When Invisible Wounds Collide: Traumatic Brain Injury and Suicide Risk Among Veterans

For many Service Members and Veterans (SMVs), the most dangerous wounds of military service are not the ones that can be seen. Traumatic Brain Injury (TBI) — especially combat-related — has become known as the signature wound of the wars in Iraq and Afghanistan. Yet its impacts extend far beyond memory loss or headaches. TBI changes the brain, affects emotional regulation, and increases risk for depression, anxiety, and post-traumatic stress disorder (PTSD).

Research shows that brain injury is not limited to combat. Veterans and active-duty service members experience TBIs through:

• Falls

• Motor vehicle collisions

• Training accidents

• Blasts or concussive force exposure

• Everyday injuries — even hitting one’s head on a hard object

According to DePalma & Hoffman (2018), TBI remains a significant wound among Vietnam Veterans as well.

For many, these injuries don’t fade when the uniform comes off.

The Link Between TBI and Suicide Risk

Recent studies make the connection starkly clear:

“Veterans endorsing multiple lifetime TBIs… had significantly higher odds of reporting recent suicidal ideation compared with those who denied a history of any TBI.”
— Robert D. Shura, Psychological Services (2019)

Even when controlling for age and gender:

“Those with a history of TBI were 2.15 times as likely to die by suicide compared with those without TBI.”
— Trisha Hostetter, Journal of Head Trauma Rehabilitation (2019)

TBI doesn’t just affect memory or cognition — it can alter emotional processing and decision-making. It can make everyday stress feel overwhelming and make mental health symptoms harder to treat.

Combine that with the transition out of military service — loss of structure, identity, purpose — and the risk escalates.

Why This Matters Now

Suicide among Veterans remains a public health crisis.
More than 17 Veterans per day die by suicide in the United States.

TBI is often unseen and undiagnosed. And yet:

• TBI is treatable.

• Suicide is preventable.

Understanding the connection helps providers screen more effectively and helps Veterans and families advocate for care that addresses both brain injury and mental health — not one or the other.

What Veterans and Families Can Do

- Ask for a TBI screening. Even past concussions matter.
- Track behavioral changes. Mood swings, irritability, or brain fog may be TBI effects — not personal failure.
- Seek coordinated care. Brain injury and mental health need to be treated together.
- Reach out to local organizations for support.

New Hampshire Brain Injury Association
They offer support groups, care navigation, and resources for Veterans and families living with brain injury.
https://www.bianh.org/

You're not alone, and you don’t have to navigate this alone.

We Can Change the Story

Our Veterans served us.
We owe them more than gratitude — we owe them care that sees the whole person.

By connecting the dots between TBI, mental health, and suicide risk, we can:

• Promote earlier screening and intervention

• Reduce stigma

• Build a system that keeps Veterans alive and supported

Every conversation helps. Every Veteran matters.

If you or someone you love is struggling

📞 Call or text 988 — then press 1 for the Veterans Crisis Line
💬 Chat online: 988lifeline.org

You are not alone. Help is available — now.