https://archive.ph/MzZMw

Qualifier: Former US special operations operator that served in multiple wars.

My anecdotal take is there are many ways that shock and trauma can accumulate through training and war that are far beyond the minimal effects of an M4.

Firearms: While the primary weapons systems are the M4 and side arm (pistol), there are many weapons systems utilized by special operations such as sniper rifles, crew serve weapons, and niche small arms.

The M82 sniper rifle shoots a 50 BMG round. In either the bolt action or semi-auto versions they feel like you are getting punched in the face when you shoot them.

Crew serve weapons like the MK19 and M2 do pack a punch. The MK19 is a machine gun that shoots 40mm grenades. The M2 is a .50 cal machine gun. These weapons systems are mounted, but the percussion of them is still far greater than an M4.

More niche arms like the M249 SAW, M16 HBAR, full-auto AKs, M240 Golf, MP9, etc are not as mild as the standard M4/M16.

Blasts: There are many types of blasts encountered such as Mortars (inbound and outbound), Flash Bangs, Entry charges, IEDs, Landmines, etc. These do make your head ring if you are close enough to them.

In my own personal experience there are many other daily jarring events that aren't nearly as sexy to talk about. Riding in the back of a 5 ton will almost shake your brain out of your head. Riding in an LCAC (hovercraft) is like riding in a 5 ton. Doing boat work in Zodiacs will bounce you all over the place, especially when doing surf passages. Doing hydrographic surveys right where the surf breaks will pound you for hours and make you a little sick afterwards. When your chute opens on a jump, if jumping round chutes, will make you see stars...the landing is not a soft pretty one like rectangle chutes...you hit the ground hard.

There are many more ways your body gets pounded on a daily basis far in excess of the weapons you use.

> Much of what is categorized as post-traumatic stress disorder may actually be caused by repeated exposure to blasts.

that is to say, it's actually shell shock? as in, actual physical shock from actual shells? george carlin would be so proud

https://www.youtube.com/watch?v=vuEQixrBKCc

the article also mentions that they'd all trained extensively in diving deep underwater, which is also known to cause brain damage, but the 'interface astroglial scarring' pathology lab results sound pretty specific to big shock waves

i'm skeptical that firing a rifle produces shock waves that induce cavitation in brain tissue, though

A lot of special forces have been doing what we used to call "door kicking" in the last few wars. Lots of explosive breaches, firing weapons and throwing grenades indoors. I'm sure this is the main contributing factor. The percussive force of firing and explosives indoors is horrible and I say this as an ex artillery officer, so I'm used to chest-breaking bangs from firing big artillery guns

This was a really well-written article. I think for years I had naturally thought that traumatic brain injury as a result of explosives basically caused the brain to rattle so hard that it smashed against the skull causing contusions, but apparently this is something different.

The way it's explained in the article is that this is actually a result of the blast energy wave bouncing off of differently dense brain tissue sections and causing cavitation.

I'm glad that these issues are finally being brought to light, It's truly unfortunate that no matter how highly trained and skilled some of these soldiers are, that blast waves from IEDs or in this case from their own munitions can result in such insidious physiological changes.

This is the kind of research I've been yearning to see on suicide.

Just telling people not to, or to call a hotline, seemed like the worst most patronizing advice as it never solved the underlying thing.

I've since learned that there is a subset of suicidal people where that's enough, where the suicidal tendency is a kneejerk decision that can be disrupted, but it bugged me that its not serving everyone that becomes suicidal with a recurring condition that's not improved by merely being present.

It always feel like people are too uncomfortable to talk about it enough, or to question the response measures. A "I'm Helping!" sentiment by copy and pasting a suicide hotline memo, when they're not helping at all, just offloading their discomfort into a protective layer for their own psyche.

In contrast, I'm comfortable enough to wonder whether suicide was the most rationale and objectively best choice, as someone with strong self preservation circuits you can see how far apart I am from everyone else. But this is opinion, a hunch, what I really want is a data driven analysis of the conditions. As with real science, I am accepting of any conclusion, instead of trying to conform a conclusion to preventing it if prevention isn't what winds up being on the table with our current infrastructure.

Artillery crew members who fired thousands of rounds in combat came home plagued by hallucinations and psychosis

Could this problem also be affecting civilian gun enthusiasts? Or is the order of magnitude of the exposure just wildly lower compared to the military, even in the most enthusiastic?

I was an infantryman in the Army for ten years, from 1998 to 2008, and deployed three times, twice to Iraq,

Encounters with IEDs were common, especially during the surge.

So many of my friends have died to suicide or have killed themselves due to drugs and/or alcohol that it is hard to keep track.

Now that primadonna seals are dying maybe someone will pay attention.

Thankfully the only lasting effects of my deployments seem to be a bad back and distaste for authority.

This is excellent journalism.

Digging into an issue that is affecting lives in such a drastic way and bringing these issues to light.

