The latest Rand study concludes that of the 1.64 million soldiers, sailors, airmen and marines that fought in Iraq and Afghanistan since 2001, 19.5% suffer from the effects of Traumatic Brain Injuries (TBI) sustained during their deployment(s). My slightly damaged brain tells me that 1,640,000 X .195 = 319,800 young men and women meet the criteria for experiencing a TBI during their service in combat. The Rand Brief (Invisible Wounds: Mental Health and Cognitive Care Needs of America’s Returning Veterans) goes on to tell us that 57% of this enormous population HAS NEVER BEEN EVALUATED by a physician specifically for a TBI.
The news is not all bad, however, in that many of our service members (53%) have actually overcome cultural, institutional or practical barriers to help seeking behavior and sought treatment for behavioral health problems such as PTSD and Major Depression.
So what is the point?
If we add PTSD, Major Depression and TBI as the three major drivers in mental health problems in re-deploying soldiers with as many as 33% of all service members suffering from one or all of these maladies, then the number soars to 541,200 moms, dads, sons and daughters effected laying the foundation for a post war societal catastrophe similar to that experienced by the post-Vietnam generation. If we remove the humanitarian consideration and talk simply in terms of dollars and cents, the cost of the suicides alone since 2001, measured in Soldier Guaranteed Life Insurance, Lost Training Investment, Social Security Death Gratuity and other costs is $2.2 Billion. As a survivor of suicide, I can tell you that the river of tears that flow in the wake of suicide dwarfs the monetary measure.
Rand explains that the costs associated with providing our veterans high-quality care more than pays for itself in less than two years as an investment in productivity and reduced long term fiduciary pay back.
Since the war began, we have seen great advancement in the development of prosthetic limbs, robotics, and other forms of adaption technology as well as a shift in culture toward persons who have suffered amputations and other traumatic physical injuries. It is not uncommon at all to see service members missing limbs running marathons and living perfectly normal adaptive lives. Likewise, albeit at a much slower rate, the landslide of behavioral health data generated by the war has greatly advanced our scientific understanding of PTSD, Major Depression and especially TBI.
As it appears that we are making headway on the overall treatment of mental health problems coming out of the war, it is important that we gain access and treat this large population of TBI Survivors by helping them understand that the prevalent symptoms generated by these injuries are in fact behavioral health related. Much of the focus on TBI is on the neuro-psychological cognitive, executive function, fine motor and speech deficits with the effects of anxiety, depression and suicidal ideation following as distant after thoughts. Much like the easy to identify effects of losing a limb, TBI research and testing is focused largely on the easy to identify and measure fore mentioned effects, which are more physical or ability related in nature.
The “mood” effects must be studied and treated in therapy with the same emphasis as the fine motor and other effects. And by treatment, I mean resisting the old standby of throwing jars of psychotropic medications at the mood problems to mask the effects of the chemical imbalances generated by the TBI. Let us instead favor starting with cognitive psyche therapy to develop coping strategies and skill sets prior to better living through chemistry in the form of low dose anti-depressants and anti-anxiety meds, which have become a standard and unsustainable practice complete with often devastating side effects.
I know of what I speak. After suffering an embolic stroke as a marathon runner in August of 2014, I was plunged into the world experience of the wartime TBI posse and let’s just say it has been the most humbling experience of my life. My participation in the confusion, fatigue, reduced ability and especially the irrational anxiety, worry, sleeplessness and depression opened a whole new window of understanding for our generation of TBI survivors. As the saying goes, “rapid injury, slow recovery”. And I have clung to the kind words of a doctor who wisely advised, me, “Jack, do not grieve what you have lost, embrace what you have, and aspire to what you will recover…now do the work to get there.”
I offer the same advice to my peers in this journey with a re-emphasis of the OneLife Warrior central themes…don’t quit, get up in the morning, put on your shoes and live your life. Don’t believe everything you think. The world is richer for the light of your life here, so shine on. You are precious, irreplaceable and unique among all people. I love you and thank you for your service and immeasurable sacrifice to others.
In closing, let us turn our awareness efforts to the behavioral health component of TBI and tie that to the broader success in physical adaption and behavioral health treatment. By shining a new light into this dark corner of our service member’s re-integration, the path to a “new normal” and their destiny as America’s Next Greatest Generation will be realized.
God bless you, OneLife Warriors…keep running, and I’ll see you tomorrow!