It depends what the extent of his injuries are. On some level, most TBI can be treated to a certain degree with a dedicated treatment team. TBI can cause emotional issues that aren't necessarily a result of PTSD. Excessive anger, irritability, inability to control what he says, forgetfulness, disorientation, blacking out, etc - while they can be signs of PTSD, it's more likely that they're due to TBI if they are very pervasive and, more specifically, if they seem not to be consistent or make any sense to him.
Wife of, your post hit a huge spot with me, too, regarding the hormone swings. I've had doctors in the past comment on whether or not my hormone levels are balanced because I am so off the map when I get really out of it. However, for me, the TBI is also responsible for my emotional symptoms. I have pseudo-bulbar affect and hyperemotionalism (it's the sort of stuff you see in people with Parkinson's disease or Multiple Sclerosis or ALS, where a person will not be able to control their emotions properly) and my impulse control is completely shot.
When combined with antipsych meds that I'm supposed to be on for the psychotic symptoms and PTSD, and borderline personality disorder, my brain hits the berserk button pretty much 100% of the time. I'm lucky I'm lucid at all.
But for the OP, the symptoms of TBI can be basically anything at all, because the brain is responsible for all of our behaviors. Physical symptoms like spasms, jerks, "zoning out" (beyond dissociation), misjudging distances (cup goes on the floor instead of on the counter), tripping and falling all the time, stuttering/stumbling/slurring speech, too hot/too cold, too sexual, asexual, etc. Mental symptoms are more subtle because they overlap with PTSD.
Some stuff can include forgetting basic facts, forgetting to complete steps in a sequence, no impulse control, wild moodswings without triggers, aggression, passivity/docility, lack of motivation (i.e getting up to do things), confusing way of speaking, misunderstands what you say a lot (could be very obvious mistakes or could be misinterpreting the meaning constantly), not understanding sarcasm, trouble with executive or rote tasks, trouble paying the bills, getting groceries, doing household chores, personal hygiene, etc. I'm just speaking from experience or from what I've seen in others so there are literally millions of other symptoms, as there are so many diverse behaviors.
If you notice any behavior that seems exaggerated maybe you should write it down. If you have at least a list of things that are different you can begin to determine what's TBI and what's PTSD from there. Have you or he met with a neurologist?
There's a number of things I do when dealing with my TBI issues. For instance I have a PDA which records what I say and what others say in written format so I can look at what's being said. This helps me so I don't forget what I'm talking about or what's just been said as my short term memory is very poor. I also try and communicate via writing as much as I can because I am a very poor spoken communicator.
I also use post-it notes around my immediate sight to remind me of things, and I keep all of my necessities in one spot so I know where they are (keys, shoes, jacket, ID, smokes, lighter, etc). When people are talking to me and giving me instructions I tell them the best way to do that so it makes sense to me. I'm still dealing with a lot of these issues but those are some immediate things that helped me cope with my TBI.
Having a schedule of things I'm supposed to do helped a lot too, having someone prompt me to do things is helpful as well. Memory games and puzzles also helped me. I play Tetris a lot. It sounds stupid but it's actually proven to be useful in both TBI and PTSD, and they've done studies with veterans who've played Tetris and found minute relief from symptoms. Puzzles and thinking games are very challenging for me because my ability to do performance tasks is very poor, but they help in maintaining what skills I do have and improving, slowly, some of the ones that can be improved.
The biggest thing I do is basically tell people that this is what's wrong with me and I would appreciate it if they could take the time to slow down so I'm not lost in the dark. Unfortunately in my life this isn't really happening and there's a lot of frustration, but I am working on figuring that out too. Anyway I hope any of this helps, and I really think you both should go see a neurologist or even a speech-language pathologist who can help a lot with devising some treatment and coping options.
