Let’s talk about traumatic brain injury (TBI) and post-traumatic stress (PTSD/PTS). This is a topic very dear to my heart as I spent 5 years of my career treating military service members (both veterans and active duty) with co-occurring TBI and psychological conditions such as PTSD. With the prominent use of IED’s (improvised explosive devices) in the wars in Iraq and Afghanistan, the rate of TBI due to blast injuries has increased. Additionally, many combat veterans may experience a head injury and trauma simultaneously in the same event. Although there are other causes of TBI such as falls or car accidents, brain injuries caused by IED blasts, breaching charges, and other combat-related injuries are unique to the military population. What I often witnessed in working with this population were clients who had experienced multiple mild traumatic brain injuries during their deployments with compounding symptoms that persisted over the course of many years until they reached a “breaking point” and sought out treatment- not just to alleviate their symptoms and understand them but to improve their quality of life.

Although TBI and PTSD are separate diagnoses, the symptoms often overlap and can be challenging to tease apart. Is it TBI, is it PTSD, or is it both? Each person with TBI and PTSD will experience a unique profile of symptoms so individualizing assessment and treatment is critical. I love this infographic from the Defense and Veterans Brain Injury Center that explains the overlap:

So how does this all apply to cognitive rehab in adult speech therapy? If you’ve ever been in a situation where your brain was in “fight or flight mode” or you felt hypervigilant, it’s no wonder you had difficulty paying attention or remembering something in that moment! First, collaborating with mental health professionals such as psychologists who have expertise in treating PTSD is essential to maximize client progress. Second, understanding the symptoms and neurobiology of PTSD in terms of how it impacts the brain is essential as well. If we as speech therapists can help reinforce strategies taught by mental health professionals such as grounding or emotion regulation tools, this will assist with training our clients to be present in the moment and being able to use cognitive tools to their fullest potential. 

Additional Resources:

988: National Suicide & Crisis Lifeline

National Center for PTSD 

Shoutout to the amazing SHARE Military Initiative at Shepherd Center- I can personally attest that the staff are incredible and this program changes lives.