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PTSD And Returning Veterans Peer Reviewed Journal

¶ … Commander-in-Chief of the Canadian Forces has declared that the country should put in more effort to treat the occurrences of Post-traumatic stress disorder and suicides among soldiers. In just a span of one week, there were four Canadian military suicides (Fekete, 2013). These soldiers went on to commit suicide after returning from war. It is known that hundreds and thousands of men and women have lost their lives in numerous battles till date. Suffering even after war is over and not being able to take over one's nerves is just horrible. Countries like Canada and U.S. are quite concerned over the increasing rates of PTSD amongst veterans. This event shows that PTSD amongst veterans is a serious problem and is becoming quite common. What is Post Traumatic Stress Disorder?

Post Traumatic Stress Disorder (PTSD) is a condition that develops after a person experiences one or more traumatic events. PTSD is a very severe condition, and it usually follows traumatic events like serious injury, threat or death, sexual assault, near death experiences or serious injury. PTSD is a psychological disorder and the diagnosis of this disease is confirmed when a certain number of symptoms occur together. Even though the name states that this disorder does occur after trauma; it is not likely that every traumatic event will result in PTSD.

It is the body's normal response to prepare to defend itself whenever there is a danger nearby. This "fight-or-flight" reaction is a healthy response that does yield positive benefits for the person who applies. However, it is known that excess of anything is never good. PTSD is a classic example of that. It is seen that people who have PTSD go on to feel frightened or stressed even when they are not in danger.

Causes

Even though the trauma is the most obvious and apparent reason for PTSD, other causes have been linked to it. Many scientists have gone to state that the genes of a person can go on to increase or decrease the risk for developing PTSD. The role of Stathmin and GRP in increasing development of fearful memories is still under research. Even though genes and brain areas might have a link with development of PTSD, there are many environmental factors such as childhood trauma, history of mental illness, or a head injury can also go on to affect the development of PTSD. A study by Bremmer (1993) when on to look at the relation of combat related PTSD with childhood trauma. The study revealed that the persons who were seeking treatment for combat linked PTSD had increased rates of childhood violence, as opposed to the veterans who were not diagnosed with PTSD.

Signs and Symptoms.

It is normal to feel sad or frightened after a traumatic experience. The normal person does, however, learn to move on with life. Despite going through the awful experience, he learns how to see things positively and does not stay stuck with a constant feeling of pain and danger at all times. The symptoms of PTSD are primarily divided into the re-experiencing the traumatic event, avoiding reminders of trauma and increased anxiety and emotional arousal.

As the name suggests, the re-experiencing symptoms are such that the person feels that he is reliving the trauma and over again. He feels the same feelings like sweating or increased heart rate like he did at the time of trauma. Even though the person might not be hallucinating, he relives that trauma in his dreams. Therefore, bad dreams are very common occurrence in PTSD. In the case of war veterans, this could mean that they witness shootings or their bunk mates dying over and over again. These people do want to forget the horrific images that they saw, but they keep dreaming about it and seeing them again. The person's thoughts are also filled with the same thoughts and images that he saw during the trauma. A very important point here is that there are always certain objects or situations that go on to remind the person of the traumatic event. Therefore, these triggers can also cause the re-experiencing symptoms.

Avoidance of symptoms basically means that the person himself tries to stay away from the events, objects or places that remind him of the experience. A veteran might not want to see his uniform ever again. The same person who used to enjoy watching movies with shootings and violence might totally avoid them after the trauma. The person might also feel emotionally numb. Having strong feelings of depression or guilt are another symptom of PTSD....

Hyperarousal symptoms are always present in the person. The person would get easily startled and would feel very tense or worried at all times. A very important symptom is that the person would have trouble sleeping, eating or concentrating on some other chore.
To be diagnosed with PTSD, a person should have at least one re-experiencing symptoms along with two hyperarousal and three avoidance symptoms for at least one month. All of these signs are to be diagnosed and confirmed with a psychologist or a psychiatrist. It should be known that all of these symptoms make everyday life very hard for the person. They cannot maintain healthy social relations and be happy. Moreover, these persons cannot go out work because their nerves take over their ability to concentrate and be a normal person.

Post Traumatic Stress in Veterans.

Even though Post traumatic stress disorder has been known for several years, its importance in relation to veterans was highlighted many folds after the Vietnam war. There were many lay and professional concerns seen in the veterans who returned from war. Recurrence of certain characteristics or symptoms in these veterans caused researchers to look deeply into this topic.

Kardiner (1941) went on to identify five different features that now come under the heading of post traumatic stress disorder. The most highlighted features in this disorder were fixation on the trauma, atypical dream life, irritability, startle pattern to an explosive, aggressive reaction (Kardiner, 1941) To further classify and explain these symptoms; Kardiner went on to relate all of these symptoms with possible experiences that must have been faced by the veterans. He emphasized that irritability is present because of exposure to auditory stimuli. The major emphasis was that auditory stimuli went on to start a reflex that was followed by fright or even violence at times. A very common thing that he noticed was that these sufferers were also sensitive to other stimuli like same, light or unique physical characteristics that were similar to the original trauma that took place.

Kardiner went on to emphasized that PTSD damaged the person's adaptive capacity. Normally, any person in the army is very strong both physically and emotionally. They are trained to build up their stamina and keep their nerves strong under tough times. However, PTSD is said to be a physiological and psychological disorder that complete takes over a person's ability to fight.

The main reason why veterans are at a greater risk of developing PTSD more than the civilians is that they return from actual life and death situations, where they are surrounded by horror and error, to the daily life activities that seem quite pointless and mundane to them. They keep on feeling that the people around them do not understand the intensity of the situation and they can only share their feelings with other military veterans. It will not be wrong to say that if veterans think that way, they have a reason to do so. It is a very common example to note that even the spouses of these combat veterans do not understand, or even try to understand, why they are acting or behaving in this way. This is the reason why the veterans develop feelings of alienation of time and they consider themselves as being 'different' from other people. When the situation further aggravates, it leads to the isolation of the veterans and worsening of the symptoms of PTSD.

Another reason why veterans are at a higher risk of developing PTSD is that they have experienced the feeling of killing someone and having someone who wants to and tries to kill them. At a very young age, these men lose their trust and innocence. These people are used to surviving by watching their backs the entire time. When they return to their homes, they find it really hard to sit among people in the middle of a room. They feel quite uncomfortable amidst crowds and they always feel like their life is threatened. Because of this paranoia, persistent anxiety and decreased trust of others, the veterans tend to stay lonely. When they are lonely, the symptoms of PTSD tend to become even more severe.

There is a great deal of guilt and self-blame associated with combat, which is another trigger factor for the development of PTSD or the worsening of its symptoms. These people lose some of their very dear friends in the battle. They understand the nature of the jobs and also know that they have been trained for the war situation. They are…

Sources used in this document:
References:

Douglas, J. (1993). Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans. Am J. Psychiatry, 150 235 -- 239.

Fekete, J. (2013). Military's 'stiff upper lip' attitude over PTSD needs to stop, Governor-General David Johnston says. [online] Retrieved from: http://news.nationalpost.com/2013/12/12/militarys-stiff-upper-lip-attitude-over-ptsd-needs-to-stop-governor-general-david-johnston-says / [Accessed: 16 Dec 2013].

Kardiner, A. (1941). The traumatic neuroses of war.. Psychosomat Med Mono, 11 (111).
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