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Navigating the Overlapping Symptoms of PTSD and TBI

Army veteran Frank Sonntag is not alone in dealing with both PTSD and TBI. Often, PTSD and TBI occur simultaneously.

U.S. Army veteran Frank Sonntag was near an explosion in Iraq in 2004. He felt the shockwaves of the explosion as he hunkered down to protect himself. When the shockwaves passed, he checked for injuries and found no visible signs of damage – he got back up and kept working. It would be a year before headaches and nightmares signaled serious health issues.

Frank had both post-traumatic stress disorder (PTSD) after 25 years of service in the Army, and traumatic brain injury (TBI) from this incident.

He was still on active duty when he realized something was wrong. “I would have nightmares all night and headaches all day,” he said.

Frank’s quality of life sunk so low that by the time he walked into a hospital for treatment in 2008, he was on the brink of suicide.

Hidden Symptoms and Long-Term Effects of PTSD and TBI

Frank is not alone in dealing with both PTSD and TBI.

In the most recent Wounded Warrior Project® (WWP) Annual Warrior Survey, 75% of respondents reported symptoms of PTSD. When asked about head injuries, 64% reported injuries, and 35% of veterans surveyed said they have a traumatic brain injury.

Often, PTSD and TBI occur simultaneously. Although they are separate diagnoses, to the person experiencing them, the symptoms of PTSD and TBI often blend into each other and can be difficult to tell apart.

Symptoms might not show up immediately after injury, and sorting through symptoms may take years. It can leave warriors wondering what is happening to them.

“PTSD doesn’t start the day you leave a combat zone,” Frank said. “When I got home, I thought I was fine. But then I started having nightmares, flashbacks, and night terrors.”

At the same time, Frank’s headaches took hold and would not go away. “I was diagnosed with TBI after I started to have headaches 40 or 50 days in a row,” Frank said.

He also started to lose his memory. “I forgot names of people who worked for me, and I forgot how to drive home. I was unable to sleep at night, and I was having nightmare after nightmare – so, I was pretty much a mess.”

While doctors diagnosed Frank with TBI, they also found internal damage on the right side of his body: a blocked carotid artery and a damaged kidney. Frank underwent two surgeries, but his physical recovery did not provide peace of mind. Thankfully, that’s when he found WWP.

When he was two months away from separating from the military, Frank attended a WWP connection event with other warriors. “Those three days changed my whole life,” Frank said. “I cried for a day because I found people who knew exactly what I had been through. It showed me there was hope. And I knew I could have a better life than I ever thought possible.”

Frank’s experience was so powerful that he dedicated himself to counseling and mentoring other warriors to ensure they never feel alone — and to help them realize they, too, can have a great life.

“Wounded Warrior Project has been a lifesaver to me,” Frank said. Since that first veteran connection event when he learned about WWP services, Frank has navigated VA benefits, bonded with other veterans through Soldier Ride, attended connection events, and became a peer mentor to other veterans through WWP.

He reconnected with being a leader – something he missed from his time in service – and learned that there is strength in accepting help.

“In the Army, I was the leader,” Frank said. “I was the guy who was supposed to be strong and set the example. I was the guy who could not take a day off or show any weakness. I found out that being the strong guy forever is not sustainable.”

Keeping a healthy balance is something that Frank works on every day. “For me, it’s a battle you fight every day,” Frank said. “The head injury and the PTSD are married to each other. For continued care, I see two doctors on a regular basis – a neurologist and a psychiatrist.” 

Finding Support and Care for Complex Issues

In the last two years, Frank has found solace in playing the piano. He plays to relax and stay challenged. He also stays socially active by connecting with veterans from his time in service and from WWP.

“My advice to other veterans is to get together with others who have the same issues you’ve had,” Frank said. “When I went to that first WWP event, I was very broken, and I wondered how I was going to live after 25 years of active duty. Through Wounded Warrior Project, I met people who had similar problems and had connected with others just like themselves and improved their lives dramatically. Go find other warriors, use WWP programs. There are dozens of programs and events to attend – and it’s free.”

In addition to connection events, physical and mental wellness programs, and telephonic help, WWP gathers expertise from around the country to offer treatment for PTSD and TBI.

WWP’s Warrior Care Network® is an intensive outpatient treatment program that makes high quality care at four academic medical centers accessible to warriors at no cost to them.

Through two- to three-week intensive outpatient programs, Warrior Care Network provides care tailored to each veteran and family member. It integrates behavioral health care, rehabilitative medicine, wellness, nutrition, mindfulness training, and family support.

“One of the unique strengths of Warrior Care Network is that it’s tailor-made for the warrior,” said Erin Fletcher, Psy.D., WWP’s Warrior Care Network director. “While we know the symptoms of PTSD and TBI are similar across the individuals who experience those symptoms, we also know what doesn’t work is a cookie-cutter approach to this care. Warrior Care Network provides tailored, comprehensive mental and brain health care to meet the unique needs of each warrior.”

Warrior Care Network provides clinical care along with wraparound support to ensure each veteran is getting the best treatment. Offering services under one roof helps warriors manage a variety of symptoms, as well as helping caregivers understand various aspects of warriors’ needs.

Learn more about how WWP helps warriors and caregivers #CombatStigma through physical and mental health programs at

Contact: Raquel Rivas — Public Relations,, 904.426.9783

About Wounded Warrior Project
Since 2003, Wounded Warrior Project® (WWP) has been meeting the growing needs of warriors, their families, and caregivers — helping them achieve their highest ambition.

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