Living with TBI & PTSD

PTSD is like an innate fear, all the time. You’re afraid something’s going to blow up, you’re afraid something’s going to hit you, you’re afraid you’re going to be shot at. You’re afraid you’re going to have to perform medical procedures on your squad mates that you know so well, and you’re always - even though, rationally, yes, I’m here at home, I’m walking down the street. You see a car coming outside, you hear an explosion, anything like that, the fear factor goes in. And what happens when you’re really scared? You either fight or you run, and that’s what happens to them. So, for them, you’ve got that, plus you’ve got an impaired brain. Okay, you’ve got TBI, you’ve got an impaired brain. So, you’ve got the fear, but you don’t really have a rational way of even reacting like you would pre-TBI.

Well, it feels. At first it feels like I could have done more, should have done more, could have done this better, so like, guilt. You know, watching somebody hit the ground, there’s nothing you can do about it. And then almost saying to yourself, god he hit right on the cement, maybe he should, he’s hurt so bad maybe we should just call it. You know, for him. It’s like oh my gosh this is, and it was pretty I mean, you didn’t know…so that type of feeling. That’s my buddy and I’m scared, you know, that feeling. Did I land my parachute close enough to him to help out, and other guys got to him first, and trying to get an airway, and I’m trying to think what are the drugs we need to give him to, so it’s just like I didn’t do enough. That was…

One night when we were flying in Iraq, I think back to a night we almost crashed. We were out looking for a helicopter that was missing and it was an army helicopter and they found it the next day. Because the weather was horrible, we lost sight of each other, two helicopters, almost hit the ground. Thank goodness for an American Airlines civilian pilot in the co-pilot seat. He’s like I’m taking over from the pilot who was in a group flying helicopters in the Army, never did instruments really, I mean knew about it but - this American Airlines guy that flew F16s and then helicopters was like, climbed out of there. Whew. That kind of haunts me back.

And then when this retirement thing happened, I was like I’m off the hook. I don’t have to go fly at night, even though I found it exciting. And I don’t have to go overseas, although I found that exciting, exhilarating. But, we almost died and there’s probably a few times that our flight, the guys in our helicopter, the flight engineers that were on com the whole time while we were getting ready, there’s time that - well we had other times where we thought you guys were on the com and you know, so…so all this pressure came off.

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. 

I don’t know if it’s more relevant to your study but I’ll mention it anyways, just nightmares, having flashbacks, still battling alcoholism. Alcohol abuse wasn’t a problem when I was in the military, but now it is, and just avoidance, isolation. But in terms of TBI thing, what I’ve noticed, sometimes it feels like I have a speech impediment or, I don’t know, jittery sort of deal, and also definitely memory and concentration which again could be PTSD or whatever. 

Yes, I don’t think the way that other people do, and I don’t know if it’s a result of the TBI but my creative centers are pretty much gone. It’s funny because the doctor who studies the PTSD said it’s a result of the TBI, and the people who have TBI say it’s a problem with the PTSD. So, I have problems when I come into the city. It’s too much for me. I can’t handle it, and I’m trying to watch everything, and I can’t do it, and I just kind of flip out. So, the TBI guys said no it’s the PTSD. The PTSD guys say no it’s the TBI. Well, somebody take responsibility. I never ever, ever had to use a MapQuest before, and then this last couple of years I’ve had to start using MapQuest because I just - especially if it’s an urban environment. I can’t do it, remembering - because I used to be really - I mean, still if you get me in the back country and you tell me you want to go somewhere I’ll get there without ever looking at a map. I can’t do it in cities anymore.

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.”

I think the initial onset, you know, is very similar. The same thing always. But once you, you get bounced out, and you start getting medication and treatment that you can actually see and distinguish a difference between the conditions that are caused by the TBI and conditions that are caused by PTSD. It has a lot, it also has a lot to do, educating the Veteran on what the differences are. Because I had no idea what was what, until they literally broke it down for me and my wife, and then we started noticing and trying to see, you know, when I had TBI problems and when I had PTSD problems.

I: How did they break it down for you? Like what was the way they categorized between the two?

So, when it started we were breaking down, like single symptoms, you know, the different symptoms, like, it might have an indication of balance for my PTSD, then that obviously, if you already know the side effects, so if you have balance problems that’s not attributable to the medication you’re taking, because you know what the side effects are, you know how to execute things like that. You know, if you know that the stuff you’re taking for something else, PTSD doesn’t cause headaches, then obviously most of the time you know. And I’ve been taking meds for years so I know that the stuff doesn’t adversely affect me with, you know, headaches or balance or visual problems, you know, those types of things. And then I also, you know, I have seasonal allergies so you know, I know when, I know if my headache caused by my allergies feels like or, you know, how to notice that versus a headache that might be caused because I’m high stress on PTSD at the time. 

I: Is it helpful for you to be able to kind of distinguish between the two? 

To me it is, but again, I’m at ten years from my injury, so it’s a lot different than other guys. And I was forced to kind of live and deal with what I have, where a lot of guys with TBI, let’s say they’ve been in, you know, multiple grenades or IED attacks, and walk away from them, they’re just starting to try and figure out what’s what, you know, and getting treatment for both at the same time. But for me, generally speaking, it is very helpful and, you know, I share that information with other guys who, you know, have that problem or are told that they have that problem.