30 May Supporting the Mental Health of Veterans Living with PTSD
For those outside of the military, Memorial Day is oftentimes referred to as the “unofficial start to summer.” The holiday weekend conjures up visions of barbeques, beach trips, and time off with family and friends. Yet, for veterans and their loved ones, this weekend may be especially challenging. Officially dedicated to those who selflessly sacrificed their own lives to protect our country, Memorial Day is intended to honor those who fell in the line of duty. For surviving veterans and active duty soldiers with post-traumatic stress disorder (PTSD), the day of remembrance may trigger painful memories, feelings, and thoughts of a traumatic event that occurred during active duty, which can exacerbate existing mental health challenges.
Memory and PTSD are intertwined, which makes Memorial Day a fitting, yet unofficial introduction to PTSD Awareness Month, which runs throughout the month of June. In order to raise awareness, boost public understanding, and reduce stigma,we’ll dive into the particulars of PTSD and CPTSD, the importance of PTSD Awareness Month, common challenges facing veterans today, and tangible ways to support our active military and veterans living with PTSD.
What is Post-traumatic Stress Disorder?
For those who have lived through a shocking, frightening, or dangerous event, initial feelings of fear and alarm are natural. The body’s automatic “fight-or-flight” adrenal response to fear instigates split-second changes that help an individual react to danger. Long-lasting symptoms that cause an individual to experience ongoing symptoms of fear, anxiety, stress, or reactivity, even when one is not in danger, can signal post-traumatic stress disorder (PTSD).
According to the National Institute of Mental Health, a PTSD diagnosis results if an individual is experiencing all of the following symptoms for at least one month:
- One or more re-experiencing symptoms, including flashbacks that cause one to relive the trauma, bad dreams, or frightening thoughts
- One or more avoidance symptoms, including purposefully staying away from places, events, or objects that remind one of the traumatic event, or avoiding related thoughts or feelings
- Two or more arousal and reactivity symptoms, including being easily startled, feeling “on edge,” experiencing difficulty sleeping, and having angry outbursts
- Two or more cognition and mood symptoms, including difficulty remembering key details of the traumatic event, negative thoughts, distorted feelings like guilt or blame, or loss of interest in activities that were once considered enjoyable
It is important to note that symptoms of PTSD may take weeks or months to surface. Once they arise, if symptoms persist for longer than one month and create a tangible negative impact on a person’s daily life, they likely signal PTSD. The disorder is often experienced along with depression, substance use, or other anxiety disorders.
While PTSD is estimated to affect up to twelve million Americans annually, the disorder is especially prevalent among our veteran population. Nearly 16% of veterans returning from Afghanistan and Iraq have been diagnosed with PTSD, though it’s important to note that PTSD is a serious concern for all veterans, regardless of their deployment status or history. When left unaddressed, PTSD can manifest into additional mental health challenges that gravely impact both quality of life and personal safety. For example, the US Department of Veterans Affairs 2021 National Veteran Suicide Prevention Annual Report reveals that the suicide rate of veterans is 1.5x that of their civilian peers.
Research is still ongoing to learn more about the underlying causes of why different individuals can experience such a broad array of reactions to traumatic events. Resilience, genetics, and neurobiology are all being studied to help predict one’s risk factors and offer ways to prevent it. Some scientists are working on ways to determine the effectiveness of various interventions for different individuals to develop more effective treatment pathways. Other researchers are studying brain maps in the hopes of pinpointing where and when PTSD begins.
Complex PTSD (CPTSD)
Researchers are only beginning to understand CPTSD, a newly identified condition that arises after long periods of abuse, neglect or trauma. While PTSD may arise after a single trauma, repeated exposure to trauma over months or years can result in a closely related disorder known as complex post-traumatic stress disorder (CPTSD). Because traumatic stress can have long-term impacts on the amygdala, hippocampus, and prefrontal cortex, veterans who were prisoners of war or those who live within wartime conditions for extended periods of time are oftentimes affected.
