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From Victim to Survivor: Reclaiming the Life That Was Never Theirs to Take

By John S. Collier, MSW, LCSW-S

There is a difference between being a victim and living permanently from the frame of mind of a victim.

If someone abused you, betrayed you, abandoned you, assaulted you, neglected you, manipulated you, or harmed you, you may have truly been a victim.

That is a fact.

Calling yourself a survivor does not change the facts. It does not make what happened smaller. It does not excuse the person who hurt you.

It changes something else.

It changes who gets to write the next chapter.

A victim asks:

“Look what they did to me.”

A survivor eventually learns to ask:

“What am I going to do with my life now?”

That may sound like a small difference.

It isn’t.

It may be one of the most important changes that happens during healing.

First, There Is No Shame in Being a Victim

Before talking about a “victim mindset,” we need to be extraordinarily careful with our words.

A person who has experienced trauma may feel afraid, angry, powerless, suspicious, overwhelmed, or emotionally numb. These responses should not automatically be interpreted as weakness or a character problem.

SAMHSA describes trauma as experiences that can have lasting effects on a person’s mental, physical, social, emotional, or spiritual well-being. It also emphasizes that people respond to traumatic experiences differently. Strong support and resilient qualities can influence how someone responds. Likewise, the American Psychological Association recognizes that trauma can have long-lasting psychological and physical consequences, including PTSD, depression, anxiety, sleep problems, dissociation, and other difficulties. So when someone has been badly hurt, telling them to “stop acting like a victim” can be cruel and clinically misguided.

There are times when surviving is enough.

Getting through the day is enough.

Staying safe is enough.

Getting out of bed is enough.

But there may eventually come a point when survival asks something more of us.

The question changes from:

“What happened to me?”

to:

“What happens next?”

The Victim Frame of Mind

The victim frame of mind is not simply sadness about something painful.

It occurs when the injury becomes the lens through which a person begins interpreting much of life.

Something terrible happened to me.

Therefore:

  • I am powerless.
  • People cannot be trusted.
  • My life will always be this way.
  • There is nothing I can do.
  • Someone else must change before I can heal.
  • My past determines my future.
  • What was taken from me can never be rebuilt.
  • Because I was hurt, I will always be broken.

These beliefs are understandable after trauma.

But understandable does not necessarily mean helpful forever.

One particularly important example is avoidance. VA National Center for PTSD explains that wanting to avoid reminders of trauma is common, but relying heavily on avoidance can worsen PTSD symptoms and make moving forward more difficult. A coping strategy that once helped you survive can eventually become the wall preventing you from living.

That is one of trauma’s cruel contradictions.

The Survivor Frame of Mind

The survivor does not pretend the wound never happened.

The survivor learns to carry the scar without allowing the scar to become an identity.

The survivor can say:

Yes, that happened.

Yes, it hurt me.

Yes, I have wounds from it.

No, it was not fair.

No, I did not deserve it.

And yes, I still have a life to live.

Research on resilience after trauma examines precisely this question: how people adapt following profoundly difficult experiences and how resilience can be fostered after trauma. Survival is therefore not denial.

It is not saying:

“It didn’t hurt.”

It is saying:

“It hurt, and I am still here.”

Victim Thinking Says, “They Have the Power.”

Survivor thinking says:

“I have choices.”

Perhaps you could not choose what happened.

You can choose what you do today.

You can choose whether to ask for help.

You can choose your boundaries.

You can choose whom you allow close to you.

You can choose whether to continue treatment.

You can choose whether the people who wounded your past are permitted to control your future.

Trauma-informed care itself recognizes the importance of safety, trust, collaboration, empowerment, voice, and choice in recovery. SAMHSA identifies these ideas among the central principles of trauma-informed approaches. That word matters:

Choice.

Trauma frequently involves losing control.

Recovery often involves discovering where control still exists.

“Why Did This Happen to Me?”

Nearly everyone who has suffered deeply has asked some version of this question.

Why me?

Why did they do it?

Why didn’t someone protect me?

Why didn’t I see it?

Why didn’t I leave sooner?

Why didn’t anyone believe me?

Those questions deserve compassion.

But there is another question that can eventually become more useful:

“Given that this happened, who do I want to become now?”

That question cannot rewrite yesterday.

It can begin changing tomorrow.

