Traumatic Brain Injury and PTSD
Traumatic brain injury (TBI) occurs from a sudden blow or jolt to the head. Brain injury often occurs during some type of trauma, such as an accident, blast, or a fall. Often when people refer to TBI, they are mistakenly talking about the symptoms that occur following a TBI. Actually, a TBI is the injury, not the symptoms.
How serious is my injury?
A TBI is basically the same thing as a concussion. A TBI can be mild, moderate, or severe. These terms tell you the nature of the injury itself. They do not tell you what symptoms you may have or how severe the symptoms will be.
A TBI can occur even when there is no direct contact to the head. For example, when a person suffers whiplash, the brain may be shaken within the skull. This damage can cause bleeding between the brain and skull. Bruises can form where the brain hits the skull. Like bruises on other parts of the body, mild injuries will heal with time.
Most TBIs in civilians are mild. If you have one, you will be back to normal within 3 month’s time without any special treatment. Even with a moderate or severe TBI, you can have a remarkable recovery.
The length of time that you are knocked out (unconscious) is one way to measure how severe the injury was. If you weren’t knocked out at all or if you were out for less than 30 minutes, your TBI was most likely minor or mild. If you were knocked out for more than 30 minutes but less than 6 hours, your TBI was most likely moderate.
Common symptoms of TBI
Symptoms that happen from TBI are known as post-concussion syndrome (PCS). Few people will have all of the symptoms, but even 1 or 2 of the symptoms can be unpleasant. PCS makes it hard to work, get along at home, or relax. You may suffer from symptoms in the days, weeks, and months following a TBI. The most common symptoms are:
Trouble with your feelings (Emotional)
Angry outbursts and quick to anger
Anxiety (fear, worry, or feeling nervous)
These symptoms are part of the normal process of getting better. They are not signs of lasting brain damage. These symptoms are to be expected and are not a cause for concern or worry. More serious symptoms include severe forms of those listed above, decreased response to standard treatments, and seizures.
TBI or PTSD -- or both?
You may notice that many of the symptoms that follow a TBI overlap with the common reactions after trauma. Because TBI is caused by trauma and there is symptom overlap, it can be hard to tell what the underlying problem is. In addition, many people who get a TBI also develop PTSD.
It is important to be checked because:
People with TBI should not use some medicines.
No matter how mild or severe the injury itself was, the effects could be serious.
Diagnosing a TBI is hard because there may not be any physical signs of injury. Details of the trauma may be hard to pin down. Sometimes right after the injury the effects are so brief that they are not noticed. You may go to the healthcare provider at a later time when details of the injury are not as clear. TBI can occur in confused times of crisis, such as combat. In the heat of events the injury may be ignored. Many of the symptoms that can result from a TBI are the same as the symptoms of PTSD. For these reasons, the best way to diagnose a TBI is by seeing a skilled healthcare provider.
Although TBI screens are used, a screen is not used to diagnose TBI. Even if your TBI screen is positive, that does not mean that you have a TBI. It means that you should be checked further.
Treatment for TBI and PTSD
Many people recover from TBI without any treatment. Problems that linger may clear up in a few weeks. You may notice some problems more as you return to your normal routine. For example, you may not realize that you get tired more quickly until you return to your regular chores, work, or school. Even so, you should get better after a head injury, not worse. Treatment for the symptoms that follow TBI usually involves rehab to improve functioning.
The good news is that effective treatments for PTSD also work well for those who have suffered a mild TBI. This includes two forms of therapy: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE).