LET’S TALK ABOUT PTSD
Posttraumatic Stress Disorder is not a new phenomenon, although the term PTSD is a fairly modern development. Throughout history, going back to the Napoleonic Wars it has been referred to as several different names, with each new iteration of the name becoming increasingly more sterilized. In 1799, “Nostalgia” was the term used to describe present day PTSD, “Soldiers Heart” during the Civil War, “Shell Shock” in World War I, “Combat Exhaustion” in WWII, “Stress Response Syndrome” post-Vietnam War and most currently, Posttraumatic Stress Disorder.
According to The Diagnostic and Statistical Manual of Mental Disorders (DSM)IV, PTSD is classified as an anxiety disorder, and may develop after a person is exposed to one or more traumatic events, such as sexual assault, warfare, serious injury, or threats of imminent death. The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.
The individual with PTSD persistently avoids all thoughts and emotions, and discussion of the stressor(trigger) event and may experience amnesia for it. However, the event is commonly relived by the individual through intrusive, recurrent recollections, flashbacks, and nightmares.
Persons considered at risk include, for example, combat military personnel, victims of natural disasters, and victims of violent crime. Individuals frequently experience “survivor’s guilt” for remaining alive while others died. Experiencing or witnessing of a stressor event involving death, serious injury or such threat to the self or others in a situation in which the individual felt intense fear, horror, or powerlessness can trigger PTSD.
Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as emergency service workers) are also at risk. As each individual may react differently to the trigger event, when assessing possible PTSD, the most common reactions are vivid nightmares, alcohol and/or drug abuse, disassociation, flash back memories and intense negative psychological or physiological responses to any reminder of the traumatic event.
WHY YOU SHOULD CARE
The Federal Veterans Affairs website estimates that there are nearly 21 million veterans living in the United States. The wars in Afghanistan and Iraq are the longest combat operations since Vietnam. Many stressors face these Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) troops. For many service members, being away from home for long periods of time can cause problems at home or work. These problems can add to the stress. This may be even more so for National Guard and Reserve troops who had not expected to be away for so long. Almost half of those who have served in the current wars have been Guard and Reservists. These are men and woman who are expected to make a seamless transition back into the workforce, most of which do not posses any physical injuries.
Some research has looked at how the response to war stressors changes over time. PTSD symptoms are more likely to show up in returning Enduring Freedom/Iraqi Freedom service members after a delay of several months. Using a brief PTSD screen, service members were assessed at their return and then again six months later. Service members were more likely to have a positive screen ,that is, they showed more PTSD symptoms at the later time. VA data show that from 2002 to 2009, one million troops left active duty in Iraq or Afghanistan and became eligible for VA care. Of those troops, 46% came in for VA services. Of those Veterans who used VA care, 48% were diagnosed with a mental health problem. However, many Veterans with mental health problems have not come in for services. Some reasons that Veterans have given for not getting treatment include:
- Concern over being seen as weak.
- Concern about being treated differently.
- Concern that others would lose confidence in them.
- Concerns about privacy.
- They prefer to rely on family and friends.
- They don’t believe treatment is effective.
- Concerns about side effects of treatments.
- Problems with access, such as cost or location of treatment.
TREATMENT: IT’S NOT ALL BAD NEWS
The main treatments for people with PTSD are psychotherapy (“talk” therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health care provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.
Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.
One helpful therapy is called cognitive behavioral therapy, or CBT. There are several parts to CBT, including:
- Exposure therapy. This therapy helps people face and control their fear. It exposes them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
- Cognitive restructuring. This therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
- Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way.
HOW CAN YOU HELP?
If you know someone who has PTSD, it affects you too. The first and most important thing you can do to help a friend or relative is to help him or her get the right diagnosis and treatment. You may need to make an appointment for your friend or relative and go with him or her to see the doctor. Encourage him or her to stay in treatment, or to seek different treatment if his or her symptoms don’t get better after 6 to 8 weeks.
To help a friend or relative, you can:
- Offer emotional support, understanding, patience, and encouragement.
- Learn about PTSD so you can understand what your friend or relative is experiencing.
- Talk to your friend or relative, and listen carefully.
- Listen to feelings your friend or relative expresses and be understanding of situations that may trigger PTSD symptoms.
- Invite your friend or relative out for positive distractions such as walks, outings, and other activities.
- Remind your friend or relative that, with time and treatment, he or she can get better.
BY THE NUMBERS
If you or someone you know is suffering from PTSD symptoms, please do not wait any longer to get assistance. There are a multitude of resources at your fingertips. The links below will all take you to PTSD Crisis Hotlines or websites dedicated to treat those suffering from PTSD.
Thank you for reading.
