Servicemen and women oftentimes face unique challenges when leaving active duty and readjusting to civilian life.
As explained by U.S. Veterans Magazine, these challenges include
- discovering ways to re-establish their roles within the family,
- having to find and obtain a civilian job (sometimes for the first time ever, such as when enlisting after graduating from high school),
- and adjusting to a life that involves making their own choices versus being told what to do, how to do it, and when.
However, sometimes soldiers also return home with challenges related to their mental well-being as a result of what they’ve witnessed while on active duty. And one of the most common mental challenges is post-traumatic stress disorder (commonly known as PTSD).
PTSD and the Military
The National Institute of Mental Health (NIMH) explains that PTSD is “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” In the case of military personnel specifically, these types of events typically occur during times of war when soldiers find themselves face-to-face with not only their own mortality, but that of their fellow comrades as well.
In fact, PTSD is more common for military personnel than for the general population. According to the U.S. Department of Veterans Affairs, approximately 7 to 8 percent of the population will experience PTSD at some time in their lives. Yet, this rate is much higher for military veterans, and the exact amount depends largely on which conflict they endured.
For instance, those serving in operations Iraqi Freedom and Enduring Freedom have somewhere between an 11 and 20 percent of developing PTSD. However, it is estimated that approximately 30 percent of Vietnam War veterans developed or will develop this particular mental health condition. So, what is it like for veterans who are living with PTSD?
Living with PTSD
The NIMH says that individuals suffering from PTSD often have flashbacks of the traumatic event, bad dreams, and other frightening thoughts. They may also develop avoidance symptoms whereby they purposely stay away from anything that reminds them of the experience. This can mean avoiding certain places and objects that serve as a reminder of what they’ve experienced.
With PTSD also often comes what the NIMH refers to as arousal and reactivity symptoms. These include being easily startled, feeling on edge, and displaying angry outbursts. Trouble sleeping is also common with PTSD. According to the National Sleep Foundation, this is generally due to the individual feeling like they need to be alert, which is a result of the anxiety that sometimes comes with the nighttime and subsequent darkness, or the nightmares the person seeks to avoid.
Veterans with PTSD may notice cognitive and mood changes as well. For instance, they may find it difficult to remember the entire traumatic event or feel guilt associated with their part in it. Sometimes, they have negative feelings toward themselves or the world at large, or they lose interest in activities they used to enjoy.
These are all trademarks of PTSD and all of these types of responses must be present on some level for a professional to render a diagnosis. But why do some military personnel develop PTSD where others don’t, even if they’ve witnessed the exact same event?
Center for American Military Music Opportunities (CAMMO’s) Voices of Service #VOS consists of veterans and active duty service members. Ron Henry, Christal Rheams, Jason Hanna, and Caleb Green.
Organizations Helping PTSD Veterans
Post-traumatic stress disorder (PTSD) can sometimes occur when an individual experiences a traumatic event like combat, military sexual trauma, violence, and terrorism. It is normal for most people to have a stress reaction after a traumatic experience. But, if the reaction doesn’t dissipate or begins to disrupt daily life, then you may have PTSD. According to the National Center for PTSD, eight out of every 100 veterans have PTSD.
If you or a fellow comrade is struggling with PTSD, here are nine organizations that can help in no particular order:
A part of the U.S. Department of Veterans Affairs, the National Center for PTSD provides resources and information to improve patient care through research, education, and training in the diagnosis of PTSD.
This organization provides free, confidential, non-medical counseling 24/7 to veterans coping with PTSD. Counselors can refer service members to services in their local community or provide support via face-to-face, online, or phone consultations.
This website provides veterans with a comprehensive list of resources. They provides the answers to questions many are afraid to ask such as: Who should I tell? How will asking for treatment affect my career? What are the dangers of not disclosing?
Their mission is to “empower and provide support for anyone affected by post-traumatic stress.” PTSD United offers an anonymous support network for veterans to connect with others who have experienced trauma. Individuals will learn about available resources to cope with PTSD, heal through shared interaction, and grow as individuals.
This organization has developed a national network of professional volunteers capable of delivering mental health care to veterans, service members, and their families. They work with various government, corporate, and non-profit partners at the local, state, and national levels. Give an Hour provides a range of mental health services to local communities throughout the nation.
A collaboration between Emory University and the Atlanta Braves, the BraveHeart: Welcome Back Initiative is based in the southeastern United States. They provide healthcare resources and specialists for service members and veterans returning from Operation Iraqi Freedom and Operation Enduring Freedom.
The PTSD Foundation of America is a non-profit dedicated to mentoring both combat veterans and their families experiencing PTSD. They offer counseling and peer mentoring, both individually and in a group setting. The organization also works to raise awareness of the needs of military families coping with PTSD through community awareness.
