Post-Traumatic Stress

Post-Traumatic Stress Disorder, or PTSD, is an anxiety disorder that can occur when an individual has experienced a terrifying ordeal or event. This experience could occur during military combat, a natural disaster, serious accident, or a violent personal assault. People with PTSD often relive the experience through nightmares and flashbacks.

Some individuals may detach to avoid reminders of the traumatic event. They may in turn end up feeling disconnected or estranged from family and friends.

What are some of the symptoms of PTSD?

It’s important to know the signs of PTSD so treatment can begin as soon as possible. Symptoms can be severe and can make daily life difficult.

Individuals may experience:

  • difficulty sleeping
  • trouble concentrating
  • irritability
  • feeling tense or on guard at all times
  • Restlessness or irritability

PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, alcohol or drug abuse, or any number of other mental health problems. PTSD is also associated with low functioning in social or family groups, including job instability, and marital or parenting issues.

FAQs

Post-Traumatic Stress Disorder (PTSD) is a disorder that can occur following exposure to actual or threatened death, serious injury, or sexual violence[i]. Examples of such events include military combat, natural disasters, terrorist incidents, serious accidents, abuse (sexual, physical, emotional, ritual), and violent personal assaults, like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, avoid reminders of the traumatic event, and feel detached or estranged. Individuals can also have difficulty sleeping and concentrating, feel irritable and constantly on guard, and may be easily startled. Symptoms can be severe and last long enough to significantly impair an individual’s daily life. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, alcohol or other substance abuse. The disorder is also associated with impairment of an individual’s ability to function in social or family settings, including job instability, marital, and family problems.

An estimated 7.7 million American adults (about 3.5 %) have PTSD in a given year[ii]. About 30 percent of Vietnam veterans developed PTSD at some point following the war[iii]. The disorder has been detected among veterans of the Persian Gulf War, with some estimates running as high as 8 percent[iv]. A recent survey found that 15.6 to 17.1% of service members met screening criteria for Posttraumatic Stress Disorder after duty in Iraq4.

In general, exposure therapy and cognitive restructuring are among the most effective treatments for PTSD[v]. Antidepressant medication can be beneficial in the treatment of PTSD, specifically two groups of antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)[vi]. Individual body chemistries are unique. One antidepressant medication does not fit all. One class of antidepressant may be more effective than another. Therefore, an individual may need to test several different medications before finding the one that works best. While antianxiety medications can help reduce anxiety symptoms and improve sleep, be aware that benzodiazepines (a type of antianxiety medication) can lead to dependence problems, so it is important to work closely with your provider to make sure that a medication and dosage is right for you.

If you are a veteran you can contact your local VA Hospital, call the VA Health Benefits Service Center toll free at 1-877-222-VETS, or visitSpecialized PTSD Treatment Programs in the U.S. Department of Veterans Affairs online. Web links and telephone numbers for the following organizations with referral capabilities include: Association for the Advancement of Behavior Therapy, 212-647-1890; Anxiety Disorders Association of America, 240-485-1001; and American Psychological Association, 1-800-964-2000.

Your primary care doctor may be able to prescribe medications for PTSD symptoms. You can discuss drug therapies with your physician during your general medical appointment. An excellent resource is available to help lead a discussion with your physician entitled Discussing Trauma and PTSD with Your Doctor.

There are also a number of steps you can take on your own to address your PTSD symptoms. Check out the self-help tools offered on this site. Finally, not all help needs to be provided by a medical professional. Sometimes family, friends, or clergy can be excellent sources of support.

References:

This was modified from the National Center for PTSD FAQ and the National Institute of Mental Health, What is Post-Traumatic Stress Disorder or PTSD?


[i] American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. Washington, DC: American Psychiatric Association.

[ii] National Institutes of Health (NIH), The Numbers Count: Mental Disorders in America Accessed 11/26/13

[iii] Kulka RA, Schlenger WE, Fairbank JA, et al. Contractual report of findings from the National Vietnam veterans readjustment study . Research Triangle Park, NC : Research Triangle Institute, 1988.

[iv] Hoge, C.W., Castro, C.A., Messer, S.C., McGurk, D., Cotting, D.I., & Koffman, R.L. (2004). Combat duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care. The New England Journal of Medicine, 351, 13-22.

[v] Foa, E. B., Keane, T. M., & Friedman, M. J. (Eds.) (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. New York : Guilford .

[vi] Veterans Health Administration, Department of Defense. VA/DoD clinical practice guideline for the management of post-traumatic stress. Version 2.0. Washington ( DC ): Veterans Health Administration, Department of Defense; 2010

TBI Resources

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
The mission of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, or DCoE, is to improve the lives of our nation’s Service members, Veterans and their families by advancing excellence in psychological health and traumatic brain injury prevention and care.

