Veterans and PTSD: Understanding Causes, Signs, Symptoms and Treatment

What is Post-traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a diagnosed condition that can develop after a person is exposed to a traumatic event. PTSD is a very common condition for many veterans after military service. Symptoms can include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress, difficulty sleeping, and changes in how a person thinks and feels.

What Causes PTSD?

PTSD can occur after witnessing or experiencing a traumatic event. For veterans, this can stem from combat, training, or military sexual trauma.

PTSD Symptoms

According to the National Institute of Mental Health, there are four types of PTSD symptoms among veterans and service members:

• Re-experiencing:
  • Flashbacks: You may find yourself reliving a traumatic event. This could include physical symptoms such as a racing heart or sweating.
  • Bad dreams: These might include dreams related to the event.
  • Frightening thoughts
• Avoidance: avoiding thoughts, feelings, places, activities, or objects that remind you of the traumatic event
• Arousal and reactivity: being easily startled, feeling tense, or having trouble sleeping
• Cognition and mood: experiencing negative thoughts, feelings of guilt or blame, or loss of interest in hobbies

When these symptoms last for a month, it is considered PTSD.

How common is PTSD in veterans?

Veterans are at a higher risk for PTSD compared to the general population, according to The National Center for PTSD. Estimates indicate at least 7% of veterans will develop the condition, with female service members having almost twice as much risk as male veterans. In Wounded Warrior Project’s most recent Warrior Survey, 76% of respondents reported having PTSD because of their military service.

What should I do if I think I have PTSD?

First, know that you’re not alone. We are very sorry to hear you are struggling, but we believe no matter what you’re going through, with help you can find a future to look forward to. If you think you or a loved one has PTSD, please contact the Wounded Warrior Project^® (WWP) Resource Center at 888.997.2586 or resourcecenter@woundedwarriorproject.org, and we will connect you with someone who can help. We’re stronger when we work together, so we collaborate with many other veterans service organizations to help veterans of all generations. Our Resource Center is always happy to work with veterans from all generations to connect them with resources specifically developed to help them.

Contact WWP Resource Center to Get Started

Treatment Options for PTSD

WWP directs every hour, dollar, and action to helping warriors achieve their highest ambition. Some of its programs focus directly on treating PTSD and creating coping skills for wounded veterans of today’s generation. Individuals respond differently to trauma. They also respond differently to treatment. Here are a few of our mental health programs:

• Project Odyssey^®: WWP mental health workshops bring veterans together to take on outdoor challenges together. During the multi-day events, we help veterans grow internally while also expanding external support structures.
• WWP Talk: WWP staff members are available for weekly calls to warriors, family members, and caregivers to provide not only a helpful ear, but also encouragement. WWP works with the individual to set goals and create a plan to exceed those targets.
• Warrior Care Network^®: WWP’s Warrior Care Network provides world-class clinical mental health care. Warrior Care Network is a partnership between WWP and four top academic medical centers. The PTSD treatment provides more than 70 hours of clinical care in 2 week programs. Warrior Care Network includes cognitive therapy, prolonged exposure, virtual reality, mindfulness, and more.

In addition to the above programs through WWP, there are a number of options to address PTSD. The VA provides free options for eligible veterans, including therapy. There are a number of ways to find suitable veteran mental health resources.

How to help a loved one with PTSD

First, let them know that acknowledging they may have PTSD shows they’re strong, not weak.

• Let the veteran determine what they are comfortable talking about, and don’t push.
• Be a good listener and don’t say things like, “I know how you felt,” or, “That’s just like when I…,” even if you also served in a combat zone. Everyone’s feelings are unique.
• Remind your loved one that they are not alone, and many others have personal stories they can share about their readjustment. Talking to other warriors can help them cope.

Tips & Resources for helping veterans with PTSD

Just like there are a wide variety of wounds warriors experience while in the military, during combat, and/ or following combat, there are a wide variety of health professionals to treat those wounds. Finding the right therapist depends on what matters most to you. Determine if you are interested in a specific type of therapy or if your selection will be limited by your health care provider and fees. Regardless of what you decide is right for you, there are a number of ways to find a suitable veterans mental health therapist.

Active Duty and Veterans Help Resources

• The WWP Resource Center can assist you with information regarding WWP programs and services to meet your specific needs. Email the WWP Resource Center at resourcecenter@woundedwarriorproject.org or call 888.WWP.ALUM (888.997.2586).
• Call the VA Health Benefits Service Center toll free at 1-877-222-VETS or explore My HealtheVet, which provides veterans help with VA health care information, services, and locations.
• Call the Vet Center's national number at 1-800-905-4675 or visit online for more information or to find the location nearest you.
• Locate non-veteran-specific mental health services online through the Mental Health Services Locator hosted by the Substance Abuse and Mental Health Services Administration (SAMHSA).
• Take a look at Sidran. They offer a referral list of therapists, as well as a fact sheet on how to choose a therapist for PTSD.
• Veteran Crisis Line: If you are in crisis, please call 911, go to your nearest emergency room, or call 1-800-273-8255 (Para Español llame 1-888-628-9454). Veterans in need of help: Press "1" after you call, or go to Veterans Crisis Line to chat live with a crisis counselor at any time.

Contact WWP Resource Center to Get Started

What is Combat Stress?

