ABSTRACT
PTSD is a relative new diagnostic term for an old problem. Soldiers returning from home from military service need time and help to readjust to civilian life. This is especially true for soldiars who served in a war zone and for the 23% of women soldiers who may not have seen combat, but were subject to sexual abuse and rape in the military. Some of these women are diagnosed with Military Sexual Trauma or MST. They may recover from this or they may go on to develop full PTSD. Some people are more susceptible to PTSD than others are. Of course women service personnel who are exposed to violence on the battle field and sexual assault on the home front are at a double risk. Part of this is prior life experiences. PTSD shows itself in a variety of different ways. This sometimes makes diagnosis difficult. One of the ways that PTSD manifests itself is in dysfunctional family interactions. This is also something that increases the chance of those children suffering PTSD in the future. Fortunately, there are a variety of different treatment methods available to help each unique service person find their way back to health. These include everything from prescription medications like selective serotonin reuptake inhibitors to community involvement. There are several counseling modalities that have proven them selves successful for military service men and women who suffer from PTSD.
Post Traumatic Stress Disorder or PTSD is a fairly new diagnosis term for a long established problem. The term came into common use in the 1980s. But everyone knew that the Vietnam Veterans tried to explain and failed because “ you just had to be there.” World War II Veterans suffered from “Combat Fatigue.” Other terms used included “Shell Shock” and “War Neurosis.” . PTSD is not reserved for the military. Civilians exposed to violence can suffer from this disorder as well. For example, on the domestic front people started to realize that rape and domestic abuse victims had more to recover from than black eyes and broken ribs. Nevertheless, it was in regards to military combat service that the largest studies and the most definitive diagnosis were made.
Not all soldiers develop PTSD. Even among units that experience the same traumatic events some individuals are more resilient than others are and do not come away with the disorder. Among the factors that can contribute to PTSD are:
- A family history of psychological problems
- A personal history of psychological problems
- Previous episodes of PTSF
- Military Sexual Trauma (MST)
- Childhood sexual abuse
- Childhood physical abuse
- Automotive accidents
- Natural disasters
- Pervious exposure to violence
- Previous sexual assaults
- Physical injuries suffered as a result of military service.
- Exposure to terrorist attacks
- Poor social skills
- Alcohol Abuse
- Drug Abuse
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Another factor that effects who, in a combat situation is likely to develop PTSD is how close the other solders in the unit are with each other. This is often termed “unit cohesion.” It is based not only on how well they function as a team, but also how well they interact as individuals.
Women in the military are also at risk for an increased exposure to sexual trauma. Although it is sometimes termed Military Sexual Trauma or MST it frequently leads to PTSD. Sexual assault, especially rape, is the most common cause of PTSD. Since most of the sexual assaults in on women in the United States Military come from other service personnel, especially superior officers this form of PTSD affects women in the military whether or not they are even actively engaged in battle. To further complicate this problem for military service women they are at a high risk for not having access to the social support, medical services or mental health services necessary to recover from sexual trauma. This is particularly true for women in active combat situations, but by no means limited to them. According to the Department of Veterans’ Affairs 23% of women in the military reported sexual assault. Military men and women also experience sexual harrassment. Women reported harrassment at the rate of 55% and men at the rate of 38%. Considering the prevalence of sexual assault in the military, it is easy to see how any woman in the military could end up with PTSD because of her military service. ,
Post Traumatic Stress Disorder can be the result of personally experiencing a single traumatic event, watching another person experience a traumatic event, or repeated exposure to a combination of traumatically stressful situations. These events can take place over a relatively short time frame or over the course of years. It is possible to recover from PTSD. However, previous episodes of PTSD put you at greater risk of reoccurring PTSD if you continue to be exposed to traumatic situations. Women in the military who suffer from MST or Military Sexual Trauma are more likely to develop PTSD.
Part of the problem of diagnosing PTSD is that it can manifest itself in many different ways. This can vary from individual to individual. In cases of repeated causes and episodes of PTDS one individual depending on the cause, can also experience it differently. This can make PTSD hard to diagnose professionally. It can also make it difficult for the individual service man or woman, or their friends and families to recognize. This is especially true in those instances where the service person experienced PTSD previously and the new case manifests differently. Some of the symptoms of PTSD include:
- Having things upset you because they remind you of the event, or series of events
- Having realistic nightmares of the event.
- Having vivid memories or flashbacks of the event that evoke feeling of reliving it.
- feeling emotionally isolated
- Depression
- A constant feeling of danger
- Hyper-arousal, feeling on edge, anxious, irritated or jittery
- Physical symptoms, including chronic pain.
