Reviewed by Melinda (Santa) Gladden, LCSW
Apparent from the fact that it was originally known as “shell shock” or “combat fatigue,” PTSD strongly correlates with veterans returning from war. Although originally it was not thought of as a mental disorder, it was recognized as a phenomenon that would affect those who went to war and witnessed the deaths of their comrades, friends, or strangers, even as far back as the times of ancient civilizations. Now, a medically recognized condition while not curable does have treatments that can help with the distress that it causes.
Veteran PTSD is, unfortunately, common. Research suggests that up to 20% of veterans of military operations in the Middle East experience symptoms of PTSD, and that number varies depending on what war the veteran served in. For instance, the percentage of veterans with PTSD after serving in the Vietnam War over their lifetime is 30%. In other words, research shows that three out of every 10 veterans of the Vietnam War experienced Vietnam PTSD.
A Short History Of Veterans and PTSD
The PTSD/ war relationship is deep and generational. From as far back as the times of the Mesopotamian civilizations, veterans with PTSD have existed. Although we may assume that PTSD existed before that point, the ancient Sumerians were the first to have a written record, in the form of the Epic of Gilgamesh, of soldiers and former soldiers being affected by memories of their experiences war. The memories did not always need a physical injury to be given to the soldier himself; typically, it was enough to just have an intense fear overcome them suddenly or be met by the sight of a fellow soldier being killed in combat. In Roman poet Lucretius’s work De Rerum Natura he recounts this information as given to him by Hippocrates, a Greek physician. In this poem, he also speaks of how frightening dreams are also common experiences among former soldiers.
Even Shakespeare seemed to have some knowledge of PTSD, as many scholars believe that his character of Henry IV displays symptoms or common thoughts and feelings among those suffering from PTSD.
During the end of the 1790s, psychiatrist Philippe Panel was recorded as the first person to formally give a name to PTSD, though he did not specifically call it. Panel referred to it as cardiorespiratory neurosis and used that term to diagnose individuals who suffered from PTSD because of the violence and the events of the brutal French Revolution.
It was also around this time that PTSD was first seen in average civilians who had never seen a combat situation. This was due to the steam engine's creation, which led to the first brutal crashes between trains that claimed numerous lives in their early years. Hermann Oppenheim created the term traumatic neurosis. Still, it was met with controversy and pushback when other scholars claimed that this was just a form of hysteria, as they were civilians, not soldiers. It was not until the Russian-Japanese war that a physician began to call cardiorespiratory neurosis something more familiar: war neurosis. The physician, Honigman, also continued Oppenheim’s convictions that what the soldiers experienced and what those who witnessed horrific train crash experienced were startlingly similar.
Shell shock was finally coined in World War I, and the link between the physical horrors of war and the emotional toll of death and violence was finally made. World War II is when treatment truly turned medicalized and was treated as a serious condition that required treatment. However, it still would not be added to any psychiatric manual as a diagnosable condition. That came later in 1980 during the aftermath of the Vietnam War when it finally led to PTSD (under the name of PTSD) being added to DSM-III, the book used by psychiatrists to determine a diagnosis for their patients. Since then, treatment and awareness of PTSD’s prominence in firefighters, police officers, civilians, and veterans has evolved and evolved to better treat these individuals.
What Symptoms Are Associated With PTSD?
Most people (if not all people) who experience a highly traumatic event will experience short-term PTSD symptoms. Still, a majority of those people will not develop the long-term symptoms of the condition. Veterans who return from war may initially feel fine, but symptoms can emerge anywhere from less than three months after the incident to a few years after the event. This means that even if you or a loved one has been away from combat for several years, they may begin experiencing PTSD symptoms. If you believe that, after reading this list of symptoms, you or a loved one might be suffering from PTSD, this short quiz can provide some insight. This quiz is not meant to be used as a diagnostic tool and should only be used as a first step in determining whether to seek guidance and treatment from a medical practitioner.
