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"The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it." - Invisible Wounds of War, Rand Corporation, 2008 The Rand Corporation study stated that as of October 2007 approximately 300,000 soldiers had experienced PTSD (Post Traumatic Stress Disorder) or depression while another 320,000 had a probable TBI (Traumatic Brain Injury). Perhaps one of the most disturbing statements in the report is that 57% of those reporting a probable TBI had not been medically evaluated nor received any type of treatment. The report, itself, shows why many soldiers do not seek treatment. PTSD, depression and TBI are lumped together under the description Mental Disorders. The report stated, "Survey respondents identified many barriers that inhibit getting treatment for their mental health problems." Getting the Brain Injury Words Right
A brain is much more complicated than a hand or foot. It contains millions and millions of tiny cells called neurons, each sending electrical charges of information throughout the brain telling both the brain and the body what to do. A torn blood vessel in the brain cannot be bandaged. Broken neuron connections cannot be put into a cast. A portion of the information flow is disrupted. Last week I had my digital video recorder making a copy of a movie while I worked on the computer. There was a loud boom outside and the house went dark. My electrical connection was disrupted. The effects of the disruption were numerous. Of course, I lost the movie recording. I lost the ability to continue working on the computer. But there were other problems. It was 90 degrees outside and I had no air-conditioning. There was food in the refrigerator and I had no cooling. The clocks in the house stopped working. The hot water heater was no longer heating water. And on and on. When I called to report the outage and described the boom, the young lady asked, "So your neighbors lost their electricity, too?" I replied that I had no idea because I hadn’t talked to any of my neighbors. I had first-hand knowledge of only how I was affected by the outage. A Brain Injury is IndividualNo two brains are exactly alike and, therefore, no two brain injuries are exactly alike. The most common problems associated with brain injury are memory loss, cognitive difficulty and behavioral problems. No two individuals have the same memories, nor do they have the same cognitive abilities. Behavioral problems can be caused by electrical disruptions in the brain or can be caused by a person’s response to memory and cognitive difficulties. My wife did not remember who I was, nor did she remember being married and having two children. More than that, however, she did not remember how to cook, how to put on makeup, and many other daily activities that most of us take for granted. More subtle, though, was not being able to remember names or anything that happened over ten minutes in the past. Something that happened five minutes ago would be totally forgotten five minutes later. This common memory problem would naturally lead to cognitive problems. The processing of information (cognition) is difficult to achieve when the information keeps disappearing. Behavioral problems, as stated previously, can be caused by the injured brain. Disinhibition describes a response that is not filtered by society’s standards, and it can apply to many areas of life since all areas of life are processed in the brain. Sexual Disinhibition probably causes the most stress to family members because of society’s attitudes about anything sexual. The brain’s filter, located in the frontal lobe, simply doesn’t filter everything correctly. The result can be quite embarrassing to those who do not understand how brain injury can affect a person. Disinhibition affects other areas such as verbal communication. Many, many brain injured persons will tell you exactly what’s on their mind, and I emphasize exactly. People who never uttered a curse word in the presence of others may now make a sailor blush. Unfiltered emotions speed through the brain to the mouth without filtering. It can be anger, love, lust, pity, or any other emotion. There can be uncontrollable laughter or uncontrollable crying. Behavioral problems can also be caused by a person’s response to the other issues related to the injured brain. In Chapter Six of our book, Brain Injury Survivor’s Guide, we examine what Beth and I called the Cycle of Response. A person with memory and cognitive issues tries to think hard about everything, and this quickly leads to Mental Fatigue, step one on the Cycle. A tired brain easily enters step two: Confusion. ‘Why can’t I remember his name?’ ‘Why can’t I multiply four times four?’ Not being able to do what was once easily performed by the brain leads to step three: Frustration. In other words, add a little anger to confusion and you get frustration. ‘WHY CAN’T I REMEMBER HIS NAME?’ Step Four enters the Danger Zone of the Cycle: Guilt. ‘I am not a good spouse because I’m different now.’ ‘I’m not a good employee because I can’t remember …’ It’s a short step from Guilt to Depression, step five on the Cycle. Depression is the most dangerous of all because it can lead to separation. Unchecked depression can lead to a person’s separation from friends, separation from family to the point of divorce, separation from employment and, even, separation from life: suicide. The Rand report stated, "With the increasing incidence of suicide and suicide attempts by returning veterans, concern about depression is also on the rise." National Public Radio reported on May 11, 2009, "Last year the rate of suicide in the military exceeded that of the general population, and is highest since the Army began tracking it in the 1980s." Help is AvailableThere are numerous brain injury resources available to families living with brain injury. Many are available that answer a soldier’s concern about confidentiality. Online support groups can be joined anonymously. Books provide another way to get information. I encourage anyone who thinks they may have an injured brain to begin gathering information. Yes, you should consult a medical professional, but these other resources can be very beneficial. Below are links to more information about Brain Injury. |
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A brain injury is just exactly what the words say: an injured brain. It is not a mental disorder. An injured brain is not too unlike an injured hand or an injured foot. Those, of course, are visible wounds and usually receive more effective treatment. X-rays are taken to determine the extent of the damage and appropriate medical procedures are taken such as bandages or casts and may even include pain medication.