While the moderate and severe forms of TBI are associated with blunt or penetrating head trauma and loss of consciousness, PTSD (an anxiety disorder) is associated with exposure to a terrifying, life-threatening danger that need not involve either head trauma or loss of consciousness. Yet the consequences of TBI and PTSD are remarkably similar. Both manifest as sleeplessness, anxiety, depression, and difficulties with memory and concentration. To further complicate matters some PTSD patients do suffer head trauma and some cannot remember if they did or not since the overwhelming fright they suffered has left them with only a patchwork of memory about the event, some of which is temporarily or permanently repressed.
So how do you differentiate TBI from PTSD and how do you treat a patient when you’re not sure? The advice from Dr. Lonser, an expert at the National Institutes of Neurological Disorders and Stroke, is not to waste time on diagnosis. The important thing is to treat the disabling behavioral symptoms. Whether the problems come from TBI or PTSD treatment should not depend on diagnostic labels. According to Micaela Cornis-Pop Ph.D., polytrauma/TBI coordinator with the U.S. Department of Veterans Affairs (VA) central office, “The mainstay of treatment [should be] symptom-specific intervention, such as managing headaches and improving sleep, and education.”