Survivors Learn the Difference Between Responsibility and Blame

This may be the hardest concept in the entire journey.

You are not necessarily responsible for what happened to you.

But you eventually become responsible for what you do with what happened to you.

Those are completely different statements.

If someone injured you, responsibility for that action belongs to that person.

Healing belongs to you.

That may feel terribly unfair.

It often is.

Sometimes another person creates the wound while you are left doing the work of repairing it.

But refusing to heal until the person who hurt you makes everything right can leave your future tied to the very person who harmed your past.

Your healing does not need their permission.

Your recovery does not require their understanding.

Your future does not require their apology.

Accountability matters. Justice matters. Acknowledgment matters. In fact, the American Psychological Association recognizes the potential importance of acknowledgment, apology, redress, and restitution in trauma recovery. But your life cannot always remain suspended while waiting for those things.

How Do You Become the Survivor?

There is no switch that suddenly changes someone from victim to survivor.

Healing tends to be a process.

Some days you may feel strong.

The next day, something may trigger an old wound and make you feel as though you have gone backward.

You haven’t necessarily failed.

Here are several places to begin.

1. Tell the Truth About What Happened

Survivorship doesn’t begin by minimizing the past.

It begins with truth.

It happened.

It hurt.

It affected me.

You do not have to defend the person who hurt you.

You do not have to rewrite history to make other people comfortable.

Healing requires honesty.

And sometimes that honesty needs to happen with a qualified mental health professional rather than alone.

2. Stop Making the Wound Your Identity

Notice the enormous difference between these statements:

“I experienced abuse.”

and

“I am damaged.”

Or:

“Someone betrayed me.”

and

“I am unlovable.”

An event is not an identity.

Trauma can influence identity development, and researchers continue to study the relationship between trauma exposure and identity. What happened may always be part of your story.

It does not have to become your entire definition.

You are more than the worst thing someone ever did to you.

3. Identify What You Still Control

Take a sheet of paper and make two columns.

I Cannot Control

  • What happened yesterday
  • What another person thinks
  • Whether someone admits wrongdoing
  • Whether someone apologizes
  • Whether everyone understands my story
  • Another person’s choices

I Can Influence or Control

  • What I do today
  • Whether I ask for help
  • My boundaries
  • Many of my daily choices
  • Whose advice I seek
  • Whether I participate in treatment
  • How I respond when old patterns appear
  • What kind of person I am trying to become

Spend less energy fighting the first list.

Invest more energy in the second.

That is where your power lives.

4. Recognize Avoidance

Avoidance can feel like safety.

Sometimes it is appropriate to avoid genuine danger. But avoiding every thought, emotion, place, relationship, or reminder associated with what happened is different.

The VA National Center for PTSD notes that emotional and behavioral avoidance can interfere with recovery and that effective PTSD treatments can help people learn to cope with trauma-related thoughts and feelings. The U.S. Department of Veterans Affairs has similarly developed recovery materials specifically focused on identifying problematic avoidance behaviors and gradually changing behaviors that keep people stuck in trauma recovery. Courage does not mean never being afraid.

Sometimes courage is simply deciding:

“Fear is present, but fear is no longer making every decision.”

5. Build Boundaries Instead of Walls

Trauma may teach:

Never trust anybody again.

Healing teaches something more sophisticated:

Learn who has earned your trust.

A wall keeps everyone outside.

A boundary has a gate.

A survivor learns when to open it, when to close it, and who receives a key.

6. Allow Yourself to Receive Help

Being a survivor does not mean doing everything alone.

Actually, refusing every form of help can sometimes keep people isolated.

SAMHSA emphasizes safety, peer support, trust, collaboration, and empowerment as important elements within trauma-informed approaches. Help may include professional counseling, trusted friends and family, support groups, medical care, community resources, or spiritual support according to your beliefs and circumstances.

Strength isn’t proving that you need nobody.

Sometimes strength is finally admitting:

“I don’t have to carry all of this by myself.”

7. Give Yourself Permission to Have a Future

Trauma keeps pulling the mind backward.

Healing gradually teaches it to look forward again.

Make plans.

Set a goal.

Learn something.

Build something.

Reconnect carefully.

Create new routines.

Find something meaningful enough that tomorrow becomes more than another day spent thinking about yesterday.

This does not dishonor what happened.

It demonstrates that what happened did not win.

