it’s often that healthcare providers are seeing both PTSD and TBI concurrently, in soldiers returning from Iraq and Afghanistan.

Military healthcare providers are screening for PTSD as soon as a soldier sets foot back in the US. There are additional screenings scheduled at 3 and 6 months post redeployment. This is vital, due to the fact that many times, PTSD may have a delayed onset. I foresee that due to so many soldiers being exposed to blasts in these areas of conflict that healthcare providers will be screening for both.

The military is very cognizant of these two medical problems, as well as the fact that both can be present at the same time, and is proactively putting resources in place at each military base, to ensure that these soldiers don’t fall through the cracks and that they receive the treatment that they need. For more information on PTSD and TBI, please visit the websites.

National Center for PTSD

Defense & Veteran’s Brain Injury Center


9 Responses to “PTSD, TBI Or Both?”

  1. David M on May 15th, 2007 9:19 am
  2. Jim on November 14th, 2007 1:03 pm

    There is a new GAO report out that addresses trauma centers, TBI, and PTSD

    Issued in September 2007. If you havn’t seen it, you can find some information and a link to it here:

    I have focused that blog on homeless veterans and PTSD issues as homeless veterans are underserved in this country and PTSD is the leading cause of homelessness in our veterans. Male veterans make up 43% of all homeless males over 25 but only 27% of the over 25 male population in this country. Not good and many of them have untreated PTSD and TBI.


  3. Terri on November 14th, 2007 2:31 pm

    I’m well aware of those statistics, as I work in the system every day at the intstallation I work at. It is unfortunate, however, many times, there are multiple issues at play along with the untreated PTSD.

    There are many things happening though to address that and other problems related to PTSD. I will be having a post up in the next couple of days, talking about some of the things that are in the works, in the area of the country where I’m at.

  4. When they think your TBI is PTSD « Broken Brain - Brilliant Mind on January 6th, 2008 8:59 am

    [...] the blog A Soldier’s Mind has some more [...]

  5. da carson on January 6th, 2008 9:07 am

    Thanks for this great post! I’ve had a TBI (a couple, actually) and I’m in counseling for post-traumatic stress, as well. I had to figure out the TBI piece myself… but I did. When I informed my counselor about my TBI, they seemed a bit concerned that I wouldn’t need their help anymore… or that I’d terminate my sessions with them. They seemed to think that TBI work would replace the cognitive-behavioral work I was doing with them. But in fact, the TBI aspect makes it even more important to do cognitive-behavioral counseling. It doesn’t make counselors superfluous. If anything, it makes them all the more essential.

  6. btj on January 12th, 2008 5:41 am

    I really don’t know alot about this condition, researching this for my own knowledge. My question is how does a Doctor PROVE one has PTSD/TBI? Is it possible for one to fake it in order to get paid? Just some questions because I really have no idea how a Doctor would prove this or a Mental Health person. If one was to plan it out and tell you the worst stories imaginable, would you diagnose PTSD, or just unstable,what?? I hope someone can shed some light, true, true facts no hypothisis. thanks.

  7. Terri on January 12th, 2008 6:04 am

    PTSD and TBI are two different conditions. While medicine is definitely not an exact science, there are things that the military doctors have at their disposal to aid in their diagnosis. With both PTSD and TBI, in the military, traumatic events are generally well documented, because in most instances, more than one person is involved in that event. Medical science has many tools at their disposal, from CAT scans, MRIs, EEGs that can help diagnose a TBI. The history of the injury of course is very important, such as loss of consciousness. With PTSD, while it can be trickier, family members and co-workers can play a big part, as tey can verify changes in behavior patterns and reactions to various stressors. Neither one, are a disorder that is diagnosed without extensive testing.

  8. Bob Corsa on June 14th, 2008 3:52 pm

    re: TBI / PTSD ! What came first the chicken or the egg.
    If we look at both diadnosis we see the word tramua .
    Post is after and TBI is happening resulting in
    head injury equals PTSD.

    My counselor got an adjudicator to admit finally
    that geting shot in the head was not only tramatic
    it probably causes a loss of hearing .

    Can you fake it ?
    you can fake anything but one of the symptons
    is denial . 40 years later there is still sleepness nights
    headaches , if I had only did it different. Well have a nice day .

  9. Jason on March 11th, 2009 4:51 pm

    I’m not a veteran, but I have both a TBI, and sever PTSD. I was a corrections of in Arizona, and was held hostage for a week. I suffered a blow to the head, among other things. Anyway, I just wanted to say that I know how it feels to have both.

    Thanks for your time.

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