Traumatic Brain Injury in Veterans

Sarah

Age at interview: 32
Outline: During her deployment in Iraq, Sarah was exposed to an IED blast, a rocket attack, and was involved in a car accident. She isn’t sure if only one incident is specifically linked to her brain injury but she began noticing issues with her short-term memory, trouble finding words, and an inability to focus after her first incident. By the third incident Sarah was experiencing significant problems including severe mood swings and periods of blackout. After years of struggle Sarah has finally begun to piece together the cause and effect of her injury. She now works at a Veteran support facility helping others secure housing and employment.
Background: Military branch: Army 

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Sarah celebrated her 21st birthday on deployment in Iraq while serving in the Army between 2003 and 2005. Although she cannot pinpoint one incident to link her brain injury to she recalls being exposed to an IED blast, a rocket attack, and was involved in a car accident doing “about 65 into a light pole.” Sarah began noticing issues with her short-term memory, trouble finding words, and an inability to focus after her first incident. She sought counseling while overseas but was quickly fed “a cocktail of super fabulous meds” and sent back to work. By her third incident Sarah was experiencing significant problems including severe mood swings and periods of blackout, leading to her discharge from the military. She was sent back to the States without any counseling or screening. “It’s a lot of paperwork and it’s a lot of effort to treat somebody and rehabilitate them versus just discharge.”

After her discharge, Sarah was married and joined her husband in Germany where he was serving. Soon after she gave birth to two daughters. Sarah continued to struggle with severe mood swings, short-term memory loss, and migraines, but attributed her ongoing symptoms to hormones. “We didn’t really even have time to contemplate dealing with it,” she says. “We didn’t have a support structure. I was just like day to day trying to keep my head above water.”

After years of struggle Sarah has finally began to piece together the cause and effect of her injury. She now works at a Veteran support facility in San Antonio helping others secure housing and employment. She says the hardest part of her injury is the way it has affected her family life. “There’s pictures of my kids I will look at and I couldn’t tell you when or where they were taken,” she says referring to the “general fog” that is a symptom of her head injury. “Like I missed a good chunk of my life.”

One of the hardest things for Sarah is the public perception of the injury, or of Veterans in general. She would like other to realize that “we’re not broken, we’re not weak.” To those struggling with similar symptoms, Sarah says it is important not to beat yourself up, recalling what a counselor told her when she said she just wanted to be normal, "She was like 'Well, what you were experiencing was not abnormal.  You were having a perfectly normal to reaction to a highly abnormal situation.' And that was like, just a lightbulb for me of like, what I’m going through is not abnormal. I’m not, I’m not broken. I’m not odd. I’m not alone in this."

 

Although Sarah sustained at least three injuries while deployed, initially she thought her symptoms were a result of PTSD.

Although Sarah sustained at least three injuries while deployed, initially she thought her symptoms were a result of PTSD.

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There were a couple, there were three really that I can pin it back to. It was probably a good six or seven years before, like anybody really even used the word TBI, and so a lot of it I attributed to the PTSD. I just didn’t put two and two together, that like maybe that wasn’t entirely as a result of the PTSD. We hit an IED, and it was probably like when I was in country, didn’t actually hit our vehicle but close enough to the front of our vehicle, it was a concussive blast that, it was pretty intense. There was a rocket incident and then there was actually a car accident I got into over there, in an SUV - did about 65 into a light pole. So, I think between the three of those, it’s probably done a number. Short term memory, like grasping for words a lot of times, inability to focus, that kind of stuff. A lot of stuff that probably crosses over into the PTSD area.

 

The hardest thing for Sarah has been the impact on her kids.

The hardest thing for Sarah has been the impact on her kids.

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My kid’s reactions to it, honestly. My two younger ones are young enough, I think they don’t really comprehend a lot of it, and they weren’t really around for the worst of it. My oldest, my ten-year-old is extremely emotionally sensitive and perceptive to begin with, and I think it had a large effect on her personality. She’s the one, she’ll see that look on my face and like give me a hug, “Mom, it’s OK.” And it’s heartbreaking to have your ten-year-old consoling you and trying to - like, and she shouldn’t, she should just be able to just be a kid. And it’s hard. I feel like, with her and my middle daughter, my son I was aware of it and made more of an effort because I missed a lot of things. With them there’s, I took a ton of pictures with my oldest daughter because I knew that I was having memory issues. I mean there’s pictures my kids will look at and I couldn’t tell you when or where they were taken. Like I know the general, like “Oh, I think that was there,” but like if I don’t label it. Which is hard. Like I feel like I missed a good chunk of my life.

 

Sarah continues to struggle with her short-term memory and focus and has a hard time reading or sitting through movies.

Sarah continues to struggle with her short-term memory and focus and has a hard time reading or sitting through movies.

