Is PTSD Psychological or Physical?

June 14, 2016

Since the advent of modern warfare, subsets of returning soldiers have suffered from memory loss, cognitive problems, inability to sleep, and profound, often suicidal, depression. Historically, these symptoms were attributed to emotional turmoil evoked by the trauma of war. Recent studies, however, reveal compelling evidence that these symptoms may in fact be caused by physical brain damage resulting from explosive blasts. Over the past 15 years, 350,000 American service members have been diagnosed with traumatic brain injury, a statistic that is likely an underestimate. 

A 2010 post-mortem study of blast-injured soldiers who died long after blast exposure revealed a common and distinctive pattern of tiny scars in areas of the brain corresponding to the centers for sleep and cognition. These physical findings differ from damage caused solely by concussions, which can lead to chronic traumatic encephalopathy. There are several hypotheses about the source of this scarring pattern, including theories that blasts cause damaging surges of blood to the brain, or compression waves that change speed when encountering different densities. Another study investigated the cumulative effects of small blasts on SWAT instructors and trainees, finding that instructors, who are exposed to more blasts, had a small but distinct decline on neuropsychological tests.

In light of recent findings, the military is starting to shift their outlook on the seriousness of blast exposure. Initial changes within the military include increased screening for brain injury, mandated removal of concussed soldiers from combat, and the requirement for soldiers to wear blast gauges that turn red when exposed to forces equal to the lower limit of possible concussion or brain injury.

Article: Is PTSD Psychological or Physical?