During Brain Injury Awareness Month we are bringing light to an invisible wound of warTraumatic Brain Injury (TBI) effects both the civilian and military population. For civilians, this can occur from a vehicle accident or a sports injury. For military, this can occur in garrison, training or deployment. In fact, service members, males ranging from age 18 to 24, are the most vulnerable to TBI. 

Here are some additional statistics about TBI:  
  • Each year, 2.5 million people sustain a TBI. 
  • Mild TBI (mTBI) makes up 80% of all civilian TBIs. 
  • More than 85% of people with concussions recover completely within months following the incident with little assistance and 90% may see recovery in as little as one week. 
  • Males are twice as likely as females to have a TBI. 
  • It is estimated that of all combat casualties from the conflict in Iraq and Afghanistan, approximately 22% are brain injuries, as compared to previous conflicts (Vietnam, 12%).  
  • From 2001 through 2016, the Department of Defense reported over 350,000 cases of diagnosed TBIs in the active duty military population, most of which were mTBI. 
  • The Defense and Veterans Brain Injury Center (DVBIC) estimates that over 50% of injuries to service members sustained during the post-9/11 Iraq and Afghanistan conflicts are from the blast of explosives

 WHAT IS TBI 

Not every hit or jolt to the head will cause a TBI. TBI for the military population often occurs from blast injuries or exposures and include loss of consciousness for a period of time. The shock after a blast can come from the blast of an IED, mortar, bomb or rocket propelled grenade.  

 There are three types of TBIs: mild, moderate, severe. The most common for military service members is mild TBI, or mTBI. This type of TBI is often recognized as interchangeable with the term concussion. Although it is mild, the effects can last long after the event without treatment.  

 Here are some common terms to be aware of when learning about TBI:  

  • Concussion- injury to the brain caused by a hard blow or violent shaking, causing a sudden and temporary impairment of brain function, such as a short loss of consciousness or disturbance of vision and equilibrium.
  • Blast Injury- trauma resulting in direct or indirect exposure to an explosion.
  • TBI- a nondegenerative, noncongenital insult to the brain from an external force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
  • mTBI- an insult to the brain from an external force causing a brief change in mental status (confusion, disorientation or loss of memory) or loss of consciousness for less than 30 minutes.
  • IED: improvised explosive device
  • Post-Concussion Syndrome – a complex, poorly understood problem that may cause headache after head injury; in most cases, patients cannot remember the event that caused the concussion and a variable period of time prior to the injury.

Definitions found on Brainline.org

 SYMPTOMS OF TBI 

After a TBI occurs, changes in behavior, personality and mood can be present. Some of the common symptoms and signs of a TBI include:  

  • ringing in ears 
  • fatigue 
  • insomnia 
  • dizziness  
  • headache  
  • the feeling of pressure in and around the head and neck 
  • loss of consciousness  
  • nausea 
  • vomiting 
  • delayed or slurred speech 
  • vision issues such as blurred or trouble focusing  

Some psychological and behavioral symptoms of TBI may overlap with symptoms of other mental health diagnosis such as PTSD. Depression, stress, impulsivity, outbursts, anxiety and apathy can arise in the weeks and months following a TBI.  

 There are also signs that can have a delayed onset, meaning they can present themselves well after the event causing the TBI. These might include issues with concentration and focus, memory loss, changes in irritability and changes in taste and smell. 

RESEARCH 

Research continues to inform the screening methodology, diagnosis, treatment and recovery for those with TBI. Along with other entities, the VA has allocated resources and research to better understanding TBI.  

 Current research conducted by the VA emphasizes the importance of the cerebellum as more vulnerable than originally thought, especially in the event of repeated blasts. Tests and scans are becoming increasingly high tech and can be used to track changes in the brain after TBI.  

 Magnetic Resonance Imaging (MRI) and cranial tomography (CT) scans help identify parts that are swollen, bruised or damaged and the use of therapy can help the brain to relearn after the damage.  

 Some forerunning TBI research institutions, such as The Brain Injury Association of Michigan, use state of the art technology to help diagnose TBI and then help to retrain the brain to reengage the damaged parts.  

 NAVIGATING LIFE WITH TBI 

In the words of the Brain Injury Association of America “A person with a brain injury is a person first.”  

 TBI is unique to every person that experiences it. Although unique, many will experience a change in life from prior to the event(s); a new normal. Communication, interpersonal relationships, employment and daily tasks may be challenging at first.  

 Here are some tips for navigating life with a TBI: 

  • Be sure to prioritize rest  
  • Protect the head from additional injury 
  • Practice healthy nutritional habits  
  • Engage with beneficial types of treatment to help manage and alleviate symptoms  
  • Practice strategies for remembering and focusing 
  • Utilize scheduling tools and apps to assist with daily tasks and reminders 
  • Engage with peer supporters that may have had similar experiences  
  • Identify and engage with resources, such as advocacy groups, non-profits and community-based clinics 
  • Find and engage with necessary accommodations needed for employment and education 
  • Dedicated time to spend with caregiver, partner, spouse, children and friends doing an enjoyable activity  

How Traumatic Brain Injury (TBI) Affects Daily Life

 FOR CAREGIVERS  

For the amazing caregivers that stand alongside our nation’s heroes, it is important to take care of yourself and be vigilant about combating compassion fatigue and burnout. As roles and responsibilities shift, scheduling time for yourself is important, even if it is for just 5 minutes!  

 Here are some tips for the caregivers: 

Engage Your Supporters  

Support is tantamount to the health of the caregiver and the individual with TBI. Many areas have local VAs, churches and support groups. There are also many online peer support networks that can provide information, insight and resources.  

 The Hope For The Warriors Military and Veteran Caregiver Support Services program is able to provide support to include an online Facebook community, an online support group and in-person Wellness Workshops.  

 Relaxation, Mindfulness, Breathing  

Here is a link to the Caregiver Self-Assessment Questionnaire that can be used to self-assess and see if you might be feeling overwhelmed.  When stress, anxiety or other feelings become overwhelming, deep breathing and mindfulness can help!  

Check out Yoga2Sleep  on the  Meditation Studio app.

Pamela Stokes Eggleston, Founder of Yoga2Sleep is a caregiver, sleep coach,  certified yoga instructor and yoga therapist who specializes in yoga for veterans and the military with combat trauma and PTSD, and their caregivers and families. We are honored to have her conduct sessions at our Caregiver Wellness Workshops.

 Health & Self-Care  

Exercise, proper nutrition and sleep are all essential. Establishing routines for each of these categories is helpful. Minimizing tobacco and alcohol use assists in managing stress and anxiety.  

 Sleep hygiene, or the practices that help you sleep well, such as the use of sleep stories, sound machines or aromatherapy may help with the process of gaining restful sleep.  

 Organize  

Managing symptoms and the recovery process of TBI often includes copious amounts of information to track.  

 Military records and medical records to include personal information, contact information or providers, medications, tests and scans, notes and questions, resources, calendars, bills, etc.  

 DVBIC provides modules for caregivers that include helpful worksheets for organization. Here is a wonderful and informative blog talk radio from two caregivers on the topic of organization. 

 Advocate  

Although this often happens organically, advocating for self and family can be empowering and strengthening. The caregiver is the expert in the day to day, hour-to-hour and minute-to-minute.  

 RESOURCES  

Here are some great resources for further information:  

 If you or someone you know is a veteran who has sustained a TBI apply for our services today