Posttraumatic stress disorder or PTSD doesn’t just affect American veterans following military service, but this population tends to be most significantly affected by this mental health condition, leaving invisible wounds. 

PTSD treatment for veterans has to take into the unique elements of their experiences. Trauma-informed treatment can happen in a wide range of settings, but it’s a unique approach to mental health care that may help heal the unseen wounds of veterans. 

What is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder or PTSD is a psychiatric disorder. The disorder affects people who have witnessed or experienced a traumatic event. Along with war or combat, traumatic events triggering PTSD can include natural disasters, terrorist attacks, rapes, serious injury, sexual violence, or the threat of violence.

During World War I, PTSD was known as shell shock. After World War II, the name combat fatigue came about, but PTSD can affect anyone, not just combat and military veterans. 

An estimated 3.5% of U.S. adults are affected by PTSD every year. Around one in 11 people will receive a diagnosis at some point in their lifetime, with women having the disorder twice as often as men.

The symptoms of PTSD broadly fall into four groups:

• Intrusive symptoms include repeated and involuntary memories, flashbacks, and distressing dreams. Flashbacks may be so vivid that a person feels like they’re reliving their traumatic experience.
• Avoidance symptoms might include keeping away from people, places, things, activities, or situations that could potentially trigger a distressing memory. Someone with PTSD may avoid discussing the event or their feelings.
• Mood and cognitive alterations include problems remembering certain aspects of the event, negative thoughts and feelings, distorted beliefs about oneself or the world, or loss of interest in things previously enjoyed. Other symptoms in this category can include feeling detached from other people or not being able to experience positive emotions like happiness.
• The fourth category of symptoms is arousal and reactive such as irritation, outbursts of anger, self-destructive behavior, or reckless behavior. Someone might experience suicidal ideation and other severe PTSD symptoms related to being reactive or self-destructive. 

So what causes PTSD? 

Your nervous system has two ways to respond to stress.

The first is mobilization, also known as fight-or-flight. This occurs when you are in a situation and need to survive the danger, such as when you’re in combat. Your blood pressure rises, muscles tense, and your heart pounds quickly. After the danger passes, your nervous system calms back down.

Immobilization occurs when you experience too high of a stress level in a situation. Even once the immediate danger passes, you may still feel stuck. You can’t move on from the event and are in a state of imbalance.

PTSD in Veterans

People who serve in the military experience exposure to many different types of trauma that other people will likely never go through. When you’re a combat veteran, you’re especially likely to experience trauma during your war zone deployment. Other causes include training accidents and military sexual trauma (MST), primarily affecting female veterans, according to the National Center for PTSD. 

• People who have difficulty readjusting to civilian life outside of the military may have PTSD. 
• Veterans may feel like they’re always on edge or on the verge of exploding. 
• Conversely, some veterans with post-traumatic stress disorder may feel emotionally disconnected from their loved ones and numb emotionally.
• Not every veteran will experience PTSD, and researchers don’t necessarily know why some will, but they have some theories. The number of tours a veteran goes through and the amount of their exposure to combat are risk factors, for example.
• Some veterans have co-occurring disorders like traumatic brain injury and combat-related PTSD. 

PTSD Treatment Options for Veterans

So what PTSD treatment for veterans is available? The U.S. Department of Veterans Affairs (VA) does have some treatment programs available, but the wait times are often long if you qualify for care through the Department’s medical centers. 

There are also options outside of the VA to receive evidence-based treatments for military veterans.  

First, a doctor must determine a diagnosis to determine the most effective treatments. Someone experiencing symptoms will likely undergo a physical exam and a psychological evaluation. The criteria used for a diagnosis are in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which the American Psychiatric Association publishes.

Then, once someone has a diagnosis, the goals of treatment options include:

• Learning skills to address symptoms
• Helping to think more positively about oneself and the world
• Learning how to cope if symptoms happen again
• Treating any other problems that might relate to trauma, like anxiety, depression, or substance abuse

Talk Therapy

Talk therapy, also known as psychotherapy, is a core part of veterans’ mental health treatment and clinical care.

The particular types of talk therapy that are helpful for trauma include:

• Cognitive processing therapy—in this form of therapy, you learn the cognitive patterns keeping you stuck so you can overcome persistent symptoms. 
• Exposure therapy—for PTSD, this type of treatment is often used along with cognitive therapy. Exposure therapy is a form of behavioral therapy where you face situations and memories in a safe environment so you can learn how to cope with them. Symptoms it is especially helpful for include nightmares and flashbacks.
• Eye movement desensitization and reprocessing (EDMR)—this type of therapy combines prolonged exposure therapy, and participants do a series of guided eye movements. During therapy sessions, you process traumatic memories and change your reactions.

Some programs might also include family therapy because of the significant impact of post-traumatic stress disorder and combat-related PTSD on loved ones. 

Medications

Different medicines help with PTSD symptoms and tend to be most effective when used with talk therapy.

Antidepressants are a class of medicines that can help with not only depression but also anxiety. Selective serotonin reuptake inhibitors (SSRIs) like Zoloft and Paxil have FDA approval for the treatment of PTSD.

Some short-term anxiety medicines may be helpful, and there’s also a medicine called prazosin that’s sometimes used to help with nightmares.

Lifestyle Changes

There are many supportive steps someone with PTSD can take in their life to improve the results from therapy and medication.

Following your treatment plan and learning about PTSD can help empower you. You must take the time to care for yourself physically and mentally through diet, exercise, and relaxation.

Staying connected to people who care and love you and talking about your feelings is also important.

Many veterans with military-related PTSD find that participating in support groups improves their quality of life, particularly along with mental health services. 

PTSD Residential Treatment Programs for Veterans

Residential treatment might be appropriate in some cases, particularly when someone is experiencing PTSD along with a co-occurring substance use disorder. 

In PTSD residential treatment programs for veterans, dual diagnosis treatment is available for both the underlying mental illness and the addiction. Some veterans need a specialized program because they struggle with PTSD, addiction, and other disorders like anxiety. 

The benefit of inpatient treatment in a residential program is that it’s carefully managed, a calm, supportive environment, and veterans can be around other people with similar experiences to their own.

If you’d like to learn more about PTSD treatment for veterans in Southern California, please connect with the Story Wellness team today by calling (866) 476-2823.