If you or someone you know is at-risk for suicide, this organization provides 24/7 free, confidential support to those in distress. It also offers resources for loved ones such as a checklist of warning signs and risk factors.
A partnership among the U.S. Department of Defense, Department of Labor, and Department of Veterans Affairs, this website pools information from federal, state, and local levels. They provide a comprehensive resource for veterans, military, and their families on everything from PTSD services to caregiver support.
Suffering from PTSD can be a lonely and isolating experience. The first step to getting well and learning how to manage your symptoms is to ask for help. There is absolutely no shame in admitting that you may not be able to cope by yourself. Know that you are not alone and use these resources to contact professionals who are ready to help.
Kristen Baker-Geczy is a communications specialist, active duty military spouse, and former MWR marketing coordinator. She was also deployed to Southwest Asia as an Air Force contractor.
PTSD in Military Veterans
For all too many, returning from military service means coping with symptoms of PTSD. But you’re not alone and there are many things you can do to start feeling better.
Understanding PTSD in veterans
Are you having a hard time readjusting to life out of the military? Or do you constantly feel on edge, emotionally numb and disconnected, or close to panicking or exploding? For all too many veterans, these are common experiences—lingering symptoms of post-traumatic stress disorder (PTSD). It’s hard living with untreated PTSD and, with long V.A. wait times, it’s easy to get discouraged. But you can feel better, and you can start today, even while you’re waiting for professional treatment.
What causes PTSD?
Post-traumatic stress disorder (PTSD), sometimes known as shell shock or combat stress, occurs after you experience severe trauma or a life-threatening event. It’s normal for your mind and body to be in shock after such an event, but this normal response becomes PTSD when your nervous system gets “stuck.”
Your nervous system has two automatic or reflexive ways of responding to stressful events:
Mobilization, or fight-or-flight, occurs when you need to defend yourself or survive the danger of a combat situation. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowering your heart rate and blood pressure, and winding back down to its normal balance.
Immobilization occurs when you’ve experienced too much stress in a situation and even though the danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its normal state of balance and you’re unable to move on from the event. This is PTSD.
Recovering from PTSD involves transitioning out of the mental and emotional war zone you’re still living in and helping your nervous system become “unstuck.”
Symptoms of PTSD in veterans
While you can develop symptoms of PTSD in the hours or days following a traumatic event, sometimes symptoms don’t surface for months or even years after you return from deployment. While PTSD develops differently in each veteran, there are four symptom clusters:
- Recurrent, intrusive reminders of the traumatic event, including distressing thoughts, nightmares, and flashbacks where you feel like the event is happening again. You may experience extreme emotional and physical reactions to reminders of the trauma such as panic attacks, uncontrollable shaking, and heart palpitations.
- Extreme avoidance of things that remind you of the traumatic event, including people, places, thoughts, or situations you associate with the bad memories. This includes withdrawing from friends and family and losing interest in everyday activities.
- Negative changes in your thoughts and mood, such as exaggerated negative beliefs about yourself or the world and persistent feelings of fear, guilt, or shame. You may notice a diminished ability to experience positive emotions.
- Being on guard all the time, jumpy, and emotionally reactive, as indicated by irritability, anger, reckless behavior, difficulty sleeping, trouble concentrating, and hypervigilance.
Suicide prevention in veterans with PTSD
It’s common for veterans with PTSD to experience suicidal thoughts. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, weak, or flawed.
If you are thinking about taking your own life, seek help immediately. Please read Suicide Help, talk to someone you trust, or call a suicide helpline:
- In the U.S., call 1-800-273-TALK (8255).
- In the UK, call 08457 90 90 90.
- In Australia, call 13 11 14.
- Or visit IASP to find a helpline in your country.
PTSD in veterans recovery step 1: Get moving
Getting regular exercise has always been key for veterans with PTSD. As well as helping to burn off adrenaline, exercise can release endorphins and improve your mood. And by really focusing on your body and how it feels as you exercise, you can even help your nervous system become “unstuck” and move out of the immobilization stress response.
Exercise that is rhythmic and engages both your arms and legs—such as running, swimming, basketball, or even dancing—works well if, instead of continuing to focus on your thoughts as you move, you focus on how your body feels.
Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. Many veterans with PTSD find that sports such as rock climbing, boxing, weight training, and martial arts make it easier to focus on your body movements—after all, if you don’t, you could injure yourself. Whatever exercise you choose, try to work out for 30 minutes or more each day—or if it’s easier, three 10-minute spurts of exercise are just as beneficial.
The benefits of the great outdoors
Pursuing outdoor activities in nature like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing can help challenge your sense of vulnerability and help you transition back into civilian life.
