PTSD in Military Veterans
Post-traumatic Stress Disorder, commonly referred to as PTSD, is a type of anxiety disorder that develops after exposure to a traumatic event. An event can be considered traumatic if it is terrifying, shocking, or extremely stressful 1.
Military service members are at considerable risk for developing PTSD due to the traumatic nature of combat. Many veterans have either witnessed traumatic events or directly experienced them during their service, making them increasingly susceptible to unwanted and troublesome symptoms associated with PTSD.
PTSD in Military Veterans
Post-traumatic Stress Disorder, commonly referred to as PTSD, is a type of anxiety disorder that develops after exposure to a traumatic event. An event can be considered traumatic if it is terrifying, shocking, or extremely stressful 1.
Military service members are at considerable risk for developing PTSD due to the traumatic nature of combat. Many veterans have either witnessed traumatic events or directly experienced them during their service, making them increasingly susceptible to unwanted and troublesome symptoms associated with PTSD.
Table of Contents
War Veteran PTSD Statistics
Over the years, many veterans have been diagnosed with PTSD. The U.S. Department of Veterans Affairs reports that according to various studies, up to 500,000 U.S. troops who have served in the past 13 years have developed PTSD 2.
The percentage of Veterans diagnosed with PTSD varies depending on the era of service 3:
- Operations Iraqi Freedom (OIF) and Operations Enduring Freedom (OEF): About 11-20% of OIF or OEF Veterans have PTSD in any given year.
- Gulf War (Desert Storm): About 12% of veterans who served in the Gulf War have PTSD in any given year.
- Vietnam War: About 15% of Vietnam Veterans were diagnosed with PTSD according to the most recent study from the late 1980s. It is now estimated that about 30% of veterans who served in the Vietnam War have had PTSD.
Signs and Symptoms of PTSD in Veterans
Symptoms of PTSD can begin quickly after a traumatic event occurs or may not appear until months or years after the event. Sometimes the symptoms may come and go, and sometimes they are constant. If they last longer than a month, cause great suffering, or interfere with daily life, it could be PTSD 4.
There are four different types of PTSD symptoms. These symptoms can be experienced in different ways, depending on each individual’s experience 4.
1. Reliving the event
When returning from their service, veterans may re-experience past trauma and the emotions that took place during the event. They may have nightmares relating to the trauma, flashbacks during which it feels as though the traumatic event is happening again, and triggers such as specific news reports, smells, or loud noises that remind someone of the event.
2. Avoiding situations that trigger memories
Veterans may try to avoid specific people or situations that cause them to have memories of the trauma. They may avoid large crowds, watching certain movies, driving a car, or even seeking help to avoid talking or thinking about the traumatic event.
3. Negative changes in beliefs and feelings
When someone experiences a traumatic event, it can alter the way they think about themselves and others. For example, they may replace positive feelings towards others with negative ones and may avoid relationships altogether. They may also think of the world as entirely dangerous and of all people as untrustworthy.
4. Experiencing hyper-arousal
Trauma can cause those affected to become increasingly alert, on edge, and jittery as if danger is never far away. Sudden feelings of anger and irritability may also occur. This hyperarousal can cause issues with sleeping and concentration. It can also cause someone to be easily startled by loud noises or surprises.
Treatment for PTSD in Veterans
There are several different treatment options for veterans with PTSD. A specific treatment approach may be used on its own or in conjunction with other treatment approaches. Some popular methods include:
Prolonged Exposure Therapy
- Psychoeducation: A therapist educates the patient about how PTSD develops, the associated symptoms, and how to treat it.
- Breathing retraining: A therapist teaches the patient breathing techniques to promote relaxation.
- Imaginal exposure: The patient imagines the feared trauma memory in therapy to become accustomed to that specific memory.
- Vivo exposure: The patient directly confronts feared objects, activities, or situations, with the guidance of a therapist, to become more comfortable with those specific stimuli.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) helps individuals understand why they think and feel the way they do. CBT can help patients with PTSD recognize negative thinking patterns and behaviors associated with their symptoms. A CBT therapist will help patients replace negative thinking patterns and practices with positive thoughts and actions 1.
Cognitive Processing Therapy
Prolonged Exposure (PE) is a PTSD treatment method with the most scientific evidence to support its effectiveness. PE involves 10 to 12 sessions that last 90 minutes each, with four main therapy components 5:
- Psychoeducation: A therapist educates the patient about how PTSD develops, the associated symptoms, and how to treat it.
- Exposure: The patient writes out their experience during a traumatic event to be read at home and read out loud during a therapy session.
- Cognitive restructuring: The patient identifies irrational or negative thoughts relating to the traumatic event and, through therapy, learn to reconstruct those thoughts.
Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy that can help with processing disturbing memories, thoughts, and feelings related to a traumatic event. During EMDR, the patient focuses on a back and forth movement or sound and recalls the disturbing memory until the experience of that memory shifts. The patient will also process more information about the past. It is widely agreed upon that EMDR is an effective PTSD treatment, but some disagree that the back and forth movement is necessary 6.
Pharmacological Treatment
Pharmacological treatments utilize medications to help control and alleviate PTSD symptoms. This is a common form of treatment for PTSD and may be used in conjunction with psychotherapy. The Food and Drug Administration (FDA) has approved two medications, paroxetine and sertraline, for the treatment of PTSD. These medications are classified as selective serotonin reuptake inhibitors (SSRIs) and are used to manage the troublesome symptoms associated with PTSD 5.
Complementary and Alternative Medicine Therapies
- Natural products: Patients may take natural supplements, such as herbal dietary supplements.
- Mind-body medicine: Patients may engage in practices like meditation, acupuncture, and yoga.
- Manipulative and body-based practices: Patients may participate in body practices such as massages and spinal manipulation.
- Other alternative practices: Patients may attend movement therapies and energy therapies, such as reiki.
- Whole medicine systems: Patients may use medicine systems like traditional Chinese medicine and Ayurvedic medicine.
References
- https://leg.mt.gov/content/Committees/Interim/2015-2016/State-Administration-and-Veterans-Affairs/Meetings/June-2016/Combat%20PTSD%20-%20CBT%20book.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/
- https://www.ptsd.va.gov/understand/common/common_veterans.asp
- https://www.ptsd.va.gov/understand/what/ptsd_basics.asp
- https://apps.dtic.mil/dtic/tr/fulltext/u2/a558284.pdf
- https://www.ptsd.va.gov/understand_tx/emdr.asp
- https://www.ptsd.va.gov/publications/rq_docs/v23n2.pdf