Combat stress is a normal reaction to the abnormal conditions of a combat environment. Symptoms can be, but are not limited to, fatigue, loss of concentration, and decreased reaction time.

Problems Associated with Combat Stress & Trauma

Exposure to combat and operational stress can leave emotional scars that linger after deployment. While every individual reacts differently, some problems service members and veterans may notice after combat or operational stress are listed below.

• Anger or Aggressive Behavior
  • Although anger is a natural and healthy emotion that may have helped you do your job while deployed, intense anger can scare people and push them away. Aggressive, hurtful behavior can also cause problems with family, friends, co-workers, and the legal system.
• Alcohol/Drug Abuse
  • While using alcohol or drugs to numb yourself ("self medicating") might seem to work in the moment, it can prevent you from helping yourself and leave you vulnerable to more problems (psychological, medical, legal) in the long run.
• Depression
  • Depression involves feeling down or sad more days than not. It is different from normal feelings of sadness, grief, or low energy. You may feel hopeless, guilty, or worthless, and you might think about hurting or killing yourself.
• Suicidal Thoughts
  • If you or someone you know is feeling suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255. Veterans should press "1" after being connected to reach the Veterans Hotline. You can also visit National Suicide Prevention Lifeline, or call a counselor, doctor, or 911. Help is available.
• Moral Injury
  • A moral injury is a lasting and powerful psychological wound that is caused by doing, failing to prevent, or observing acts that go against deeply held moral beliefs and expectations. Veterans who experience moral injury may experience a reluctance to get close to other people, difficulty trusting others or themselves, and a loss of faith or spirituality.
• Post-traumatic Stress Disorder (PTSD)
  • Traumatic deployment experiences, such as threat to life, the loss of others, and seeing the wounded and the dying, can leave lasting emotional scars. PTSD in war veterans is a common condition that can develop after you have gone through such experiences. If you have PTSD, you may find yourself reliving deployment events over and over again in the form of unwanted memories or nightmares. You may try to avoid situations or experiences that trigger these memories or otherwise remind you of the traumatic event. You may also feel numb, have difficulty communicating with other people, and even have trouble feeling loving feelings toward others. You may also find that you feel "on high alert" and irritable all the time, making it hard to relax, sleep, or concentrate.

Common Reactions to Combat and Operational Stress and Trauma

Four important things to know about combat stress and trauma:

1. You are not alone.
2. This is not about weakness.
3. You deserve to heal and recover from the invisible, psychological wounds of war as much as you would deserve the best care for the physical wounds of war.
4. Help is available.

Staying informed and learning ways to manage and cope with what you're experiencing are key in the readjustment process. Some common reactions to combat and operation stress and trauma are listed below. Keep in mind that these post-traumatic reactions can present themselves at varying times and to varying degrees from individual to individual. If your reactions interfere with your life, do not improve, or worsen over time, please take the steps to get the help you need and deserve.

 Reactions to combat and operational stress and trauma may include:

• Problems concentrating or making decisions
• Having disturbing dreams and memories or flashbacks
• Feeling hopeless about the future
• Feeling numb or lacking interest in anything
• Having a negative view of the world or other people
• Guilt and shame
• Avoiding people, places, and things related to stressful operational experiences
• Feeling on guard, constantly alert, or jumpy
• Being irritable or having outbursts of anger
• Having trouble sleeping
• Feeling detached or withdrawn from others

Tips & Resources for helping veterans

What is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) is an injury to the brain caused by an external force. The symptoms of the injury can vary. Mild or moderate TBI symptoms can include mood changes, trouble with concentration, headaches, difficulty with sleep, and reduced motor coordination. Severe TBI can cause greatly reduced or lack of motor control, greatly reduced ability or inability to speak, and restlessness or agitation.

There are three main types of TBI that doctors consider:

• Mild TBI (mTBI – also known as a concussion) that occurs when a person loses consciousness for 30 minutes or less (or doesn’t lose consciousness)
• Moderate TBI a person loses consciousness for more than 30 minutes but wakes up within 24 hours
• Severe if they remain unconscious for 24 hours or longer.

TBI does not always cause loss of consciousness. Someone with a mild TBI may not lose consciousness, but they can experience confusion while awake.

TBI symptoms and PTSD can overlap. The effects of TBI may impact the way a person reacts to PTSD symptoms, therefore, treating the person with a comprehensive approach is best.

Even in the military, TBI is not always caused by explosions or blasts. Military training, physical exercise, or engaging in off-duty sports can expose servicemen and women to potential TBI.

All injuries are not the same and every TBI diagnosis must be treated differently. Two people can be involved in the same event but have different symptoms.

What are the most common symptoms and problems that begin or worsen after incurring a TBI?

• Sleep Problems
• Headaches
• Trouble Concentrating
• Irritability
• Memory Problems

How is a mild TBI Diagnosed?

Most often, mild TBI is diagnosed at home or “at garrison,” at a military base or post, and not during deployment. A mild TBI might be detected by a battle buddy, unit leader, or family member who notices something has changed.

How Common is TBI in the Military?

The Department of Defense reports 449,000 servicemen and women were diagnosed with some form of TBI between 2000 and 2021. In WWP's most recent Warrior Survey, 37% of WWP-registered warriors reported experiencing head injuries and 35% reported incurring TBI as a result of their post-9/11 service.

Tips & Resources for helping veterans