Forgiveness Is Not the Price of Admission

People are sometimes told that they cannot heal unless they forgive the person who hurt them.

I would be careful with that message.

Forgiveness may be deeply meaningful for some people, especially within their spiritual beliefs. But forgiveness should not be confused with denying harm, restoring an unsafe relationship, abandoning boundaries, or removing accountability.

You can heal while still saying:

“What you did was wrong.”

You can move forward without pretending it never happened.

You can have compassion and boundaries at the same time.

Survival Is Not Becoming Who You Were Before

Perhaps this is where we sometimes misunderstand recovery.

After something profound happens, you may never become exactly the person you were before.

That doesn’t automatically mean something has been lost forever.

Perhaps the goal isn’t to go backward.

Perhaps it is to move forward.

Wiser.

More discerning.

More compassionate.

Better acquainted with your boundaries.

More aware of your strength.

More intentional about the life you build.

Resilience research has increasingly examined not merely whether people endure trauma, but how resilience may be fostered following it. The goal isn’t to become untouched.

It is to become unowned by what touched you.

The Day You Become a Survivor

There may never be a ceremony.

Nobody hands you a certificate.

You probably won’t wake up one morning completely free from every painful memory.

Instead, the transformation may happen quietly.

One day you realize you haven’t thought about it for several hours.

Then perhaps an entire day.

You recognize a trigger and choose a different response.

You establish a boundary you once believed you couldn’t establish.

You stop explaining yourself to somebody committed to misunderstanding you.

You ask for help.

You laugh again without feeling guilty.

You make plans.

You love again.

You hope again.

And somewhere along the way, your vocabulary changes.

You stop saying:

“This is who I am because of what they did.”

And begin saying:

“This is who I am becoming despite what happened.”

That is the difference.

The victim’s story is centered around what was done.

The survivor’s story acknowledges what was done but slowly turns toward what comes next.

Conclusion: Take Back the Pen

You cannot erase pages that have already been written.

Some pages may contain things you wish had never happened.

Some contain loss.

Others contain betrayal, fear, grief, humiliation, abandonment, or pain.

There is no wisdom in pretending those pages aren’t there.

Read them when you need to.

Grieve them.

Talk about them.

Learn from them.

Get professional help working through them when necessary.

But eventually, remember something extraordinarily important:

There are blank pages after them.

And those pages still belong to you.

Being a survivor does not mean saying, “It didn’t hurt me.”

It means being able to say:

“It hurt me. It changed me. There were days when I didn’t know whether I could carry it anymore. But I am still here, and what happened to me will not be given the authority to decide everything that happens next.”

You didn’t choose every chapter.

But you can still take back the pen.

About the Author

John S. Collier, MSW, LCSW-S

John S. Collier is a Licensed Clinical Social Worker Supervisor and the Executive Director of Southeast Kentucky Behavioral Health, LLC. His career in social work and behavioral health has included years of work with individuals and families experiencing mental health concerns, trauma, behavioral challenges, relationship difficulties, developmental disabilities, and complicated life transitions.

He earned his bachelor’s degree and became a Certified Social Worker in 2004 before continuing his education and professional development in clinical social work. He became a Licensed Clinical Social Worker in 2010 and later earned the credential of Licensed Clinical Social Worker Supervisor.

As Executive Director of Southeast Kentucky Behavioral Health, Collier works in behavioral health leadership, clinical services, organizational development, community-based behavioral supports, and advocacy for individuals and families throughout southeastern Kentucky.

He is also the author of The Mind’s Trestle Board, where he writes about mental health, relationships, masculinity, family, morality, personal responsibility, faith, emotional growth, and the difficult process of becoming a better version of ourselves. His writing often draws from the intersection of clinical experience, human behavior, personal reflection, and the belief that people should never be reduced to the worst moment of their lives.

References

American Psychological Association. (2024). Individual, collective, and intergenerational trauma recovery: Considering the restorative roles of restitution and reparations.

American Psychological Association. Nugent, N. R., Sumner, J. A., & Amstadter, A. B. (2014). Resilience after trauma: From surviving to thriving. European Journal of Psychotraumatology, 5.

PubMed Central. Substance Abuse and Mental Health Services Administration. (2026). Trauma and violence: What is trauma and its effects? SAMHSA.

