February 23, 2016 – Post-Traumatic Stress Disorder is known as an “invisible wound of war”, a Defense Health Agency official said.
John Davison, a clinical psychologist and chief of condition-based specialty care in DHA’s clinical support division, said that it’s important to recognize PTSD’s signs and symptoms.
“We know a lot more about PTSD today than we did after previous wars, such as Vietnam,” Davison said, noting that symptoms of PTSD have existed in every war in American history.
“It’s important to know that deploying to a combat zone does not necessarily cause one to [develop] PTSD,” Davison said. “The vast majority who deploy in dangerous situations do not develop PTSD.”
Know PTSD Symptoms
PTSD has a variety of symptoms and side effects including emotional numbness, difficulty concentrating, anxiety, felt stress and irritability.
Nonetheless, service members, veterans and their family members and friends should learn to recognize the signs and symptoms of PTSD. Families are key since they are often the first ones to detect a change in the behavior of their Soldier.
There are four types of PTSD symptoms:
1. Reliving the event (also called re-experiencing symptoms)
Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. For example:
• You may have nightmares.
• You may feel like you are going through the event again. This is called a flashback.
• You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing a car backfire are examples of triggers.
2. Avoiding situations that remind you of the event
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:
• You may avoid crowds, because they feel dangerous.
• You may avoid driving if you were in a car accident or if your military convoy was bombed.
• If you were in an earthquake, you may avoid watching movies about earthquakes.
• You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.
3. Negative changes in beliefs and feelings
The way you think about yourself and others changes because of the trauma. This symptom has many aspects, including the following:
• You may not have positive or loving feelings toward other people and may stay away from relationships.
• You may forget about parts of the traumatic event or not be able to talk about them.
• You may think the world is completely dangerous, and no one can be trusted.
4. Feeling keyed up (also called hyperarousal)
A state of increased psychological and physiological tension marked by effects such as reduced pain tolerance, anxiety, exaggeration of startle responses, insomnia, fatigue and accentuation of personality traits is known as hyperarousal. For example:
• You may have a hard time sleeping.
• You may be jittery and hyperalert.
• You might suddenly become angry or irritable.
• You may have trouble concentrating.
• You may be startled by a loud noise or surprise.
• You might want to have your back to a wall in a restaurant or waiting room.
Signs of ‘Survivor Guilt’
Others might allude to blaming themselves for a trauma experienced by someone else, which is called “survivor guilt,” Davison said. “If someone close died as result of trauma, those with PTSD might wonder, ‘Why him and not me?’” he said.
Another category of symptoms features hyperactivity when the person remains “on guard,” has angry outbursts, problems with sleep, and reckless or self-destructive behavior, Davison said.
Successful Treatments Vary
There is a stigma attached to seeking treatment for mental health and the Department of Defense is taking steps to remove that stigma and get troops access to the help they need sooner.
The good news is that DoD and the Veterans Affairs Department have gone to great lengths to increase access to evidence-based treatment for PTSD.
“The Army has embedded [behavioral health] providers close to operational units to increase access to help and decrease stigma some might feel [about] pursuing mental health treatment or counseling,” Davison said. “We have a number of effective treatments available that have demonstrated through research to be helpful.”
Treatments range from various psychotherapy approaches to pharmacotherapy – using “very safe, common medications for depression and anxiety” that can accompany disorder symptoms, Davison said.
Counseling is available from an individual’s primary care doctor, and they also can talk to a behavioral health provider, he said. Counseling also is available from a behavioral health specialty clinic and nonclinical settings where people can talk to a chaplain or access help from Military OneSource or VA’s readjustment counseling services.
Whom do I contact for help with PTSD?
You can contact your local VA hospital or Vet Center.
The VA also has Community Based Outpatient Clinics (CBOC’s) around each state. Many of these clinics offer mental health services.
To find a VA medical center, CBOC, or Vet Center near you, use the online VHA Facilities Locator.
Other resources include:
• The VA Health Benefits Service Center toll free at 1-877-222-VETS (1-877-222-8387)
• The Vet Centers’ national number 1-800-905-4675
• The VA Office of Mental Health Returning Veterans page
• The VA Returning Service Members (OEF/OIF) page
• My HealtheVet
How to Get Help If You Are in Crisis
If you are in crisis:
• Call 911.
• Go to your nearest Emergency Room.
• Call the National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255). Spanish/Español 1-888-628-9454. Veterans, press “1” after you call.
• Go to the Veterans Crisis Line website to chat live with a crisis counselor at any time of day or night.
• The National Center for PTSD does not provide any direct clinical care. We can provide information, though, to help you locate mental health services in your area. Please see this fact sheet on Finding and Choosing a Therapist.
For more information on PTSD please visit: