Treating PTSD in Veterans Successfully Requires Overcoming Misconceptions
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By John Ubaldi
Special Contributor, In Military
One of the main misconceptions about the wars in Iraq and Afghanistan is that all returning veterans suffer from Post-Traumatic Stress Disorder (PTSD). This assumption fails to fully understand the causes of PTSD and further stigmatizes those who serve in the armed forces.
On June 27, the nation marked National PTSD Awareness Day. The U.S. Senate officially designated this day in 2010 to create a better understanding of PTSD; in 2014, the Senate designated June as PTSD Awareness Month.
Veterans Are Stigmatized by PTSD
The term PTSD has often been bandied about in a cavalier manner. Many Americans unwittingly believe all veterans have mental health issues, making it difficult for them to transition to civilian life.
The sad part of this misperception is that whenever veterans come up for discussion, many civilians acknowledge that they are a valuable asset, but believe them to be poorly educated and suffering from PTSD. A poll taken by Stars and Stripes in 2012 reflected that assessment.
In my book, “The New Business Brigade: Veteran Dynamic Impact on U.S. Business,” I cited a corporate trainer who believed most enlisted personnel do not have a high school diploma or can barely read. This critical misunderstanding of the armed forces is mirrored by employers who believe that all veterans have PTSD.
Treatment of PTSD Starts with Understanding Its Root Causes
To understand PTSD, it’s necessary to first understand the root causes of the illness. PTSD is a mental health disorder that can develop from having suffered an extremely traumatic event, such as armed combat, a sexual assault, a natural disaster or even a bad auto accident.
According to The National Institute of Mental Health, it is important to remember that not everyone who lives through a traumatic event develops PTSD. In fact, most people do not develop the disorder at all.
At some point in life, however, everyone will experience a traumatic event. It is completely natural and normal for those who experience such an event to feel on edge or have trouble sleeping afterward.
However, after a few weeks or months they begin to return to their normal activities. Of course, there will be a few who will develop symptoms of PTSD.
PTSD Is Not a Weakness
PTSD doesn’t make someone weak or in the case of the military or law enforcement, less of a person. Everyone processes things differently.
Many triggers for PTSD begin even before the traumatic event occurs. The trauma just brings the illness to the forefront.
Writing in “Psychology Today,” Dr. Michael S. Scheeringa lists the diagnostic criteria for PTSD. He notes that the 20 possible symptoms of PTSD can be subdivided into four clusters: re-experiencing, avoidance, altered cognitions and moods, and increased arousal.
The five symptoms in the re-experiencing cluster are:
- Intrusive recollections
- Psychological distress at reminders
- Physiological distress at reminders
The two symptoms in the avoidance cluster are:
- Avoidance of internal reminders
- Avoidance of external reminders
The seven symptoms in the altered cognitions and moods cluster are:
- Dissociative amnesia
- Negative beliefs about oneself and the world
- Distorted blaming of oneself
- Negative persistent emotional states
- Loss of interests
- Detachment from loved ones
- Restricted range of affect
The six symptoms in the increased arousal cluster:
- Exaggerated startle response
- Concentration difficulty
- Sleep difficulty
- Irritability or outbursts of anger
- Self-destructive or reckless behavior
The Proper Diagnosis for PTSD
To qualify for a diagnosis of PTSD, one may have experienced as few as six criteria or as many as 20 over a period of months.
The Department of Veterans Affairs found that many people suffering from PTSD also have other mental health problems. They include depression, anxiety, alcohol and drug abuse, or thinking about harming themselves or others. It’s also common for PTSD sufferers to have problems at work, in relationships or with physical health.
There are many misconceptions about PTSD, including the idea that it is a lifetime condition. This false premise distorts the reality that treatment can be successful. Among the more effective methods are psychotherapy and behavior modification.
Links between Medication and PTSD
Medication is the most controversial aspect of any PTSD treatment. Medication has been used to help individuals with various forms of sleep disorders. Sometimes, however, behavioral treatment focuses on the issues associated with the “trigger,” such as a traumatic event in the individual’s background. The trigger needs to be addressed in a more comprehensive manner rather than strictly with medication.
Medication is prescribed far too often and fails to account for other, secondary issues such as alcohol dependency. At times, veterans are given additional medications that have harmful side effects when they are mixed with other drugs.
VA Inspector General Recommends Opioid Prescriptions Go through VA Pharmacies to Prevent Over-Medication of Veterans
The consequence of over-medication of veterans was highlighted in November 2017, when Veterans Affairs Inspector General Michael Missal addressed a congressional committee.
To reduce harmful over-medication, Missal proposed requiring that all opioid prescriptions be submitted directly to and filled by a VA pharmacy. That will help ensure that VA providers have information about all opioids prescribed to a patient by all providers.
Much of the reporting on PTSD has focused on over-prescribing narcotics and mixing the various antidepressants to treat the illness and its associated symptoms. Often, news accounts allege a connection between PTSD and the high rate of suicides by returning veterans.
PTSD is a serious problem that needs to be addressed without the public misconceptions. Not all veterans suffer from PTSD, but those who do need quality care, not stigmatization. They do not need to be over-medicated to combat the symptoms of PTSD.
Awareness is the first step in helping those suffering from PTSD and its related symptoms.
About the Author
John Ubaldi is president and founder of Ubaldi Reports, which provides credible, political content, addressing domestic and global issues. John is a 30-year retired veteran of the United States Marine Corps with three combat tours in Iraq and Afghanistan. He is also a contributor to In Homeland Security.
During his time in the Marine Corps, John became a foremost authority on civil affairs as it relates to counterinsurgency and irregular warfare, and he is an author in various military journals. John authored the book, The New Business Brigade: Veterans Dynamic Impact on U.S. Business, currently available on Amazon. His knowledge of Middle Eastern culture and national security policy has afforded him the opportunity to speak on many national and local news programs such as the syndicated national news program “Washington Journal” and other radio and television programs.
John has a master’s degree in National Security Studies from American Military University with a concentration in Middle Eastern Studies, and a bachelor’s degree in Government from California State University, Sacramento.
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