Reviewed by Melinda (Santa) Gladden, LCSW
Contrary to popular belief, Post-Traumatic Stress Disorder (PTSD) cannot only affect veterans or active duty military men and women, but anyone can experience PTSD. Though war and combat are two commonly known reasons for a person to experience PTSD, true to its name, anyone with significant trauma can develop PTSD.
That said, PTSD is only diagnosed given specific symptoms. According to the National Institute of Mental Health (NIMH), one-half of all adults in the United States experience trauma sometime in their lives, but not all develop PTSD. In 2016, PTSD in the United States was present in approximately 3.6% of adults (AKA - 1 in every 11 individuals), with statistics higher for females than males.
Before we dive into the potential management of PTSD symptoms, it is important to understand what PTSD looks like to understand why and how a service dog for PTSD could help.
Four Symptoms Of PTSD
In order to be properly diagnosed with PTSD, these four symptoms must be present, with flexibility in terms of severity:
- Intrusion: Intrusive thoughts, or memories, can take hold in the form of nightmares, or flashbacks. They are recurring, and distressing, and can even be triggered by small, seemingly unrelated reminders.
- Avoidance: Avoidance is described as steering clear of certain places, people, activities, or objects that could potentially trigger a PTSD episode. A person with PTSD might also avoid talking about the topic, the memory, or anything seemingly related to the cause.
- Changes In Cognitive Mood: Alterations in the stabilization of mood are described as negative, and distorted thoughts about oneself, or others. It can present itself in feelings of anger, fear, hopelessness, guilt, or numbness. Additionally, these moods can shift seemingly rapidly, and occur for relatively unexplained reasons.
- Changes In Arousal and Reactivity: Physical changes in behavior, outbursts, or self-destructive choices are categorized as alterations in physical and emotional responses. Having a “guard” up, trouble sleeping, and reactive behavior can be frequent in those with PTSD.
The severity of each symptom can depend on both the person, and sometimes on how much guidance they have sought thus far for rehabilitation. Symptoms of PTSD are manageable, with the right tools and professional help.
Can Dogs Sense PTSD?
With proper training, service dogs can sense the signs of a PTSD episode, and can be trained to provide assistance in the ways necessary, depending on what the person needs. If a person with PTSD is prone to anxiety attacks, a service dog has the potential to interrupt the distressing episode.
Service dogs for PTSD appear to be helpful for most individuals who seek assistance in that manner. The compassionate, attentive nature of most service dogs tends to be beneficial for both the tasks they can accomplish and the mere companionship they offer.
Stages Of PTSD
To better understand how a person is coping with their PTSD, it is good to understand what the stages of PTSD can look like. To assess the needs, and recovery growth of a person with PTSD, it is sometimes broken down into particular phases. The stages are often referenced as follows:
- Impact: This stage usually happens soon after the traumatic episode. It can feel like the surrounding world's weight is intensifying, and a fight or flight state of emergency can kick in. The impact phase can entail (but is not limited to) feelings of shock, fear, or high anxiety.
- Rescue: This stage can be thought of more or less in the way we think about the five stages of grief. In this phase, a person might experience a range of emotions, from anger and denial to despair and numbness. It is the stage in which most people begin to process what has happened, and intrusive thoughts might begin to crop up while the brain works hard to protect itself from stress. Because of the extensive range of feelings that can occur during this phase, it is sometimes broken up into two different stages.
- Intermediate Recovery: Like the stages of grief, this is the stage where the person begins their journey to acceptance and healing. Though it is seemingly positive, often it can go one of two ways. Some people might be inspired by the support they might receive, and take it to heart. Others might feel as though they need more support than they received or quickly dip in recovery once support begins to fade.
- Long-Term Reconstruction: This stage is considered the beginning of reintegration. A person might have more coping mechanisms available to resume their lives without constant PTSD complications. However, it is long-term for a reason. Frequently, comorbid feelings of depression and anxiety can still slow reconstruction down more than desired.
Who Qualifies for A Service Dog?
There are a few different certifications for animals meant to help with rehabilitation. You might have heard the phrases “emotional support animal,” “therapy dog” or “service dog.” They are each different, with unique capabilities and public allowances.
