By P. Casey Arrillaga, LCSW, LCDC
NOTE: This is the third post in our series on TBI. The first post was TBI and Addiction, released on 3/3/25, followed by our post on TBI and Other Mental Health Issues on 3/17/25.
Military personnel risk their lives every day to keep our country safe and our society free, yet they are often not free of the long-term effects of physical and emotional trauma from doing their jobs. Traumatic Brain Injury [TBI]is a very common hazard in the military, and its effects can go on for a lifetime, especially if untreated. TBI is a serious condition for anyone, especially impacting mental health including addiction, and thus overall life functioning, yet its dangers have often been misunderstood and even overlooked in the military, meaning that those who have served their country are at risk long after they leave the theater of war. This post explores what we know so far and what we can do to help.
What We Know So Far
TBI has been studied in some form in the military as far back as the Civil War, but until the modern conflicts in Iraq and Afghanistan, only the most serious injuries, usually involving skull penetration, were treated with anything more than exercises to restore motor function. This is not to suggest that the military didn’t care, so much as that the effects of TBI were poorly understood.
It must also be considered that the age-old goal of most military medicine is to restore military personnel to warfighting capability. Thus, TBI, which is much less obvious than a gunshot wound, got less focus until the most recent conflicts. Now that these wounds are getting more closely tracked, it is estimated that as many as 35% of the more than 1.6 million military personnel who served in Iraq and Afghanistan suffered a TBI of some sort.
As medicine has advanced, so has the understanding that TBI is a form of military trauma that affects both physical and psychological health long after the fighting is over. We now know that after they have left the military, veterans must still combat the effects of their head injuries. As detailed in our earlier posts on TBI, such invisible wounds bring with them a significant risk of developing or increasing addiction, depression, anxiety, and suicidal thinking, among other problems.
For those in military service, common causes of TBI include exposure to blasts from improvised explosive devices [IEDs], falls, vehicle crashes, training accidents, and direct combat-related trauma. Service members deployed in conflict zones are particularly vulnerable to these injuries. In such dangerous situations, medical personnel may have limited resources to assess and treat brain injuries promptly. Additionally, warfighters may downplay symptoms to continue their missions, putting them at even greater risk. That mission-first attitude helps to advance military objectives, but can lead to veterans habitually downplaying their symptoms while they are actually suffering. This affects not only them, but also their families, who may be puzzled and worried by symptoms that none of them realize are actually from invisible combat trauma.
Mild TBI, often referred to as concussions, may result in temporary confusion, headaches, dizziness, and memory issues. More severe TBI can lead to long-term cognitive impairments, emotional disturbances, and physical disabilities. Service members with moderate to severe TBI may experience difficulty with speech, motor skills, and executive functions, significantly affecting their ability to perform military duties and reintegrate into civilian life. Repeated mild TBI, which are common in combat environments, can compound over time and lead to chronic traumatic encephalopathy (CTE), a degenerative brain condition associated with memory loss, behavioral changes, and cognitive decline.
The Department of Veterans Affairs (VA) provides specialized TBI rehabilitation programs, mental health support, and disability compensation to assist affected veterans. Despite these resources, many veterans face barriers to care, such as long wait times and difficulties navigating the healthcare system. The normal frustration and barriers around the VA are made worse for veterans who are suffering from TBI effects.
How Do We Use This Knowledge to Help People?
At Windmill, we not only screen every client for TBI as part of our thorough assessments, every client is also given an EEG shortly after arrival, which allows us to directly see if there are effects of concussion and TBI. Through this process, our clients, team, and family members can then move forward armed with objectively accurate information. When we find evidence that someone has had TBI, we have cutting-edge tools including validated psychometric tools and individualized Transcranial Magnetic Stimulation [TMS], as well as some of the best trauma therapy available to help people not only manage their lives, but also directly reduce the effects of TBI, thus giving them a much greater chance of recovery from both the TBI and any mental health struggles.
In addition, we offer specialized services for active-duty military, military veterans, and first responders. We have what it takes to overcome combat trauma, other military trauma, and first-responder trauma, both physical and psychological, including any TBI effects.
Given the social challenges that many veterans with TBI experience, we use as social approach in working with each client to make sure they have the resources to continue building their network and their understanding of the support available to them. This includes our strong alumni program for both clients and their families.
The Bottom Line
Addressing the long-term effects of TBI in those who have served is crucial for their overall well-being and successful reintegration into civilian life. By understanding the unique challenges faced by service members and veterans, we can provide targeted support and advanced treatments to mitigate the impact of TBI. If you or anyone you love has been affected by TBI and/or mental health struggles, reach out for help now.
About The Author
P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
Created specifically for those who have loved ones that struggle with addiction.