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event that threatens your safety or makes you feel helpless. Most people associate PTSD with
battle-scarred soldiers – and military combat is the most common cause in men – but any
overwhelming life experience can trigger PTSD, especially if the event is perceived as
unpredictable and uncontrollable. Post-traumatic stress disorder (PTSD) can affect those who
personally experience the catastrophe, those who witness it, and those who pick up the pieces
afterwards, including emergency workers and law enforcement officers. It can even occur in the
friends or family members of those who went through the actual trauma.
The Army’s first study of the mental health of troops who fought in Iraq found that about
one in eight reported symptoms of post-traumatic stress disorder. The survey also showed that
less than half of those with problems sought help, mostly out of fear of being stigmatized or
The survey of Army and Marine combat units was conducted a few months after their
return from Iraq or Afghanistan last year. Most studies of past wars’ effects on mental health
were done years later, making it difficult to compare the latest results with those from the
Vietnam or Persian Gulf wars, said Dr. Charles W. Hoge, one of the researchers at the Walter
“The most important thing we can do for service members who have been in combat is to
help them understand that the earlier that they get help when they need it, the better off they’ll
PTSD in soldiers is known as “The combat wound that you can’t see, touch or feel
without asking.” In 2004 on my first deployment, my unit redeployed home to the United States.
When we arrived home we were released to our families for two hours. After the two hours of
family time we had to report back to our units and turn in all of our gear. Once the gear was
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turned in, the commander spoke with all of us, family members included. His topic was Post
deployment re-integration (PDR). He advised everyone that the men of his unit will be busy the
next week getting shots and speaking with health care professionals from all different back
grounds. The idea behind it was to have all of the soldiers shots up-dated and screened for a
The big issue is, once the process was started most soldiers just wanted to get back home
to rest and relax with their families as soon as possible. This type of mind set in the soldiers to
include myself resulted in a disaster. For example, all of us said we “felt fine” or “I’m 100%
doc” when the doctors asked if there was anything wrong. The doctors knew and understood that
PTSD did not have time to set in. So the doctors just made a number code in our records and said
“welcome home,” as they handed us back our records. After several months had passed and
soldiers had time to reflect on their combat tours, many found that something was not right.
Some soldiers found it impossible to sleep at night; others found that their home life was not the
same as it used to be. For some of my closest friends it was the horror manifested itself deep
inside people in their normal daily activities, such as driving, shopping and work.
My symptom of PTSD was constant restlessness. I always had to be doing something and
I kept telling myself it was a direct reflection of my on the go mindset from Iraq; I really thought
that it was too; that’s until I started having terrifying nightmares. The nightmares were getting to
the point where I was hardly sleeping out all. I realized that if I slept in my living room with the
TV on the Military channel I could sleep almost five to six hours. After deciding to visit the
“head doctor” or psychologist, he told me that he wanted to give me a full physical followed by a
What I failed to point out to the doctors one month earlier during the PDR, was the fact
that I suffered two traumatic brain injuries or (TBI’s) while serving in Iraq. Traumatic brain
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injury is a complex injury with a broad spectrum of symptoms and disabilities. The impact on a
person and his or her family can be devastating. A traumatic brain injury (TBI) is a blow or jolt
to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or
The severity of such an injury may range from "mild" (a brief change in mental status or
consciousness) to "severe" (an extended period of unconsciousness or amnesia after the injury).
A TBI can result in short or long-term problems. My particular TBI experience occurred during
two mobile combat patrols. My vehicle was hit by an Improvised explosive device (IED); I was
thrown from the vehicle and landed me on my head. You would think I would have learned my
lesson after the first time this happened, but I thought that my brush with death was nothing
much to worry about considering that the worst of the war was coming to an end. Truthfully, I
thought I was superman. After I explained this to the doctor, the doctor told me he would also
I researched TBI’s during the days that I waited for my test results. The information I
found explains that TBI can cause a wide range of functional changes affecting thinking,
sensation, movement, language, and/or emotions. Some symptoms may appear immediately after
the injury and other symptoms may not appear for days or weeks. Because of the nature of the
injury and the symptoms, sometimes people may not recognize or admit that they have a
problem. Not admitting it could result in death. In post-concussion/mild TBI patients, recovery
time is within weeks/months, but a small percentage may have persistent symptoms. Patients
with moderate to severe TBI may never fully recover their pre-injury function. The rate of
combat-related brain injuries in service members returning from the current conflicts in Iraq and
Afghanistan appears to be higher than in previous conflicts. Nearly 30% of all patients with
combat-related injuries seen at Walter Reed Army Medical Center from 2003 to 2005 sustained a
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TBI. Blast injuries are a frequent cause of TBIs. TBI is often associated with severe multiple
trauma, post traumatic stress disorder (PTSD) or undiagnosed concussions. Screening patients
who are at risk for a TBI is important in order to ensure that TBIs are identified and
appropriately treated.