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A lot of short-term memory issues. I probably couldn’t tell you what I had for lunch yesterday. If it’s not on my calendar, on a post-it note - extreme OCD like everything has to be, because I need to know where things are at. I park in the same parking spot every day here. If I can’t find the parking spot I park on the same row, that way I know if I just keep walking eventually I’ll find my car. So, memory issues, mood swings, inability to focus, which here isn’t so bad because the job is very fast-paced and you’re always doing a lot of different things, so that kind of benefits that I can switch from one thing to another. But like anything that requires long term focus. Like I used to be an avid reader. I used to love going to the movies. I have a hard time sitting through a full movie now because my attention just gets like, I get bored, which is the polar opposite of how I used to be. 

 

Sarah talks about having severe mood swings and feeling like there is a “switch” that goes off that makes her “see red.”

Sarah talks about having severe mood swings and feeling like there is a “switch” that goes off that makes her “see red.”

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Really severe mood swings beyond just like I’m anxious and upset. It’s like a switch. Like when I get - and it doesn’t even have to be anything serious. It’ll be something just really like small that like normal people don’t get super upset about, but like I will see red, and it’s just like an instantaneous switch, and then afterwards I’m like “Why, why did I get so upset about that?  Like that shouldn’t have been something that triggered that”

 

Although her memory issues are pretty clearly linked to TBI, Sarah attributes her short temper and anger to both TBI and PTSD.

Although her memory issues are pretty clearly linked to TBI, Sarah attributes her short temper and anger to both TBI and PTSD.

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It’s just one massive - because I haven’t really been able to evaluate enough what is, what, like I say, the memory issues I think are pretty clearly TBI because it’s beyond just like “Oh, I was stressed when that happened.” I know, I can be really calm and still not remember, you know, more than 12 hours ago. Long term memory is fine, it’s just the short-term memory that seems to be the issue. Like the, you know, “Where did I put my keys” and “What is it that I have next on my agenda” and if it’s not on my calendar it doesn’t exist. Because I, I won’t remember. I put like “Go to the grocery store after work” because if I don’t, I autopilot, I get home and like “Crap I was supposed to stop at the grocery store.” So yeah, I think the memory issues, the short, kind of the short temper and getting angry is, I think, a little harder to separate. Because definitely, I think, can be attributed to both. I think the severity of it is probably what I think distinguishes it from just PTSD. It’s not just a general like “Oh I’m angry all the time.” It’s like, I get, like I said there’s that switch, like, this is how I am 90% of the time. Like just very kind of, and then, and then it will just trigger it and so extreme, and it’s like, it’s, hear myself and like I, I’m aware of what’s happening but there’s a disconnect between how I’m feeling when I’m saying what I’m thinking, like even in the midst of it I think to myself like “Why am I so angry about this? Why are you freaking out about this” and it just like goes on autopilot and I can’t reel it in. 

 

Sarah wishes there was a way to distinguish between the symptoms of PTSD and TBI and to know which symptoms can be treated.

Sarah wishes there was a way to distinguish between the symptoms of PTSD and TBI and to know which symptoms can be treated.

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I would love to be able to distinguish between the two. I would love there to be like some sort of diagnostic test. Particularly for PTSD which, there again, there’s a branch of the Cohen Veteran Network that has been kind of really venturing into that kind of research and study. I have her card I’ll give to you too. Kind of trying to formulate some sort of diagnostic approach to, “Yes, you have PTSD” and like, “Yes you have TBI, and this is where that line is.”  Like, “This is what your TBI is affecting, this we can clinically treat. This is what your PTSD is affecting. This is what you can treat through counseling.” Because it’s very frustrating, I think, a lot of the times when you’re getting counseling for PTSD but these symptoms, just like nothing’s happening with this, and so you, kind of, you feel like you’re hitting this wall in treatment, when in reality you’re treating the PTSD, there’s just has nothing to do with it. And I think it would be, it would be helpful, and a lot less discouraging if I could say, “OK, this, this is what I’m going to be able to treat through counseling, and then these are the things that I’m just going to have to learn to manage.”

 

Sarah finds it more helpful to talk with counselors who have military backgrounds and some idea of what she has been through.

Sarah finds it more helpful to talk with counselors who have military backgrounds and some idea of what she has been through.

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My counselor at the VA up in Washington was a very well versed and gave me a lot of good coping mechanisms. He was really young, no military background, which I think, I’ve heard, kind of from both spectrums. I’ve heard from some of my friends who are like, “I want to go to somebody that has absolutely no idea what I’m talking about so I can just like verbal vomit and be done.” And then I’ve heard from some people who are like “I don’t want to talk to somebody who has no idea what I’ve been through.” I think for me, I kind of fall in that side of the spectrum of it. It’s really hard to like go in and talk to somebody who, like, has a relative who’s in the military but hasn’t ever been there. And I think it’s just because of the way that I function.  I have a hard time asking for help. And I hate putting that on somebody else. Even if it’s their - rationally I know it’s like their job to sit and listen to me. But just some of the stuff is so traumatic and messed up and out there, and like I hate putting that on another person.

