The visible and invisible wounds of today's veterans
The Visible and Invisible
Wounds of Today’s Veterans
U-M Veteran and Military Services
• This presentation may be a trigger for those
who have experienced combat
• This is heavy material
• Some of what I will say and discuss may
• I am not a doctor, clinician, social worker or
• I have never served in combat
• Roadside and footpath blasts
• Limb loss – 11% lost more than one limb
• Genital injuries
– (often combined with double amputation of legs)
• Shrapnel wounds
• Psychological Trauma
• High velocity rounds
• Head and Neck wounds
• Psychological Trauma
• Caused by sudden trauma to the head or a
penetrating head injury, that disrupts the
normal functioning of the brain.
• Blasts are leading cause in combat zones
• Person may remain conscious or be dazed or
confused after injury takes place
• Symptoms are subtle and may not occur for
days or weeks following the injury.
• Mild TBI
– Headaches or neck pain that does not go away.
– Light-headedness, dizziness or loss of balance.
– Urge to vomit (nausea).
– Loss of sense of smell or taste.
– Ringing in the ears.
– Difficulty remembering, concentrating or making decisions.
– Slowness in thinking, speaking, acting or reading.
– Getting lost or easily confused.
– Feeling tired all of the time and having no energy or motivation.
– Mood changes (feeling sad or angry for no reason).
– Changes in sleep patterns (sleeping a lot more or having a hard time sleeping).
– Increased sensitivity to lights, sounds or distractions.
– Blurred vision or eyes that tire easily.
• Severe TBI
• Headache that gets worse or does not go away.
• Repeated vomiting or nausea.
• Convulsions or seizures.
• Inability to awaken from sleep.
• Dilation of one or both pupils of the eyes.
• Slurred speech.
• Weakness or numbness in the extremities.
• Loss of coordination.
• Increased confusion, restlessness or agitation.3
• 2012 SVA Survey:
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
Severe Depressive Symptoms
Significant PTSD symptoms
Thoughts about suicide
• Fallujah family home
• Convoy Duty
• M1 Tank
• Experience or witness of an event that
involved actual or threatened death or injury
• Response involves intense fear, helplessness
• Moral injury
• Can be acute or chronic
Re-experience the event
• Recurrent and intrusive recollection of the
– Images, thoughts, perceptions
• Act as though the event was recurring
• Reaction to “triggers”
• Thoughts, feelings, conversations
• Activities, places, people
– Inability to recall event or pieces of event
– Feeling of detachment
– Restricted emotions
– Inability to look ahead
– Shame, Guilt, Loss
• Physical arousal
– Difficulty falling or staying asleep
– Irritability or outbursts of anger
– Difficulty concentrating
– Exaggerated startle response
– Safety and Security
– Telling the story
• talking, art, writing, acting
– Dealing with the moral injury
– Managing Triggers
– Sleep management
– Emotional management
From a veteran’s perspective
(ten things you should know about todays student veteran)
• Student Veterans are a highly diverse group
• Veterans do not see themselves as victims, ever!
• They can feel alone on campus
• They are often unaware of their PTSD or TBI
• There are three things you should never say to a
veteran but they still hear them every day
– These wars were atrocities and a waste of human life.
– I don’t understand what you’re having trouble – you
volunteered for service.
– Did you kill anyone?
Veteran’s perspective cont.
• Female soldiers suffer in silence
– 15% of military
– 22% of whom will be sexually assaulted during their
• They often want to go back to the war zone
• Combat trauma is an injury not a mental illness
• Veterans need your understanding, compassion and
• Student Veterans are one of America’s greatest
untapped human resources
• The Battle for Marjah
• http://www.bbc.co.uk/schools/0/ww1/25403864 - WWI Injuries
injuries-and-medicine.htm - WWII injuries
• http://www.va.gov/oaa/pocketcard/korea.asp - Korea injuries
stories/articles/0609-03.jsp - survival rates
• http://www.nea.org/home/53407.htm - Ten Things You Should Know
About Today’s Student Veteran
• http://www.realwarriors.net/active/treatment/tbisigns.php - TBI signs
• University of Michigan P.A.V.E program – SVA statistics
• Williams, Mary Beth, Ph.D., LCSW, CTS & Poijula, Soili, Ph.D. (2002) . The
PTSD Workbook, Oakland, CA, New Harbinger Publications