- Panic attacks
- Difficulty sleeping
- Problems concentrating
- Marital problems
- Family discord
- Difficulties in being a parent
- Sexual dysfunction
- Social dysfunction
- Social isolation
- Alcohol abuse
- Drug or other substance abuse
- Suicidal idealization
- Self destructive thoughts or actions
- Event, place or situation avoidance
- Preoccupation with work
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Fortunately, there are effective treatments for PTSD. In most cases, these involve a combination of counseling and medication. These modalities need to be tailored for the individual. People respond differently from each other, as the treatment progresses the same person might begin to respond differently to the same medication or other treatment modality that was effective at the outset of the disorder. Sometimes family members and friends can also participate to make the process easier for the victim and to also help provide a stable environment for the service person to recover in. PTSD can place a great deal of stress on the service person’s family and social contacts. For this reason, it is best that they are informed about PTSD even if they do not actively participate in the counseling and other aspects of the psychological treatment process. , . ,
There are several types of psychological and psychotherapeutic options that have proven successful in treating PTDS. These include Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE) and Eye Movement Desensitization And Reprocessing (EMDR).
CBT or Cognitive Behavioral Therapy, has proven itself to be the most effective psychological treatment for PTSD to date. It involves the counselor and patient working together to understand the ways trauma has transformed the victim’s life and to gain an understanding of the thought processes behind it. Two of the most popular forms of CBT are CPT or Cognitive Processing Therapy and PE, or Prolonged Exposure Therapy. ,
In CPT the patient talks about the experience and explores how it transformed their life. This includes thoughts, feelings and actions. ,
In PE patients are required to talk about the experience and go over it again and again until they can discuess it without the memory upsetting them. Patients may also go to places that are safe, but none the less remind them of, or are in other ways connected to the trauma or traumas that brought on the PTSD. ,
EMDR, or Eye Movement Desensitization and Reprocessing is similar to the various CBT modalities however it also utilizes physical clues as well as talk therapy to help overcome the symptoms of PTSD. Because of its nature, many people who suffer from PTSD have difficulties verbalizing their problems. However, eye movements, sounds or hand movements, sometimes called “body language” may provide additional insight into what the victims are experiencing, even when they have not yet realized it for their selves. ,
Medications for PTSD include Selective Serotonin Reuptake Inhibitors (SSRI). SSRIs are most commonly used to treat depression, which can also be a symptom of PTSD. However, in the case of PTSD they can also help relieve some of the other stress related symptoms as well. Prozosin has proven to help with sleep disorders, including nightmares. Benzodiazepines and atypical antipsychotics do not treat the core symptoms of PTSD and should therefore be avoided. ,
In addition to formal treatment PTSD sufferers can make changes to their lifestyles that may help relieve them of PTSD symptoms and speed their recovery. Most people with PTSD will benefit by connecting with and talking to others who also suffer from PTSD. Learning or relearning how to trust other people helps. This includes other military personnel who suffer from PTSD as well as friends and family who may or may not be outside the military. Volunteering can help the victim connect with their community, as can religious activities. Exercise is a healthy was to relieve physical tension. .
The most important first step is of course connecting with someone who can help. This could be a VA Medical Center, which is logical because they are professionally trained to recognize the symptoms of PTSD in military service personnel, but it does not have to be. A family doctor can help, and can help refer a service person to an appropriate caregiver. A mental health professional may be able to help personally, and will definitely be able to provide references to other professionals who may be more experienced in the treatment of PTSD as suffered by militarily service men and women, or even do both. Spiritual and religious advisors can not only help directly by providing counseling, they can also help direct a PTSD sufferer to a wide range of other resources from medical and psychological care to volunteering opportunities. .
American Veterans who suffer from PTSD can also apply for disability based upon their PTSD problems. This can be a lengthy process. It involves making a formal request or claim. This must be submitted to the VA Veterans’ Benefits Administration using their claim forms. Submission of the claim forms is followed by interviews and further evaluations. The Veterans’ Service Organizations (VSOs) have Service Officers available at no charge to assist service personnel and their families through the disability application process. ,
Friends and family can help service people deal with PTSD. This is true even though the symptoms include various dysfunctional social and family behavior patterns. In fact, sympathetic friends and family may be just what a service person who is feeling isolated needs. Some of the ways family and friends can help a PTSD sufferer are:
- Learning about PTSD
- Being available to listen, without pushing the person to talk
- Accompanying the person to doctor visits
- Helping to keep track of medications
- Having meals together
- Planning activities like going to the movies
- Exercise together
- Go for a walk, go shopping, and participate in other small tasks together.
- Encourage the PTSD sufferer to have contact with other friends and family members
- Go to religious or spiritual gatherings together
- Plan small gatherings of family and friends
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One of the most disturbing problems associated with Post Traumatic Stress Disorder is the increased rate of subsequent violent behavior, particularly spousal abuse that PTDS sufferers are likely to be involved in. The first, most vital thing to do is to make sure no children are present. This means that the children should be calmly and totally away from the situation where they are not just physically safe, but also where they cannot see or hear any loud, abusive physical or emotional behavior. This is vital for at least two reasons, first to benefit the children. As we know being exposed to childhood abuse is one of the factors in increasing the likelihood that a person will suffer PTSD later on in life. Another reason is for the benefit of the PTSD sufferers themselves. Close family relationships contribute to more rapid recoveries. Children who are afraid of their parents are not likely to be able to develop those close relationships. . .
References
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