Signs of Post-Traumatic Stress Disorder (PTSD) in Military Service Members & Veterans

Veterans and military service members are particularly vulnerable to symptoms of PTSD because they are often exposed to many different types of traumas while they serve. Active duty, war zone deployment, training accidents, and military sexual trauma (or MST) are just a few of the traumas that may lead to PTSD and PTSD symptoms. 

While it’s more common to find a link between combat and deployments and an increased risk for mental disorders and health conditions, military service can also lead to mental health struggles as well. There are a range of conditions that those in the community may experience beyond PTSD, including depression, so if the world feels unsafe or you or a loved one is displaying feelings of everyday fear, reach out to a trusted medical professional to learn more about what’s going on.

When applying these PTSD signs and symptoms to veterans it’s worthwhile to be aware of the specific challenges they may face due to their circumstances. For example, the incidence of combat-related PTSD increases with the number of tours or amount of combat a military service member has experienced. As a result, many of the responses they once relied on during deployment might resurface when they return home, in a place where those responses are less appropriate. These survival responses can include hypervigilance, hyperawareness, and adrenaline-quick reflexes – all of which are symptoms of combat-related PTSD.

When it comes to reliving the event, service members may re-experience traumas triggered by smells, news reports, or loud noises. Service members may also try to avoid people or situations that bring up memories of their deployment, especially in an attempt to avoid talking about these experiences. They also may stay away from crowds or avoid watching films and tv shows that are related to a triggering event.

Finally, military service members who have returned from combat may seem different than they were before their deployment. As a result, they may be more withdrawn or seem more introverted. These signs are important to identify because they may be a symptom of PTSD or another potential health problem.

Other symptoms veterans and military service members may develop besides the four main types above include:

• Depression and feelings of shame or hopelessness
• Substance abuse or excessive substance use
• Difficulty keeping employment or other important, personal, commitments
• Trouble in relationships increased irritability or fighting with loved ones
• Physical symptoms, including chronic pain

Substance abuse is a warning sign that you or a loved one may be struggling to cope with a traumatic event. If you notice any changes in behavior, someone drinking more regularly, or increased dependence on pills or another substance, it’s important to get help immediately. These can also be signs of substance use disorder (SUD) and not will not only make it more difficult to overcome the feelings associated with a traumatic event but also lead to a more serious issue of addiction.

PTSD is a mental health issue that extends beyond the military – affecting approximately 8 million American adults a year – however, those in the military community are at a greater risk than the general population. Military service members and veterans must also overcome unique barriers in accessing adequate treatment for mental illnesses such as PTSD. This challenge to receiving treatment contributes to an increased risk for potential substance abuse; feeling forced to turn to substances as a means to manage uncomfortable mental health struggles on their own.

According to the National Institute of Mental Health (NIMH), post-traumatic stress disorder (PTSD) may develop in individuals who experience “shocking, scary or dangerous” events. Though feeling frightened or afraid, both during and after, a traumatic event is a natural “fight-or-flight” response, PTSD symptoms last long beyond the event itself.

Fight or flight responses are meant to trigger split-second changes in the body to help defend the body against danger, or, avoid danger altogether. For those experiencing PTSD, these stressful or fearful responses from the event, continue even after the threat or fear of danger has subsided. 

Additionally, the National Center for PTSD classifies PTSD as a mental health issue that can make it difficult for individuals to get through daily activities such as going to work, attending school, or spending time with loved ones. These PTSD symptoms may start immediately or after some time has passed from the event, and symptoms may also come and go over time. If these symptoms carry on for longer than 4 weeks and the feelings from the traumatic event are upsetting or causing disruptions to everyday life, it is worth looking more deeply into whether or not you have PTSD.

Anyone can develop PTSD symptoms, at any age. The main contributing factors to someone experiencing PTSD are the following: 

• having a very intense or long-lasting traumatic event 
• an injury 
• being exposed to certain types of trauma, like combat or even sexual assault.

While risk factors are important to be aware of, it’s more important to focus on what happens after the traumatic event and how to get support.

According to a study conducted by the RAND Center for Military Health Policy Research, less than half of veterans who returned to civilian life and needed mental health treatments received any treatment at all. Of those who were receiving treatment for PTSD and major depression, less than one-third were receiving evidence-based care. War-induced psychological trauma can be traced as far back as 490 B.C. and throughout the years, the amount of veterans suffering from mental health issues has been evidenced with each war.