This information shocked me. I went to work the next morning with a different frame of
mind, a different perspective on work. After being at work for awhile, I started to feel as if
possibly everyone was hiding their issues. Some soldiers dealt with their problems head on by
seeing doctors or talking about them. While others acted like nothing was happening. They went
about their lives as if the horrible things that they were exposed to in Iraq did not affect them. I
on the other hand found myself surrounded by lower enlisted soldiers in the platoon asking for
my help and advice. These soldiers had seen and done many of the same things I had so I was
able to relate better to them then some doctor could. Later on that same day, I took all of the
soldiers in need of help to the mental health clinic. I spoke with the RN at the front desk and
explained to her the delicate situation of my soldiers. As I was talking with her she cut me off
“Sergeant Sullivan, we are completely booked for the next few months and to be honest
My mouth dropped to the floor. I could not believe what I was hearing. I replied,
“You mean to tell me that, there are soldiers in need of help and there is no help to be
given? Are the doctors that work here even trained on how to diagnose personnel for PTSD?”
There was no reply from the RN, just a red face. The soldiers just made appointments
anyway and hoped for the best. Meanwhile, I waited to speak with the officer in charge to find
out if there was another location that could help with their anxiety problems sooner. I was told he
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was unavailable, so we decided to help each other out. We started learning as much as humanly
possible in a short amount of time we had left together before vacation. I made a power point
slide show with all of the information to sum up PTSD and TBI’s. Below is some information we
put together.
behavior". He believed we acquire anxious feelings through classical conditioning and traumatic
experiences. This belief by Sigmund Freud could not be more accurate in the case of PTSD.
Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the
experience, illusions, hallucinations, and dissociative flashback episodes, including those that
Persistent symptoms of increased arousal (not present before the trauma), as indicated by
two (or more) of the following: Difficulty falling or staying asleep, irritability or outbursts of
• Anger/Guilt: "Why me? It's not fair." “He should be alive instead of me!”
• Someone always knows what is going on. Not telling is not helping!
• If afraid of “Chain of Command,” seek counseling on the outside. One source gives eight
• Share with someone and don’t withdraw. Find a safe place to do this. Commander’s
• The more you become unattached the more you will lose feeling of everything around
• Get help so you can continue to be an effective soldier in the force, and an effective
According to the August 2006 Analysis of VA Health Care Utilization among US Southwest
Asian War Veterans: Operation Iraqi Freedom/Operation Enduring Freedom, 184,524 veterans
have sought care from a VA Medical Center since the start of OEF in October 2001 through May
2006. During this time, 1,304 OIF/OEF veterans were identified as having been evaluated or
treated for a condition possibly related to TBI. There is no medical code specific to TBI, and a
patient may carry more than one diagnostic code, but the most prominent injuries included
fracture of facial bones, concussions, and/or brain injury of an unspecified nature. August 2006
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analysis reports 29,041 of the enrolled OIF/OEF veterans who visited VA Medical Centers or
As you can see, there are now a number of ways you could find help and information. I only
wished that back in 2004 I could have found some of this information to help soldiers. Doctors
and their staff members are now better equipped with the correct tools to fight the war on PTSD
and TBI’s. Soldiers are more receptive to people, such as a well trained medical staff, who
Since 2004, I have been on two more deployments. One in 2005 and a second in 2007 for a
total of three; during both deployments I have seen medical staffs acting in a more caring manor
toward soldiers with both PTSD and TBI’s. Once we have returned home to the US, the medical
personnel meet with you (one on one) to screen you for any issues before releasing you into back
into main stream America. There are now a number of medical personnel on military
instillations solely dedicated to help soldiers with the “Combat wounds you cannot see.” This is a
huge improvement since my first deployment. For instance the Army established a New
prototype for rapid triage and diagnostic tool for combat casualty care (CCC) (titled Biomarker
Assessment for Neurotrauma Diagnosis and Improved Triage System; BANDITS) (Walter Reed
My fight with PTSD is over for the most part. These days I hardly have any flash backs and
loss of sleep. I have read and have been told that “PTSD will never leave your side until you deal
with the issues at hand” (Tokutomi, T. 2008). I believe that I overcome my PTSD by doing just
that, dealing with the problems head on. A fact that I found staggering was, one out of every five
active-duty Army soldiers and 42 percent of Army Reservists who have served in Iraq cite
mental health concerns months after they return home, according to a new Army medical study,
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(Luis Martinez, ABC news). My doctor told me that the Army still finds the 42 percent to be
The truth is all soldiers have a form of PTSD or suffered a TBI while in the service. It’s just
those who admit that they do receive help. That equals better health care, and the health care is
for life.
• (Tokutomi, T., et al. 2008) brain injury .com | traumatic brain injury -- Latest Medical
Research
Some of the other programs that the Army has in place now are:
• The Army's Post Traumatic Stress Disorder and Mild Traumatic Brain Injury
(PTSD/MTBI) Chain Teaching Program