Substance Abuse and Mental Health Services Administration. (2023). Practical guide for implementing a trauma-informed approach. SAMHSA.

Truskauskaite-Kuneviciene, I., Brailovskaia, J., Kamite, Y., Petrauskaite, G., Margraf, J., & Kazlauskas, E. (2020). Does trauma shape identity? Exploring the links between lifetime trauma exposure and identity status in emerging adulthood. Frontiers in Psychology, 11, 570644.

PubMed Central. U.S. Department of Veterans Affairs, National Center for PTSD. (2026). Avoidance. National Center for PTSD. U.S. Department of Veterans Affairs, South Central MIRECC. (2022). An active approach to recovering from trauma: Breaking the cycle of safety aids and avoidance. U.S. Department of Veterans Affairs.

Are There Different Kinds of Trauma?

Trauma is often spoken about as a single experience, yet psychological research and clinical practice show that trauma is not one-size-fits-all. Individuals may experience different types of trauma, each with distinct causes, symptom patterns, and treatment considerations. Understanding these differences is essential for accurate assessment, compassionate care, and effective intervention.

What Is Trauma?

Trauma refers to an emotional, psychological, or physiological response to an event (or series of events) that is perceived as deeply distressing or threatening. According to the DSM-5-TR, trauma typically involves exposure to actual or threatened death, serious injury, or sexual violence, either directly, indirectly, or through repeated exposure (APA, 2022). However, clinicians also recognize that trauma can arise from experiences that overwhelm an individual’s capacity to cope, even if they fall outside strict diagnostic definitions.

Major Categories of Trauma

1. Acute Trauma

Acute trauma results from a single, time-limited event such as:

Car accidents Natural disasters Assault Sudden medical emergencies

Common reactions may include shock, anxiety, intrusive memories, sleep disturbance, and hypervigilance (Bryant, 2019).

2. Chronic Trauma

Chronic trauma involves repeated and prolonged exposure to distressing events, including:

Ongoing domestic violence Long-term child abuse Persistent bullying Living in unsafe environments

Chronic trauma often leads to more complex emotional and relational difficulties due to sustained stress activation (Courtois & Ford, 2013).

3. Complex Trauma

Complex trauma typically arises from multiple, interpersonal, and invasive traumatic experiences, often during childhood. Examples include:

Emotional, physical, or sexual abuse Severe neglect Attachment disruptions

Complex trauma is associated with difficulties in emotional regulation, self-identity, trust, and interpersonal functioning (van der Kolk, 2005).

4. Developmental Trauma

Developmental trauma refers to trauma that occurs during critical developmental stages, affecting brain development, attachment, and emotional regulation. Early adversity can alter stress-response systems and cognitive functioning (Teicher & Samson, 2016).

5. Secondary (Vicarious) Trauma

Secondary trauma affects individuals who are indirectly exposed to traumatic material, such as:

Therapists First responders Healthcare professionals Caregivers

Repeated exposure to others’ trauma can produce symptoms similar to PTSD (Figley, 1995).

6. Historical / Intergenerational Trauma

Historical trauma describes the cumulative emotional harm across generations, often linked to systemic oppression, colonization, war, or cultural displacement (Brave Heart, 2003).

7. Collective Trauma

Collective trauma impacts entire communities or societies, such as during:

Pandemics Terrorist attacks Wars Large-scale disasters

These events disrupt social stability and shared sense of safety (Erikson, 1976).

Trauma Can Also Differ by Source

Trauma may vary depending on the nature of the event:

Interpersonal trauma (abuse, assault, betrayal) Medical trauma (invasive procedures, life-threatening diagnoses) Combat trauma Sexual trauma Grief-related trauma

Each source may shape how symptoms emerge and how treatment is approached.

Why Distinguishing Trauma Types Matters

Different trauma experiences may produce overlapping yet distinct effects:

Domain Affected

Possible Impact

Emotional

Anxiety, depression, mood swings

Cognitive

Intrusive thoughts, memory problems

Physiological

Sleep disruption, hyperarousal

Relational

Trust issues, attachment difficulties

Behavioral

Avoidance, substance use

For example, acute trauma may produce short-term stress reactions, while complex trauma may contribute to long-standing difficulties with identity, boundaries, and emotional regulation (Cloitre et al., 2019).

