Where PTSD + TBI collide.
5 June 2025
There’s been lots of discussion on various platforms around TBI in the veteran community, and it’s an important discussion that has been long neglected. Thought I’d post it here too as it’s a topic deserving of more attention, especially during PTSD Awareness Month, because traumatic brain injury (TBI) is a critical and too often overlooked factor that intersects with PTSD, depression, and suicide risk in complex and compounding ways.
These injuries are not just co-occurring; they are interlinked, with each one shaping the course and severity of the other. TBI can amplify the symptoms of PTSD, disrupt emotional regulation, and interfere with cognitive processing making recovery far more challenging. More concerning still, TBI is an independent risk factor for suicide, even when PTSD is not present.
Despite this, clinical care and support systems often address these injuries in silos (if they acknowledge the TBI component at all) rather than as a single, integrated experience. This fragmentation can leave individuals feeling misunderstood or inadequately supported.
For those supporting veterans, whether as clinicians, family members, or peers, it can be helpful to introduce simple, grounded ways of exploring and externalising internal experiences that are difficult to untangle.
Expression can begin with quiet, practical exercises that help map the emotional and cognitive terrain of someone living with both PTSD and TBI.
For example:
1. Creating a visual timeline of symptom intensity can help identify patterns or triggers that aren’t immediately obvious in conversation.
2. Sorting objects to represent sources of stress, support, or sensory overload can give shape to feelings that are hard to articulate.
3. Some people find value in sketching out a “mental load” chart, a visual representation of what they’re carrying day to day, or in journaling through structured prompts that track fatigue, irritability, or clarity across the week.
4. Try creating a personal “soundtrack of the day” by choosing songs that match how different moments feel: from stress to calm to clarity. It can help track mood, offer distraction during distress, or support reorientation when things feel scattered.
These practices are a way to make inner experiences more tangible and easier to work with.
When PTSD and TBI occur together, healing isn’t always effective when it relies on traditional talk-based approaches alone. It can require a fuller understanding of how injury, memory, emotion, and identity intersect and finding ways to see the shape of what’s being carried.
This June, as we reflect on the impact of PTSD, let’s also make space for the complexity of these dual injuries and for the creative ways we can respond.