Home from deployment, the hidden injury, the invisible battle

11 Sep 2009 | Marine Cpl. Jessica L. Martinez

For Marines returning home from a deployment, adjusting from being deployed to now being home with family and friends isn’t always easy.

Marines may finally be safe and far from the war going on thousands of miles away, but for some the war within them is a new battle. Marines no longer need to fight the hidden battles of traumatic brain injury and post-traumatic stress disorder alone.

Marines now complete a small series of health assessment questionnaires prior to, while on and upon returning from deployments to help evaluate their psychological and physiological health.

These assessments are done through the Deployment Health Services Center aboard Marine Corps Base Camp Lejeune. After the questionnaires are complete, they are reviewed by medical providers. From that point, if a Marine needs to see a specialist for any psychological or physiological injuries, they get the treatment they need.

“A TBI or a concussion can affect a person in several ways depending on the severity of the incident, number of times it occurs and the area of the brain it impacts,” said Dr. Jamie Pollack, a neuropsychologist with the center. “In the military environment these head injuries are mostly caused by being exposed to blasts, hitting one’s head, or being hit in the head with objects.”

Symptoms of TBI vary depending on the incident and can include, but are not limited to the following:

            -memory, attention or concentration problems

            -difficulty with proper balance or slower than usual movements

            -vision issues or light sensitivity

            -word finding problems or slower than usual speech

            -difficulty with judgment and reasoning

            -limited ability to perform cognitive functions that used to be easy for a person, such as finding their way around a familiar neighborhood and comprehension of written passages and verbal commands

            -mild to severe headaches

            -personality changes

            -emotional and psychological functioning difficulties

“The symptoms may be very mild to very severe in nature,” said Pollack. “Due to this it can cause impairment for Marines not only in their day-to-day functioning within their family, such as not being able to balance a checkbook statement or remembering how to get to the supermarket, but also during their performance as a Marine as in not being able to remember multiple step commands due to memory problems or attention and concentration difficulties.”

Typically, a Marine suspected of a head injury will be seen by a neurologist and a neuropsychological evaluation will be performed to further clarify deficits the Marine may be suffering, said Pollack. This helps with treatment planning. Treatment is typically tailored to the individual patient and the symptoms they are suffering from. Therefore, treatment may consist of some or all of the following:

             -medication management


             -speech therapy

             -vestibular rehabilitation

              -cognitive rehabilitation

Whereas TBI is caused by some sort of impact to the head, PTSD has a different cause.

PTSD is caused by any type of event that is life-threatening or severely compromises the emotional well-being of a person. Events such as a Marine witnessing another Marine in a fatal vehicle accident while deployed or someone being raped, can cause serious emotional issues for the individual.

Some signs of PTSD in an individual may appear as such:

            -recurrent re-experiencing of the trauma

            -avoidance to the point of having a phobia of places, people and experiences that remind the sufferer of the trauma

            -general numbing of emotional responsiveness

            -chronic physical signs of hyper arousal, including sleep problems, trouble concentrating, irritability, anger, blackouts, difficulty remembering things, increased tendency and reaction to being startled and hyper vigilance to threat.

For those who experience PTSD, dealing with the past can be difficult and instead of expressing one’s feelings they tend to keep them bottled up inside, but talking with a therapist can help.

There are several ways to treat PTSD. Currently the most effective type of counseling is cognitive-behavioral therapy. This type of counseling breaks up into different types of therapies such as cognitive therapy and exposure therapy.

            -Cognitive therapy, the therapist helps one understand and change the way one thinks about the trauma and its aftermath. The goal is to understand how certain thoughts can cause stress and make symptoms worse, and then learn to replace those thoughts with more accurate thoughts that are less stressful. It also helps one learn how to deal with feelings of anger, guilt and fear.

            -Exposure therapy helps one to feel less fear about one’s memories. This therapy is based on the idea that people learn to fear feelings and thoughts that remind them of a traumatic event. A therapist helps one to learn how to control their thoughts and feelings and that they don’t need to be afraid of them. The therapist will help one to change how he reacts to stressful memories by having the person focus on less upsetting memories prior to talking about the worse ones.

Other ways to treat PTSD are with group and family therapy and using certain medications which are also used to treat depression.

We are seeing more cases of TBI and PTSD from service members when they return from deployments, said Dr. Chris Wellford, a clinical psychologist with the Deployment Health Services Center. The symptoms are often subtle and noticeable over a course of time.

Wellford went on to say how a Marine returning home from a deployment can have a diagnosis of both disorders.

Now, Marines who come home from deployments and have been injured or experienced overwhelming and stressful situations, no longer need to battle these silent and unseen injuries alone. There are several treatments available to the Marines.

For more information on the disorders or for available help, visit the Military One Source Web site at or the United States Department of Veterans Affairs Web site at