• 700,000 Vietnam veterans (almost 25%) were diagnosed with needing some form of psychological care for delayed effects from combat exposure.
• 60,000 Veterans from Iraq and Afghanistan (Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF)) (13.5%) screened positive for PTSD.
• Approximately 12 out of every 100 Veterans (12%) from the Gulf War (Desert Storm)
• Approximately 15 out of every 100 Vietnam Veterans (15%) and about 30 out of 100 (30%) have had PTSD in their lifetime.

Combat Stress Reaction (CSR), also known as “shell shock” or “battle fatigue” is another response to the mental and emotional strain members of military service and combat veterans experience, after returning home from combat.

Military One Source highlights that this emotional and mental strain can result from dangerous and traumatic experiences and is a natural reaction to the “wear and tear” of the body and mind after extended and demanding operations.

Though the symptoms are similar to PTSD, key combat stress symptoms can include:

• Headaches and fatigue
• Loss of appetite
• excessive fear or worry
• irritability and outbursts of anger
• depression or feelings of apathy
• personality changes
• difficulty sleeping 

Combat stress is recognized as occurring for brief periods of time and falls within the realm of a more natural reaction to traumatic events like combat, disaster, or assault. 

A military service member or veteran experiencing combat stress will likely disappear after a few months of them being home – sometimes even weeks. 

PTSD however is characterized as more severe and includes symptoms that last for longer than 4 weeks. The symptoms one may experience from PTSD are often more aggressive than those of someone experiencing CSR and will interfere with daily responsibilities and may require professional assistance to process difficult emotions.

Finding a healthy way to manage and deal with symptoms of PTSD is possible. This is not a mental illness that you have to face alone or simply live with. Numerous veterans and military service members – army, marine corps, navy, air force, coast guards – have received treatment for PTSD and found relief from their symptoms thanks to research advancements in this area.

The two types of treatment that the U.S. Department of Veterans Affairs (VA) identifies are:

1. Trauma-focused Psychotherapy
2. Medications for treating PTSD symptoms

This is the most highly recommended form of treatment for someone struggling with PTSD symptoms. The VA describes “trauma-focused” to mean treatment that focuses on the memory of a traumatic event or its meaning. There are various forms of trauma-focused psychotherapy that have been found to be most effective. Some of them include the following:

Cognitive Processing Therapy (CPT).  CPT is a type of cognitive-behavioral therapy (CBT) but is specifically trauma-focused. It aims to help individuals understand and learn the skills necessary to deal with how the traumatic event changed their thoughts and feelings. This type of therapy helps change how one thinks about the trauma and can change how one feels.

Cognitive Behavioral Therapy (CBT). CBT can teach you the reasons behind your thinking and actions, as well as recognize triggers that may be connected. Research has shown CBT to be a successful treatment for PTSD in service members through different methods that involve identifying and exchanging destructive thought patterns and behaviors with healthier and more positive ones.

Prolonged Exposure (PE). Gradually approaching trauma-related memories, and repeating the memory ‘on purpose’ until the memories are no longer upsetting.

Art Therapy.  A study revealed the therapeutic effects of making masks as part of an art therapy program for service members suffering from PTSD. Through the creation of masks, individuals could visually express their difficulties and hardships which proved beneficial in working toward recovery.

Eye Movement Desensitization and Reprocessing (EMDR). A structured therapy that encourages focusing on the trauma memory while simultaneously experiencing bilateral stimulation (eye movements, hand movements, etc.) while talking about the trauma. This method helps your brain work through traumatic or distressing memories.

The medications most often recommended for treating PTSD symptoms are certain antidepressants, or SSRIs (selective serotonin reuptake inhibitors), and SNRIs (serotonin-norepinephrine reuptake inhibitors). These inhibitors are commonly used for depression and anxiety, but also work for PTSD. Examples include:

• Fluoxetine
• Paroxetine
• Sertraline
• Venlafaxine

Alternative treatment methods also include pursuing outdoor activities like camping, hiking, rock climbing, and anything that helps challenge your sense of vulnerability and transition back into civilian life. There are lots of organizations and facilities that offer social support, outdoor recreation, and opportunities to be in nature to help you get moving.

For many veterans and military service members, coping with the symptoms of PTSD can be overwhelming but there are things you can do to start feeling better today. It is important not to blame yourself or a family member for experiencing PTSD symptoms or even combat stress. The most important thing you can do is make a change to get your life back today. 

Reach out to our admissions team and learn more about PTSD treatment options for war veterans. Get back the life you love today.