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Post-Traumatic Stress Disorder: Awareness, Recognition, and Support

What is Post-Traumatic Stress Disorder?

Life is full of events that cause challenge, fear, or even sometimes pose a threat to us. Those serving in the military are even more susceptible than the general public to these events due to the high-stress, high-risk nature of their occupation. Often and commonly, individuals react to the situation at hand and are temporarily unsettled by these events before returning to normal daily living. In other cases, the event that is experienced can have long-lasting, life-altering negative effects and this is known as post-traumatic stress disorder. The National Institute of Mental Health (NIMH) defines post-traumatic stress disorder, commonly referred to as PTSD, as a disorder that develops in individuals who have experienced shocking, scary, or dangerous events who continue to feel stress or fear even after they are safe from the original event.

Signs and Symptoms

While it is common for individuals to be temporarily disrupted by a trauma, especially during combat, PTSD diagnosis is less common and requires an individual to experience symptoms for more than a month and in a great enough capacity to interfere with work and/or relationships. Symptoms are categorized into four subgroups: re-experiencing, avoidance, arousal and reactivity, and cognition and mood symptoms. Below are some examples of each.

Re-experiencing

Avoidance

Arousal and Reactivity

Cognition and Mood

Treatment Options

Whether you recognize these signs or symptoms in a loved one or perhaps in your own behaviors, you are not alone and there are many treatment options available. Treatment by a mental health provider can open up the door to options such as medication or psychotherapy, or a combination of both. The medications that have been studied and utilized most extensively are antidepressant medications which help to mitigate anger, worry, sadness and numbness. Additional medications can be sought out and explored to help alleviate other symptoms such as trouble sleeping and nightmares. Psychotherapy, also referred to as “talk therapy”, can be done one-on-one or in a group setting. Along with specific and individualized therapy goals, treatment should aim to educate individuals about their triggers and symptoms and prepare them with strategies to manage them when they occur.

PTSD can be incredibly isolating and takes a toll on the lives of many individuals in our community. While it may be hard to imagine living without the symptoms, recovery is possible. In congruence with medication and therapy, there are steps you can take on your own to facilitate recovery. Exercise can be a useful tool to improve both physical and mental health, as it is proven to reduce stress and improve mood. A strong support system of family and friends, as well as the veteran community, can be key to recovery. Involving loved ones in your life and engaging in a community that can relate to your experience can help to alleviate the loneliness associated with PTSD. While working with your therapist to build skills to reduce symptoms, consider partaking in activities that previously sparked joy and interest.

Caring for someone with PTSD can take a serious toll on those providing support as well. If you are a family member, friend or loved one of someone with PTSD, it is imperative to

prioritize your health and seek care and support for yourself as well. Look into local support groups within your community or virtual platforms to connect with other individuals in similar positions and keep regular checkups with your doctor. Make sure to set aside time to sleep, exercise and eat while you are offering care. You are not alone in offering care; seek out professionals and encourage the individual you are caring for to get further treatment. The better you care for yourself, the better you will be able to offer support.

Looking to the Future

Research has been underway for years looking into both the mental and biological components of PTSD, and new research directions continue to develop as scientists acquire new information. A subgroup of research studies called clinical trials seek to study if new tests, prevention measures, or treatments are effective. While clinical trials are an excellent method to further scientific knowledge, individuals should be aware that new information is the goal and there is no guarantee of successful treatment. If you are interested in learning more about current clinical trials or being involved in one, you can visit clinicaltrials.gov for a current list of National Institutes of Health (NIH) studies being conducted across the country or visit the NIMH’s Clinical Trials webpage for information about partaking in a study.

Resources for Veterans and Caregivers

Seeking treatment can feel overwhelming and lonely initially, and it is important to know that there are many organizations that are in place to help you find the support you or your loved one may need.