PTSD is not a straightforward diagnosis at first glance, but it can be boiled down to these four points. An individual must have experienced all of these four things for at least one month to be considered for a PTSD diagnosis:
- One or more avoidance symptoms
- One or more re-experiencing symptoms
- Two or more cognition and mood symptoms
- Two or more arousal and reactivity symptoms
Avoidance symptoms may affect a person’s everyday routine, as they will begin to actively avoid locations that remind them of the event. This does not have to be a specific location, such as a specific park or a specific building. For example, someone who fell from a great height may avoid going to locations with a high altitude, such as a mountain or a tall roller coaster.
Avoidance symptoms include:
- Avoiding thinking about the event or feeling emotions about the event
- Avoiding locations that remind the individual of the event
Re-experiencing symptoms include:
- This might also include feeling physical sensations during the event, such as a racing heart or sweating.
Although the person suffering from PTSD can cause the symptoms to occur through their own thoughts and actions, outside forces may also trigger the symptoms. For instance, words (including phrases or sentences), objects, or experiences may remind the person of the traumatic event and cause them to experience a re-experiencing symptom. Common triggers for veterans are the sound of popping popcorn or fireworks, which might sound like gunfire. People who have not lived their experiences may not even think that these actions would have an adverse effect on their loved one, so it is important to be mindful of sounds and sights that could trigger a PTSD episode.
Cognition and Mood Symptoms
It is important to ensure that these emotions or experiences are not being caused by substance use or an injury with cognition and mood symptoms.
Cognition and mood symptoms include:
- Difficulty remembering major aspects of the traumatic event
- Thoughts of negativity about the world or themselves
- Blaming oneself for the event or feeling guilt over the event even when you could have done nothing to stop it or anything more to help others
- Lack of motivation or interest in taking part in activities that one used to enjoy
Arousal and Reactivity Symptoms
Events or other things that remind the individual of the traumatic event do not trigger these symptoms. Instead, these are typically in reaction to just about anything and are constant. They can affect a person’s ability to concentrate or do everyday tasks, even eating or sleeping. An individual can become angry or anxious due to these symptoms.
Arousal and reactivity symptoms include:
- Being easily surprised or startled
- Feeling uneasy even when in a safe environment.
- Difficulty sleeping
- Having episodes of anger
What Causes PTSD?
PTSD can be developed by anyone who experiences something traumatic. However, not everyone who experiences something traumatic will develop PTSD. Through early intervention, such as talking about the event with loved ones or a therapist, PTSD can be prevented. Some people are more likely to develop PTSD than others, though, based on these factors:
- Your gender (Women are more likely to develop PTSD)
- Having a history of medical illness
- Previous substance abuse
- Lack of support after the event
- Dealing with additional stress such as grief due to losing a friend during the event
- Having the traumatic event last for a long period of time
Treatment Options for PTSD
There is no one specific treatment for PTSD, as PTSD in soldiers is a combination of several different conditions. For example, an individual might experience depression and difficulty sleeping.
A treatment option for individuals with PTSD is talk therapy. Regular sessions with a licensed therapist can help alleviate symptoms and educate you on how to handle them. You may be able to learn what triggers to avoid and how to manage them. If one method of talk therapy is not effective, then another can be tried out, as there are several types of talk therapy for those suffering from PTSD.
As stated before, a preventative measure for PTSD is talking about the incident after it happens with someone who you trust and can help you through the process of coping with the event. It is not guaranteed to prevent PTSD from developing, but it may prevent it from some individuals.
Most importantly, if you believe that a loved one has veteran PTSD, firefighter PTSD, police PTSD, sexual assault PTSD, or any related type of PTSD, then the greatest help you can offer is support. Be there for them during episodes where they are experiencing symptoms. Encourage them to seek guidance from a medical practitioner who can refer them to a specialist. That specialist can then, in turn, provide them with a diagnosis and give them guidance on what further treatment to seek. Remember that your mental health matters as well, and you should never feel ashamed or embarrassed if you experience burnout and need to seek out help.
PTSD treatment for veterans is available and effective.