Healing and Treatment Implications

Effective trauma treatment often includes:

Trauma-focused CBT EMDR Somatic therapies Attachment-based approaches Psychoeducation Nervous system regulation

Treatment planning should consider type, duration, developmental timing, and individual resilience factors (SAMHSA, 2014).

Conclusion

Yes — there are different kinds of trauma, and recognizing these distinctions helps clinicians, caregivers, and individuals better understand the wide range of trauma responses. Trauma is defined not only by the event itself but by how it affects the mind, body, and sense of safety. With appropriate support and evidence-based care, recovery is possible.

About the Author

John S. Collier, MSW, LCSW, is a behavioral health therapist and clinical professional dedicated to helping individuals understand emotional distress, trauma, and pathways to healing. His work focuses on translating psychological concepts into practical, compassionate guidance for everyday life.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR).

Brave Heart, M. Y. H. (2003). The historical trauma response among natives. Journal of Psychoactive Drugs, 35(1), 7–13.

Bryant, R. A. (2019). Acute stress disorder. Current Opinion in Psychology, 29, 127–131.

Cloitre, M., et al. (2019). Complex PTSD and emotion regulation. European Journal of Psychotraumatology, 10(1).

Courtois, C. A., & Ford, J. D. (2013). Treatment of Complex Trauma. Guilford Press.

Erikson, K. (1976). Everything in Its Path. Simon & Schuster.

Figley, C. R. (1995). Compassion fatigue. Brunner/Mazel.

SAMHSA. (2014). Trauma-Informed Care in Behavioral Health Services.

Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse. Journal of Child Psychology and Psychiatry, 57(3), 241–266.

van der Kolk, B. A. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408

How Trauma Changes the Brain: What You Need to Know

Trauma, whether it’s from a physical injury or an emotional experience, can have a lasting impact on the brain. Thanks to research in neuroscience, we now know that trauma doesn’t just affect how we feel—it actually changes how the brain works. Understanding these changes can help us see why trauma has such powerful effects and how recovery is possible.

What Happens to the Brain During Trauma?

When you go through a traumatic event, your brain switches into “survival mode.” This is controlled by something called the stress response system, which prepares your body to deal with danger. You may have heard of the “fight, flight, or freeze” response. This is when stress hormones like cortisol and adrenaline flood your body, helping you react quickly to protect yourself.

This response is helpful in the short term, like when you need to escape danger. But if trauma is ongoing, or if your brain keeps thinking you’re in danger even after the threat is gone, this stress response can do more harm than good.

How Trauma Changes the Brain

Trauma can change how different parts of the brain work and even how they look. Here are the three key areas affected:

1. The Amygdala: The Alarm System

The amygdala is the part of your brain that helps detect threats and process emotions like fear. After trauma, the amygdala can become overactive, making you feel on edge or jumpy even when you’re safe. This is why people who’ve experienced trauma often feel anxious or have trouble calming down.

2. The Prefrontal Cortex: The Decision Maker

The prefrontal cortex is like the brain’s “control center.” It helps you think logically, make decisions, and calm down after a stressful event. Trauma can make this part of the brain less active, which means it’s harder to think clearly, control your emotions, or feel in control of your reactions.

3. The Hippocampus: The Memory Keeper

The hippocampus is responsible for organizing memories and distinguishing between the past and the present. Trauma can make the hippocampus shrink, which is why some people have trouble remembering details of the trauma or feel like they’re reliving it (flashbacks), even when it’s over.

Why Do These Changes Matter?

The changes in the brain after trauma explain many of the symptoms people experience, such as:

• Flashbacks or nightmares: The brain struggles to tell the difference between past and present, so it feels like the trauma is happening again.

• Anxiety or hypervigilance: The overactive amygdala keeps you constantly on the lookout for danger.

• Difficulty focusing or making decisions: A less active prefrontal cortex makes it harder to think clearly.

These changes also show why trauma doesn’t just “go away” on its own—your brain needs time and support to heal.

Can the Brain Heal After Trauma?

The good news is that the brain is adaptable. This ability to change and heal is called neuroplasticity. With the right support, the brain can recover from the effects of trauma. Here’s how:

1. Therapy: Treatments like trauma-focused cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) can help “rewire” the brain and reduce symptoms.

2. Mindfulness and relaxation techniques: Practices like meditation can help calm the amygdala and strengthen the prefrontal cortex.

