PTSD - What it is and How to Get Help

Service members returning from combat can be wounded emotionally/psychologically as well as wounded physically.  Unfortunately, the psychological wounds are not as obvious and/or visible as the physical wounds.  Additionally, they cannot be diagnosed or treated (generally speaking) without the reporting, consent, and participation of the sufferer--which can be difficult for many reasons, the least of which is the stigma associated with seeking "mental" help.

MSC has sought out information from professional resources and is sharing that information with you here.  The most important thing you can do is be empowered with knowledge about post-traumatic stress disorder ("PTSD").  We want to emphasize that PTSD is NOT a sign of "mental weakness"; it is a VERY NORMAL response to very ABNORMAL and traumatic experiences and circumstances.  Further, PTSD can be treated.  But most importantly, if someone you love has some PTSD symptoms, it is critical that you find out if he or she was COMPREHENSIVELY evaluated for signs of traumatic brain injury (TBI) after returning from OEF/OIF. 

There is often an overlap in symptoms between TBI (find TBI resources here)and PTSD (irritability, memory loss, mood changes--including depression).  A medical professional has to ascertain whether the sufferer has an undiagnosed TBI because it can affect how he or she responds to medication as well as cognitive therapy.  It is NOT AT ALL uncommon for our OEF/OIF veterans to suffer from both TBIs AND PTSD.  Often soldiers think that because they are no longer suffering form headaches or tinitus that they do not have a TBI.  This is not true.  Those symptoms are the immediate, acute reactions to exposure a blast the long-term symptoms do not have to include either and can be very different. 

At the bottom of this page we will give you a rundown of the preliminary resources available if you or someone you love needs help. 

What is PTSD?

The National Institute of Mental Health states that Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. 

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

~Margaret Mead

All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD. Understanding what is happening when someone you know reacts to a traumatic event will help you be less fearful and better able to handle the situation.PTSD does not always show up right away.  It can take weeks or even months for the signs to appear.  Again, the important thing as a spouse or family member is for you to be able to recognize the symptoms.What are the symptoms of PTSD?

Symptoms may include:

  • Feeling hopeless about the future & detached or unconcerned about others
  • Having trouble concentrating, indecisiveness
  • Jumpy & startle easily at sudden noise
  • On guard and constantly alert
  • Having disturbing dreams/memories or flashbacks
  • Work problems

Or more physical reactions such as:

  • Stomach upset, trouble eating
  • Trouble sleeping, exhaustion, edginess, restlessness
  • Pounding heart, rapid breathing, shortness of breath, trembling
  • Severe headache if thinking of the event, sweating
  • Failure to engage in exercise, diet, safe sex, regular health care
  • Excess smoking, alcohol, drugs, food
  • Muscle tension
  • Worsening of chronic medical problems

Or have more emotional troubles such as:

  • Feeling nervous, helpless, fearful, sad, moody
  • Feeling shock, numb, unable to experience love or joy
  • Avoiding people, places, and things related to the event
  • Being irritable or outbursts of anger
  • Becoming easily upset or agitated
  • Self-blame or negative views of oneself or the world
  • Distrust of others, conflict, being over controlling
  • Withdrawal, feeling rejected or abandoned
  • Loss of intimacy or feeling detached
  • A fear of losing control or going crazy
  • Excessive fearfulness  

PTSD and the Military 

If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTSD. Experts think PTSD occurs:

In about 30% of Vietnam veterans, or about 30 out of 100 Vietnam veterans. In as many as 10% of Gulf War (Desert Storm) veterans, or in 10 veterans out of 100.9 In about 6% to 11% of veterans of the Afghanistan war (Enduring Freedom), or in 6 to 11 veterans out of 100.

In about 12% to 20% of veterans of the Iraq war (Iraqi Freedom), or in 12 to 20 veterans out of 100.

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face. Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war. Among veterans using VA health care, about:

23 out of 100 women (23%) reported sexual assault when in the military

55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military

Even though military sexual trauma is far more common in women, over half of all veterans with military sexual trauma are men.

Where to Go for Help

If you are an active duty service member who is experiencing symptoms: 

  1. For the Army: any soldier returning from combat should be able to go to his or her base hospital/medical facility and ask for the Resilience and Restoration Center (R&R Center).  He or she can do this without the permission of his or her unit/commander and it is SELF-REFERRAL.  When the soldier goes to the R&R Center, he or she tells them about the symptoms or that they think they need a TBI and PTSD evaluation.  It SHOULD be done without ANY questions or problems.  ON FORT HOOD: the person who evaluates the soldier should comply with the soldier's request to see an off-post therapist and it should be granted.  The policy is to allow the soldier eight free sessions off-post.  After that, the soldier will have to go through his or her primary care manager.  Contact us if this does not happen
  2. Tricare - Simply tell your Primary Care Manager that you are "having trouble adjusting" and he or she will give you a referral for counseling.  Of course, you may want to utilize the free, confidential Army One Source counseling prior to this.  (See number two below.)
  3. Army One Source (800. 464.8107.) - Six free off-post confidential sessions are available to Active Duty personnel.  (If you are in another branch of service, you can contact Military OneSource (1-800-342-9647) to find the number to call for your free off-post counseling sessions.)
  4. Chaplain (on post) or clergy/local churches off post.

