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Eugene Greathead
Professor Victoria Herman
MA102L
16 January 2016
Statistics of TBI/PTSD vs. Suicide on Veterans
This paper will focus on the statistics between veterans who have committed
suicide and previously suffered Traumatic Brain Injury (TBI) and Post-Traumatic Stress
Disorder (PTSD, some medical professionals are using Post-Traumatic Stress, PTS
eliminating the term disorder, I will use PTSD throughout the paper as this is the
commonly known term). With the two wars reaching over thirteen years of constant
fighting on our force and the insurmountable increase on Traumatic Brain Injuries
suffered by the force there should be a link between PTSD/TBI and suicide. I will dive
into the numbers and try and see if it is something that is case by case or do the statistics
show that the injury and illness can lead to suicide. I also want to show that outlying
factors such as experience may also play into these statistics, but are impossible to
explore.
First, let us get into some numbers, “there are over 2.3 million American Veterans
of the Iraq and Afghanistan wars (compared to 2.6 million Vietnam veterans who fought
in Vietnam; there are 8.2 million "Vietnam Era Veterans" (personnel who served
anywhere during any time of the Vietnam War) at least 20% of Iraq and Afghanistan
veterans have PTSD and/or Depression. (Military counselors I have interviewed state
that, in their opinion, the percentage of veterans with PTSD is much higher; the number
climbs higher when combined with TBI.) Other accepted studies have found a PTSD

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prevalence of 14%”. What is even more amazing than the numbers above is the majority,
close to 50% of veterans, never seeks medical or psychological help for their issues.
Now, add to this that a study by the Rand Corporation concluded that close to 19% of
Veterans also has Traumatic Brain Injury. The Veterans who suffer both PTSD and TBI
are 7%, could possibly make them more susceptible to suicide. To end the basic numbers
I want to show a very staggering statistic, in 2012, more active duty military personnel
died by their own hand than in combat (Veterans and PTSD 1). So, these numbers
averaged; Veterans with PTSD: approximately 460,000; Veterans with TBI:
approximately 437,000; Veterans with PTSD/TBI: approximately 161,000

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The above graphs depict the rise in both PTSD and TBI throughout the force
starting back in 2000. The entry into Operation Enduring Freedom (OEF) in 2001 then
Operation Iraqi Freedom (OIF) in 2003 definitely had an affect on the rise of both. In the
years 2005-2006 there was a sharp increase of enemy use of Improvised Explosive
Devices (IEDs) that also show another sharp rise in Traumatic Brain Injuries as well as
PTSD. The PTSD graph is a non-normal representation of the growth of PTSD in the
force. The non-normal distribution is due to the outlying factors for the increase and
decrease of cases that cannot been foreseen, such as number of deployments, troop
number escalation as in 2008 in Afghanistan, and the changing in enemy tactics used

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against our military such as the use of IEDs. Tannenbauam defines normal distributions
as “A distribution of data having a bar graph that is perfectly bell shaped” (Tannenbaum
522). So, with the downsizing of combat forces in a combat zone, these numbers should
reduce, possibly making the “bell shape” graph, but only time will tell. Another factor for
gaining TBI statistics is how we diagnose TBI. For instance, I was blown up in 2003,
2004, and 2005 from RPGs, but that was never medically diagnosed, back then there was
no real concern for TBI, basically the “no blood no wound rule”. I was Medevac’d in
2007 for an IED strike, but again, no test for a brain injury until months later when I
returned home and that became my baseline. The method to determine a possible TBI is a
test called the Military Acute Concussion Evaluation (MACE) (McCrea 1). A test
concluded “Findings from the current study support the use of the MACE as a valid
screening tool to assess for cognitive dysfunction in military service members during the
acute phase after mTBI” (McCrea 1). The local medical facilitators, such as the unit
surgeon, use this test or the team Medical Sergeant (18D Special Forces Medical
Sergeant) soon after a soldier is part of a blast injury or head injury. The first time I ever
received this test was in 2013 after a couple IEDs blew near me, so at least four
concussions went undiagnosed. Now, I conclude this was not just an isolated case; there
were probably hundreds of undiagnosed concussions/brain injuries since the beginning of
the Global War on Terrorism (GWOT). The conclusion on these facts are that the number
of diagnosed military personnel with TBI and/or PTSD is skewed due to the insufficient
effort of the medical branch into the two issues. These issues changed as the war went on,
so there is too many factors that lead to the numbers in the above graphs skewed and
possibly lower than the actual numbers.