3. Exercise: Physical activity can increase the size of the hippocampus and improve mood by releasing feel-good chemicals like endorphins.

Trauma changes the brain, but these changes don’t have to be permanent. Understanding how trauma affects the brain can help us be more compassionate toward ourselves and others who are struggling. With the right tools and support, healing is not only possible—it’s likely.

This article has been written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years experience in the social work field. He currently serves as the executive director in outpatient behavioral health therapist at Southeast Kentucky Behavioral health based out of London Kentucky. He may be reached by phone at 606-657-0532 extension 101 or by email at john@sckybh.com

References

• Shin, L. M., Rauch, S. L., & Pitman, R. K. (2006). Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Annals of the New York Academy of Sciences, 1071(1), 67-79.

• Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445-461.

• van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

Post-Traumatic Stress Disorder in Soldiers: Understanding, Effects, and Treatment

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that has long affected soldiers and military personnel, often impacting their lives in profound ways. According to the U.S. Department of Veterans Affairs, up to 20% of veterans who served in Iraq and Afghanistan experience PTSD, underscoring the prevalence of this condition among soldiers who endure the harsh realities of combat and warfare. This article explores the causes, symptoms, and effects of PTSD in soldiers, examines various treatment options, and discusses emerging approaches to care.

Causes of PTSD in Soldiers

PTSD is generally triggered by exposure to traumatic events. For soldiers, combat is a primary source of trauma, involving life-threatening situations, witnessing injury or death, and enduring extreme physical and emotional stress. Studies have found that prolonged and repeated exposure to combat conditions increases the risk of PTSD, particularly if soldiers are subjected to high levels of intensity and frequency of traumatic events (American Psychological Association, 2020). Further risk factors include military rank, training, and support systems, with enlisted personnel and those lacking robust support networks being more vulnerable (Gradus, 2023).

The severity of PTSD symptoms often varies based on the intensity and nature of the traumatic events experienced. For instance, individuals who encounter close combat situations or who witness the death of comrades are more likely to develop severe PTSD symptoms (Hoge et al., 2004).

Symptoms of PTSD in Soldiers

PTSD symptoms are generally grouped into four categories:

  1. Intrusive Thoughts: Soldiers with PTSD often experience unwanted, distressing memories or flashbacks of traumatic events, causing them to relive the traumatic moment repeatedly.
  2. Avoidance: Avoiding situations, people, or places that remind the individual of the trauma is a common coping mechanism. Soldiers might withdraw from social settings or avoid seeking help.
  3. Negative Changes in Thought and Mood: Symptoms may include persistent negative emotions, distorted beliefs about oneself or others, and a feeling of detachment from family and friends.
  4. Hyperarousal and Reactivity: PTSD often causes soldiers to experience heightened anxiety, irritability, or hypervigilance. They may have difficulty sleeping and feel constantly on edge (National Institute of Mental Health, 2021).

In military contexts, PTSD can lead to significant challenges in social and family relationships, making reintegration into civilian life difficult. Soldiers may experience guilt over actions taken or not taken in combat, known as moral injury, which exacerbates the symptoms of PTSD (Litz et al., 2009).

Effects of PTSD on Soldiers’ Lives

PTSD can have a severe impact on veterans’ physical, mental, and emotional well-being, with potential long-term consequences that affect not only the individual but also their families and communities. Some of the major effects include:

  • Depression and Anxiety: Soldiers with PTSD often experience comorbid depression and anxiety, which can further complicate their recovery. The stress and trauma they face in combat environments have lasting effects that increase susceptibility to these conditions.
  • Substance Abuse: To cope with symptoms, many veterans turn to alcohol or drugs, which often results in dependency issues. Research has shown that PTSD and substance use disorders are closely linked in military populations, with soldiers attempting to self-medicate to alleviate PTSD symptoms (Seal et al., 2011).
  • Suicidal Ideation and Attempts: PTSD is a significant risk factor for suicide among veterans, with some studies indicating that the risk of suicide is higher among those with PTSD than the general population (Kang et al., 2015).
  • Difficulties in Employment and Social Reintegration: Veterans with PTSD may struggle to find and maintain stable employment due to symptoms such as hyperarousal, anxiety, and avoidance, impacting their social and economic well-being. Reintegration challenges, compounded by stigmatization of mental health issues, further isolate veterans from support systems that could aid in their recovery.

