Blast Injury PTSD in Reservists and National Guard by Marilyn Lash, M.S.W.

The New “Citizen Soldier” 

by Marilyn Lash, M.S.W.

Risks of injury, PTSD and concussion among troops and veterans

 The wars in Iraq and Afghanistan have involved the greatest numbers of American armed forces fighting in foreign lands since the end of the Vietnam War. But the men and women who have been deployed for Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan) differ markedly from the troops fighting in any other war in US history. The Department of Defense reported close to half – about 45% – of them are Reservists and members of the National Guard. More than 40% of National Guard members have been sent there more than once. And it’s not just the male Reservists who have been called up. Over 14% are women, many who have young children at home (Driscoll, 2008).

Time to move!

These men and women have been in active service for periods often as long as 2 years or more. This has resulted in enormous disruptions for their families and communities. For many, it means leaving their job, putting educational plans on hold, and taking a drop in income. But the biggest changes are those faced by their families as siblings, parents, sons and daughters leave for combat.

The changes and stresses are enormous for the family members who are left behind – whether it is aging parents worried about their son or daughter’s safety or spouses now raising children and managing a household as single parents. All worry about the safety of their loved one. There is always the fear of injury or death– with daily reminders in the newspaper and news programs of just how dangerous it is over there. Not until they return home can their loved ones finally experience the relief of knowing they are safe.

Coming home can boomerang 

For too many, this initial relief is followed by puzzling alterations in the veteran’s moods, emotions, and behaviors. With no visible injury or clear cause for these changes, both veterans and family members sometimes find that coming home from combat is not always easy.Post Traumatic Stress Disorders (PTSD) haunt many veterans as they experience flashbacks and become hyper-vigilant in everyday situations. Nightmares, irritability, headaches, dizziness and mood swings can be confusing, frustrating, and frightening. Withdrawing at home and seeking escape via alcohol or drugs can lead to a downward spiral of social alienation and depression. When PTSD is coupled with mild brain injury, it can feel like a double whammy for the veteran and family.

Because our Reservists have such extended tours of duty, many are exposed to multiple explosive blasts. Each blast carries the risk of having a concussion or mild brain injury. Under the intense pressures of combat, symptoms may not be recognized. However, cognitive changes may be more evident months later when they interfere with returning to work, resuming studies, and living with family. Mild traumatic brain injury has been found to be strongly associated with PTSD and physical health problems three to four months after service members returned home (Driscoll, 2008).

Local providers need new expertise

The Veterans Administration has implemented a national system for TBI screening and referral. However, as National Guard members and Reservists return home and come back to their local communities, they are likely to be seeking care in many different settings, some within the VA and others in the civilian sector. This means that community providers, including primary care physicians, counselors, clergy, and emergency departments are now on the front lines for identifying the effects of PTSD and mild brain injuries. It becomes imperative for the private health sector to become educated and familiar with these conditions in order to provide the necessary care, treatment and support (Driscoll, 2008).


Driscoll, J. 2008. Traumatic Brain Injury among “Citizen Soldiers”. Brain Injury/Professional 5(2): 18-21.

Recommended reading

This Fact Sheet is based on the special issue of Hidden Issues in Brain Injury of the Brain Injury/Professional (vol. 5, issue 2), 2008. Back issues are available by calling the publisher at  (800) 321-7037 . 

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