With the annual Memorial Day weekend upon us, I thought it might be a good time to look a little more closely at posttraumatic stress disorder (PTSD). PTSD occurs after experiencing or witnessing an extremely traumatic, terrifying or tragic event. Combat PTSD is more common in soldiers who have experienced active military action on the battlefield. There’s no rhyme or reason as to why some soldiers can perform well on the battlefield with no problems, while some get PTSD. Sometimes the symptoms of PTSD — terrifying recurrent nightmares or flashbacks — don’t start until after the soldier has returned home.
Treatment for combat PTSD is usually handled by the Veterans Administration (VA) for returning soldiers. Treatment usually consists of a combination of individual and group psychotherapy with psychologists who are specially trained in the treatment of PTSD. Medication is often prescribed as well to help treat the acute symptoms of PTSD (such as an accompanying depressive episode). Treatment usually takes time and patience, and can last anywhere from a few months to years. Psychotherapy has a solid research base showing positive results for people with PTSD; the specific type of psychotherapy used seems not to matter in helping a person with PTSD feel better (Benish, et. al., 2008). Cognitive-behavioral therapy (CBT) is the usual preferred psychotherapy treatment (Mueser, et. al., 2008).
Soldiers dealing with the trauma of combat usually first tell a military physician of their feelings, usually as a result of pressure from others. Most soldiers who disclose feelings of PTSD are glad they did so, but nearly half perceived at least one negative response from a doctor or health care provider they told (Leibowitz, et. al., 2008). This suggests healthcare providers need to be more sensitive to the mental health needs of soldiers, especially as it relates to trauma.
It’s really challenging to capture the frustration of random flashbacks and living with daily nightmares for the ordinary person. Your life feels out of control and you feel helpless to stop the images from invading your head. The Daily Times has a great article from a few months back that really paints the picture of a veteran dealing with PTSD:
Instead of dimming with time, [the Vietnam veteran] Collard’s nightmares and flashbacks became more vivid, taking him back to Vietnam in graphic detail. His senses are magnified during the flashbacks, and he actually experiences the traumatic incidents just as he did the first time, he said.
“The dreams, the actual reliving of the experiences, those were horrendous,” he said. “What was going on in my head was just totally unbelievable.”
One flashback rewinds the clock to a day in 1969 when Collard tried to retrieve a soldier from a burning Army personnel carrier. The incident still haunts him, he said, and the sound of a helicopter or the smell of fire can send him back in time.
“When I got the door open, the carrier was totally engulfed in flames,” he said. “I reached in and grabbed a hand and when I pulled on that hand, all the meat come off in my hand.”
When a person senses danger, the brain reacts in one of three ways, Snuggerud said. It instructs the body to fight, flee or freeze. Reactions are the same whether the danger actually exists, and can translate into intense anger or violent confrontations. On the battlefield, fighting or fleeing is expected, she said, but the same reactions in a domestic situation are not appropriate.
“A person’s whole life is influenced by this,” Snuggerud said. “The brain will push the trauma away, but those reactions are still triggered, just like they were in war.
Sadly, not all veterans who receive care for posttraumatic stress disorder get better. Up to 10% may experience PTSD symptoms for years later. Those who do receive care will experience better family relationships, less smoking and more life satisfaction and happiness in general (Koenen, et. al., 2008).
The key to recovery in PTSD is to seek treatment, even if the person is uncertain it will work for them. Because they’ll never know one way or another if they don’t give it a try.
This Memorial Day, we remember not only those who’ve made the ultimate sacrifice for our freedoms, but for all veterans still dealing with the lingering effects of war. Thank you for your service.
Benish, S.G., et. al. (2008). The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: A meta-analysis of direct comparisons. Clinical Psychology Review, 28(5), 746-758.
Koenen, K.C., et. al. (2008). Persisting posttraumatic stress disorder symptoms and their relationship to functioning in Vietnam Veterans: A 14-year follow-up. Journal of Traumatic Stress, 21(1), 49-57.
Leibowitz, R.Q., et. al. (2008). Veterans’ disclosure of trauma to healthcare providers. General Hospital Psychiatry, 30(2), 100-103.
Mueser, K.T., et. al. (2008). A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 76(2), 259-271.