Post traumatic stress disorder (PTSD) is a common psychological health concern that can happen after any traumatic event on or off the battlefield. For people suffering distress after experiencing a serious trauma, it can be hard to find any relief. Post-traumatic stress disorder has been reported to feel like being trapped in a room without any exits and can cause trouble with everyday activities like sleeping or functioning at work.
Since the founding of our country, those who serve have been placed in unthinkable situations, where they are faced with making decisions. Often, such decisions have traumatic lifelong consequences. After talking to many Veterans who served across generations, I have learned that most want to be the person they were before the trauma occurred. These men and women have tried to suppress and avoid the memories.
Suppressing the Memory
At first, using suppression as a coping strategy seems to work as those memories can’t be consciously accessed. The mind creates a barrier to protect the person from the emotional pain of recalling the event. However, those suppressed memories can cause devastating psychological problems. According to psychologists, this avoidance coping strategy, is like a band aide; a temporary solution that can be counterproductive.
Unfortunately, avoiding the traumatic events can end up exacerbating the intensity and frequency of the trauma resurfacing. This can lead to emotional instability, anxiety, depression, impulsiveness, anger, lack of sleep, frustration, helplessness, fear of abandonment, and often, thoughts of suicide.
Not Everyone Develops PTSD
However, not everyone who suppresses a traumatic event will suffer from PTSD. There is no way of knowing who will develop post-traumatic stress disorder after a traumatizing event. As shown by past research, not everyone who is witness, or lives through a traumatic event will not suffer from PTSD.
Most will likely have memories of the events, but their lives will not become negatively affected by it in their daily interactions. It’s normal to have nightmares, be fearful, and find difficulty “forgetting” what happened. It is when you get stuck in a state of fear and shock and your symptoms don’t improve or get worse, post-traumatic stress disorder is likely settling in. our body is having problems restoring itself to equilibrium.
Feelings From Those Struggling with PTSD
“Even just falling asleep was tough. The minute I would start dozing off I would get a surge of adrenaline or anxiety, and would wake up. And even when I did fall asleep, I would wake up with night terrors or sweats.” Stacy L. Pearsall US Air Force (1998–2008)
“I avoid elevators, crowds and July 4th fireworks; I’m claustrophobic from the 12 days I spent in a lightless cell at the Luftwaffe interrogation center in Germany, and I won’t fly unless I have an aisle seat. I tell them about my bombing missions with the Eighth Air Force during WWII and the day that my B-17 exploded over Berlin. How I am plagued with guilt over the loss of four of my crewmates that day. What it was like being a POW for a year and how exhilarating it was to see Patton lead his troops through the barbed wire gates of our Stalag to liberate us.” Anon WW II vet
“Memory of the improvised explosive device (IED) that had taken my leg remained fresh in my mind. It took me a while to get down from that. Especially driving on the road, anything that looked like trash or debris on the side … I had nightmares.” Dexter Pitts Iraq 2014 VA PTSD Handbook
“It was almost eight years ago that I took all the sleeping pills and medication I could get, drove to a farmer’s field and laid down, hoping for the end. I didn’t understand what was going on with me and it seemed everything I was doing was hurting people around me.” Corporal Joseph Rustenburg
“I was convinced I was going crazy. I’ve been fine for years. Now I have nightmares every night and can barely function at work. What’s going on? Why is it all coming back again? I feel like I’m falling apart, a little more each day.” Anonymous 2011 VA PTSD Handbook
These words reveal how our veterans struggle with PTSD. It’s not beautiful, it’s not glamorous, it’s downright scary and ugly. Those with PTSD relive the trauma over and over.
PTSD Over Time
Over time, PTSD can also affect the way sufferers think about themselves and others.Victims report having more negative beliefs and feelings. The most common feelings include guilt or shame. Some report losing interest in activities they once enjoyed. Many find it impossible to trust others, or even themselves.
Some PTSD sufferers enter a state of hypervigilance or hyperarousal, during which they are easily startled, overly alert and “on edge.” They can sometimes be more aggressive or irritable and engage in reckless, self-destructive behavior. These states can also cause difficulty with concentration and sleeping.
According to the Department of Veteran Services, some veterans can move past trauma with minimal dysfunction in their lives; however, for others, the traumatic event creates discord and chaos in daily life. Sadly, for far too many of our veterans, the impact from the trauma triggers family and social dysfunction, physical health complications, suicide and legal problems, just to name a few.
Because certain thoughts, feelings, or situations can bring up uncomfortable PTSD symptoms, it is important to know your triggers. By identifying your triggers, you can prevent or lessen the impact of certain PTSD symptoms.
Types of Triggers
Triggers can fall into two categories: Internal Triggers and External Triggers. Internal triggers are things that you feel or experience inside your body. Internal triggers include thoughts or memories, emotions, and bodily sensations (such as, your heart racing). External triggers are situations, people, or places that you might meet throughout your day (or things that happen outside your body). Listed below are some common internal and external triggers.
