Veterans and PTSD

PTSD is a mental health condition affecting many U.S. military members, but specific treatment options for veterans are available.

Military service is one of the most selfless contributions a person can make, but it comes with risks. People often understand the possibility of physical harm and danger linked to military service, but additional risks exist. People may not fully grasp the adverse influences of war, combat and violence on the mental health of service members, which may result in veterans with post-traumatic stress disorder (PTSD).

PTSD and the Military

PTSDis a troubling mental health condition that can develop following exposure to actual or threatened death, injury or assault. Contact with a trauma can happen by:

• Personally living through the traumatic event
• Seeing the events happen to someone else in real life
• Hearing about the death or traumatic experience of a close friend or family member
• Repeatedly experiencing exposure to traumatic events, like in the case of military service members

Unfortunately, people in the military confront all these experiences, especially during active duty. During deployment or in combat, a person may be injured, see others killed and hear about the injuries and deaths of others.

Even people out of the line of fire can endure repeated exposure to traumatic events and stories. A medic may have to care for those harmed in duty and consistently witness great pain and suffering.

Away from combat, a significant portion of the military faces another type of trauma in the form of sexual assault. According to the U.S. Office of Veterans Affairs, among veterans who use Veterans Affairs (VA) health care:

• One in three women experienced military sexual trauma (MST) during their service.
• One in 50 men experienced MST during their service.
• Over one in three veterans who report experiencing MST to their VA provider are men.

How Common Is PTSD in Veterans?

PTSD is all too common in members of the military. Experts became particularly interested in the diagnosis after the Vietnam War when many soldiers returning home showed the impact of their traumatic experiences.

According to the U.S. Office of Veterans Affairs:

• As many as 10% of Vietnam veterans had PTSD during their lifetime
• Of veterans from the Gulf War, 21% reported experiencing PTSD in their lifetime
• The rate of PTSD in Iraq and Afghanistan war veterans is approximately 30% in any given year

The rate differences of PTSD by war are caused by:

• Politics of the war
• Location of the war
• Type of warfare

Veteran PTSD and Substance Abuse

According to the U.S. Department of Veterans Affairs, 46.4% of veterans with PTSD also met the criteria for substance use disorder (SUD). Over the past 10 years, the number of veterans who have received care through the VA (Veterans Affairs) for co-occurring PTSD and SUD has increased three times. It is also important to note that the co-occurring diagnosis of PTSD and SUD is higher in veterans compared to other populations.

Symptoms of PTSD in Veterans

The signs and symptoms of PTSD in veterans will be the same as the PTSD symptoms people experience from car accidents, dog bites and other traumatic situations. PTSD will trigger four distinct symptoms:

1. Reliving or reexperiencing the event
2. Staying away from people, places or things related to the event
3. Problematic feelings and beliefs about the event
4. Feeling on edge or keyed up

Each symptom may cause issues linked to the trauma and PTSD. In the case of reliving the event, the veteran could have:

• Frequent, vivid or frightening nightmares
• Flashbacks, which is the feeling that the event is happening all over again
• Triggers, which are sights, sounds or smells that remind the person of the danger, like a loud car triggering memories of gunfire

The symptom of avoidance can result in:

• Isolating and staying away from crowds because they create stress
• Being unwilling to drive if the event involved cars or some type of transportation
• Avoiding thoughts and feelings related to the trauma

The negative changes in beliefs and feelings can cause:

• The notion that the world or a particular group of people is completely dangerous
• Memory loss and forgetfulness about the event
• Decreased interest in forming relationships
• Anger or mistrust in people who they previously loved

Lastly, a person feeling on edge from the trauma could:

• Become highly irritable, angry and aggressive
• Struggle with sleep
• Become reckless and self-destructive
• Have difficulty concentrating
• Be more easily startled

Some people with PTSD could also note dissociative symptoms where they experience depersonalization or feeling detached from their body, derealization or feeling that the world is not real.

The symptoms of PTSD in veterans differ from person to person, so some people will have many unwanted influences of the condition while others only experience a few.

PTSD Risk Factors

A scary, life-threatening event will cause PTSD, but not every person exposed to the same trauma will react similarly. This difference is due to several risk factors that increase the odds of a person having PTSD symptoms.

PTSD risk factors are complicated. Because of this, the risk factors for PTSD in veterans and others are separated into three groups:

• Risk factors before the trauma
• Risk factors during the trauma
• Risk factors after the trauma

The risk factors a person has before the trauma includes:

• Childhood emotional and environmental problems like low socioeconomic status, poor education, family dysfunction and limited social supports
• Prior traumatic experiences
• Mental health conditions like anxiety and depression
• Gender and age as younger females are at higher risk for PTSD

The specific traumatic event serves as a powerful risk factor for PTSD. More severe or intense events tend to produce a higher likelihood of PTSD.

