Honor a veteran; understand PTSD

My ability to sit peacefully day after day and write about health or enjoy my family owes more than I’ll ever know to the hard work and sacrifice of generations of American men and women who served in the Armed Forces. On behalf of my colleagues at Harvard Health Publishing: Thank you for your service.

One of the challenges faced by many servicemen and servicewomen returning from war is post-traumatic stress disorder, or PTSD.

In a nutshell, post-traumatic stress disorder is a lasting and exaggerated reaction to a terrifying or life-threatening event. It makes a person feel like he or she is living through the event over and over again. PTSD shows itself in three main ways:

Re-experiencing. People with PTSD mentally relive the triggering trauma in daytime flashbacks, nightmares, or inescapable thoughts about the event. Sights, sounds, smells, or other stimuli can bring the event to life.

Avoidance. People with PTSD tend to avoid people, places, thoughts, feelings, and activities that remind them of the trauma.

Arousal. People with PTSD are constantly on guard against danger. They have trouble falling asleep or staying asleep. They tend to be irritable and have trouble concentrating. And they startle easily.

Traumatic events can create memories that are stronger, more vivid, and more easily recalled than normal events. These haunting memories activate brain circuits that are responsible for instantly responding to potentially life-threatening situations.

Most men and women who experience something horrific during military service don’t experience PTSD. But even if the rate is two in ten, as estimated for those returning from Iraq and Afghanistan, that’s still thousands of people who come home wounded in a subtle, often hard-to-detect way. Research from Virginia Commonwealth University suggests that genes may play a role in who develops PTSD and who doesn’t.

Recognizing PTSD

How would you know if you or a loved one had PTSD? Think about these four questions:

• Do you find yourself thinking about the traumatic event even when you don’t want to, or having nightmares about it?
• Do you go out of your way to avoid situations, thoughts, or feelings that remind you of it?
• Do you feel constantly on alert, or find yourself getting startled easily?
• Are you feeling detached from family, friends, or other loved ones, or avoiding people or activities that used to give you pleasure?

Answering yes to some or all of these questions should prompt a talk with a doctor or counselor about being evaluated for PTSD or depression.

Recognizing PTSD is the first step to helping ease it. There are good treatments available. A type of talk therapy known as cognitive-behavioral therapy appears to be the most effective. Antidepressants and other medications can also help. Results of a study presented earlier this week at the American Psychiatric Association’s 2011 Institute on Psychiatric Services indicates the veterans of the current conflicts are less likely to seek help for PTSD, and less likely to take a full course of prescribed antidepressants.

If you know a veteran who seems to be having trouble adjusting to life back home, and who has the signs and symptoms of PTSD, talking about it with him or her would be a good way to honor that veteran’s service.

Excellent information about PTSD is available from the National Center for PTSD, developed by the U.S. Department of Veterans Affairs.