PTSD in Veterans and the General Population

When we think of post-traumatic stress disorder (PTSD), we usually think of it in terms of combat veterans. In reality, civilians aren’t immune to the effects. However, the reason the disorder is associated so heavily with combat veterans is because they are one of the most visible and are vocal examples of the effects of PTSD.

What is PTSD?

PTSD usually develops after someone has experienced a terrifying ordeal, which could be a one-time event, such as a mugging or similar violent crime, or a series of events over time, such as living in an area with repeated bombings and air strikes. The trauma of the event can actually damage the person’s nervous system, making them more sensitive to similar trauma.

Under normal circumstances, the “fight-or-flight” response kicks in when faced with the threat of physical harm. In people with post-traumatic stress disorder (PTSD), the normal “fight-or-flight” response kicks into overdrive causing them to experience extreme stress, and even terror, even when there is no overt threat.

For example, if a combat veteran hears a car backfire, it could trigger in them the same fear or terror that he felt while actually under fire. Sometimes the triggers can be very subtle, and the person might not even realize they are being triggered until they have a negative response.

PTSD in Veterans

Although PTSD also affects the general population, much of the focus has been on veterans because, on average, the rate of PTSD among veterans is higher than that of the general population (1), with PTSD present in:

• Up to 20 percent of veterans from Operation Iraqi Freedom and Operation Enduring Freedom;·
• Approximately 12 percent of Gulf War veterans; and,
• Up to 30 percent of Vietnam veterans.

There are also cases of PTSD from non-combat situations, specifically rape and sexual harassment or Military Sexual Trauma (MST).

• Approximately 23 percent of women reported sexual assault while in the military; and,
• Approximately 55 percent of women, and 28 percent of men, reported sexual harassment.

Another reason that we tend to focus on veterans is that veterans groups have done a lot of work in boosting PTSD awareness, not just in terms of the effects of war on military personnel, but also in terms of the presence of PTSD in the general population.

PTSD in the General Population

Approximately seven to eight percent of the civilian population suffers from PTSD, and women are more likely to develop it than men. (1)

Just like with veterans, PTSD is usually triggered by a single traumatic event, or a series of events over time.

For example, a rape and sexual assault survivor could develop PTSD after a single event; but a survivor of domestic abuse could develop PTSD after months, or years of living in constant fear.

Civilians can also develop PTSD from serious and life-threatening health crises, such as a stroke or asthma attack (2). Health related PTSD can be especially difficult because almost anything can trigger an episode.

For example, someone who has PTSD after having a stroke could be afraid of having another one. As a result, anything that seems to threaten a stroke could trigger an episode of PTSD. This could include:

• Having a headache;
• Feeling dizzy;
• Forgetting a dose of medication; and
• Performing similar activities to what they were doing before the stroke.

Additionally, the symptoms of the PTSD episode could actually make it worse. Someone with stroke-related PTSD gets triggered by something, he feels anxiety and fear, his blood pressure and heart rate go up, which then triggers even more anxiety and fear about having a stroke.

It could get to the point where the fear of having a relapse is so great that the person is afraid to do anything at all for fear of triggering a stroke.

Regardless of how it happens, and whether it affects a civilian or a veteran, PTSD can be extremely debilitating. Not only can it trigger erratic behavior, but it can also lead to severe isolation and depression as people struggle to avoid having attacks.

Treatments for PTSD

One of the greatest obstacles that people with PTSD face is the stigma associated with the disorder, a stigma that can often prevent them from getting treatment.

There’s this sort of mind-over-matter belief that tends to dominate discussions about mental health in general, and PTD in particular. This idea that anyone who suffers the lingering effects of trauma must be inherently weak, and that all they need to do is toughen up and try harder to cope.

There is also the idea that there are certain levels of trauma that are “PTSD worthy” and anything “less” isn’t that serious. So seeing a convoy get blown up is somehow considered less traumatic than being in the convoy that got blown up, and therefore PTSD shouldn’t be an issue for the guy who only witnessed the event.

This stigma surrounding PTSD can be especially prevalent among veterans, who are expected to cope with the horrors of war with macho aplomb — individuals for whom coming home physically intact somehow implies that there wasn’t also psychological damage.

However, once people can get past the stigma, there are several options available, including exposure therapy where they experience the triggering event in a safe environment and learn techniques for coping with the stress and fear.

Veterans with PTSD can also take up hobbies that can help them adjust to life outside of the military (3). Civilians can also use the same hobbies to help them cope with their PTSD.

Resources:

• How Common is PTSD?
• Post-Traumatic Stress Disorder
• 7 Hobbies to Help Veterans Adjust

See Jenny’s other post on PTSD: PTSD: What Military Families Need to Know.