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This brings us to the next issue, once diagnosed; military personnel can get
treatment as needed. Thus, to a greater degree than not receiving treatment, lowering the
chance of suicide.
As we see above the number of suicides in our military has risen after a decade of war.
The graph above depicts these numbers broke down by military branch. The Army is
highest due to the Army having the largest number of personnel in combat. The graph is
also downplayed by the limiting factor of numbers that only show the suicides through
June 3rd
of each year represented on the graph. One will have to assume the rest of the
year would at least double. If we use the above numbers through June 3rd
as being the

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middle of the year, or the mean (in a normal distribution) then we can conclude these
numbers may double, not exact, but an educated guess that works. In 2012 the above
graph depicts a total of approximately 145 total suicides in the military. The below graph,
showing a total number of approximately 300 suicides in the military leans towards the
above graph showing a mean in numbers for suicides (Tannenbaum 523).
The above chart depicts the most disturbing fact that U.S. Military lost more service
members to suicide that combat in 2012. How could this have happened? The severe
increased number of TBI and PTSD patients, which means an increased number going
undiagnosed, only leads to the conclusion more military members may lead to their own
cure, suicide. I never once thought Math could help this issue, but the numbers do not lie.
Maybe the VA or the Department of the Army Medical Branch should hire statisticians to

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explore what they may be missing to reduce the number of suicides, before Congress
pushes for a Bill that is way late and probably not much thought or research put into it.
The symptoms of each actually overlap each other as well, again, skewing
numbers from misdiagnosing and wrong treatment. Symptoms of TBI include headaches,
being tired, trouble sleeping, vision problems, bothered by noise and light, memory
issues, focusing issues, slowed down, depression, anger, anxiety, and personality
changes. Now, the list of some of the symptoms of PTSD include, trouble sleeping,
trouble concentrating, jumpy, nervousness, emotionally numb, forgetfulness, avoidance,
negative changes in beliefs and feelings, and hyper-arousal or hyper-vigilance (Dept. of
Veteran Affairs 1). As we can see, these two share some symptoms, again making it
harder to diagnose. Also, one symptom can bring out another; for example, lack of sleep
sometimes causes headaches and irritability, again, making it difficult to diagnose. I
believe, to actually help minimize the suicide rate amongst our military members we
must first dive into the numbers and see where we are lacking as described above. The
steps in this process including diagnosing, treatment, and education can all be improved.
Second, and most important, education for the soldiers; get the stigma away from having
PTSD and/or TBI, and the veteran needs to seek help themselves or possibly help a
Brother or Sister in need.

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Works Cited
Tannenbaum, Peter. Excursions in Modern Mathematics. 8e ed. Boston: Pearson
Education, 2014. Print.
"Veterans Statistics: PTSD, Depression, TBI, Suicide." Veterans and PTSD. Veterans
and PTSD, 1 Jan. 2013. Web. 15 Dec. 2014. <http://veteransandptsd.com/PTSD-
statistics.html>.
McCrea M, Guskiewicz K, Doncevic S, Helmick K, Kennedy J, Boyd C, Asmussen S,
Ahn KW, Wang Y, Hoelzle J, Jaffee M. Day of injury cognitive performance on
the Military Acute Concussion Evaluation (MACE) by U.S. military service
members in OEF/OIF. Mil Med. 2014 Sep. 14 Dec. 2014.
<http://www.ncbi.nlm.nih.gov/pubmed/25181717>
"Traumatic Brain Injury and PTSD." PTSD: Veteran Affairs. U.S. Department of Veteran
Affairs, 3 Jan. 2014. Web. 16 Dec. 2014.
<http://www.ptsd.va.gov/public/problems/traumatic_brain_injury_and_ptsd.asp>.