Tuesday 21 June 2016

2016 - Real Warriors Campaign: June is PTSD Awareness Month

Real Warriors Campaign:  June is PTSD Awareness Month
Information provided by the Real Warriors Campaign. For more articles and resources from the Real Warriors Campaign, visit www.realwarriors.net.”

The Real Warriors Campaign (USA) provides resources to help service members, veterans, and their loved ones learn about the signs of psychological health concerns, including posttraumatic stress disorder (PTSD). If you’re not sure whether you or someone you love is coping with PTSD, read these campaign articles to learn about signs, symptoms and treatment options:

Dispelling Myths About Posttraumatic Stress Disorder

U.S. Air Force photo by Senior Airman Renae Kleckner/Released

Combat brings the possibility of losing close friends, bodily harm, exposure to terrifying events, and extended separation from loved ones. As many as 30 percent of service members redeploying from Iraq and Afghanistan can experience stress reactions associated with these situations.1 Posttraumatic stress disorder (PTSD) may also develop, however, the facts and fiction about PTSD are sometimes hard to tell apart.

While service members may experience stress reactions resulting from a combat deployment, they are not necessarily an indication of PTSD. Common symptoms associated with both combat stress and PTSD, like nightmares, increased anxiety, and reliving the event, could result in a diagnosis of PTSD if there is no noticeable improvement during a short-term period.2 PTSD is a psychiatric condition that requires long-term treatment to deal with symptoms.2

Many service members who experience PTSD can benefit from treatment and support, but some fear that they may be considered weak or that peers might lose confidence in their abilities. This is due, in part, to the perception that some service members have about seeking help, as well as the myths surrounding PTSD. Knowing the truth about PTSD can make a real difference in the lives of those who need support. This article debunks some of the common myths about PTSD.

Five Myths and Facts about PTSD

  • Myth: I cannot get or maintain my security clearance if I am diagnosed with PTSD.
    Fact: Getting treatment for PTSD is not necessarily a threat to an individual’s security clearance. In fact, mental health counseling can be a positive factor in the clearance process.3 Army records show that 99.98 percent of cases with psychological concerns obtained/retained their security clearance.4 Additionally, service members are not required to report some treatments, including those for PTSD, they received due to service in the military when they apply for a security clearance.5 Factors that could result in clearance refusal include not meeting financial obligations, criminal actions or engaging in activities benefiting a foreign nation.3
  • Myth: My military career will end if I am diagnosed with PTSD.
    Fact: Being diagnosed with PTSD in and of itself does not end your military career. There are plenty of examples where service members have sought treatment for various psychological health concerns, including PTSD, and it did not put their careers in jeopardy. In fact, a failure to seek treatment can lead to a more serious psychological condition, and could eventually prevent someone from carrying out some sensitive tasks.4 Seeking support to address psychological health concerns shows inner strength and is commonly looked on favorably. Check out these video profiles of some service members who have received treatment for psychological health concerns and continue to fulfill their regular duties in uniform, as well as veterans who sought care and continue to serve the military community as civilians.
  • Myth: Service members only experience PTSD symptoms immediately following combat or a traumatic event.
    Fact: Symptoms associated with PTSD usually occur within three months after the traumatic event6, but symptoms may not appear until six months, or even years later.7 The types of symptoms can be broken down into four categories: hyperarousal (feeling “keyed up”), avoidance (avoiding reminders of the event), intrusion (reliving the event), and feeling numb or detached.8 Nightmares, one of the most common symptoms, are experienced by 71-96 percent of those with PTSD.9Reaching out for care is an important step since symptoms, such as nightmares, may lessen or disappear and then re-appear later in life. Early intervention can provide the right coping tools to deal with these symptoms, and sometimes even prevent development of chronic PTSD. Visit the National Center for PTSD to learn more about the types of symptoms associated with PTSD.
  • Myth: Service members can never fully recover from PTSD.
    Fact: Successful treatment and positive outcome are greatly enhanced by early intervention. With therapy, and in some cases medication, the symptoms of PTSD can be greatly reduced, even eliminated.6 Treatment can help you feel more in control and teach effective coping mechanisms to deal with stressful situations when they arise. There are many types of treatment; your medical provider can help you determine which one is best. You can also contact the DCoE Outreach Center 24/7 at 866-966-1020 where highly trained professionals can answer questions and connect you with local resources for support.
  • Myth: PTSD is a sign of weakness in character.
    Fact:  PTSD is a common human reaction to very traumatic situations. PTSD seems to be due to complex chemical changes in the brain when an individual witnesses or experiences a traumatic event. The symptoms of PTSD appear to be frequently experienced in situations where someone perceives they have been exposed to a life-threatening event, although symptoms and reactions vary from person to person.10 As a service member dealing with PTSD symptoms, seeking help demonstrates strength and will provide benefits to yourself, your family, your unit, and your service. Do not hesitate to seek care – PTSD is treatable and reaching out early often leads to the best outcomes.7
Many service members have sought help and continue serving in the military, as shown in these videos. Knowing the facts about PTSD can help you overcome concerns you may have. Visit the following web sites to get additional information and resources on PTSD:


