Veterans and the hidden wounds of wars: Don't ignore traumatic brain injury, mental illness

I had the opportunity this fall to hike fourteen miles with a group of wounded veterans, British and American, as part of the Walk of Britain. We joined the group for a section of Wales coastline where the hills were steep and rocky and the weather wet and brooding.

It was humbling to see these heroes, some with very visible injuries like prosthetic legs or relying on braces. I was there for just one day. Their challenge was to endure this grueling pace for 10 weeks as a physical reminder of the sacrifice of those who have served and still do.

Parts of the route ventured through towns, where the public often dropped a pound or two in a donation bucket carried by British Lieutenant Colonel Stewart Hill who would explain the purpose of the 1,000-mile walk to raise funds and generate awareness for veteran’s issues on both sides of the Atlantic.

On more than a few occasions he heard in reply, “but you don’t look wounded.”

“You’re so lucky your husband came back unharmed,” was the oft-repeated phrase one Army wife told me made her inwardly furious, despite her outward smile. There is no natural response as a loved one when the internal injuries are both stigmatized and impossible to quantify, the way one can with a missing limb.

Like many veterans of the wars in Iraq and Afghanistan, Stewart has a traumatic brain injury that affects his cognitive skills. Nearly 1-in-5 post-9/11 American veterans suffer from hidden wounds like TBI, post-traumatic stress and depression.

I’ve learned a lot about TBI and PTS over the past decade through my husband Bob’s injuries when he was nearly killed by a roadside bomb while reporting for ABC’s “World News Tonight” from Iraq. While he has recovered in miraculous ways and returned to work as a journalist, many are not so lucky.

I would bristle every time someone would tell me “he looks so great.” In those early days of his healing I wanted to scream, “but how does he seem?”

The losses suffered by veterans and civilians with TBI are compounded by the fact that the injuries are inside. And each brain injury is different from the next, changing behavior, mood and emotion in different amounts. Sometimes the almost imperceptible differences are the most heart breaking for both the loved ones and the individual.

“You’re so lucky your husband came back unharmed,” was the oft-repeated phrase one Army wife told me made her inwardly furious, despite her outward smile. There is no natural response as a loved one when the internal injuries are both stigmatized and impossible to quantify, the way one can with a missing limb.

While there have been many advances in armor and military medicine that have saved lives on the battlefield, there is much work to be done to understand and treat the growing number of brain injuries and mental illness.

According to the Department of Veterans Affairs, 640,537 (or roughly 23.7 of post-9/11 deployers) have been diagnosed with some form of mental health issue. More than 322,000 have TBI, but it’s believed many more cases haven’t been treated.

Many will need care for years to come, while many others go undiagnosed due to the stigma and the shame of carrying these hidden wounds.

Fortunately there are many organizations addressing these needs that the Bob Woodruff Foundation has been proud to support, like One Mind, which is led by retired Army General Peter Chiarelli.

All of what needs to be done requires not only funding, but a shift in the way we look at treating those who serve.

It’s time to view illness as illness—regardless of whether it is physical or mental. And when it affects our brave young men and women in uniform, we need to view these hidden wounds in the same way we would an amputation.

No one should ever have to hear, “but you don’t look wounded.”

Lee Woodruff is an author, journalist and cofounder of the Bob Woodruff Foundation. Lee’s husband Bob Woodruff was seriously injured by a roadside bomb that struck his vehicle near Taji, Iraq while reporting on U.S. and Iraqi security forces for ABC's “World News Tonight” in 2006.

The Bob Woodruff Foundation is teaming up with the Love the GIVE campaign this Veteran’s Day to encourage Americans to honor the folks who have served by sharing acts of kindness through social media using the hashtag #Give2Veterans. The Bob Woodruff Foundation gets $1 each time the hashtag #Give2Veterans is used -- on any social network, up to $500,000.