• Angela Joyce

War Veteran Post Traumatic Stress Disorder

ABSTRACT


This study was conducted to draw conclusions about the affects of war on human behavior. Posttraumatic stress disorder observations were made through textbook research, natural observations and through interaction with the U.S. Veterans of Foreign Wars. The etiology, symptoms and treatment for posttraumatic stress disorder are explored in this report. Self-reports from veterans of World War I, Vietnam and Operation Iraqi Freedom were documented for this report.


WAR VETERAN POSTTRAUMATIC STRESS DISORDER


Posttraumatic Stress Disorder (PTSD) is a mental disorder diagnosed after an exposure to trauma, including actual or threatened death, serious injury, or sexual violation. It is characterized by intrusive and distressing memories or dreams, dissociative reactions, and substantial physiological or psychological distress related to the event. (Psych Database) It is theorized that no experience on earth is more traumatizing than exposure to active-duty warfare. War is a once in a lifetime experience in which one must kill or be killed, sounded by others who are on a racist, religious or political mission to murder you.


Posttraumatic Stress Disorder can occur at any point in life, beginning after age one. Symptoms usually begin within the first three months after trauma, although for some there may be delays of months or even years before the criteria for a full diagnosis is met. Posttraumatic Stress Disorder can be chronic, lasting for years to decades after the initial trauma takes place. Long-term employment disability related to posttraumatic stress disorder is rare but individuals with posttraumatic stress disorder are at an increased risk for suicidal ideation and suicide attempts. (Psych Database) War veterans accounted for 20.2% of suicides among American adults in 2001. In 2019, an average of seventeen war veterans committed suicide each day. (U.S. Department of Veteran Affairs)


Exposure to trauma is the underlying causal factor for every individual who is diagnosed with posttraumatic stress disorder. It is suggested that those most susceptible to developing posttraumatic stress disorder after exposure to trauma are those who have a history of childhood emotional problems, prior mental disorders and/or a family history of psychiatric disorders. Individuals exposed to trauma are more likely to develop posttraumatic stress disorder if they have lower socioeconomic status, lower levels of education, poor support networks and/or temperamental traits like negative appraisal and premorbid maladaptive coping behaviors. (Psych Database) War veteran exposure to trauma may involve the intentional murder of a man, woman or child. Traumatic experiences may include bearing witness to close range murder, ambush, bombing or massacre. Trauma may be induced by one or multiple near-death experiences, responsibility for the detonation of a bomb or through consistent exposure to perceived threats of danger.


In a book titled, “PTSD: A Short History” by Allan V. Horwitz it is documented that symptoms of posttraumatic stress disorder include depression, anxiety and insomnia. He compares posttraumatic stress disorder from World War I to shellshock, stating that the psychic wounds of war remain with veterans long after they return home. It was noted in his book that veterans returned home young, jobless and psychologically impaired. They were labeled as cowardice, personally or morally defective and weak if they reported psychological problems to their health care providers. Resultant of this, many veterans turned to alcohol, laudanum and opioids to escape or suppress their pain. Alcoholism was noted as the most sever substance abuse addiction acquired by active-duty war veterans. In his book, Allan V. Horwitz refers to alcohol as “the veteran’s most stubborn enemy.” He also states that active-duty war veterans experience flashbacks, night terrors and intense paranoia upon their return home.


In Oakland County, Michigan, I observed four veterans returning home from Operation Iraqi Freedom who were experiencing similar symptoms and stigmas. Consistent with the remarks of World War I veterans, these veterans returned home young, jobless and psychologically impaired. Veterans returning home from Operation Iraqi Freedom showed signs of depression, insomnia and paranoia. Veterans returning home from the Operation Iraqi Freedom frequently abused drugs and alcohol. They were not encouraged to seek mental health support. There was a shame culture among young veterans. Veterans were called demeaning names by fellow service members if they mentioned experiencing any symptoms of mental illness. They also did not speak openly about their trauma exposures with anyone. Veterans of Operation Iraqi Freedom frequently suffered from night terrors and insomnia. They developed maladaptive behaviors including searching for suspicious cars on the freeway or touching the ground when fireworks went off on the fourth of July. None of the veterans I observed in Oakland County, Michigan received mental health support for their posttraumatic stress disorders. Two veterans were arrested for assault. One was arrested for attempted murder. None of these men received mental health support.


