Post-Traumatic Stress Disorder (PTSD) is a very serious mental health condition for many veterans. At some point in their life, 7% of veterans will have PTSD compared to 6% in the general population. PTSD is more common among female veterans (13%) versus male Veterans (6%).
But the rates vary with different eras of service, ranging from 10% for Vietnam War vets, to 21% for Persian Gulf War (Desert Storm) veterans, and 29% for Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) veterans, during their lifetimes [1].
Understanding the signs of PTSD and when to seek help is important for veterans and their loved ones.
Understanding PTSD in Veterans
PTSD is a mental health condition that can develop after a person experiences or witnesses a life-threatening, terrifying, or deeply traumatic event. For veterans, this is not a sign of weakness; it is a normal reaction to the profoundly abnormal and extreme stresses of military service.
While anyone can develop PTSD, the nature of military combat and deployment creates a uniquely high-risk environment. The “trauma” for a veteran isn’t always a single moment. It can be a combination of many things [2]:
- Direct Combat: Firefights, explosions, witnessing death or injury.
- Moral Injury: The profound psychological distress that results from actions, or the failure to act, which violate a person’s core moral beliefs and values. This can include things like killing an enemy, failing to prevent the death of a fellow soldier, or witnessing atrocities.
- Military Sexual Trauma (MST): Sexual assault or repeated, threatening sexual harassment experienced during military service. This is a significant cause of PTSD for both male and female veterans.
- Fear of the Unknown: The constant, high-alert state of being in a hostile environment where any moment could be your last (e.g., fear of IEDs, ambushes, snipers).
- Loss and Grief: Losing close friends and comrades in combat.
- Training and Conditioning: The military trains individuals to be highly alert and reactive to survive. For some, the brain has difficulty “switching off” this survival mode after returning home.
Stigma for many of those who have PTSD is a significant issue as the associated shame can prevent veterans from seeking help.
Top 14 Signs of PTSD in Veterans
PTSD symptoms are grouped into four main categories. They must persist for more than a month and cause significant distress or problems in the person’s daily life. Below are some of the main symptoms [3] [4].
Re-Experiencing (Intrusive Memories)
The traumatic event forcefully and involuntarily intrudes into the veteran’s present life.
- Flashbacks
- Nightmares
- Distressing Memories
- Psychological or Physical Distress
Avoidance
The veteran actively avoids anything that reminds them of the trauma.
- Avoiding Thoughts/Feelings
- Avoiding People/Places
Negative Changes in Mood and Cognition
The trauma changes how the veteran thinks and feels about themselves and the world.
- Negative Beliefs
- Distorted Blame
- Emotional detachment/Estrangement
- Inability to Experience Positive Emotions
Hyperarousal (Being “On Guard”)
The veteran’s body and mind are constantly in a state of high alert, as if still in danger.
- Irritability or Angry Outbursts
- Hypervigilance/Being on guard
- Exaggerated Startle Response
- Sleep Problems
How PTSD Impacts Veterans’ Lives and Families
PTSD can have significant impacts on the lives of veterans and their families. Common issues experienced by those with PTSD include:
- Depression
- Self-blame, guilt, and shame
- Suicidal thoughts
- Alcohol or drug abuse
PTSD doesn’t just impact the veteran; it deeply affects their loved ones. Family members often live in a state of hypervigilance, managing around the veteran’s anger, emotional numbness, and irritability. They may walk on eggshells to avoid triggers, leading to a tense household. The veteran’s social withdrawal can cause isolation for the entire family.
Partners may become caregivers, straining the marital relationship. Children can feel confused, scared, or neglected, impacting their emotional development. This constant stress can lead to secondary trauma, anxiety, and depression in family members.
While loving support is crucial, the entire family system is under immense pressure, often requiring their own support and counseling to cope.
When and How to Seek Help for PTSD
According to the DSM-5, the manual used by psychiatrists to diagnose mental health conditions, a diagnosis of PTSD requires that a total of at least six symptoms persist for more than one month.
These symptoms must be distributed across the four symptom clusters, referenced above. These symptoms must also cause significant distress or functional impairment in the person’s life.
Signs that professional urgent help is needed include:
- A range of prolonged symptoms from the four clusters
- Aggression towards others
- Alcohol or drug misuse
- Self-harm
- Suicidal ideation
U.S. veterans or service members who are in suicidal crisis, can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
Early intervention is highly recommended and results in a higher rate of recovery. The VA has approved a number of evidence-based therapies and medications including:
- Prolonged Exposure (PE)
- Cognitive Processing Therapy (CPT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Secondary options include:
- Cognitive Therapy
- Written Exposure Therapy [WET]
- Present Centered Therapy [PCT]
- Medication (specifically, sertraline, paroxetine, or venlafaxine)
Seeking help is a sign of strength, not weakness. As well it shows caring for loved ones and families who are carrying the burden of someone with PTSD. There are a number of treatment programs for veterans, active-duty military, and their families.
PTSD Treatment for Veterans at Miramar Health
While most people will recover naturally, some will benefit from mental health and addictions treatment. When these occur together it is called co-occurring treatment. At Miramar Health, we offer a range of programs focused on healing the whole person, including:
- Withdrawal management (detox)
- Residential Program
- Intensive Outpatient Program
- Partial Hospitalization Program
- Relapse Prevention
To assist in recovery, we offer the following therapy approaches:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Acceptance and Commitment Therapy (ACT)
- Group Therapy
- Family Therapy
- Meditation & Mindfulness
- Motivational Interviewing (MI)
- Solution-Focused Therapy
- Creative Expression
- Holistic Activities
- The Social Model
- Medication-Assisted Treatment (MAT)
- Relapse Prevention and Long-Term Recovery Support
- Discharge Planning
Help Is Available at Miramar Health, California
As a veteran-owned treatment facility focused exclusively on support for active-duty military and veterans, Miramar Health offers years of experience helping military members recover from substance abuse and co-occurring mental health conditions. We know and understand military culture. We use the trauma-informed therapy approaches referred to above and customize treatment to each member’s needs. We also provide related support to military family members. Contact our admissions team today if you know a veteran who needs support.
Sources
[1] US Department of Veterans Affairs. National Center for PTSD. nd. How Common is PTSD in Veterans?
[2] US Department of Veterans Affairs. National Center for PTSD. nd. PTSD Basics.
[3] US Department of Veterans Affairs. National Center for PTSD. nd. Common Reactions After Trauma.
[4] Mayo Clinic. Post-traumatic stress disorder (PTSD). Mayoclinic.org