As we observe Veterans Day, the U.S. honors all of those who have served our country in all military branches. Given the depth of experience veterans have had and the trauma that some of them continue to face, this holiday can bring a flood of emotions, memories, and questions for those who have served, and their loved ones. But, it’s essential that our care, respect, and support for veterans doesn’t fade after November 11.
It’s been a challenging year for all of those who have served over the last twenty years during Operation Enduring Freedom and Operation Iraqi Freedom. Many of the veterans who served in these conflicts have post-traumatic stress disorder (PTSD)—all while questioning whether the last twenty years of service and sacrifice were in vain. To that, I say: Thank you for being here, for being you, and for what you bring to this world.
If you are reading this article as a veteran seeking support and relief from the pain you’ve been feeling in your daily life, or if you’re a loved one of a veteran that wants to understand PTSD better, you are appreciated. Your efforts to heal or help someone else’s healing in your life is an act of compassion.
Understanding veteran culture is essential to help with PTSD. It’s an act of empathy for the people that have served our communities. The clinical term for this awareness is Veteran Cultural Competency—a theory that acknowledges and raises awareness that the military is a unique culture. Those who have served face experiences that civilians cannot know first-hand but should aim to understand alongside this unique culture (Botero et al., 2020).
What is PTSD?
According to the American Psychological Association, PTSD is “An anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident, or a natural disaster.
People with PTSD may:
- Relive the event via intrusive memories, flashbacks, and nightmares.
- Avoid anything that reminds them of the trauma.
- Have anxious feelings they didn’t have previously, which are so intense their lives are disrupted (American Psychological Association, 2013).
Traumatic events alter your mind and body, and the resulting PTSD can be incredibly disruptive to daily life. For veterans, a particular battle, the time surrounding an engagement, injury in the line of duty, fear of death, or witnessing someone else’s death or severe injury can cause the disorder.
PTSD Triggers
Symptoms can creep into your life when you least expect it. The sounds, smells, voices, and even temperatures associated with those scenes hold the keys to unlocking a trauma response in your body.
A trauma response may look like your hands shaking, heart racing, feelings of anger, sadness, fear, crying, retreating, panic, and the inability to sleep without nightmares, eat, enjoy pleasure, or connect with others.
These reactions are part of the “sympathetic response,” which is when your mind believes you’re in danger, and it begins to either:
- Gear up to fight.
- Retreat into itself and/or dissociate.
- Shut down in an automatic bodily response commonly known as “fight, flight, or freeze.”
This sympathetic response is a common survival mechanism for our brains. Our ability to detect and respond to danger has kept us alive through history. Trauma hijacks that response, making it difficult to discern what is and isn’t an immediate threat.
As a result, you might change where you go around town, what you’re capable of focusing on, and who you socialize with. These can be signs that you’re avoiding what initiates your fight or flight responses. Maybe specific noises and environments have become too much to manage without losing control.
When life becomes unpredictable, everything is more complex. The unexpectedness of when and where a trauma response occurs forces some people who have PTSD to isolate themselves, thinking this is the safest option. It makes sense because no one can hurt you or judge you.
While isolating is an attractive form of avoidance, the downside is that there can be an increase in feelings of loneliness, distress, and overall dissatisfaction with one's life.
Symptoms of PTSD in Veterans
Before the formal diagnosis of PTSD, the symptoms went with vague recognition and were thought to be temporary and acute—people referred to it as “shell shock” or “battle fatigue” (Zilmer, 2012, p. 75).
Despite PTSD research and awareness progressing, stigmas persist. A recent poll conducted by Cohen Veterans Network (2021) reported that one-in-four Americans still believe that PTSD is untreatable and makes a veteran dangerous.
Bessel van der Kolk is a PTSD specialist as a psychiatrist, author, researcher, and educator. He says, “…what has happened cannot be undone. But what we can deal with are the imprints of the trauma on body, mind, and soul” (Bessel van der Kolk, 2014). Although the impact of trauma cannot be erased, we can manage it.
How to Help Veterans with PTSD
Although there are many ways to help veterans, here are a few tips for working through PTSD.
- Find a trauma-informed therapist. They can provide you or your loved one with a safe space to heal—you are never alone. Therapeutic space is a neutral ground where there is no judgment, and you can guide the pace of your healing journey.
It might feel difficult to trust someone who wasn’t a battle buddy or someone who served in the military. Therapists can support you in learning about your symptoms, living with them, and healing.
There are many therapists trained explicitly in PTSD, trauma processing, and military psychology—and it is possible to find a therapist that’s a veteran too. It’s not easy to accept or ask for help when your duty and culture are to serve others, but therapists are patient and can support you along the way.
- Learn to listen to your body. Physical symptoms are straightforward signs that something is stirring inside of you. Are your hands sweating or shaking? Do you feel a lump suddenly forming in your throat? Are your ears ringing? Are you tasting something? Did you jump, stiffen up, or recoil? Identify how your body reacts to external stimuli.