1 Carden, Michael J., Sgt. 1st Class. “Army Works to Expand Combat Stress Detection,” American Forces Press Service. Published July 22, 2010.
2 Combat Stress for Medical Providers [PDF 2.3 MB], Deployment Health Clinical Center, Department of Defense. Published August 2006.
3 Implementation of Adjudicative Guidelines for Determining Eligibility for Access to Classified Information [PDF 1.1 MB], Department of Defense. Published August 30, 2006.
4 Haire, Tamara. “Financial Problems or PTSD Need Not Affect Security Clearance,” Army News Service. Published July 8, 2009.
5 Miles, Donna. “Gates Works to Reduce Mental Health Stigma,” American Forces Press Service. Published May 1, 2008.
6 “TBI and PTSD Quick Facts [PDF 28.7 KB],” Deployment Health Clinical Center, Department of Defense. Last accessed June 19, 2014.
7 Pueschel, Matt. “Combat Exposure Raises PTSD, Smoking, Alcohol Abuse Risks,” Force Health Protection & Readiness, Department of Defense. Published May 22, 2009.
8 “What is PTSD?,” National Center for PTSD, Department of Veterans Affairs. Last accessed June 19, 2014.
9 “Nightmares & PTSD,” National Center for PTSD, Department of Veterans Affairs. Last accessed June 19, 2014.
10 Stress & Trauma, Fact Sheets: A Normal Reaction to an Abnormal Situation, Deployment Health Clinical Center, Department of Defense. Last accessed June 19, 2014.

Treatment Options for Posttraumatic Stress Disorder

Source: U.S. Marine Corps photo by Sgt. Austin Hazard/Released

Posttraumatic stress disorder (PTSD) is a psychological health concern that can occur following a traumatic or life-threatening event. You can learn to cope with and recover from these events over time. However, others may experience stress-related changes in behavior that continue for months and develop into PTSD.1 
Just as service members may experience different symptoms of PTSD, there are several options for care.
This article provides information about the types of care and treatment available for PTSD and how to access them.

What is PTSD?

PTSD may occur when you experience intense stress from a traumatic or life-threatening event, such as combat exposure, natural disasters or any event that may harm your physical or psychological well-being. Reactions to trauma may include 1,2,3:
  • Reliving:
    • Frequently remembering trauma
    • Re-experiencing fear felt at time of trauma
    • Having nightmares
    • Experiencing hallucinations
  • Avoidance:
    • Avoiding thoughts and conversations associated with trauma
    • Avoiding activities, places or people that relate to trauma
  • Negativity
    • Feeling guilty or ashamed
    • Having trouble expressing feelings
    • Feeling like no one can be trusted
    • Changing the way you think about yourself and others
  • Arousal:
    • Difficulty sleeping
    • Feeling easily annoyed
    • Extreme and constant alertness
    • Difficulty concentrating
These symptoms are common responses to traumatic events. If left untreated, they can lead to other concerns such as substance abuse, depression or relationship problems. If symptoms impact daily life, you should consider seeking professional health care.

If you or someone you know is experiencing symptoms of PTSD, make an appointment at a military treatment facility near you.

Accessing Care

Military treatment facilities are medical centers, hospitals or clinics that provide care for service members and their families. They are available on almost every installation and accept TRICARE, the insurance provider of the military health system. If you live near a military treatment facility, it should be your first stop for seeking care for PTSD.1During your visit, a health care professional will talk with you about your trauma and symptoms and provide recommendations for care.