Like this part of the article for example:

Until The Times told the Navy of the lab’s findings about the SEALs who died by suicide, the Navy had not been informed, the service confirmed in a statement. A Navy officer close to the SEAL leadership expressed audible shock, and then frustration, when told about the findings by The Times. “That’s the problem,” said the officer, who asked not to be named in order to discuss a sensitive topic. “We are trying to understand this issue, but so often the information never reaches us.”

From a NYT article about the Lewiston, Maine shooter's brain injuries [1]:

> Researchers found that before they worked around blasts, the instructors brains looked healthy. But in follow-up scans five months later, their brains were teeming with an abnormal protein called beta amyloid that is associated with Alzheimer’s disease.

> “In a young brain you should see no amyloid. None. Zero,” said Dr. Carlos Leiva-Salinas, the University of Missouri neuroradiologist who ran the study. “We were surprised, very surprised.”

[1] http://archive.today/ju6iq

Prisoners is another population where we would find pervasive brain damage if we scanned them.[0] In time I believe we will find that a ton of destructive/aggressive behavior is due to physical issues in the brain.

[0] https://link.springer.com/article/10.1007/s00406-013-0403-6

I've said for several years that my estimation of the United States military's treatment of its enlistees makes it basically indistinguishable from psychological torture in my eyes. I'm glad there's finally research that says something essentially similar.

From a couple of the sources referred to in the article:

Impact of repeated blast exposure on active-duty United States Special Operations Forces - https://www.pnas.org/doi/10.1073/pnas.2313568121

"We performed a multimodal study of active-duty United States Special Operations Forces (SOF)—an elite group repeatedly exposed to explosive blasts in training and combat—to identify diagnostic biomarkers of brain injury associated with repeated blast exposure (RBE). We found that higher blast exposure was associated with alterations in brain structure, function, and neuroimmune markers, as well as lower quality of life. Neuroimaging findings converged on an association between cumulative blast exposure and the rostral anterior cingulate cortex (rACC), a widely connected brain region that modulates cognition and emotion. This work supports the use of a network-based approach, focusing on the rACC, in future studies investigating the impact of RBE on SOF brain health."

Characterisation of interface astroglial scarring in the human brain after blast exposure: a post-mortem case series - https://pubmed.ncbi.nlm.nih.gov/27291520/

"The blast exposure cases showed a distinct and previously undescribed pattern of interface astroglial scarring at boundaries between brain parenchyma and fluids, and at junctions between grey and white matter. This distinctive pattern of scarring may indicate specific areas of damage from blast exposure consistent with the general principles of blast biophysics, and further, could account for aspects of the neuropsychiatric clinical sequelae reported. The generalisability of these findings needs to be explored in future studies, as the number of cases, clinical data, and tissue availability were limited."

This isn't new knowledge. I've heard about blasts causing sudden pressure buildup in the brain via the spinal cord years ago.

Of course this is now a much bigger problem for the military as it affects all combat soldiers even during training exercises.

Wonder if something similar happens to people who have exposure to drilling sound for significantly continuous amount of time (few hours a day). I often see construction/roadworks crew around my area without ear protection while drilling is going on.

I really don’t know how to move forward on some of the effects of these “lighter” crew served weapons. Carl G comes to mind.

In many cases, doctors treating the injured troops give them diagnoses of psychiatric disorders that miss the underlying physical damage. Much of what is categorized as post-traumatic stress disorder may actually be caused by repeated exposure to blasts.

I've said for years that people who are suicidal typically have very serious, intractable personal problems but get dismissed like it's "mental" or emotional. They need actual help for actual problems, not "attaboys" and not empty assurances that "Someone cares."

"It was not chronic traumatic encephalopathy, or C.T.E., which is found in football players and other athletes who have been repeatedly hit in the head. It was something new."

OK, so not that.

There are going to be a huge number of people with this problem from the Ukraine war. There haven't been years of artillery duels since WWII.

Misc info on weapon sound pressure.

The Carl Gustav 8.4cm recoilless rifle now be procured by the Marines has a big back-blast through the typical venturi used by these kinds of weapons. In training, (Sweden at least) they are limited to the number of rounds they can fire. I do not know if this for merely hearing loss, or if there are concussive effects.

Also, while "small arms" do not typically have concussive effects, I have stood behind a.50 Barrett rifle discharge and there was a noticable shock wave in the air. I didn't feel it in my head, but my intestines were not happy. If you were in the front hemisphere of the muzzle blast it would be far worse.

Muzzle brakes on rifles usually make the blast wave propagate more to the side. A high caliber rifle with a muzzle brake could easily hit 160db. Maybe a .50 cal could go higher. So now you are even punishing your friends, not just folks downrange.

What an incredible article. The other articles referenced within are also excellent.

My concern: given that this is becoming more common knowledge, in a world in which other, potentially adversarial, countries are more than fine sending their soldiers through the mental meat grinder, how can we prevent outcomes like the ones shared here while retaining hard power?

Mandatory shock absorbing helmet during training would be helpful I guess.

What other preventive measures could be employed?