Seek out local organizations that offer outdoor recreation or teambuilding opportunities, or, in the U.S., check out Sierra Club Military Outdoors. This program provides service members, veterans, and their families with opportunities to get out into nature and get moving.
Step 2: Self-regulate your nervous system
PTSD can leave you feeling vulnerable and helpless. But you have more control over your nervous system than you may realize. When you feel agitated, anxious, or out of control, these tips can help you change your arousal system and calm yourself.
Mindful breathing. To quickly calm yourself in any situation, simply take 60 breaths, focusing your attention on each ‘out’ breath.
Sensory input. Just as loud noises, certain smells, or the feel of sand in your clothes can instantly transport you back to the combat zone, so too can sensory input quickly calm you. Everyone responds a little differently, so experiment to find what works best for you. Think back to your time on deployment: what brought you comfort at the end of the day? Perhaps it was looking at photos of your family? Or listening to a favorite song, or smelling a certain brand of soap? Or maybe petting an animal quickly makes you feel calm?
Reconnect emotionally. By reconnecting to uncomfortable emotions without becoming overwhelmed, you can make a huge difference in your ability to manage stress, balance your moods, and take back control of your life. See our Emotional Intelligence Toolkit.
Step 3: Connect with others
Connecting with others face to face doesn’t have to include a lot of talking. For any veteran with PTSD, it’s important to find someone who will listen without judging when you want to talk, or just hang out with you when you don’t. That person may be your significant other, a family member, one of your buddies from the service, or a civilian friend. Or try:
Volunteering your time or reaching out to someone in need. This is a great way to both connect to others and reclaim your sense of power.
Joining a PTSD support group. Connecting with other veterans facing similar problems can help you feel less isolated and provide useful tips on how to cope with symptoms and work towards recovery.
Connecting with civilians
You may feel like the civilians in your life can’t understand you since they haven’t been in the service or seen what you have. But people don’t have to have gone through the exact same experiences to relate to painful emotions and be able to offer support. What matters is that the person you’re turning to cares about you, is a good listener, and a source of comfort.
You don’t have to talk about your combat experiences. If you’re not ready to open up about the details of what happened, that’s perfectly okay. You can talk about how you feel without going into a blow-by-blow account of events.
Tell the other person what you need or how they can help. That could be just sitting with you, listening, or doing something practical. Comfort comes from someone else understanding your emotional experience.
People who care about you want to help. Listening is not a burden for them but a welcome opportunity to provide support.
If connecting is difficult
No matter how close you are to someone, having PTSD can mean that you still don’t feel any better after talking. If that describes you, there are ways to help the process along.
Exercise or move. Before chatting with a friend, either exercise or move around. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.
Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Find a quiet place before you meet a friend. Sit up straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.
Step 4: Take care of your body
The symptoms of PTSD in veterans, such as insomnia, anger, concentration problems, and jumpiness, can be hard on your body and eventually take a toll on your overall health. That’s why it’s so important to take care of yourself.
You may be drawn to activities and behaviors that pump up adrenaline, whether it’s caffeine, drugs, violent video games, driving recklessly, or daredevil sports. After being in a combat zone, that’s what feels normal. But if you recognize these urges for what they are, you can make better choices that will calm and protect your body—and your mind.
Take time to relax. Relaxation techniques such as massage, meditation, or yoga can reduce stress, ease the symptoms of anxiety and depression, help you sleep better, and increase feelings of peace and well-being.
Find safe ways to blow off steam. Pound on a punching bag, pummel a pillow, go for a hard run, sing along to loud music, or find a secluded place to scream at the top of your lungs.
Support your body with a healthy diet. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed and fried food, sugars, and refined carbs which can exacerbate mood swings and energy fluctuations.
Get plenty of sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for 7 to 9 hours of quality sleep each night. Develop a relaxing bedtime ritual (listen to calming music, take a hot shower, or read something light and entertaining), turn off screens at least one hour before bedtime, and make your bedroom as dark and quiet as possible.
Avoid alcohol and drugs (including nicotine). It can be tempting to turn to drugs and alcohol to numb painful memories and get to sleep. But substance abuse can make the symptoms of PTSD worse. The same applies to cigarettes. If possible, stop smoking and seek help for drinking and drug problems.
Step 5: Deal with flashbacks, nightmares, and intrusive thoughts
For veterans with PTSD, flashbacks usually involve visual and auditory memories of combat. It feels as if it’s happening all over again so it’s vital to reassure yourself that the experience is not occurring in the present. Trauma specialists call this “dual awareness.”