If you are a veteran who is experiencing PTSD symptoms:Government Resources:

  1. United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder (802.296.6300)
  2. Military Homefront
  3.  U.S. Army Wounded Warrior Program (1.800.237.1336)

Private Resources: Give An Hour
Give An Hour is a nonprofit organization dedicated to developing a national network of volunteers to respond to acute and chronic needs within our society. We are currently establishing a national network of mental health professionals and reaching out to our first target population, the U.S. troops and families affected by the current military conflicts in Afghanistan and Iraq. The mental health professionals who join us are giving an hour of their time each week to provide free mental health services to military personnel and their families. Those who receive services from the Give an Hour network will be given the opportunity to give back to their own communities. Visitors can log on and enter their zip code to locate the counselor nearest them.

Returning Veterans Research Project (NW)
Returning Veterans Resource Project NW is a nonprofit organization comprised of politically unaffiliated and independent health care practitioners who offer free and confidential* services to veterans and their families of past and current Iraq and Afghanistan campaigns. Our volunteers include mental health professionals, acupuncturists and other allied health care providers. We believe it is our collective responsibility to offer education, support, and healing for the short and long-term repercussions of military combat on veterans and their families.

Sidran Institute
Because many people underestimate the developmental, emotional, psychological, and spiritual injuries that can result when people experience or witness traumatic events, Sidran Traumatic Stress Institute, Inc. (formerly Foundation) helps people understand, recover from, and treat traumatic stress (including PTSD), dissociative disorders, and co-occurring issues, such as addictions, self injury, and suicidality.

Wounded Warrior Project
The Wounded Warrior Project's mission is to raise the awareness and enlist the public's aid for the needs of severely injured service men and women, to help severely injured service members aid and assist each other, and to provide unique, direct programs and services to meet their needs.  They conduct  "Coping with Combat Stress Seminars".  These free, two-day events offer workshops and sessions for service members who are transitioning into civilian life from Operations Enduring and Iraqi Freedom. The seminar is designed for both disabled and able-bodied service members who are understandably dealing with the effects of combat stress while reintegrating back into civilian life.

Hear4You
The Silver Star Families of America has joined forces with Give An Hour to help provide treatment to Soldiers who are suffering PTSD.  The Silver Star Families of America supports wounded service members and their families by offering troops a friendly ear with its newest program, "Hear 4 You." The no-cost program aims to develop a network of volunteers to listen to military personnel and their families affected by post-deployment stress and post-traumatic stress disorder. Military personnel or family members wishing talk to a volunteer through the Hear 4 You program can follow this link  Hear4You from the Silver Star Families of America website at www.silverstarfamilies.org. The program's website shows which volunteers are online at any given moment.

Healing Those Who Serve
With the unmet mental health needs of our military men and women reaching critical mass, The Second Wind Foundation, a 501c3, has created a publicly funded treatment program for returning military personnel suffering from trauma and PTSD called Healing Those Who Serve (HTWS). Funded through private and corporate donations, the Healing Those Who Serve pilot program is slated to launch at The Ranch, an internationally renowned recovery center set on 2,000-acres in rural Tennessee, in February 2008. The monies raised will create scholarships to fund Veterans in need of PTSD treatment for the recommended 60 to 90-day stay.  For more information on The Ranch, please visit http://www.recoveryranch.com.

Support for Active Duty and Their Dependents

First of all, dependents can utilize the free sessions through  Army One Source (800.464.8107.)/ Military OneSource (1-800-342-9647) as well.   Otherwise, they can go through Tricare.  Below is a recent article on Tricare behavioral health care benefits:  Beneficiaries Can Let TRICARE Do the Talking When It Comes To Behavioral Health Care Assistance

December 21, 2007

TRICARE is making behavioral health care access simpler for Prime beneficiaries by offering assistance with appointments.

The Behavioral Health Provider Locator and Appointment Assistance Service is open for business.  All active duty service members and their enrolled family members living in the U.S. who need help locating and making appointments with behavioral health care providers can now contact their Managed Care Support Contractor (MCSC) for assistance.

“This program is especially helpful for those who may find it hard to locate a behavioral health care provider in the network,” said Maj. Gen. Elder Granger, Deputy Director, TRICARE Management Activity.  “The contractor can even engage the beneficiary in a conference call with the provider to ensure scheduling is satisfactory.”

For assistance making behavioral health appointments the toll-free numbers are: West Region, 1-866-651- 4970; North Region, 1-877-747-9579; and in the South Region the number is 1-877-298-3514. Hours vary according to region.

All active duty service members must have a referral from their primary care manager for behavioral health care before calling the MCSC appointment assistance line.  TRICARE Prime active duty family members can receive the first eight outpatient behavioral health care visits per fiscal year (Oct. 1-Sept. 30) without a referral, but they must receive the care from TRICARE network providers to avoid point-of-service cost sharing charges.
TRICARE Overseas Program beneficiaries can also use the appointment assistance line when traveling in the U.S.
Beneficiaries are reminded that the Behavioral Health Provider Locator and Appointment Assistance Service is not a help line for behavioral health treatment, counseling or advice.

For more information about TRICARE and the behavioral health appointment assistance service, visit the mental health and behavior section at www.tricare.mil and enter a profile.

More Information on PTSD for Service members, Veterans, and their Families

RETURNING FROM THE WAR ZONE:  A Guide for Families of Military Members (PDF)  
"Many veterans, including National Guard and Reserve members, and active duty service members (deployed to a war zone) will receive treatment for PTSD at the Department of Veterans Affairs (VA)and Readjustment Counseling Service Vet Centers. Make sure all service members enroll, even if there is no plan to use VA services. Once service members have returned from deployment, they are eligible to receive cost-free health care and readjustment services through the VA for any conditions related to combat service for two years following active duty."  They must enroll to be eligible for these services. Fill out an application online at: www1.va.gov/health_benefits/ 

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