Thursday, July 1, 2010

TBI & PTSD, No Fully Efective Cure or Treatment

Even when TBI is correctly identified, the sad fact is that there is no fully effective treatment or cure for this condition. Although several expensive, long-term treatment approaches help TBI patients to some extent, no therapy can restore the kind of automatic, intuitive decision making that is essential for maintaining jobs and relationships."


Full Article at: The Uncounted Costs and Casualties of War

Ruth Bettelheim, Ph.D. and Allen I. Arieff, M.S., M.D
Posted: June 29, 2010 03:42 PM

Normally we think of the costs of war in terms of dollars spent and body bags delivered to loved ones. However, this perspective overlooks the enormous financial and social burdens of veterans' long term disabilities such as those caused by traumatic brain injury (TBI), which is both under diagnosed and largely untreatable. As Dr. John Hart Jr., the President of the Society for Behavioral and Cognitive Neurology, notes: "A majority of the soldiers returning from the Iraq and Afghan wars are at risk of developing TBI."

Early estimates predicted that one tenth of veterans of the Iraq and Afghanistan wars would have TBI. More recently, this figure has been revised upward to 22%. However, the actual incidence of TBI among veterans is still unknown, and is likely to be much higher.

There are several reasons for these escalating estimates. They include the fact that body armor and helmets cannot fully protect against brain damage, the ubiquitous nature of improvised explosive devices (IEDs) in these conflicts, and systemic failures in medical treatment such as under diagnosis and misdiagnosis. Also, TBI victims may deliberately choose not to report their head injuries out of concern for their career prospects, or may simply be unaware of their condition. Repeated exposure to head injuries, even mild ones, can later result in permanent damage, which is one reason such injuries are so insidious.

The most common symptoms of TBI include memory problems, depression, irritability, slowed mental processing, difficulty finding words, and inability to concentrate. They can lead to job loss, social difficulties, strained family relationships, and plummeting self-esteem. Without correct diagnosis and help, TBI victims frequently find themselves unemployed, isolated, homeless or even suicidal, without ever knowing why.

Unfortunately, the symptoms of TBI are nearly indistinguishable from symptoms of other conditions such as post-traumatic stress disorder (PTSD) and depression, both of which also often co-occur with TBI among veterans. This diagnostic difficulty is compounded by lack of adequate training; as the 2007 Bradshaw Report to the Surgeon General noted, due to varying levels of knowledge, many cases of TBI escape detection by medical providers. Even when TBI is correctly identified, the sad fact is that there is no fully effective treatment or cure for this condition. Although several expensive, long-term treatment approaches help TBI patients to some extent, no therapy can restore the kind of automatic, intuitive decision making that is essential for maintaining jobs and relationships.