If you are a veteran with PTSD, the Veterans Crisis Line is available to you and your loved ones. You do not need to be enrolled in VA benefits or health care to access the 24/7, 365-day-a-year support that this line offers. Veterans Crisis Line: 1-800-273-8255 and press 1

If you are a caregiver for a friend, family member, or loved one dealing with PTSD, the VA offers caregiver support in the form of a helpline as well as a caregiver program. To visit the website, go to caregiver.va.gov or call the helpline to speak to someone directly. Caregiver Support: 855-260-3274

The Substance Abuse and Mental Health Services Administrations, abbreviated SAMHSA, has a free and confidential hotline for individuals and family members facing mental health and/or substance abuse disorders. This hotline is also referred to as the Treatment Referral Routing Service and provides referrals to treatment centers, support groups, and community-based programs. The hotline is free, confidential, 24/7, 365-day-a-year and is available in Spanish and English. SAMHSA hotline: 1-800-662-HELP (4357)

Additionally, the National Alliance on Mental Health (NAMI) has a Monday-Friday, 10am-10pm, ET. informational helpline as well as an email address, helpline@nami.org, to

provide support and resources to individuals in need. The NAMI is NOT a hotline, crisis line, or suicide prevention line. NAMI helpline: 1-800-950-NAMI (6264)

Thank you to our veterans and their community caregivers.

We see you, and we support you.

References

NIH – https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd#part_2241 SAMHSA – https://www.samhsa.gov/find-help/national-helpline https://www.caregiver.va.gov/Tips_by_Diagnosis/PTSD.asp https://www.veteranscrisisline.net/

NAMI – https://www.nami.org/help Image – https://www.heroesmile.com/intersection-of-ptsd-and-veterans/

Hospice for Veterans with PTSD

By: Portia Wofford

After dedicating their lives to our nation, our nation’s veterans often face difficulty as they near the end of their lives. While every veteran has different needs, those with post-traumatic stress disorder (PTSD) face unique challenges. PTSD, sometimes known as combat stress or shell shock, often occurs after a person experiences severe trauma or a life-threatening event.

According to the U.S. Department of Veteran Affairs, the number of Veterans with PTSD, in any given year, varies by service era:

  • Operations Iraqi Freedom and Enduring Freedom. About 11-20%
  • Gulf War (Desert Storm). About 12%
  • Vietnam About 15% were diagnosed at a time of a study in the 1980s. It’s estimated that about 30% have had PTSD in their lifetime

It’s becoming increasingly more evident that veterans have a greater need for quality end-of-life care. Hospice care is a benefit that the VA offers to qualified veterans in the final phase of their lives.

Understanding Symptoms of PTSD in Veterans

Dangerous or life-threatening experiences such as combat can cause veterans to relive frightening events. These experiences cause feelings of uneasiness, anger, irritability, or anxiety. While it’s normal to be alarmed by unsettling memories, veterans with PTSD may experience these symptoms for more than a few months. Additionally, they may have difficulty sleeping, experience nightmares, and feel on edge. The veteran may also lose interest or find it extremely hard to participate in everyday activities. Other symptoms include:

  • Recurrent, intrusive reminders of the traumatic event
  • Extreme avoidance of people or places
  • Negative changes in attitude, mood, and personality
  • Emotionally reactive to people, places, or situations that remind them of the traumatic event

Ways to Alleviate PTSD in Veterans

When providing hospice care for veterans with PTSD, there are several considerations for the hospice team. Some symptoms of terminal illnesses, like severe pain, shortness of breath, and anxiety, may trigger flashbacks or nightmares. Additionally, opioid pain medication can make PTSD symptoms worse. The hospice team will collaborate with the patient’s healthcare team to prescribe the appropriate and most effective medication regimen. The hospice team will work with the veteran’s physician, social worker, and other interdisciplinary team members to create a plan of care. This plan of care may include:

  • Connecting with others
  • Staying social
  • Personalized medication and treatments
  • Personalized and effective non-pharmacological treatments
  • Professional social, emotional, and mental support

How Can Hospice Help Veterans?

Veterans are eligible for hospice care if enrolled in benefits and meet medical needs for hospice (terminal illness with a prognosis of six months or less). As of 2019, because of the VA Mission Act, Veterans now have increased access to more community healthcare options. Those who must drive 30 minutes or more to a VA provider or 60 minutes for specialty care may choose a provider closer to home.

Hospice uses a multi-disciplinary team approach to support and provide Veterans with end-of-life treatment. The team works closely with the VA and can provide support and treatment in the home. Hospice offers the veteran and caregivers:

  • 24/7 on-call care
  • Medical equipment and supplies
  • Pain and symptom management
  • No co-pay for hospice care
  • Collaboration with the entire medical and healthcare team
  • Social workers
  • Spiritual and emotional support
  • Grief counseling
  • Medication management
  • Nurses
  • Hospice aides
  • Case managers

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