For military personnel, additional risk factors during the trauma include:

• Witnessing horrible events
• Killing others in battle
• Causing the dangerous event either intentionally or accidentally

The person’s reaction and treatment in the moments and days following a traumatic event are also risk factors for PTSD. If a person blames themselves for the event, lacks coping skills, has limited support and is confronted by frequent reminders, their chances of developing PTSD are higher.

There is not one issue that causes PTSD in veterans. Instead, PTSD is caused by an interaction of pre-trauma, trauma and post-trauma factors that create symptoms or establish protection.

Treatment for Veterans with PTSD

The people who put themselves in harm’s way for the good of the country deserve the best, evidence-based treatments to diagnose and resolve symptoms caused by the trauma quickly. After decades of studies and trials, several psychotherapy and medication options have been proven effective for PTSD treatments for veterans.

Anyone looking to find help for a veteran with PTSD should consider therapy options like:

• Cognitive Processing Therapy (CPT): A therapy that helps veterans understand how their trauma changed their thoughts and feelings so they can process and reframe their experiences in a healthier way
• Prolonged Exposure: A talk therapy focused on veterans repeating details about the trauma and visiting upsetting places until they no longer find them distressing
• Eye Movement Desensitization and Reprocessing (EMDR): EMDR for PTSD in veterans is a therapy that combines talking about the trauma with eye movement or tapping to help the brain process the traumatic memories more effectively

Medications for PTSD in veterans may be used with therapy or alone to reduce and resolve symptoms. A psychiatrist or other prescriber can offer several medications that help increase the amount of serotonin and norepinephrine in the brain. Common medications for PTSD include:

• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Fluoxetine (Prozac)
• Venlafaxine (Effexor)

Other treatments include alternative and complementary options, like:

• Trained service dogs for veterans with PTSD
• Medical marijuana for veterans with PTSD
• Deep brain stimulation for PTSD involving the use of an electric current

How To Help a Veteran With PTSD

Helping a veteran with PTSD can be difficult for a family member or loved one who doesn’t know how to support them best. A veteran may hesitate to seek mental health treatment for PTSD due to fear of stigma or that getting help is a sign of weakness. When supporting someone with PTSD, it is important not to give ultimatums for treatment or become judgemental or controlling about someone’s treatment of their PTSD.

Loved ones can help support someone seeking treatment for PTSD by validating their concerns and remaining encouraging about the benefits of treatment for PTSD. Other ways to support a veteran with PTSD can include educating others in the community about PTSD, encouraging a veteran to join a support group specifically geared towards veterans with PTSD and using resources such as the VA and other military organizations that have services for veterans.

FORTITUDE: Specialized Substance Abuse Treatment for Veterans

PTSD is a challenging condition to treat. Care can become more complicated when a person adds alcohol or other drug use to the situation. Substance abuse may seem helpful in treating the problem, but it only adds to the risks.

At select The Recovery Village facilities, a specialty program for veterans called FORTITUDE is available. FORTITUDE focuses on treating co-occurring substance abuse and mental health disorders and trauma in veterans so they can confidently re-enter their lives and society. 

This program is for anyone in active or retired service struggling with a co-occurring mental health disorder and substance use disorder (SUD) who would benefit from veteran-specific and inclusive treatment. FORTITUDE offers:

• Individual and group therapy that is exclusive to veterans and first responders
• EMDR therapy, which results in better outcomes for those with co-occurring trauma and substance abuse
• Cognitive-processing therapy (CPT) for veterans
• Trauma-informed care with specially-trained clinicians
• A continuation of care with different treatment levels
• Vetted aftercare network specific to veterans

If you served in the military and struggle with PTSD symptoms and substance abuse, we can help. The treatment experts at our facility can properly assess and treat PTSD and co-occurring substance use disorder to establish symptom reduction and recovery.

The Recovery Village is a part of the VA Community Care Network and can accept VA health insurance for treatment.

Other Helpful Resources for Veterans

Some veterans do well with professional treatments for PTSD, while others need additional services and resources to overcome the condition. A person seeking more resources for veterans with PTSD should always start with their local Office of Veterans Affairs at 1-800-827-1000.

Other helpful resources for veterans include:

• VA PTSD Homepage
• VA National Center for PTSD
• My HealtheVet PTSD and Family Support
• After Deployment

Someone seeking PTSD support groups for veterans can check out the VA’s Peer Support Groups page for information about what support groups are available and how to find one close to home.