When we think of post-traumatic stress disorder (PTSD), we often associate it with the military. This is understandable – PTSD is a new term that sprouted during the Vietnam War. However, it’s become more mainstream since the start of the Iraq and Afghanistan conflict.

Currently, an estimated 1.4 million actively serve in the United States military. ¹ Over 200,000 service members return home from deployment annually.

That’s a lot of people who are at a higher susceptibility to PTSD than the general population. Unfortunately, modern mental health practices aren’t always efficient in treating the condition. This has led to military members struggling with other mental illnesses, such as depression or substance use disorder.

Throughout this article, we’ll take a deeper look at military PTSD and what your options are for transitioning back into civilian life.

PTSD in Veterans and Military

Post-traumatic stress disorder (PTSD) is a condition that appears when you’ve witnessed a traumatic incident. As a result of this event, you develop severe symptoms of anxiety alongside specific PTSD symptoms, including avoidance and flashbacks. ¹

It’s common for military personnel to struggle with PTSD due to the nature of their work. Combat situations and emergency responses can reveal elements of this world that are all too much for the brain to handle within a moment.

Therefore, the brain holds the capacity to dissociate from a traumatic event. However, this dissociation doesn’t allow you to process what you witness. As a result, your brain will continually try to “remind” you of the incident to address it. ²

PTSD Military Statistics

It’s estimated that 20% to 30% of military members are diagnosed with PTSD. ³ However, this number may be greatly underappreciated. These statistics are based on those who’ve been diagnosed. The difficulty is many people (especially men) struggle with PTSD without reaching out for help.

Military PTSD Symptoms

If you struggle with military PTSD, you’ll experience the same symptoms as anyone else with the condition. These include: ⁴ ⁵ ⁶ ⁷

• Anger outbursts and aggressive behavior
• Avoiding people, places, and/or activities that remind you of a trauma
• Constantly on guard
• Difficulty concentrating
• Easily startled or frightened
• Emotional numbness
• Flashbacks of the event
• Insomnia
• Irritability
• Lack of interest in activities you once enjoyed
• Nightmares or dreams about the event
• Self-destructive behavior
• Severe emotional anguish

However, other components of military PTSD may be unique to you. These include:

Survivor’s Guilt

Some military members feel survivor’s guilt as a result of losing fellow soldiers with whom they developed a connection. This guilt may come from a lack of action (i.e. not doing enough to help or save a fellow soldier). ⁸

Survivor’s guilt is usually specific to those who’ve witnessed combat. It’s a complex issue as most people in this position did the best they could at that moment.

With that in mind, if you have a loved one with survivor’s guilt, it’s best to talk about this topic lightly. Naturally, it’s a sensitive matter and your loved one will discuss it when ready.

Avoidance Behaviors

While avoidance behaviors are common in all people with PTSD, those who’ve served in the military may be more prone to avoiding specific situations. For example, loud noises can trigger a PTSD flashback. Therefore, a military member may avoid places with loud sounds (i.e. a music festival or firework show).

The Causes of Military PTSD

Simply put, military PTSD comes about when you’ve witnessed a traumatic event during the time you served. What this traumatic event is will vary from person to person. Some may have experienced it during combat while others received it from rescue operations. ⁹

Still, not everyone who experiences a traumatic event will develop military PTSD. These cases are determined by pre-existing risk factors (i.e. susceptibility to anxiety).

Complications of Military PTSD

Once PTSD is diagnosed, it can greatly inhibit your ability to manage daily responsibilities. As such, you may develop unhealthy coping techniques, such as:

Self-Medication

Instead of addressing the pain from a traumatic event, you can numb it through drug and alcohol use. It’s been found that an average of one out of 10 Veterans struggle with a substance use disorder. ¹⁰ The difficulty here is drugs and alcohol can worsen symptoms of PTSD, leading to more problems for Veterans down the line. ¹¹

Self-Harm & Suicide

Difficulties with PTSD can lead to loneliness and isolation. Naturally, these tendencies can turn into severe depression, marked by self-harm and suicidal ideation. ¹²

On average, 121 Veterans commit suicide in the United States every day. Men are more likely to take their own lives than women, at about four times the rate.

If you currently struggle with suicidal ideation, we greatly encourage you to reach out to the 988 Suicide & Crisis Lifeline.

Military PTSD Treatment

As with other forms of PTSD, there are two forms of treatment: medication and psychotherapy.

