A Veteran’s Story
I spend a lot of time with veterans in my line of work. After speaking with veterans from all decades and walks of life, many with a history of significant combat exposure, one theme rings true when they talk about trauma – “Just because you can’t see it doesn’t mean it’s not there.” One of my patients said these very eloquent words to me during a session when he described his difficulty with relating to his family after returning from the Vietnam War. He expanded on this by telling me that his family was under the impression that he was “fine” when he came home from Vietnam because he returned with no physical injuries, but the pain he endured was internal and buried deep beneath the surface. He spent an entire lifetime hiding his story from his friends and family, until there came a day when he saw a news report on Post-Traumatic Stress Disorder (PTSD) that changed his life. “There wasn’t a name for what we were experiencing when we came back. I knew other people that had it, we just didn’t talk about it. We just tried to move on. Forget. But you never really forget. How can you?”
What is PTSD?
PTSD is a mental health diagnosis found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is an important diagnostic tool “providing guidelines for diagnoses that can inform treatment and management decisions.” It essentially allows different providers who use this tool to speak the same language with regard to mental health diagnoses and their features. Each condition in the manual is followed by a specific set of criteria which is meant to help psychiatrists, other physicians, and non-physician mental health providers practicing in different clinical settings to come to an accurate diagnosis, and thus formulate an appropriate treatment plan. To date, the most recent edition of this manual is the 5th edition also known as the DSM-5.
A diagnosis of PTSD is made when a person witnesses, directly experiences, learns about a traumatic event that happened to a close family member or friend, or is repeatedly exposed to negative details of traumatic events and subsequently displays hallmark symptoms consistent with PTSD for a time period greater than one month after the trauma. The DSM-5 defines a traumatic event as actual or threatened death, extreme injury, or sexual violence. Pictures, movies, or media exposure does not qualify as a traumatic event unless the exposure is related to a person’s occupation.
The most common symptoms of PTSD are:
- Distressing, involuntary, intrusive thoughts/memories that begin to occur after the traumatic event
- Significantly distressing recurring dreams/nightmares that are related to the traumatic event
- Flashbacks or reliving of the traumatic event where the affected person feels or behaves as though the event is happening in real time
- Extreme emotional and/or physical distress when exposed to triggers that remind an individual of the traumatic event
- Avoidance of events, activities, situations, people, places, etc. that remind people of their trauma
- Inability to remember important parts of the traumatic event
- An overly distorted negative belief about oneself
- Self-blame or blame of others for the occurrence of the traumatic event
- Withdrawal and isolation
- Inability to experience positive emotion
- Marked irritability or anger outbursts that are out of proportion to inciting event
- Exaggerated startle in response to external stimuli
- Poor sleep
- Difficulty with focus and concentration
- Decreased ability to function in one’s occupation or personal life
How is PTSD treated?
No case of PTSD is exactly identical to another. There is no “one size fits all” approach when it comes to the treatment of any mental health condition. In general PTSD is treated with therapy, medication or a combination of both, but exact treatment plans should be tailored to the individual and need to be determined on a case by case basis by a qualified mental health provider. Potential options for treatment include, but are not limited to, support groups, group therapy, individual therapy, obtaining a service animal, medications, eye movement desensitization and reprocessing (EMDR), diet and exercise, treatment of co-occurring substance use, and more.
When to see a doctor
If there is any concern that you or a loved one may be experiencing symptoms of PTSD, it is a good idea to get checked out by a provider who can evaluate you, and/or refer you to a mental health specialist if necessary. If you or a loved one is having thoughts of self-harm, or harming others, it is important to call 911 immediately, or present to the nearest emergency room or crisis center for further evaluation.
1. Find your local VA Medical Center at https://www.va.gov/health/vamc/
2. Contact your local Vet Center at https://www.va.gov/directory/guide/vetcenter.asp
3. Veteran’s Crisis Line. Call 1-800-273-8255. Or text 838255. Or start a confidential chat at VeteransCrisisLine.net/chat
4. For additional information on PTSD visit the National Center for PTSD website at https://www.ptsd.va.gov/
6. If you are active duty, reserve, or guard visit MilitaryCrisisLine.net