Veterans can seek health care at a local Department of Veterans Affairs medical center. The centers provide health care for physical and psychological health concerns, including PTSD. PTSD specialists are available to help veterans access care or treatment through a program that is most appropriate for them2

If you are unsure about seeking help, you can access free resources through the Department of Veterans Affairs’ online survey. Only a health care professional can diagnose PTSD, but seek care if you receive a positive result on this health screening tool.

Treatment Options for PTSD

There are many treatment options available for PTSD. When seeking treatment, you can expect a safe and controlled setting to discuss the traumatic event and any symptoms you may have. The most common form of treatment is cognitive behavioral therapy (CBT). This can be in individual, group or family settings. Types of CBT include: 3,4
  • Prolonged Exposure Therapy: Write down or speak out loud about trauma, confront situations you have avoided and review trauma until memories are less painful
  • Cognitive Processing Therapy: Learn skills to change your negative beliefs associated with trauma and understand how it has changed your thoughts or feelings
  • Stress Inoculation Training: Learn breathing and muscle relaxation skills and practice controlling your thoughts.
Eye Movement Desensitization and Reprocessing (EMDR) is another treatment for PTSD. In EMDR therapy, you focus on sounds and alternating eye and hand movements while thinking of the trauma to reduce anxiety of the memory.4 You also learn relaxation methods to help you cope with PTSD symptoms.

Patient-Centered Community Care, a new program by the Department of Veterans Affairs (VA), offers veterans better access to high quality health care through partnerships with local community providers. These civilian providers meet VA care standards and provide additional resources for veterans who seek care for PTSD and other psychological health concerns.5

Alternative Care Options

There are alternative care options that may also provide relief for PTSD symptoms. These include:4
  • Acupuncture
  • Mindfulness (e.g., yoga, relaxation techniques)
  • Prescribed medications
A health care professional can provide guidance on the use of alternative care options in treating PTSD.

Watch the video profile of 1st Sgt. Aaron Tippett who began counseling through the RESPECT-Mil programafter his diagnosis with PTSD. He shares his recovery story and how seeking care has helped him cope with PTSD and advance in his career.

Reaching Out Makes a Difference

Reaching out for support is a sign of strength. Treatment options are accessible and can be effective in helping you cope with PTSD. If you or someone you know is in need of immediate help, log on to Real Warriors Live Chat or call the DCoE Outreach Center at 866-966-1020. Trained health care professionals are available 24/7 to offer free assistance.

Additional Resources

1 “Understanding PTSD,” [PDF 1.36MB] National Center for Posttraumatic Stress Disorder. Published August 2013.  Last accessed July 29, 2014.
2 “PTSD Treatment Programs in the U.S. Department of Veterans Affairs,” Department ofVeterans Affairs. Last updated Jan. 3, 2014.Last accessed July 29, 2014.
3 "Understanding PTSD treatment,” [PDF 1.45MB] National Center for Posttraumatic Stress Disorder. Published August 2013. Last accessed July 29, 2014.
"PTSD Treatment Options,” Defense Centers of Excellence for Psychological health and Traumatic Brain Injury. Last updated June 29, 2014. Last accessed July 29, 2014.
5 “PC3,” Department of Veterans Affairs. Last updated April 11, 2014. Last accessed July 29, 2014.

Five Steps Veterans Can Take to Support PTSD Treatment

Recovery from posttraumatic stress disorder (PTSD) can be an ongoing, daily and gradual process.1 It does not happen through sudden insight and it requires veterans to use their strength to reach out for treatment. But influences outside of treatment such as support from fellow veterans, continuing education or returning to work can have a positive influence on recovery. If you are a veteran coping with PTSD, consider taking the following five steps to support your return to peak performance.

1. Lean on Your Fellow Veterans
Stress injuries are common among veterans of the conflicts in Afghanistan and Iraq, so you are not alone. Reaching out to other brave men and women who have served our nation can bolster your return to peak functioning, and support groups for PTSD are available at each stage of the recovery process. These groups focus on topics ranging from overcoming daily challenges to entering into VA or DoD counseling programs.2 Whatever the topic, support groups can offer veterans coping with PTSD a sense of community and encouragement during a time of uncertainty.
Support groups can be held in informal environments, such as another veteran’s home or a community center, or in settings such as a Vet Center or VA Medical Center. They offer helpful information and encouragement to those who are looking for information about seeking professional, clinical counseling, and can show veterans that seeking treatment is a sign of courage. Finally, PTSD support groups provide an environment filled with others who have shared traumatic experiences and begun to follow a path toward recovery.