- Practice calming your mind by lowering your heart rate through grounding techniques. A helpful yet simple way to do this is by “square breathing.” You can do this by first imagining a square. Now begin to trace the square.
For the first line, breathe in for three seconds. For the second line, hold your breath in for three seconds. Then exhale for three seconds. Lastly, rest and breathe naturally for three seconds. Now, repeat three to five times.
Mindful breathing like this grounding exercise decreases the heart rate, allowing your parasympathetic nervous system to support relaxation and promoting a response that tells your body it’s safe again.
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Keep a trauma journal. This tip might take some getting used to for those skeptical of journaling’s benefits, but it’s a highly effective and valuable way to process trauma.
Try these journal prompts so you don’t have to sit down and wonder what to write about (Williams, Poijula, 2013):A. How do you assess danger? You may be used to risk evaluation in the field, but how are you doing so in your regular life? Are you constantly checking around you (e.g., at a playground)? What do you feel like when you always have to be on guard?
B. How do you make decisions? You’re used to making last-minute decisions in high-risk situations, but how does it feel to make decisions in your life as a veteran? Do you take time to gather input from a partner, spouse, or friend? Do you listen to others? What does it feel like to not have a standard operating procedure for life after your time in the military?
C. How do you talk about war (whether you deployed or not)? Do you feel like you can talk about this with anyone in your life? Why or why not? Is there anyone in your life you trust enough to do so? How long did it take to trust them?
5. Write your story. Narrative therapy is a standard therapeutic modality for processing trauma that allows you to tell your story how you remember it. This provides time to sit with aspects of the traumatic experience slowly and reduces the overwhelming element of speaking words aloud that you may not feel comfortable saying.
Write a first-person account of what you felt. How did the incident change your life, or how do you want it to support you in changing your life? This is your story, and you have control over the memories. Tell it with the language, descriptions, and honesty you need it to have.
6. Find what brings you healthy relief and joy. Remember, nothing can erase your experiences or memories. The goal is to find a life balance so you can live where trauma doesn’t consume you—discovering ways to acknowledge and be aware of how to cope with PTSD when it surfaces. Creating more moments where you smile, even if momentarily, is vital. Are you an animal lover? If so, consider checking out options for a service animal.
Research has shown that having a support animal decreases the severity of PTSD symptoms (think parasympathetic nervous system again)! Some organizations support veterans in making the connection with a support animal. Is it music? Working out? Being in nature? Prioritize these things in your life if so. Even if only one day a week. Start small. You don’t have to perfect every healthy coping strategy in an instant.
7. Write about your future. How would you like it to appear? Do you want to feel calmer? What would you like to accomplish to reach that goal? Would you like to have a family? Go back to school? Travel the world? Build your own home? Take as much time as you need to think about what you want life to be like. It doesn’t have to be a perfect life. PTSD symptoms don’t have to magically become eradicated. Be realistic and honest with yourself.
8. Give yourself credit. Remind yourself of one good thing you do per day. What have you made it through? What are your strengths? What lessons have you learned from making it through another day of life? You have done what very few have been willing to do—put it all on the line to sacrifice your time, family, and safety for this country. You deserve to have each of us rally with you. You are seen, valued, and respected.
Days will come and go where maybe you don’t feel so great, but always know that you have made it through a lot. Know if you are hurting, feel lost or alone, that you have been strong before. Know that feeling sad is okay, too—sadness and vulnerability are not weaknesses. They require tremendous strength and courage to express. Lean into facing the fears of trauma and giving words to your experiences. It will all help your healing process.
PTSD does not define anyone. It does not define your future; it only shapes the landscape of your future into a version of yourself that is raw, honest, strong, and intuitive. There is life with and after PTSD.
It may be treacherous and painful, but healing is possible. Humantold is here to help. We thank you for your service.
References:
- APA: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Bessel van der Kolk, (2014),The body keeps the score: Brain, mind, and body in the healing of trauma., APA PsycNet, https://psycnet.apa.org/record/2014-44678-000
- Botero et al, (2020), A lifeline in the dark: Breaking through the stigma of veteran mental health and treating America's combat veterans, Journal of Clinical Psychology, https://doi.org/10.1002/jclp.22918
- Cohen Veterans Network, https://www.cohenveteransnetwork.org/amhpulse/
- Kennedy, Carrie H. (Ed)., Zillmer, Eric A. (Ed)., (2012), Military psychology: Clinical and operational applications, 2nd ed., APA PsycNet, https://psycnet.apa.org/record/2012-21042-000
- Williams, Mary Beth., Poijula, Soili., (2013), The PTSD workbook: Simple, effective techniques for overcoming traumatic stress symptoms, 2nd ed., APA PsycNet, https://psycnet.apa.org/record/2013-12630-000
- (1996), Clinical perspectives on stress, traumatic stress, and PTSD in children and adolescents,