The article says "The vast majority of blast exposure for Navy SEALs comes from firing their own weapons, not from enemy action."

Is it possible damage can be modeled with something like:

total_damage = incident_count * Impulse - or - total_damage = incident_count * Energy Density

It seems like the question of potential damage from small arms and personal weapons should be investigated.

There’s an Apple podcast that touches on some of the aspects related to this: https://www.apple.com/tv-pr/originals/the-line-podcast/

https://www.independent.co.uk/news/the-mystery-of-shellshock...

Topical: just a few minutes from where I live, in Lewiston Maine, a former grenade range instructor walked into a bar recently and killed 18 people. His brain was found to have the same kinds of damage- he had been hearing voices and experiencing other psychotic symptoms and he had access to guns. It seems likely that the repeated concussions at the grenade range were a contributing factor.

https://www.nytimes.com/2024/03/06/us/maine-shooting-brain-i...

This reminds me of the movie Concussion (2015) with Will Smith, which is about a similar pattern of brain damage and suicide in football players.

If this is accurate there is likely very little to be done, and the solution will likely be to have less training and retire a decade sooner.

the way people understand mood and suicide is completely wrong. i have had very unusual bipolar disorder symptoms in the past and it allowed me to experience extreme depression one day and then good mood the next day. i have experienced depression that is so bad that it was difficult to physically move. i remember not being able to stand up from being seated in a chair. this is what i consider to be basically the far side of the spectrum of symptoms — the worst that depression can be. its absolutely deadly because at this point you are effectively experiencing unbearable pain as well as, for some reason, having trouble moving. it hurts to think about the future. every moment is agony. people in this situation kill themselves to end the pain most of all and because they feel trapped. and also because in this state of mind you are unable to work, support yourself or even have relationships. but the real insight is whats next.

luckily i only experienced those lows for a period of time. and some days i would be lifted out of it and feel perfectly normal. this experience is what made me realize what almost nobody realizes: that there is no situation where a healthy person will feel the desire to kill themselves. this is because mood is an illusion. i would go from having this entire world view that my life is hopeless and being completely lost and almost instantly switch over to having lots of things on my mind and looking forward to many things and wanting to get on with life. having a normal mood involves being blind to negative things as much as being depressed involves seeing bad things that arent bad. the human mind is designed to translate sensory input into action by any means and when this system breaks down it weirdly feels painful and makes you want to kill yourself. i think the breakdown of this system can be isolated to a domain, concept or situation or be global. and i think that high stress can cause this effect through inflammatory dysregulation or some other stress pathology giving the incorrect impression that suicide is a reaction to stress. if there were a pill to stop the root cause of depression, nobody would ever kill themselves except for terminally ill people. and just because someone killed themself doesnt mean that their life was especially hard, hopeless or messed up or whatever. it just means they were sick. thats it. and yet every time theres a suicide, all people talk about are the circumstances surrounding the suicide even though they probably are indirectly involved at best!

when i was in those deep depressions i would connect the dots of all the things about my life into a causal web and would be convinced myself that it was the circumstances of my life were the reason i felt depressed. but then within hours that mental framework would disappear completely and i would feel fine. its an extremely powerful illusion. thats why the word trapped resonates so powerfully with people who have been through it. the illusion makes you feel trapped.

this realization has made me basically immune to depression. i recognize mood disfunction immediately now and i have coached myself to remember its an illusion. i am sure that i have experienced significant mood dysfunction in the past, and that most people have, and gotten lost in it simply because i didnt understand what was going on. i think that this is a huge component of the decision to commit suicide: people start experiencing pain, they think its intrinsic to their life situation, they get lost in it, and they would hold on if only they had some context. i wish there was a way to induce severe depression temporarily to show people what it is and educate them so they could not go into it completely blind when the time comes. that would really help people.

I think it is pretty obvious that there should be more government funding to determine whether the brain damage occurred while defending our freedom within the US borders or outside it.

4x more soldiers killed themselves than died in combat since 9/11. [0]

At least 2X more soldiers kill themselves in peacetime than die in combat in every war that we as a species has tracked suicide rates for veterans.

[0](https://www.npr.org/2021/06/24/1009846329/military-suicides-...)

Of course it doesn't reach them. Same with any black project, the dangers get swept under the rug.

I didn’t read the article. I mainly come here for the commentary and the backdoor links. But!

Hormone replacement therapy is a game changer for a lot of men who have CTE. I’m a clinical social worker. I’ve worked in emergency medicine, correctional medicine, and now outpatient psychotherapy. I used to think HRT was for ego lifters and old ladies. But I have seen first hand the value of HRT for CTE patients. I’ve seen guys go from three OWIs and unable to manage an entry level job at Lowe’s to law-abiding, midlevel executive at national corporations within months of starting on HRT.

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Land of the free, home of the brave - doesn't come cheap.

By definition "Leadership" in this capitalistic society is predatory - this style extends to the armed forces, where everyone is expendable.

Important stuff as the Anglo-American global-empire prepares to fight WW3.