Defense and Veterans Brain Injury Center
This resource is specific for veterans and good info for family members.

Traumatic Brain Injury
Helpful information for caregivers.

The Brain Injury Association of America
(BIAA) is the country’s oldest and largest nationwide brain injury advocacy organization.

National Association of State Head Injury Administrators
This website is useful for researching resources from State grants, research and veteran’s resources.

Professional Help

Community Resources

Association for the Advancement of Behavior Therapy – Find a Therapist
or call 1-212-647-1890.

American Psychological Association – Find a Psychologist
or call 1-800-964-2000.

National Association of Social Workers – Search Clinical Register

Locate a Psychiatrist, call toll-free 1-888-35-PSYCH. Outside the U.S. and Canada call 1-703-907-7300.

Vet Center Counseling Services

Self-Help Resources

PTSD information and tools are organized here, with links additional resources. Individuals being treated for PTSD may also be struggling with depression, substance abuse, anger management issues, or any number of other physical and/or mental health conditions. You may find the self-help information posted under other behavioral health categories on this web site to be helpful.

Fact Sheets and Handouts

A Guide for Families of Wounded Soldiers

Seeking Help for PTSD — Getting Motivated
The symptoms and problems associated with PTSD can interfere with a person’s life and become difficult to manage. Turning to someone for help is the first step in addressing the impact of PTSD in your life.

Coping with PTSD and Recommended Lifestyle Changes
When a trauma survivor takes direct action to cope with problems, he or she often gains a sense of personal power and control.

War-Zone Related Stress Reactions: What Families Need to Know
Military personnel in war zones frequently have serious reactions to their traumatic war experiences. Sometimes the reactions continue after they return home. Read how traumatic stress reactions can affect families.

Help for Veterans with PTSD
Answers to service-connected disability and PTSD questions that are frequently asked by Veterans and their families along with Veterans resources.

PTSD and the Family
Because the symptoms of PTSD and other trauma reactions change how a trauma survivor feels and acts, traumatic experiences that happen to one member of a family can affect everyone else in the family.

How Does Trauma Affect Relationships?
Trauma survivors with PTSD often experience problems in their intimate and family relationships or close friendships. PTSD involves symptoms that interfere with trust, emotional closeness,communication, responsible assertiveness, and effective problem solving.

Videos

National Center for PTSD Videos
Video presentations can be downloaded from the National Center from PTSD web site, including videos focused on the cultural impact of PTSD on veteran’s from different ethnic groups.

Books & Workbooks

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms
M.B. Williams & S. Poijula

This workbook provides information about PTSD, self-administered assessments, self-help techniques for coping with PTSD, and references to additional resources. The workbook is not specificto combat-related trauma, but it is relevant for combat-related trauma. It costs about $18 new, but used copies of the workbook can be obtained for a reduced price.

Reclaiming Your Life After Rape
B.O. Rothbaum & E.B. Foa

This is a workbook designed for patients who have been victims of sexual trauma. It costs about $23 new, but used copies of the workbook may be obtained for a reduced price.

PTSD Web Resources

National Center for PTSD

Military OneSource

Defense Centers of Excellence
Questions about traumatic brain injury, post-traumatic stress disorder, or other psychological health issues. The DCoE establishes quality standards for: clinical care; education and training; prevention; patient, family and community outreach; and program excellence.

24/7 Help from DCoE 1-866-966-1020

Resources for Returning Veterans
Department of Veterans Affairs

Real Warriors Campaign
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury

Other Helpful Resources

Mental Health Self Assessment Program
Screening for Mental Health, Inc.
At the end of each anonymous screening you will receive results that can be printed and shared with your doctor or other trusted clinician. While this screening tool is not a substitute for a complete evaluation, it can help you identify symptoms that are consistent with depression, and learn how to access help. This assessment tool is designed for individuals aged 17 and older. To access the anonymous telephone assessment, call MHSA’s toll-free number at 1-877-877-3647.

Veteran and Military Family Health
U.S. National Library of Medicine and the National Institute of Health

Drug Therapy and PTSD

Antidepressant medication can be beneficial in the treatment of PTSD, and antianxiety medications can help reduce anxiety symptoms and improve sleep. Individual body chemistries are unique. One antidepressant medication does not fit all. One class of antidepressant may be more effective over another. Therefore, an individual may need to test a couple of different medications before finding the one that works best. While antianxiety medications can help reduce anxiety symptoms and improve sleep, be aware that benzodiazepines (a category of antianxiety medication) can lead to dependence problems, so it is important to work closely with your provider to make sure that a medication and dosage is right for you.

Counseling Services and Resources

Counseling services available through the installation are free to service members and DoD civilian personnel designated as Civilian Expeditionary Workforce and their family members. More information on substance abuse treatment and prevention programs within each Service is available online on their respective websites: