PTSD is a severe and on-going emotional reaction resulting from exposure to extreme stress or trauma. It can be caused by childhood or adult emotional, verbal, physical, or sexual abuse; prolonged or extreme neglect; witnessing abuse or a serious accident; sexual assault or rape; incarceration; being involved in natural disasters or witnessing a traumatic event. Veterans with PTSD usually have witnessed people being injured or dying, or had experienced physical harm themselves or participated in events where they felt as if their lives or the lives of others were in danger or they had no control over what was happening, and not having proper support after the event.
Signs and Symptoms of PTSD
Those suffering from PTSD are more likely to suffer from anxiety, and are more likely to being depressed. One study of military sexual trauma survivors found nearly 46% of female and more than 28% of male survivors suffered from depression; they also have trouble with anxiety, and memory problems. Others emotional symptoms including feeling emotionally cut off from others, constantly on guard, irritated, or having angry outbursts. They have sleeping difficulties, nightmares, vivid memories or flashbacks of the event that make them feel like it’s happening all over again. They are also at higher risk of committing suicide.
Physical symptoms include stomach or bowel problems, headaches, backache, chronic body aches and being diagnosed with fibromyalgia, heart palpitations. Sleep disorders are very common. Survivors of sexual trauma may also see changes in their sexual responses such as lack of desire, painful intercourse, or lack of orgasm. Sexual experiences may be interrupted by angry reactions, anxiety, fear, or unexpected memories of the incident. They are most likely to having trouble sleeping: trouble falling or staying asleep; bad dreams or nightmares and eating disorders, having problems in relationships: feeling alone or not connecting to others, and staying in abusive relationships, having problems with alcohol: drinking to excess or getting drunk to cope with memories or unpleasant feelings; drinking to fall asleep.
Veterans with PTSD may think it is a kind of spiritual punishment; some may lose their trust and faith completely. Not having trust faith only compounds the inability to respond to stressors and aggravating emotional and physical conditions. Sometimes these symptoms don’t surface for months or even years after the event occurred or after returning from deployment. They may also come and go.
Military Sexual Trauma – MST as A Cause for PTSD.
As per former Congresswoman Jane Harman, “Women serving in the US military are more likely to be raped by a fellow soldier than killed by enemy fire in Iraq. In the case of sexual assault and rape, the enemy eats across the table at the mess hall, shares a vehicle on patrol, and bandages wounds inflicted on the battlefield.”
The Department of Veterans Affairs (VA) released an independent study in 2010 that reports an estimated 23% of Veterans describe having experienced sexual trauma while on active service. That is double the rate for civilians, which is one in six, according to the US Department of Justice. These figures are only a fraction of the reality since sexual assaults are notoriously under-reported both within the military, and amongst civilians. Victims of MST often have the perception that no serious action will be taken on their behalf; are more likely to be ridiculed and ostracized by fellow soldiers; being called a liar, whore, or slut, accused of being gay, and sometimes demoted, or dishonorably discharged under false pretenses.
Being penalized for reporting incidents while the offenders go unpunished, having nowhere to turn, not want¬ing to lose their job or rank, most of these men and women suffer in silence, many go AWOL out of a sense of desperation, abuse drug and alcohol to mitigate their pain, and many become homeless.
Veterans re¬turning home from a war often have PTSD, and when this is compounded with MST, the effects of these traumas are substantial.
Treatment Approaches
Each case of PTSD is unique therefore treatment needs to be tailored for each patient. Even Veterans who did not realize that they had PTSD years after they have been home can benefit. Veterans themselves, who feel like a failure if they acknowledge that they have PTSD because of shame, not wanting to appear weak, can hinder unfortunately receiving treatment. Some are also plagued with survivor’s guilt.
Treatments include prescribed medication, behavioral and psychotherapy modalities. Patients may need to work with their doctors or counselors and try different types of treatment before finding the one that’s best for dealing with their PTSD symptoms.