- Therapy Dog: A therapy dog is often just a docile furry friend, which is frequently volunteered in nursing homes, and mental health institutions, to provide joy and relaxation. They do undergo a bit of training, but are usually declared therapy dogs because of their easygoing, tame disposition.
- Emotional Support Animal (ESA): ESA’s have a bit more flexibility when it comes to the type of animal it can be. Some people have cats, dogs, rabbits, or virtually any domesticated pet. With a doctor's note, these animals can be declared ESA’s, giving a bit more leeway to the owner when it comes to renting an apartment with pets, or allowing pets in specified places.
- Service Dog: A service dog has the most leeway with allowance in public places because they require the most training. Unlike an ESA, the “service dog” title cannot be extended to just any domesticated animal. They are working creatures, with specified duties, and special rights. PTSD service dogs fall under this category.
To qualify for a service dog in the United States, a person needs to be diagnosed with a disorder recognized by the Americans with Disabilities Act (ADA), ranging from physical, and psychological impairments. PTSD does fall within this category. So, let us review what the standards for PTSD diagnosis are.
The Diagnosis and Statistical Manual for Mental Disorders (DSM-V, published in 2013), outlines the PTSD criteria for diagnosis as follows:
- Stressor: There was a direct or indirect exposure to a severely traumatizing, specifically pinpointed event, injury, or threat.
- Intrusion Symptoms
- Negative Alterations In Mood
- Alterations in Arousal and Reactivity
- Duration: Symptoms must be present for at least one month minimum.
- Functional Significance: Symptoms are debilitating, or impairments through daily life.
- Exclusion: Symptoms cannot be better explained by other mental health concerns.
What Tasks Does A Service Dog Perform For PTSD?
For those diagnosed with PTSD, PTSD service dogs can provide a litany of tasks. PTSD service dog tasks include, but are not limited to:
- Alerting the individual with PTSD when...
- His or her blood sugar is low
- An intruder is present
- A seizure is coming (if applicable)
- To take medicine (if applicable)
- To wake up
- Household Tasks
- Opening and closing doors
- Turning lights on or off
- Retrieving and delivering an item
- Carrying or dragging household items upon request
- Assistance with mobility
- Finding an item upon request
- Emergency Response
- Alerting a family member when problems occur
- Alerting surrounding people when the individual with PTSD is experiencing an episode.
- Calling 911 or emergency hotlines if needed on a dog-established phone
- Guiding the individual to safety
- Interrupting nightmares, anxiety attacks, or moments of disassociation
In addition to being extremely responsive to individual experiencing at-risk behaviors, PTSD dogs can provide comfort and a sense of safety for a person with PTSD. Getting a written recommendation from your healthcare provider is the first step for how to get a service dog for PTSD.
Comorbid Conditions And PTSD
Service dogs for PTSD are additionally beneficial given the fact that many individuals with PTSD also have other co-occurring conditions. In fact, according to the U.S. Department for Veteran Affairs, 80% of individuals with PTSD have another mental health diagnosis.
The list for common comorbid conditions includes, but is not limited to:
- Sleep Issues
- Generalized Anxiety
- Major Depressive Disorder
- Substance Abuse/ Addiction
- Moral Injury
- Traumatic Brain Injury
- Anger Issues and Violent Behavior
- Compromised Physical Health
- Obsessive-Compulsive Disorder (OCD)
- Borderline Personality Disorder
For those with PTSD, service dogs can be incredibly helpful for managing daily activities.
The process of rehabilitation and healing for those with PTSD often requires specialized, and long term care. However, given the frequency of diagnosis, the normalization, and increased understanding of the disorder, assistance can be one click away.
In the meantime, if you think you or a loved one might be experiencing PTSD, take this short, free, and confidential assessment for more insight, and guidance. It is important to note that this assessment can offer information and resources, but it is in no way a substitute for an official diagnosis from a mental health professional. For further information regarding treatment, please schedule a consultation with a mental healthcare provider.
Seeking help is never a sign of weakness, and it can offer some real, tangible solutions. Not all hope is lost. You are a human, deserving of peace, and peace is worth fighting for.