Treatment Options for PTSD in Soldiers

A wide range of treatment options is available for soldiers with PTSD. The goal of these treatments is not only to alleviate symptoms but to enable veterans to lead fulfilling lives after service. Treatments can be broadly categorized into:

  1. Psychotherapy: Psychotherapy, particularly Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), are among the most effective treatments for PTSD. CBT helps patients process and alter their trauma-related thoughts and behaviors, while EMDR helps in processing traumatic memories by stimulating the brain’s natural healing process (Watkins et al., 2018).
  2. Pharmacotherapy: Antidepressants like selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for PTSD, as they help manage symptoms of anxiety and depression. Medication, however, is often used alongside psychotherapy rather than as a standalone treatment (VA/DoD Clinical Practice Guideline, 2017).
  3. Group Therapy and Support Groups: These provide veterans with a community that understands their experiences, fostering a support system that can help them cope with the effects of trauma. Research indicates that group therapy is particularly beneficial for soldiers, as it promotes shared understanding and mutual support (Browne et al., 2016).
  4. Emerging Treatments: New therapies, such as virtual reality exposure therapy (VRET) and MDMA-assisted psychotherapy, have shown promising results. VRET immerses patients in a controlled, simulated environment to help them confront and process traumatic experiences. MDMA-assisted therapy, under clinical investigation, has demonstrated significant reductions in PTSD symptoms in early trials (Mithoefer et al., 2018).

Challenges in Addressing PTSD in Military Contexts

Despite available treatments, several challenges remain in addressing PTSD among soldiers. A significant barrier is stigma—many military personnel fear seeking help for PTSD due to concerns about appearing weak or unfit for duty. Additionally, the military structure can sometimes be resistant to mental health care initiatives, emphasizing resilience and self-reliance over seeking assistance. Efforts are ongoing to destigmatize PTSD and encourage open discussions about mental health in military settings (Hoge et al., 2004).

Accessibility of mental health services is another issue. Many veterans live in rural areas with limited access to specialized PTSD treatments. Telemedicine has been identified as a potential solution, offering remote therapy sessions that improve access for veterans in underserved areas (Rosen et al., 2017).

Conclusion

PTSD remains a significant mental health concern for soldiers, with far-reaching impacts on individuals, families, and communities. The military context poses unique challenges for both the onset and treatment of PTSD, underscoring the need for continued research, awareness, and innovation in treatment options. By addressing stigma and improving access to mental health care, society can better support veterans in managing PTSD and lead them toward healthier, more fulfilling lives post-service.

This article was written by John S. Collier, MSW, LCSW. Mr. Collier has over 25 years of experience in the Social Work field. He currently serves as the Executive Director and Outpatient provider for Southeast Kentucky Behavioral Health based out of London Kentucky. He may be reached at (606) 657-0532 extension 101 or by email at john@sekybh.com

References

  • American Psychological Association. (2020). PTSD and the Military. Retrieved from APA.org.
  • Gradus, J. (2023). PTSD in Military Veterans. VA National Center for PTSD. Retrieved from PTSD.va.gov.
  • Hoge, C. W., et al. (2004). Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care. The New England Journal of Medicine, 351(1), 13-22.
  • Kang, H. K., et al. (2015). Association of PTSD with increased suicide risk among veterans. Journal of Military Medicine, 180(9), 982-989.
  • Litz, B. T., et al. (2009). Moral injury and moral repair in war veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29(8), 695-706.
  • Mithoefer, M. C., et al. (2018). MDMA-assisted psychotherapy for PTSD: A breakthrough therapy. Journal of Psychopharmacology, 32(1), 4-12.
  • National Institute of Mental Health. (2021). Post-Traumatic Stress Disorder. Retrieved from NIMH.nih.gov.
  • Rosen, C. S., et al. (2017). Telemedicine for PTSD: A review of clinical evidence and practice. Telemedicine and e-Health, 23(3), 192-202.
  • Seal, K. H., et al. (2011). Substance use disorders in Iraq and Afghanistan veterans. Journal of Addiction Medicine, 5(1), 5-10.
  • VA/DoD Clinical Practice Guideline. (2017). Management of Post-Traumatic Stress Disorder and Acute Stress Reaction. Department of Veterans Affairs.