Veterans since the Vietnam War have used marijuana to help deal with their PTSD.
But this has not been without controversy since marijuana is considered an illegal substance by the Federal government. But with time it was noted that it has helped them deal with their PTSD symptoms as well with their anxiety disorders and chronic pain, reducing the use of stronger prescription drugs with their side effects as well as saving taxpayers money.
On July 22, 2010, the Department of Veterans Affairs released a directive allowing Veterans to use medical marijuana while participating in VHA substance abuse programs, pain control programs, or other clinical programs, as long as they live in a state where medical marijuana is legal. But VA providers are prohibited from completing forms giving recommendations but it could be obtained from an outside source. As of last year, a patient can even discuss the use of medical marijuana with their VA doctors without fear of repercussion. Congress and the Senate are presently considering bills on the subject.
What Should Loved Ones Do?
PTSD can also change family life making them feeling scared, frustrated and angry about what is happening wondering if things will ever go back the way they were. Ways to help loved ones with PTSD include:
• Learn as much as you can about PTSD.
• Offer to participate in their care such as going to doctor visits with them, help them keep track of medicine and therapy
• Be there for them when they want someone to talk to or just be there when they don’t feel like talking.
• Involve them in family activities as often as possible.
• Getting help yourself from family members, support groups, etc.
VA Resource for Veterans with PTSD
1. Moving Forward is a free online course designed for Veterans and servicemembers who are facing challenges such as managing stress, balancing school and family, relationship problems, adjustment issues, coping with physical injuries and financial difficulties. A free mobile app is available for users of iOS devices (iPhone, iPad, iPod Touch) and can be downloaded from the App store.
2.The Veterans Crisis Line is available 24 hours a day, 7 days a week and helps Veterans in crisis and their families and friends anonymously connect with qualified, caring VA responders.
•Call 1-800-273-8255 and press 1
• Send a text message to 838255
Chat online
3. Understanding PTSD Treatment Booklet
www.ptsd.va.gov/public/understanding_TX/booklet.pdf
4. National Center for PTSD
This website provides information, resources, and practical advice for Veterans, their family and friends, and the public.
www.ptsd.va.gov/public/index.asp
5. VA’s PTSD Program Locator
Explore eligibility for health care using VA’s Health Benefits Explorer tool and find out about available treatment options. www.va.gov/directory/guide/PTSD.asp
6. Vet Center
Combat Veterans can bring their DD214 to their local Vet Center and speak with a counselor or therapist — many of whom are Veterans themselves — for free, without an appointment, and regardless of enrollment status with VA. In addition, any Veterans who was sexually traumatized while serving in the military is eligible to receive counseling regardless of gender or era of service. www2.va.gov/directory/guide/vetcenter_flsh.asp
Research into ways to prevent PTSD is ongoing. In the meantime, since we cannot presently prevent what is happening – especially when it comes to the casualties of war, stricter rules, education, and accountability for those who commit “friendly fire” crimes need to be set in place. When someone experiences a trauma, it takes a toll on the entire family. It prevents the individual from living their life fully, and being a productive citizen; at a high cost to society as a whole. San Diego County has the highest rate of homeless Veterans in the nation. We can increase the chance of a good outcome for those who are presently in the forces as well as our Veterans with an early diagnosis, prompt treatment, and the development of strong social support inside and outside of the forces. Hopefully our wounded warriors will not become just another statistic.
Written by Dr. Carolle Jean-Murat, MD
Dr. Carolle Jean-Murat has worked extensively since 1991 with female Veterans who suffered from PTSD due to sexual trauma during their military experience—MST, to include in-depth assessments, providing specialized alternative treatments, reviewing their medical records, and testifying on their behalf at the Department of Veterans Affairs. She has been working with male Veterans as well since 2011 in many different capacities. She is the medical director of the new True Healing and Wellness Institute in San Diego working closely with the VA to offer comprehensive programs for both male and female Veterans suffering from PTSD.