 

Sarah talks about the benefit of working in an office environment with other Veterans.

Sarah talks about the benefit of working in an office environment with other Veterans.

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I don’t know. I, being in this office environment has been great. Although for somebody who avoids counseling, it’s ironic that I’ve thrown myself into an office where everybody has a clinical background. Because they will regularly, our, our case manager was a little like “Hey, how are you doing? Like, you look a little stressed.” “Like, I don’t have time for counseling right now. I have to get this done. Maybe later!” So that’s been - but there again, that’s, it’s such a rare environment here. Like, I wish there were more work environments like this for Vets. Just to be able to work around, and for other Vets, doing something that they feel like is then…purpose. 

 

Sarah has struggled to find support from people in her immediate family.

Sarah has struggled to find support from people in her immediate family.

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My parents live here in town, and I have a younger sister whose husband is in the Air Force up at Dyess. My dad is very old school when it comes to, you used to be able to talk about those things, very disappointed that I got out before my contract was over. We didn’t speak for probably about two years after I got out, knew when my homecoming was, did not show up.  There was nobody there when I got back. I think that my dad’s starting to understand a little bit more now that I’ve been back in town for a while, cause up until now, I mean, we’ve always lived somewhere else. Like we visited, but there’s never been an extended period of time. But he, I don’t think will every verbally validate any of it out loud. It’s just not his personality. My mom, much more understanding but has to walk the fine line between me and my dad, so it’s a very strained relationship. And there’s six and a half years between me and my sister. She was a teenager when I was in Iraq, so her ability to really grasp or understand it is limited at best.

 

Sarah describes coming to the realization that she wasn’t “broken,” and was having a normal reaction to an abnormal situation.

Sarah describes coming to the realization that she wasn’t “broken,” and was having a normal reaction to an abnormal situation.

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A counselor said once to me, because I kept saying “I just, I just want to be normal. I just want to be normal. I’m tired of being like this.” And she was like “Well, what you were experiencing was not abnormal. You were having a perfectly normal reaction to a highly abnormal situation.” And that was like, just a lightbulb for me of like, what I’m going through is not abnormal. I’m not, I’m not broken. I’m not odd. I’m not alone in this. Like there are other people having the same reaction. This is a normal reaction to have to seeing what we saw. Trying to explain that to my family is challenging. Trying to explain to anybody who hasn’t seen it or isn’t well versed in the treatment of it is, is difficult. Like, even people out in the community are kind of like, “I don’t understand why you guys are like that.” Well I mean, “Cause you weren’t there.”

 

Sarah says that the hardest part is the public perception that Veterans are “crazy” or “incapable” or “weak.”

Sarah says that the hardest part is the public perception that Veterans are “crazy” or “incapable” or “weak.”

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I mean I’d like to say the, the injury itself, but honestly, I think maybe the public perception of the injury. Or the public perception of Veterans with PTSD in general. We’re like, you know, “Oh, she’s a Veteran, she’s crazy” which like yeah, some of us are imbalanced. But, it would be nice to not be perceived in a negative way. I think everything that you hear in the news, and I mean, even with the best of intentions. The whole 22-a-day thing, like now everybody’s like “Oh they’re a Veteran. They’re going to try and kill themselves.” Which isn’t the case and it wasn’t the intention of the movement starting and the public just kind of takes it and takes on a life of its own. So, if I could change any one thing, that would be public perception.

I: Yeah, what would you like them to hear instead of, or perceive, or know?

That we’re not, that we’re not broken. That we’re not weak. I think they perceive it as like, almost like, and I know it’s, it’s met with the best of intentions. Like they have empathy and sympathy towards us. But I think on the receiving end of it, it feels like pity. And that’s really hard, to go from being in an environment where you’re so strong and capable to being perceived as like just weak and incapable. That and the hero word bothers me, and I’ve talked to a lot of other Vets and like even people who are still active duty, that it really bothers them. I did what I signed up to do. Like the heroes are the guys that died so that I could come home. My buddies that didn’t make it back. In my eyes, and I think in a lot of other Veterans eyes. We appreciate the, the sentiment, but it’s definitely not how we want to be perceived. Like we went, we did a job. We have some issues that have resulted. We’d love the support but we don’t want the, I don’t, I don’t want to be idolized or put on a pedestal and like, “Oh, you served, like you’re a hero.” Like no, I’m not. I signed on the dotted line and raised my right hand. I went, I did my job. There are guys that went far more above and beyond and I think those are the ones that should be acknowledged more often.

 

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