When they think your TBI is PTSD

I just checked my blog stats, and somebody came over to this site while Googling for info on soldiers and PTSD.

I want to quickly put in a word for military folks who are seeking help for post-combat/deployment issues, who may be headed down the PTSD treatment road, but may miss TBI treatment in the process.

I started professional counseling about six months ago for “coping issues” that I couldn’t get my head around. Everything in life had just gotten so difficult, and I couldn’t understand why I kept running into dead ends with jobs and relationships and why I couldn’t seem to advance in life. All my peers have “moved on” and “grown up” — many of them now with grandkids and advanced careers, long-term homeownership, and all the accoutrements of adult life… while I languished in a no-man’s-land of false starts, scattered ideas, and a long line of failed or aborted attempts at living a normal life.

Now, don’t get me wrong — on the surface, my life looks like it’s highly advanced. I’ve got a great home, a wonderful marriage, and two cars in the garage. My resume looks fabulous, and I’ve got a lot of respect from folks. But my external circumstances don’t match my internal state… and they haven’t for a long time. Nobody really knows just how deep the self-doubt, anxiety, self-criticism, abysmally low self-esteem, and constant invisible struggle really goes.

Except me. And I don’t breathe a word of it to anyone. Not if I can help it.

So, when my health and career and personal life all started to tank in a very big way, this past year, I sought professional help. The counselor I found is highly experienced, compassionate, insightful, kind, caring, and very adept at what they do. But I found myself over time feeling as though they were looking for some sort of horrific trauma in my past that would cause me to lose big chunks of my memory, be uncertain around people, and erode my emotional and behavioral (and cognitive) foundation.

I got the distinct impression they were looking for emotional trauma. Abuse. Neglect. Some sort of terrible thing(s) others did/do to me that cause me to have PTSD. Or some life-threatening event that brought on PTSD.

We had talked about post-traumatic stress a good deal, and both of us accepted that it could have a part in my difficulties. But no matter how closely I looked at my life, I couldn’t for the life of me find THE Event(s) that had wrecked me for “normal” life.

It just didn’t make any sense to me. And when I dug deep and did my own research and realized that sustaining a traumatic brain injury at the age of 8 (and possibly other times), as well as another TBI three years ago, did actually fill in a huge, gaping missing piece of the puzzle.

It’s not that my counselor was incapable or incompetent. They were just looking for the wrong thing in the wrong place. They’re a wonderful resource for me, and I really value their input, but in the case of TBI, I had to come up with my own diagnosis.

This article was very helpful:

Concerns grow about war veterans’ misdiagnoses – Brain injuries can defy easy detection” – I passed it along to my counselor, and they found it very helpful… as well as a bit disconcerting.

And the blog “A Soldier’s Mind” has some more info.

If you’re in the same boat I am/was, you may need to do your own research & preliminary diagnosis, too. After all, TBI tends to make it very difficult for people to tell what’s going on inside our heads — and it can make it tough for us to figure that out, too. Doing research online is a great way to make a start.

I’m finding that TBI is not particularly well-known in the psychotherapeutic community — I have a bunch of friends and associates who are therapists, and when I’ve talked about TBI, I’ve gotten blank stares. That’s not entirely their fault. They aren’t always trained to look for physical ailments, which are the domain of medical doctors. If anything, they’re taught to look away, in terms of medical issues — liability issues, I suppose. Unfortunately, there seem to be a lot of highly trained individuals who simply don’t have the kind of physiological orientation that treats cognitive-behavioral symptoms as possible neuro-physiological phenomena. They are accustomed to looking at emotionally traumatic life experiences as the root of PTSD problems. They’re looking for the right thing… but they’re looking in the wrong place.

I really want to devote a fair amount of time and energy on this site to explaining to psychotherapeutic professionals the personal realities of living with TBI, as it relates to trauma. There are different aspects of the condition that both mask post-traumatic stress and exacerbate it. TBI adds another wrinkle to the whole scene that complicates matters and requires greater sensitivity to our situation.

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.

Other posts about PTSD:

Better today… of pain and ptsd

Technorati tags: Brain Injury Bush combat counseling Emotional Fallout Employment fall Family Issues government head injury Head Trauma headache health insomnia Iraq Iraqi Freedom Mild Traumatic Brain Injury military mtbi neglect Neuropsychological Effects of TBI OEF OIF Personal Experiences with TBI PTSD recovery ringing in ears sleep disturbance Social Issues soldier TBI Symptoms tbi therapist therapy tinnitis trauma traumatic brain injury veteran veterans vets

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Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

5 thoughts on “When they think your TBI is PTSD”

  1. Please help if you can need help suspect brain injury.
    I was rear ended,6 weeks later 42 lbs box fell on my neck.
    brain injury not diagnosed.can’t seem to find help.told nothing swrong.
    I suffer rentless head pain 24/7 .cant,t lay back of my head down without throwing up.head hurts just to lay it on a pillow.
    have to make adjustments to normal stuff so I don’t make it worse,get sick, physical,sicological,emotional changes,lash out . change in personaliyt,crying for no reason,hearing changes,dizzy nausa,ect.

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  2. Tina –

    I am NOT a doctor, so I cannot confirm or deny your situation. I’m not qualified to diagnose others, but if I were in your shoes, I would definitely look into information about TBI.

    The TRAUMATIC BRAIN INJURY SURVIVAL GUIDE by Dr. Glen Johnson has a helpful checklist that got me started down the right path — you can see the work all online at http://www.tbiguide.com/.

    Especially the Common Indicators of a Head Injury at http://www.tbiguide.com/indicators.html — print this out and fill it out and then visit your doctor, is what I say.

    Again, I’m not a doctor, but if you were rear-ended (my neuropsychologist tells me that whiplash and/or other sorts of car accidents can cause injury to the brain) AND a 42 lb box fell on your neck, AND you’ve been suffering from problems that weren’t there before, then my gut tells me you need to follow this up aggressively.

    I have found that communicating with medical professionals is very tricky, especially since I have problems verbalizing, and there is often not enough time for me to get my head around what I need to say. So, if you have a checklist from a medical doctor — which this is — it can help smooth over the bumps in communication.

    It’s very important to find the right kind of help. I would call your local Brain Injury Association office — http://www.biausa.org/stateoffices.htm has contact details — for more help.

    They helped me!!!

    Best of luck
    BB

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  3. Great point.For me, the trauma has been about loss of self and the mistreatment from society who judge me as morally corrupt or just a lazy crap. Even demon-possessed. Ptsd is so secondary to the TBI in my case. But also very real as I Relive situations that caused the TBI. So, it is important to be treated in my case. It took twenty years to even realize TBI was the major culprit for so many of my life’s losses and screwiness. Doing the sobriety again, almost two years. What did it convince me? Same as 1992 sobriety and other stints. Alcohol was not the big issue, unfortunately. TBI was or back in 92 manic-depression, supposedly. No no…..

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  4. I am absolutely convinced that TBI brings a lot of trauma with it. Just as all the subconcussive hits in football can add up to CTE, so can all the “micro-traumas” of TBI. Lost sense of who we are, lost jobs, lost relationships, lost place in the world, as well as the constant *surprise* of things turning out very differently from what you intended/hoped… it all adds up, and it fills our system with “stress sludge” from all the upheavals. It’s complex, but it’s not that complicated. And I don’t know why people can’t see the connections.

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