A Health Campaign of Uniformed Services University, www.usuhs.edu, and theCenter for the Study of Traumatic Stress, Bethesda, Maryland, www.CSTSonline.org

Traumatic Brain Injury:

What Military Families Need to Know
Traumatic brain injury (TBI) has
Any medical condition that gains
become a topic of interest and concern
such
rapid attention often results inWe explain mild TBI (concussion) and its
amongst military families, especiallyincomplete or inaccurate information.
symptoms to help military families identify
those with loved ones previously
It is important that military members
it and seek treatment along with some ofor currently deployed to Iraq orand families understand the facts
Afghanistan. Among the causes ofabout TBI, especially the mild
the important issues for families living with
war-related TBI are exposure to blast,form, in order to help recognize themore severe TBI.
gunshot wounds and shrapnel, falls, andsymptoms and provide support. It is
motor vehicle accidents. The good news
also important that families impacted
is that most of these injuries are mild,by more severe TBI understandand commonly referred to as “concussion”. Concussion issome of its long-term implications, especially on children.
seldom life threatening but can result in symptoms that
This Courage to Care fact sheet describes what many are
may interfere with one’s normal routine. Moderate toreferring to as the signature wound of war — TBI. We
severe brain injury often occurs in combination with otherexplain mild TBI (concussion) and its symptoms to help
serious injuries such as those involving amputations andmilitary families identify it and seek treatment. We alsoburns. This level of TBI injury can have lasting effects that
describe some of the important issues for families living
challenge service members and families over time.
with more severe TBI.
Mild TBI (Concussion)
Concussion occurs when the head is hit or shaken
and leaves a person dazed, confused, or with loss ofconsciousness for a short time. In civilian life, concussion
often occurs during sporting events such as a footballgame. Mild TBI (mTBI) is also referred to as a “closedhead injury”. While concussion is seldom life threatening,it can cause serious symptoms especially for those who
may have suffered multiple concussions. People who have
had a concussion may say that they are “fine” although
their personality or behavior may seem to have changed.
Symptoms of mTBI can appear days, weeks, or months
after the injury. Being aware of the symptoms of TBI
can assist in the family understanding and being able toprovide support:
Symptoms of TBI■ Sleep problems (either too much or too little)■ Fatigue, feeling tired all the time
■ Difficulty organizing/completing tasks■ Trouble making decisions■ Sensitivity to lights/sounds■ Headaches■ Feeling depressed, sad■ Trouble with concentration, memory, and/or attention■ Easily overwhelmed■ Irritable, angry■ Impulsive, outbursts

Do’s and Don’ts to Speed Recovery
Just as an injury to a muscle or joint, mTBI requires thesame care in order to help speed recovery.
Do’s■ Get appropriate amounts of sleep and rest
■ Get into a regular routine of everyday activities (e.g.,exercise and eating)■ Do one thing at a time (e.g., reduce distractions whenworking)■ Increase your activity slowly■ Write important things down to help you remember

themContinued■ Engage your brain in activities that require fine motor

skills and use of strategy (e.g., playing an instrument,games, writing, and leisure puzzles)

Don’ts, while the TBI is healing■ Engage in activities that can produce another brain

injury, such as contact sports■ Drink alcohol or use excessive amounts of caffeine■ Take over-the-counter sleep medications

Healing takes patience and time. Support from family
members and taking care of oneself can go a long way inassisting in recovery.
If symptoms become more severe or prolonged, it
may indicate the presence of another condition such as
posttraumatic stress disorder, depression, or substance abuse.
If this is the case, you or your family member should tell yourprimary care provider.
Moderate to Severe TBI: Implications for Families
More serious TBI, often occurring along with complex
war injuries, presents a number of challenges that families
must deal with over time. Military healthcare providers
who have worked with families impacted with moderate
to severe TBI have identified some of the issues below
as commonly felt by families dealing with this medicalcondition.
■ Injury as grief and loss: With moderate to severe

TBI, the service member is not who they used to be.
There is grief and loss of the service member not being
able to return to the normal individual and familyroutines that had been there before the injury. There
are memories of how the person used to function withdirect comparison to present abilities.

■ Inappropriate behaviors: The family must manage

the injured service member’s potentially inappropriate
behaviors in public. These may include lack ofinhibition, anger, and outbursts, as well as the otherextreme — withdrawal, apathy, and depression.

■ Social isolation: This may be an issue due to theexhausting care giving responsibilities and fear over
how the TBI patient is going to behave. It is important
for the family to avoid social isolation and engage in thecommunity and available supports.

■ Implications for children: Children, especially younger

children, may think they are responsible for thepersonality changes a parent with TBI has (irritabilityor withdrawal), or even that the injured parent may notlove them. Protect children from outbursts and sharecalm, loving time with them. Talking helps. Explain,“Dad is grumpy or angry because his brain was hurt. He
doesn’t mean what he often says or does.”■ Family management: With moderate to severe TBI, themanagement of the injured service member often must
be delegated to the non-injured spouse.

The military healthcare community is engaged inresearch, education, and treatment for TBI in both its mildand more moderate to severe forms. Below are resources tolearn more about war-related brain injury.
Resources■ Defense and Veterans Brain Injury Center: 			

https://dvbic.dcoe.mil/■ Military OneSource: 					https://www.militaryonesource.mil/

Courage to Care is a health promotion campaign of Uniformed Services University
and its Center for the Study of Traumatic Stress (CSTS). CSTS is the academic
arm and a partnering Center of the Defense Centers of Excellence (DCoE) for
Psychological Health and Traumatic Brain Injury.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org