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iStock_000017481456_XXXLargePosttraumatic stress disorder (PTSD) and traumatic brain injuries (TBI) together have often been called the “signature, invisible” injury of the Iraq and Afghanistan conflicts. PTSD is defined as the reaction to a traumatic event, such as combat exposure.1 Those with PTSD might have nightmares, flashbacks, hypervigilance, hyperarousal and an avoidance of crowded places or situations that tend to trigger memories of trauma. TBI is often caused by a traumatic injury to the head or neck and can cause physical, behavioral and cognitive changes.

Caregivers play an important role in the recovery of those individuals and veterans with PTSD and TBI, although little is known of them. According to Tenielian et al (2013), an estimated 275,000 to 1 million people are currently caring for, or have cared for, an individual returning from Iraq and Afghanistan. What is unique about these caregivers is that they are young, sometimes with children, and they are caring for a unique and understudied population for long periods of time.

In the 2010 report from the National Alliance for Caregiving (NAC), it was reported that “80 percent of veterans live in the same household as their caregiver, with 96 percent of caregivers being women and 70 percent of those being wives.”1 Alternately, in non-military caregiving (NMCG) populations, around 65 percent of caregivers are women with only 6 percent being wives. Given the amount of military family caregivers, it is important to have an understanding of the stresses the caregivers are faced with.

When comparing caregiver burden between NMCG and veteran caregivers (VCG) populations, 65 percent of VCGs reported caregiver burden versus the 31 percent of NMCGs. NAC also found that 95 percent of caregivers caring for a veteran with PTSD reported helping the veteran with mood regulation. The toll on the VCGs was also significant as they suffer more physically, psychologically and emotionally compared to NMCGs. “A common theme with caregivers is that families no longer recognized the veteran who has returned from combat and are unprepared or unwilling to hear about the psychological impact of warfare on the veteran (PATEL).”1

Another downfall for VCGs is the stigma within the military culture surrounding mental health disorders. According to Phelan et al, (2001) there are different types of stigma associated with veterans with PTSD or TBI as well as their caregivers. The three categories are as follows:

  1. Caregivers feeling discriminated against or being treated differently because of the veteran’s condition
  2. Stigma associated with being a caregiver
  3. Caregivers’ need to conceal or to explain the veterans condition


It is suggested by Patel that further exploration into the type of stigma caregivers experience be further studied, as some forms of stigma appear to have a greater affect on caregiver burden than others.

For more information about the affects on caregivers of veterans with PTSD and TBI, as well as the implications for social work practice, read the article written by Bina R. Patel entitled “Caregivers of Veterans with “Invisible” Injuries: What We Know and Implications for Social Work Practice.”



  1. Patel, B.R., (2015). Caregivers of veterans with “invisible” injuries: what we know and implications for social work practice, Social Work. 60(1). 9-17. Doi:10.1093/sw/swu043
  1. Phelan, S.M., Griffin, J.M., Hellerstedt, W.L., Sayer, N.A., Jensen, A.C., Burgess, D.J., & Ryn, M.V. (2011). Perceived stigma, strain and mental health among caregivers of veterans with traumatic brain injury. Disability and Health Journal, 4, 177-184. Doi:10.1016/j.dhjo.2011.03.003
  1. Tanielian, T., Ramchand, R., Fisher, M.P., Sims, C.S., Harris, R.S., & Harrell, M.C., (2013). Military caregivers: Cornerstones of support for our nation’s wounded, ill, and injured veterans.



This MFLN-Military Caregiving concentration blog post was published on August 26, 2016.