Dual awareness is the recognition that there is a difference between your “experiencing self” and your “observing self.” On the one hand, there is your internal emotional reality: you feel as if the trauma is currently happening. On the other hand, you can look to your external environment and recognize that you’re safe. You’re aware that despite what you’re experiencing, the trauma happened in the past. It is not happening now.
State to yourself (out loud or in your head) the reality that while you feel as if the trauma is currently happening, you can look around and recognize that you’re safe.
Use a simple script when you awaken from a nightmare or start to experience a flashback: “I feel [panicked, overwhelmed, etc.] because I’m remembering [traumatic event], but as I look around I can see that the event isn’t happening right now and I’m not in danger.”
Describe what you see when you look around (name the place where you are, the current date, and three things you see when you look around).
Try tapping your arms to bring you back to the present.
Tips for grounding yourself during a flashback:
If you’re starting to disassociate or experience a flashback, try using your senses to bring you back to the present and “ground” yourself. Experiment to find what works best for you.
Movement – Move around vigorously (run in place, jump up and down, etc.); rub your hands together; shake your head
Touch – Splash cold water on your face; grip a piece of ice; touch or grab on to a safe object; pinch yourself; play with worry beads or a stress ball
Sight – Blink rapidly and firmly; look around and take inventory of what you see
Sound – Turn on loud music; clap your hands or stomp your feet; talk to yourself (tell yourself you’re safe, and that you’ll be okay)
Smell – Smell something that links you to the present (coffee, mouthwash, your wife’s perfume) or a scent that recalls good memories
Taste – Suck on a strong mint or chew a piece of gum; bite into something tart or spicy; drink a glass of cold water or juice
Step 6: Work through survivor’s guilt
Feelings of guilt are very common among veterans with PTSD. You may have seen people injured or killed, often your friends and comrades. In the heat of the moment, you don’t have time to fully process these events as they happen. But later—often when you’ve returned home—these experiences come back to haunt you. You may ask yourself questions such as:
- Why didn’t I get hurt?
- Why did I survive when others didn’t?
- Could I have done something differently to save them?
You may end up blaming yourself for what happened and believing that your actions (or inability to act) led to someone else’s death. You may feel like others deserved to live more than you—that you’re the one who should have died. This is survivor’s guilt.
Recovering from survivor’s guilt
Healing doesn’t mean that you’ll forget what happened or those who died. And it doesn’t mean you’ll have no regrets. What it does mean is that you’ll view your role more realistically.
- Is the amount of responsibility you’re assuming reasonable?
- Could you really have prevented or stopped what happened?
- Are you judging your decisions based on complete information about the event, or just your emotions?
- Did you do your best at the time, under challenging circumstances?
- Do you truly believe that if you had died, someone else would have survived?
Honestly assessing your responsibility and role can free you to move on and grieve your losses. Even if you continue to feel some guilt, instead of punishing yourself, you can redirect your energy into honoring those you lost and finding ways to keep their memory alive. For example, you could volunteer for a cause that’s connected in some way to one of the friends you lost. The goal is to put your guilt to positive use and thus transform a tragedy, even in a small way, into something worthwhile.
Step 7: Seek professional treatment
Professional treatment for PTSD can help you confront what happened to you and learn to accept it as a part of your past. When working with an experienced therapist or doctor, treatment may involve:
Cognitive-behavioral therapy (CBT) or counseling. This involves gradually “exposing” yourself to thoughts and feelings that remind you of the event. Therapy also involves identifying distorted and irrational thoughts about the event—and replacing them with more balanced picture.
Medication, such as antidepressants. While medication may help you feel less sad, worried, or on edge, it doesn’t treat the causes of PTSD.
Eye Movement Desensitization and Reprocessing (EMDR). This incorporates elements of CBT with eye movements or other rhythmic, left-right stimulation such as hand taps or sounds. These can help your nervous system become “unstuck” and move on from the traumatic event.
Helping a veteran with PTSD
When a loved one returns from military service with PTSD, it can take a heavy toll on your relationship and family life. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who won’t open up, or even deal with anger or other disturbing behavior.
Don’t take the symptoms of PTSD personally. If your loved one seems distant, irritable, angry, or closed off, remember that this may not have anything to do with you or your relationship.
Don’t pressure your loved one into talking. Many veterans with PTSD find it difficult to talk about their experiences. Never try to force your loved one to open up but let them know that you’re there if they want to talk. It’s your understanding that provides comfort, not anything you say.
Be patient and understanding. Feeling better takes time so be patient with the pace of recovery. Offer support but don’t try to direct your loved one.
Try to anticipate and prepare for PTSD triggers such as certain sounds, sights, or smells. If you are aware of what causes an upsetting reaction, you’ll be in a better position to help your loved one calm down.
Take care of yourself. Letting your loved one’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. Make time for yourself and learn to manage stress. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one.
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