- Internal Triggers
- Feeling lonely
- Feeling abandoned
- Feeling out of control
- Feeling vulnerable
- Racing heartbeat
- Muscle tension
- External Triggers
- An argument
- Seeing a news article that reminds you of your traumatic event
- Watching a movie or television show that reminds you of your traumatic event
- Seeing a car accident
- Certain smells
- The end of a relationship
- An anniversary
- A specific place
- Seeing someone who reminds you of a person connected to your traumatic event
Sadly, the slightest sound, smell or feeling can transport those suffering right back into the traumatic event. Thus, without the treatments and coping skills, PTSD can become a debilitating, and often life-threatening condition. Please remember, PTSD is not a choice, it’s the result of trauma. The sufferer was inflicted through no fault of their own.
PTSD research and statistics for veterans are much like a moving target; always running, always fuzzy. There is a similar problem with suicide statistics. Part of the problem is that the DoD and their researchers tend to lose track of military personnel once they leave the military. Furthermore, data from World War II and Korea lacks in diagnosis and mental health records would need researched and evaluated. Not to mention. In the World War I era, PTSD was known as “shell shock,” and as far back as the Civil War, symptoms were referred to as “soldier’s heart” and “irritable heart. The other part of the problem is how to conduct effective research.
- Do you look only at PTSD diagnosed within one year of return from battle?
- Should you count PTSD that limits a soldier’s ability to go back into battle or stay employed, but that may have destroyed a marriage or wrecked a family?
- Are PTSD statistics for PTSD that comes up at any time in a person’s life accessible?
- Is it possible to have undiagnosed PTSD for 30 years and not realize it–possibly never or until you find a way to get better and then you realize there is another way to live?
- When you count the PTSD statistic of “what percentage of a population gets PTSD,” is your overall starting group combat veterans, veterans who served in the target country, or all military personnel for the duration of a war?
In compiling research for this article, I found out firsthand how difficult it was to find reliable statistics. However according to Epidemiology of PTSD, the number of Veterans with PTSD varies by service era:
- Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF): About 11-20 out of every 100 Veterans (or between 11-20%) who served in OIF or OEF have PTSD in a given year.
- Gulf War (Desert Storm): About 12 out of every 100 Gulf War Veterans (or 12%) have PTSD in a given year.
- Vietnam War: About 15 out of every 100 Vietnam Veterans (or 15%) were diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study (NVVRS). It is estimated that about 30 out of every 100 (or 30%) of Vietnam Veterans have had PTSD in their lifetime.
- 50% of those with PTSD do not seek treatment
- Out of the half that seek treatment, only half of them get “minimally adequate” treatment
- A sample of 600 veterans from Iraq and Afghanistan found: 14% post-traumatic stress disorder; 39% alcohol abuse; 3% drug abuse. Major depression also a problem
PTSD from Sexual Trauma
Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to both men and women and can occur during peacetime, training, or war.
Among Veterans who use VA health care:
- 23 out of 100 women (or 23%) reported sexual assault when in the military.
- 55 out of 100 women (or 55%) and 38 out of 100 men (or 38%) have experienced sexual harassment when in the military.
- There are more male Veterans than female Veterans. Although military sexual trauma is more common in women Veterans, over half of all Veterans with military sexual trauma are men.
Veterans Face Barriers
Both active duty service members and veterans face barriers to treatment for mental health issues. Unfortunately, there are many more veterans out there who have not sought care because of the stigma associated with the defining organ of our humanity – our brain. Some of the barriers veterans face, identified by the USGAO include:
- Personal embarrassment about service-related mental disabilities
- Long wait times to receive mental health treatment
- Shame over needing to seek mental health treatment
- Fear of being viewed as weak
- Stigma associated with mental health issues
- A lack of understanding or lack of awareness about mental health problems and treatment options
- Logistical problems, such as long travel distances to receive this type of care
- Concerns over the veteran mental health treatment offered by the VA
- Demographic barriers and false perceptions based on these demographics such as age or gender
PTSD and the Brain
PTSD changes the chemistry and physiology of the brain as a result of a stressful event or events.It is important to stress that PTSD is not self-inflicted. TIn fact, the brain is constantly changing and creating new connections, every day and through every experience. We can improve our brain performance. With or without diagnoses, we can all be better than we were yesterday.
Identifying the Need for Treatment
One important part of veteran mental health treatment is identifying when treatment is needed. For newly released veterans, the delay between release and the onset of PTSD was considered unpredictable. However, a study from BMC Psychology discovered a potential solution to this problem. BMC suggests a series of validated, self-reported questions administered early in the solder’s career. These questions could help to predict a soldier’s potential for developing PTSD, depression or other mental illnesses as a direct result of their military service.