Antidepressants are most commonly prescribed for PTSD. These are meant to help with anger, sadness, and worry. Still, other medications may be helpful for certain symptoms. ¹³ For example, Prazosin may help relieve sleep problems (i.e. insomnia and nightmares). ¹⁴

Psychotherapy (or, “talk therapy”) is also used to help address symptoms. The purpose of these therapies is to help you understand negative emotions and develop healthier coping mechanisms. The most common is cognitive behavioral therapy (CBT), which may be offered through:

• Cognitive Restructuring – Helps you understand the memory your trauma stems from, ensuring you are looking at it from a realistic angle. ¹⁵

• Exposure Therapy – Exposing yourself to fears that your trauma stems from and learning how to control the anxiety that follows. ¹⁶

References

¹ Mann SK, Marwaha R, Torrico TJ. Posttraumatic Stress Disorder. 2024 Feb 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644555.

² Atchley R, Bedford C. Dissociative Symptoms In Posttraumatic Stress Disorder: A Systematic Review. J Trauma Dissociation. 2021 Jan-Feb;22(1):69-88. doi: 10.1080/15299732.2020.1760410. Epub 2020 May 13. PMID: 32401657.

³ Reisman M. PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. P T. 2016 Oct;41(10):623-634. PMID: 27757001; PMCID: PMC5047000.

⁴ Sheynin J, Shind C, Radell M, Ebanks-Williams Y, Gilbertson MW, Beck KD, Myers CE. Greater avoidance behavior in individuals with posttraumatic stress disorder symptoms. Stress. 2017 May;20(3):285-293. doi: 10.1080/10253890.2017.1309523. Epub 2017 Apr 16. PMID: 28322068; PMCID: PMC5490437.

⁵ van der Kolk BA. The body keeps the score: memory and the evolving psychobiology of posttraumatic stress. Harv Rev Psychiatry. 1994 Jan-Feb;1(5):253-65. doi: 10.3109/10673229409017088. PMID: 9384857.

⁶ Iyadurai L, Visser RM, Lau-Zhu A, Porcheret K, Horsch A, Holmes EA, James EL. Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application. Clin Psychol Rev. 2019 Apr;69:67-82. doi: 10.1016/j.cpr.2018.08.005. Epub 2018 Aug 23. PMID: 30293686; PMCID: PMC6475651.

⁷ Rosenthal MZ, Cheavens JS, Lynch TR, Follette V. Thought suppression mediates the relationship between negative mood and PTSD in sexually assaulted women. J Trauma Stress. 2006 Oct;19(5):741-5. doi: 10.1002/jts.20162. PMID: 17075920.

⁸ Murray H, Pethania Y, Medin E. Survivor Guilt: A Cognitive Approach. Cogn Behav Therap. 2021 Sep 16;14:e28. doi: 10.1017/S1754470X21000246. PMID: 34557258; PMCID: PMC7611691.

⁹ Friedman MJ, Schnurr PP, McDonagh-Coyle A. Post-traumatic stress disorder in the military veteran. Psychiatr Clin North Am. 1994 Jun;17(2):265-77. PMID: 7937358.

¹⁰ Boden MT, Hoggatt KJ. Substance Use Disorders Among Veterans in a Nationally Representative Sample: Prevalence and Associated Functioning and Treatment Utilization. J Stud Alcohol Drugs. 2018 Nov;79(6):853-861. doi: 10.15288/jsad.2018.79.853. PMID: 30573015; PMCID: PMC6308169.

¹¹ McCauley JL, Killeen T, Gros DF, Brady KT, Back SE. Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment. Clin Psychol (New York). 2012 Sep 1;19(3):10.1111/cpsp.12006. doi: 10.1111/cpsp.12006. PMID: 24179316; PMCID: PMC3811127.

¹² Dagan Y, Yager J. Addressing Loneliness in Complex PTSD. J Nerv Ment Dis. 2019 Jun;207(6):433-439. doi: 10.1097/NMD.0000000000000992. PMID: 31045977.

¹³ Asnis GM, Kohn SR, Henderson M, Brown NL. SSRIs versus non-SSRIs in post-traumatic stress disorder: an update with recommendations. Drugs. 2004;64(4):383-404. doi: 10.2165/00003495-200464040-00004. PMID: 14969574.

¹⁴ Koola MM, Varghese SP, Fawcett JA. High-dose prazosin for the treatment of post-traumatic stress disorder. Ther Adv Psychopharmacol. 2014 Feb;4(1):43-7. doi: 10.1177/2045125313500982. PMID: 24490030; PMCID: PMC3896131.

¹⁵ Mueser KT, Gottlieb JD, Xie H, Lu W, Yanos PT, Rosenberg SD, Silverstein SM, Duva SM, Minsky S, Wolfe RS, McHugo GJ. Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness. Br J Psychiatry. 2015 Jun;206(6):501-8. doi: 10.1192/bjp.bp.114.147926. Epub 2015 Apr 9. PMID: 25858178; PMCID: PMC4450219.

¹⁶ Rothbaum BO, Schwartz AC. Exposure therapy for posttraumatic stress disorder. Am J Psychother. 2002;56(1):59-75. doi: 10.1176/appi.psychotherapy.2002.56.1.59. PMID: 11977784.