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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.