In Midland County, Michigan I attended a support group for U.S. Veterans of Foreign Wars. There were seven veterans present at this meeting. All veterans present served in the Vietnam War. This support group was different from other support groups including alcoholics anonymous or narcotics anonymous because the men at this meeting did not sit around 4 discussing their thoughts, problems or feelings. It was mentioned by this group of men that they did not like to talk about their trauma exposers with anyone. This is consistent with my observations of Operation Iraqi Freedom veterans. Vietnam War veterans also expressed an increase in alcohol consumption upon return from active-duty warfare. They mentioned that seeking mental health services was frowned upon. While physical health care was quickly established through the office of Veteran’s Affairs, requests for mental health support were often dismissed or otherwise pushed aside. Veterans of the Vietnam War expressed poor community and social support upon their return home. One veteran mentioned believing that he was a burden to the civilian population. Another recalled being spit on and called a “baby killer” by one American citizen.


I observed lighthearted comradery offered by the support group for U.S. Veterans of Foreign Wars. Although the men did not examine cognitive distortions, physiological symptoms or psychoanalytic processes, they did receive social and emotional support from their voluntary community. Veterans of the Vietnam War enjoyed playful conversation about military politics, operations and structure. None of the veterans showed signs of depression, hostility or paranoia. It was mentioned that mental health services were recently becoming more available for veterans of foreign wars. Men at this meeting mentioned seeing advertisements for cognitive processing therapy and educational seminars for posttraumatic stress disorder. These materials have recently been circulating the Veterans Affairs offices, making mental health care solutions more readily available for Veterans of U.S. Foreign Wars.


One veteran of the Vietnam War chose to embark on a lifelong military career after his active-duty deployment had ended. He mentioned that he re-enlisted because he enjoyed the adrenaline rush of not knowing what was going to happen to him next. He proudly stated that civilian life was “kind of boring”. This observation is consistent with observations I made of Operation Iraqi War veterans who chose to remain active in the military after developing posttraumatic stress disorder. Two veterans from Operation Iraqi Freedom continued working for high-risk government agencies after exposure to trauma and the development of posttraumatic stress disorder. Both veterans mentioned that they enjoyed the thrill of not knowing if they were going to live or die. Both veterans also mentioned lack of availability for employment elsewhere. It is also observed that veterans who did not reenlist experienced feelings of guilt and shame for not reenlisting. They mentioned feeling as though they were abandoning their brothers who were still deployed or preparing for deployment.


As expected, all veterans reported gradual relief from symptoms of posttraumatic stress disorder. Unexpectedly, many Vietnam veterans experienced a delayed onset of symptoms related to posttraumatic stress disorder. There has been little research on the delayed manifestation of symptoms related to post traumatic stress disorder. One veteran mentioned that he started having nightmares eight to ten years after he returned home from Vietnam. He reported having flashbacks in his dreams, usually occurring close to the anniversary of a traumatic exposure. He reports waking up in the middle of the night, sweating with his pillow soaking wet. This self-report is consistent with observations I made in one Operation Iraqi Freedom war veteran. This veteran also began waking up in the middle of the night, experiencing nightmares. His pillow was also soaking wet. Both men attended a sleep study conducted by Veteran’s Affairs. Both men were offered psychiatric medication to suppress their sleep disturbances.


The most popular treatment for posttraumatic stress disorder is trauma-focused cognitive behavioral therapy, which uses a combination of cognitive behavioral therapy 6 techniques and trauma-sensitive principles focused on identifying and challenging dysfunctional cognitions about traumatic events and current beliefs about the self and others. (Sue, Essentials of Understanding Abnormal Behavior) Cognitive processing therapy is also recommended. This therapy is similar to cognitive behavioral therapy but is time limited, making it more accessible and easier to finance. Growing evidence suggests that yoga therapy can also accelerate recovery because it has been proven to strengthens the response of the autonomic nervous system while posttraumatic stress disorder is thought to be caused by a dysregulation in the autonomic nervous system. Antidepressants appear to have moderate effectiveness on posttraumatic stress disorder. Medication is the most popular treatment plan for veterans with posttraumatic stress disorder. Research also suggests it is the least effective.


Posttraumatic stress disorder is a mental disorder diagnosed after exposure to trauma, including actual or threatened death, serious injury or sexual violation. Active-duty warfare is one of the most traumatic human events one can experience. War veterans account for 20.2% of suicides in 2001 and approximately seventeen veterans died premature deaths today in the United States. Symptoms of posttraumatic stress disorder may begin to emerge immediately after exposure to trauma or they may appear years later. This disorder is characterized by intrusive and distressing memories or dreams, dissociative reactions, and substantial psychological or physiological distress related to a traumatic event. It is not socially acceptable for veterans to seek treatment after exposure to trauma. Veterans who seek support are more likely to recover. This study was conducted to draw conclusion about the affects of war on human behavior. My observations confirm that warfare changes the human brain, experience and life trajectory. War is bad for the brain and community is the best medicine.




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