Tips for Civilian Providers: Treating Military Members with Traumatic Brain Injury /Posttraumatic Stress Disorder
U.S. Army photo by Spc. Elisha Dawkins
Below are tips, resources and information for civilian health care professionals treating military patients with a traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD).
Learn About Military Culture
To best recognize the connection between certain health effects and military service, research and develop an understanding of the experiences and exposures U.S. service members and veterans face.
Become familiar with
military culture, including military ranks and the difference between National Guard and reserve members.
Common fundamentals distinguish military culture from many others. Cultural norms include a high standard of discipline, a professional ethos of loyalty and self-sacrifice, distinct ceremonial and etiquette requirements, and an emphasis on group cohesion and esprit de corps that connects service members to each other.
These cultural basics can make it challenging for providers to help returning warriors with a TBI or with psychological health concerns such as PTSD — especially when compounded with everyday stressors from their civilian lives.
- TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.
- TBI can happen to anyone, whether it happens while playing sports, at work, or just slipping on an icy sidewalk. Injuries can range from “mild” to “severe”, with a majority of cases being concussions or mild TBI. The good news is that most cases are treatable and there are several ways to help prevent injury.
- Common symptoms of a brain injury include headaches, dizziness, cognitive impairment, fatigue, irritability, vision changes, balance problems, mood changes and sleep difficulty. For concussion or mild TBI, these symptoms can resolve in minutes to days.
- Most patients who experience a concussion recover fully within weeks, but some may continue to have symptoms for a longer period of time. Patients with chronic symptoms of concussion should get evaluated for other medical problems to include psychological concerns.
- The cause of prolonged symptoms following concussion is not well understood. Possible causes include: psychological health conditions, physiological changes to the brain, ability to manage stress, pre-existing health conditions or co-occurring injuries or illnesses.
- Post-traumatic stress (PTS) vs. PTSD: It’s easy to confuse PTS and PTSD. In addition to sharing similar names, there’s considerable overlap in symptoms between the two conditions. Read more about the differences in this DCoE Blog post.
- PTSD is an anxiety disorder that can occur after experiencing a traumatic event. Anyone who experiences a life-threatening event can develop PTSD. These events can include combat or military exposure, sexual or physical abuse, terrorist attacks and natural disasters.
- Strong emotions caused by the event create changes in the brain that may result in PTSD. Most PTSD reactions go away over time, however, some patients may continue to have symptoms. PTSD symptoms are categorized into four types: re-living the event, avoidance, numbing and hyperarousal.
|Type of Symptom ||Symptoms |
Re-living ||Feels the same horror and fear that was felt when the event took place; nightmares, flashbacks; sights or sounds that trigger re-living the event |
Avoidance || Avoiding situations or people that trigger memories of the traumatic event; avoid thinking or talking about the event |
Numbing || Difficulty expressing feelings; does not feel positive or loving feelings toward others; avoids personal relationships; uninterested in activities that previously brought feelings of joy |
Hyperarousal || Jittery; constantly on high alert for danger; sudden mood swings; difficulty sleeping; trouble concentrating; always on guard; fearful; very easily startled |
Treatment Tips and Resources
Help the military members you’re treating stay focused on their course of treatment. They are likely to feel overwhelmed with a variety of problems — from family and friends, to workplace, finances and physical health. These problems can distract from therapy and add stress that may interfere with resolving symptoms. Helping warriors identify, prioritize and take action to address their concerns helps both patient and health professional reduce the likelihood of future problems.
Treating Service Members with a Chronic Symptomatic Mild TBI
Inform the patient about possible symptoms and the path to recovery. While many patients with a concussion can improve in minutes or days, some may take up to three months. Rest, physical and mental, is an important aspect of recovery, as well as avoiding further injury. For more information on early treatment of concussion, please visit the Defense and Veterans Brain Injury Center website.
Treating Service Members with PTSD
Inform the patient of possible symptoms and the path to recovery. While there are a number of treatment options for PTSD, and because patient response to treatment can vary, some treatments are more beneficial for patients than others. The main treatments for people with PTSD are counseling or
(talk therapy), medications or both. To learn more about these treatments, refer to
PTSD Treatment Options
Management of Post-Traumatic Stress VA/DoD Clinical Practice Guideline.