Individuals living with CPTSD experience all the symptoms of PTSD, along with an extended list of emotional and cognitive changes that are largely disruptive to social interactions, deep relationships, and steady employment, including:
- Difficulty regulating emotions, resulting in explosive anger or relentless periods of sadness
- Chronic isolation and negative self-perception as a result of guilt or shame
- Changes in consciousness, such as emotional detachment or dissociation
- Relationship difficulties, including avoidance or toxic dynamics
- Loss of meaning, including losing faith in long-held beliefs
- Despair or hopelessness about the world
Because it is so new, CPTSD can be difficult to diagnose. Currently, there is no test that officially identifies CPTSD, but medical professionals typically begin by conducting a comprehensive work-up of symptoms to help determine the extent of the trauma and its impact on one’s life. Additional awareness measures are needed to help educate both the medical world and the general public about the extended impact of CPTSD on veterans struggling with trauma.
PTSD Awareness Month
Every June, the US Department of Veterans Affairs honors PTSD Awareness Month, so those who are struggling in silence can learn how to access the help they need. The month-long awareness event is meant to reduce stigma and spread the word about the variety of available treatment options and their effectiveness. It also encourages everyone with PTSD – including veterans, civilian survivors of sexual assault, serious accidents, natural disasters or other traumas – to seek help.
To engage the public and harness the power of social media, the VA promotes a series of action-oriented tasks for each day of the month. Here is a list of the first week of activities:
- June 1 – Pledge: Take the pledge to raise PTSD awareness
- June 2 – Solidarity: Use the VA’s awareness month image as your social media profile photo
- June 3 – Share: Socialize emergency resources, like the Veterans Crisis Line
- June 4 – Support: Download PTSD Coach or PTSD Family Coach apps
- June 5 – Connect: Text a Veteran
- June 6 – Engage: Like the VA’s National Center for PTSD Facebook Page
- June 7 – Learn: Review educational information on trauma, PTSD, and treatment options
To join in and follow along with the entire awareness month’s events, visit the VA’s PTSD Awareness Month website.
How to Support Veterans Living with PTSD
Unfortunately, there are some very specific challenges associated with the stigma of veterans seeking mental health care services that may restrict them from getting the care they need. This Memorial Day, here are some suggestions on ways you can help veterans living with PTSD:
Encourage professional treatment. PTSD therapy – especially prolonged exposure (PE), cognitive processing therapy (CPT), and trauma-focused cognitive behavioral therapy (CBT) – has been proven extremely effective. Treatment options that involve directly facing memories of the traumatic event and related thoughts or feelings are thought to be more helpful in reducing symptoms.
Engage in remembrance together. Ask your friend or loved one how you both might honor fallen men and women. Volunteer at local Memorial Day events, leave flags or flowers on gravesites, or visit a military memorial, museum, or monument to pay your respects. Sharing your time can help your veteran feel less alone.
Help them build consistent and stable habits. By remaining present and available to your loved one, you are helping to offer a sense of stability and safety that was missing during their traumatic time(s). By being a constant, you may signal respect and help a veteran feel comfortable opening up – and even seeking support. There are many resources available online that offer guided audio meditations.
Encourage self-care practices. Meditation and mindfulness have been shown to help alleviate PTSD symptoms by encouraging being present, which can help veterans create a boundary from painfully reliving their past. It reduces reactiveness, can relieve anxiety, and even curb negative feelings. Breath work is an excellent introductory exercise to the practice of mindfulness, which helps ground one in the present moment. Physical activity or exercise can also help reduce stress.
Listen to others’ stories. Listening to how others cope with PTSD can be motivating, educational, and healing. On the “The Heart of a Warrior” podcast, host Jen Satterly, author of Arsenal of Hope: Tactics for Taking on PTSD, Together, discusses the impact PTSD and trauma has on military personnel and first responders.
Resources for Service Members and Their Loved Ones
Veterans Crisis Line: Call 1-800-273-8255 (x1) or Text 838255. An emergency line to use in moments of crisis or when support is needed. This free, round-the-clock phone, text, and online chat service is offered to all Service members.
National Center for PTSD: Actionable resources for service members and their loved ones who would like to access mental health resources.
All Secure Foundation: A non-profit that ensures all Special Operation active duty and veteran combat war fighters know they are never alone, and helps them heal from the trauma of war.
Objective Zero Foundation: Connects the military and veteran community to peer support, wellness activities, and mental health resources.
Warrior Canine Connection: Utilizes a Mission Based Trauma Recovery model to help recovering Warriors reconnect with life, their families, their communities, and each other.
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