PTSD Services are Essential
In order to help our Veterans, mental health services are essential. There are multiple troubling statistics showing that enough is not being done. More disturbing, many of our veterans are not receiving the care that they deserve.
According to the U.S. Government Accountability Office, 2.1 million veterans received mental health treatment from the U.S. Department of Veterans Affairs in the five-year period from 2006 through 2010. A study by the Substance Abuse and Mental Health Services Administration revealed that only 50 percent of returning vets who need veteran mental health treatment will receive these services.
According to the American Psychological Association, in the year 2005 22 percent of veterans sought veteran mental health treatment in the private sector and not using the VA. That number has increased becuase of long wait times at many of the VA mental health facilities around the country.
Another important aspect of veteran mental health treatment is substance abuse. The National Institute of Drug Abuse reports that substance abuse among veterans is strongly related to their exposure to combat. One study by the organization showed that 25% of returning Iraq and Afghanistan veterans showed signs of substance abuse disorder.
At the National Veterans Foundation, many of the crisis calls we handle begin with issues of isolation and loneliness. Untreated, this can lead to substance abuse, relationship problems and violent behavior.
Research conducted by NIDA, showed that in 2008 active duty and veteran military personnel abused prescription drugs. Most noteworthy, the veterans’ drug use was at a rate that was more than twice the rate for the civilian population. Another study, conducted by the VA in 2009, estimated that around 13,000 vets from Iraq and Afghanistan suffer from alcohol dependence syndrome.
Veteran Health Care Funding Needs to be Increased
In reviewing the US Department of Veterans Affairs website I found that there is a lack of funding allocated for veteran mental health care needs. Furthermore, findings from a pair of separate studies intensifies concern. Sadly, both show that resources from the Department of Veterans Affairs aren’t sufficient to help veterans overcome lingering problems related to their service.
Results From Nations Academies of Sciences, Engineering and Medicine
Results released by the National Academies of Sciences, Engineering and Medicine ,and mandated by Congress, found a “substantial unmet need for mental health services.” These findings applied specifically to veterans from the Iraq and Afghanistan wars era. Citing about half of those veterans surveyed needed mental health care and are not currently receiving such care. That group includes many veterans with an earlier diagnoses of PTSD, depression or related challenges.
Furthermore, the study concluded that “To become a high-reliability provider of mental health care services, the VA needs to consistently and predictably provide readily accessible, high-quality mental health care.” Additionally, those services need to be available “for every veteran on every occasion.” Also, more work needs to be done to improve outreach to veterans while also raising public awareness.
Results for The Clinical Psychology Review
The study released by the Clinical Psychology Review, indicates that public focus on serious mental health problems, like PTSD, can not be overlooked.
Those who serve are undeniably resilient; but, they are not superhuman. The process of transitioning and reintegrating back to civilian life is often stressful and can generate lasting psychological difficulties.
Additionally, researchers found that veterans’ transition stress can include challenges such as confusion over their new role — “loss of the military self” — in civilian life, unexpected isolation or grief, and anger over military stereotypes from new civilian co-workers.
Finally, the study suggested that more research needs to be done to mitigate related challenges from combat, stress and loss of self.
The bottom line is that funding needs increased. Every veteran deserves access to metal health care when they need it. Stop using veterans’ mental health as a political pawn in spending battles. Reduce the excessive wait times at local VA facilities.
Most importantly, we can no longer look the other way. These men and women stepped up and sacrificed to protect our country. We need to make sure that our veterans’ mental health treatment is a priority, not an after thought.
As a result of my research, I want those suffering from mental health issues to know you are not alone. There are people who want to help you overcome the crippling effects of PTSD. Next, please recognize that the only way out is through. Finally, I am asking fellow Americans to commit to shattering the stigma associated with mental health conditions. Concurrently, this is not just for our veterans, it is for all of us. Let’s gain a real understanding of our greatest asset – our brains.
Furthermore, we can cut the stigma of PTSD. First, we ditch the antiquated notion that the brain can’t be fixed. Then, we start a conversation and make people listen. Hopefully, the outcome of our efforts wil save lives.
Where to Find Help For PTSD and Other Mental Health Issues
- PTSD Treatment Programs
Information on specialized treatment for PTSD within VA Medical Centers.
- Care for Women Veterans Describes VA services offered to women Veterans, including the Women Veterans Health Care Program.
- VA Benefits and Claims
Answers to some questions about PTSD and service-connected disability that are often asked by veterans. Provides information about resources for treatment.
- Understanding PTSD and PTSD Treatment (PDF) A complete guide to PTSD basics.
- About Face Hear from Veterans who have turned their lives around with PTSD treatment.
- PTSD Decision Aid Compare options and make the best choice for PTSD treatment.
- National Veterans Foundation or call 888-777-4443 to speak to another veteran who “gets it”