PTSD: Not Just a Veterans’ or Combat Issue

Written by: Leah Blain, PhD, Clinic Director & Licensed Psychologist

As a trauma therapist, I often hear folks say that only veterans – or only people with combat experience – can develop Post Traumatic Stress Disorder. It makes sense that many people may have this impression. Everything from research to media and pop culture frequently frames PTSD in a military or veteran context. But developing PTSD is not exclusive to a particular group or type of experience. Understanding the prevalence of, causes of, and effective treatments for PTSD is an important public health issue. And it benefits all of our communities, military and beyond.

First, let’s look at some misconceptions about PTSD.

A new Cohen Veterans Network survey shows that 67 percent of Americans believe that most veterans experience PTSD. And almost one in four believe that Post Traumatic Stress Disorder is not treatable. Neither of these beliefs are supported by what we know about PTSD and evidence-based treatments that have been proven to reduce symptoms and, often, achieve remission.

Post-Traumatic Stress Disorder is a mental health condition that sometimes develops after a person experiences or witnesses a traumatic event. It affects people of all ages, genders, races, and backgrounds. Yet many people believe only military combat causes PTSD. One likely reason for this is that PTSD is frequently studied among military combat survivors. This is helpful from a research standpoint: the trauma is known, a large group of healthy individuals deploys and return as a group, and the group is clinically assessed before and after combat exposure. This allows researchers to observe the effects of trauma, PTSD, and treatment outcomes in large groups of people who share a similar experience of one kind of trauma. 

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U.S. Army Sgt. Joshua Morris shoots a mortar round from a 120 mm mortar tube during a training and certification test at a combat outpost in Afghanistan on May 18, 2010. DoD photo by Sgt. Derec Pierson, U.S. Army. (Released)

However, many kinds of traumatic events can lead to PTSD.

Experiencing or witnessing a traumatic event (natural disaster, violence, or an accident) or being threatened with death, sexual violence, or serious injury can lead to PTSD. Child abuse and many forms of assault can also cause PTSD. Both are the least likely to be reported and therefore much harder to study in relation to PTSD prevalence.

Unfortunately, our military service members and veterans are more likely to have experienced childhood trauma than their civilian counterparts. We find that a lot of trauma recovery work at the Cohen Clinic is related to events and experiences that happened before military service. That service – especially further trauma exposure – can lead to new or aggravated PTSD symptoms. In addition to other post-traumatic responses, like depression, panic, or chronic anger.

While PTSD isn’t just a veterans’ issue. It’s important to understand that not everyone who experiences trauma will develop PTSD. Sixty percent of men and fifty percent of women will experience at least one trauma during their lives. Yet four percent of men and ten percent of women develop PTSD. Each year, more than three percent of adults in the U.S. experience PTSD, and seven to eight percent of the entire population – adults and children, veterans and civilians alike – will develop PTSD. 

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The good news –

For our veterans and others who experience Post Traumatic Stress Disorder symptoms – is that evidence-based treatments, such as cognitive behavior therapy, are helpful for recovering from all kinds of traumatic experiences. In fact, the leading PTSD treatments were all developed in work with civilians and later used in work with veterans. And, with the increased usage of telehealth following the pandemic. Accessing treatment may be easier and just as effective as in-person therapy.

So, what should we look out for and when should someone consider getting assessed for PTSD? First, it’s important to know that it’s natural to feel afraid during a traumatic experience or event. Fear is part of our natural “fight-or-flight” response. It helps keep us safe. It’s also normal to feel a range of feelings and reactions after trauma. These include trouble sleeping or feeling stressed. But these should not last more than a few weeks.

Most people will recover without developing PTSD

but some folks may need some extra support. If someone is continuing to struggle with the effects of trauma for more than a month after the event, it may be time to reach out for help and get assessed. Signs and symptoms of PTSD include:
  • Re-experiencing the event: flashbacks or reliving the trauma over and over (including feeling physical sensations like a racing heart), nightmares, or intrusive frightening thoughts
  • Avoidance: staying away from places, events, objects or other reminders of the event; avoiding thoughts or feelings related to the event
  • Arousal and reactivity: being easily startled, feeling tense or “on edge,” difficulty sleeping, unusual angry outbursts
  • Cognition and mood: trouble remembering key details of the event, negative thoughts about oneself or the world, distorted feelings (guilt or blame), loss of interest in enjoyable activities

Know the signs

Because PTSD can be caused by many different kinds of trauma, including child abuse, it’s important to know the signs of possible PTSD and understand that some people with a history of child abuse may not connect their current symptoms with the past trauma. However, treatment works, regardless of the cause of the PTSD, and treatment can also help with a wide range of issues, from relationship challenges to depression and anxiety to insomnia and more.

For veterans and military families, Cohen Veterans Network is a great resource to learn about treatment options. There you can find accessible care in your local area. For civilians, Psychology Today has a searchable database of providers with filter options based on location, diagnosis, and even insurance.

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Check out the full interview with Leah Blain.

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