PTSD in Veterans: Symptoms, Family Impact, and Treatment

Introduction: Veterans Returning from War

Military members are sent to war leaving behind family, communities, and their way of life in order to fight. Upon their return, they are thrust back into their "old lives" and are expected to adapt quickly and remain unchanged (Cooter, 2004). Even though some veterans can readapt into their communities and become productive members of society, others end up with psychological issues as a result of their exposure to the hardships of leaving family and friends behind, as well as the traumatic events they experience during war. War affects a great many individuals and can cause mental illness, co-occurring disorders, and substance abuse, including alcohol dependence (Weine, 2001).

In 2009, there were over twenty million military veterans in the United States (Lewis, 2011). Many of these veterans suffer from what is known as Post-Traumatic Stress Disorder (PTSD), a mental health condition triggered by a terrifying event. Symptoms often include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event (Post-traumatic stress disorder, 2011). "More than 230,000 Iraq and Afghanistan war veterans sought treatment for the first time at VA healthcare facilities nationwide between 2002 and 2008. More than 20% of these veterans—almost 50,000—received a new PTSD diagnosis" (Many Veterans Not Getting Enough Treatment for PTSD, 2011).

Understanding PTSD and Its Symptoms

Symptoms of PTSD can be terrifying. They often disrupt a person's life and make it difficult to carry on with daily activities. Many people find it hard just to get through the day. PTSD symptoms typically begin soon after the traumatic event, but they may not appear until months or even years later. They may also come and go over the years. If symptoms last longer than four weeks, cause significant distress, or interfere with work or home life, the person is likely suffering from PTSD. There are four main types of PTSD symptoms.

Reliving the event (re-experiencing symptoms): Bad memories of the traumatic event can resurface at any time. The person may feel the same fear and horror they experienced when the event occurred. They may have nightmares or feel as though they are going through the event again—a phenomenon known as a flashback. Sometimes a trigger such as a sound or a sight causes the person to relive the event.

Avoiding situations that are reminders of the event: The person may try to stay away from situations or people that trigger memories of the traumatic event, and may avoid talking or thinking about it altogether.

Feeling numb: The person may find it hard to articulate their feelings. This is another way of avoiding memories. They may not have positive or loving feelings toward others, or may withdraw from relationships. They may lose interest in activities they once enjoyed, or be unable to remember parts of the traumatic event or to discuss them.

Feeling keyed up (hyperarousal): The person may feel jittery, or constantly alert and watching for danger. This state can cause sudden anger or irritability, difficulty sleeping, trouble concentrating, persistent fear for their safety, and an exaggerated startle response when surprised (Many Veterans Not Getting Enough Treatment for PTSD, 2011).

Other common problems that people with PTSD may also experience include:

Drinking or drug problems; feelings of hopelessness, shame, or despair; employment difficulties; relationship problems including divorce and domestic violence; and physical health symptoms (Many Veterans Not Getting Enough Treatment for PTSD, 2011).

Veterans are having difficulty adapting upon their return in part because there are insufficient programs to help them deal with PTSD (PTSD Breakdown: We're Failing the American Military Family, 2011). Society is beginning to recognize the prevalence of Post-Traumatic Stress Disorder among war veterans. The issue extends beyond PTSD itself to include its effects on military spouses and families. Secondhand PTSD is widespread but, unfortunately, not commonly recognized. War veterans should not be blamed for the issues they face upon their return. The blame lies in the lack of facilities aimed at helping veterans and their families combat PTSD and transition into civilian life. War is a harrowing experience, and it is no surprise that it continues to plague veterans long after they come home (Eaton, 2011).

Social issues can directly or indirectly affect an entire society, communities, or individual persons. It is through education and effective preventive programs that societies, veterans, and family members can be informed and provided with the proper support they need. Veterans should be receiving help both prior to deployment and upon their return. Not only do veterans need treatment, but families should also receive pre-counseling to ensure they know what to expect before the veteran leaves and when they return. Establishing support groups for veterans and their families before deployment and after return is one meaningful way to create change.

Social and Economic Consequences of Untreated PTSD

Untreated PTSD can have overwhelming and far-reaching consequences for sufferers' functioning and relationships, their families, and for society as a whole. People who suffer from this illness are at greater risk of experiencing additional medical problems as well as reproductive difficulties. Emotionally, PTSD sufferers may find it harder to achieve positive outcomes from mental health treatment compared to those dealing with other emotional disorders. The economic consequences of PTSD are also significant. "As of 2005, more than 200,000 veterans were receiving disability compensation for this illness, at a cost of $4.3 billion. This represents an 80% increase in the number of military personnel receiving disability benefits for PTSD and an increase of 149% in the amount of disability benefits paid compared to those figures five years earlier" (Posttraumatic Stress Disorder, 2011).

Treatment Options for Veterans with PTSD

Today, many effective treatments are available for PTSD. When a veteran has PTSD, confronting the past can be extremely difficult. Group therapy allows veterans to share their traumatic experiences and find healing by supporting one another. It is an ideal therapeutic environment for helping veterans release feelings of anger, doubt, guilt, fear, and shame. Being able to tell their story to fellow veterans helps them face the fears caused by trauma and move forward.

Psychodynamic psychotherapy can help a veteran become more independent and develop coping skills by gradually exposing them to situations that trigger memories of the trauma, helping them learn to navigate those situations. Cognitive behavioral therapy focuses on helping veterans manage negative thoughts by building skills to handle difficult feelings and stressors, reducing the likelihood that they will turn to drugs or alcohol for relief. Drug therapy can be used as a last resort for patients who need assistance managing anxiety and depression; by calming the patient through medication, they may become more willing to participate in group therapy and ultimately be weaned from pharmacological support (Treatment of PTSD, 2010).

Conclusion

Military personnel perform a wonderful service to this country and should not be cast aside or forgotten once they return from active duty. PTSD should be vigorously studied so that counselors understand everything involved with it, enabling better treatment of those who suffer from it. The overall goal should be to reduce the incidence of this disorder and its symptoms. A program that includes both pre-deployment and post-deployment services stands a strong chance of reducing the incidence of PTSD. Military personnel and their families would be better prepared to manage deployment and the transition home.

Communities need to put effective and useful programs in place for veterans—such as groups where veterans can discuss their feelings, needs, and experiences with others who have lived through the same environments and circumstances. Talking to a counselor or participating in a group whose members may not understand war can leave veterans feeling alone and misunderstood. Incorporating more group treatment centers, along with psychodynamic psychotherapy and, when necessary, drug therapy, can all assist a veteran in achieving a successful return to civilian life.

References

Cooter, R. (1998). War, medicine, and modernity (pp. 125–148).

Eaton, E. (2011). PTSD plagues life at home. Retrieved from

Lewis, K. (2011). Interesting Veterans Day facts. Retrieved from

Many Veterans Not Getting Enough Treatment for PTSD. (2011). Retrieved from http://www.sciencedaily.com/releases/2010/02/100210110742.htm

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Post-traumatic stress disorder (PTSD). (2011). Retrieved from http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

Posttraumatic Stress Disorder. (2011). Retrieved from http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm

PTSD Breakdown: We're failing the American military family. (2011). Retrieved from http://ptsdcombat.blogspot.com/2006/03/ptsd-breakdown-were-failing-american.html

Treatment of PTSD. (2010). Retrieved from http://www.ptsd.va.gov/public/pages/treatment-ptsd.asp

Weine, S. (2001). From war zone to contact zone: Culture and refugee mental health services. Journal of the American Medical Association, 285(9), 1214.