Tools for Success

Use the following resources to find PTSD support groups in your area:
2. Continue Your Education with Support from VA
Continuing your education can positively influence recovery from PTSD, and enrolling in a degree or certificate program can help channel your thoughts toward learning and new ways to be involved in productive activities.

Photo by Staff Sgt. Orly N. Tyrell

Veterans who have successfully coped with PTSD have found that working towards a goal like a degree or certificate can be beneficial to recovery. (Watch Staff Sgt. Megan Krause discuss how she coped with PTSD while pursuing her degree.)

Tools for Success

In recognition of their service, VA provides three programs to veterans to aid them in continuing their education:
  • The Post-9/11 GI Bill is the largest investment in veterans’ education since World War II, covering the full cost of an undergraduate education at any public university or college in the country, as well as many private schools
  • The Montgomery GI Bill – Active Duty provides up to 36 months of education benefits to eligible veterans for several types of education, including college, vocational courses and flight training
  • The Reserve Educational Assistance Program (REAP) was established in 2005 to provide educational assistance to veterans from Reserve components called or ordered to active duty in response to a war or national emergency.

3. Return to Work or Volunteering
One of the major symptoms of PTSD is a strong feeling of anxiety. Employment offers an opportunity to keep focused on specific tasks, minimizing the amount of time the mind has to wander back to stressful memories. In addition, seeing that you can achieve goals at work while coping with symptoms of PTSD can help you feel more empowered in your quest for full recovery.
Volunteering for a community organization is a similar way to positively aid your recovery. Working with local youth programs, medical services, literacy programs or sporting activities allows veterans to feel they are contributing to their community.1

Tools for Success

To start searching for a job today, use the following resources:
4. Exercise to Relax Your Body and Mind
Exercise can benefit those coping with PTSD. Activities like jogging, swimming, weight lifting and walking may reduce physical tension, and activities like stretching, yoga or pilates are effective relaxation techniques. Using these types of activities can help you feel more energized and confident, and can provide a break from painful memories or difficult emotions. Perhaps most importantly, exercise can improve self-esteem and create feelings of personal control.1 (Always be sure to consult with your health care provider before starting any new exercise program.)

Tools for Success

Learn more about how regular exercise can reduce stress and positively impact recovery:
  • Read a success story about a wounded Navy corpsman who used exercise to support his recovery from PTSD and substance misuse

5. Talk with Your Social Support Network
It’s easy to feel lonely when you’re coping with PTSD, but you are not alone and isolation can actually make you feel worse.3Reestablishing or increasing contact with a child, spouse, partner, friend or work colleague can help you feel less isolated, and aid in your recovery.1 Members of your social support network are an important part of your recovery, and they are there to listen and help you through rough times.2 In addition, research shows that spending time talking with friends can make you feel better and have a significant effect on your health.4 So don’t isolate yourself — use the strength you built as a warrior to reach out to your family, friends, colleagues or fellow veterans for support.

Tools for Success

To get free, confidential advice about tools for discussing PTSD — or for information about any of the tools discussed above — contact a trained health resource consultant 24/7 at the DCoE Outreach Center:
Make the Connection is a public awareness campaign sponsored by the Department of Veterans Affairs that connects veterans and their families with information and resources to help them cope with transitions, physical and psychological health concerns and challenging life events.

Additional Resources

Making a plan to talk with a health care provider about your psychological health concerns is an important step toward improving your overall health. If you have been through trauma or other challenges, it may be hard to talk about your experiences. A health care provider can help you understand your feelings and maintain your mental fitness. This article offers useful tips to help you choose a provider, prepare for your first appointment and make the most of your visit.

Finding a health care professional that you are comfortable with can help you have a positive experience. If the first provider you meet is not right for you, keep looking until you find someone you feel comfortable connecting with. A psychological health care professional should:
  • Respect you and your feelings
  • Allow you to express yourself
  • Understand that you may need time before you are ready to talk
  • Talk to you about a plan to help address your concerns

Keep track of any feelings or symptoms you experience with as much detail as possible, such as:
  • How long the feeling or symptom lasts
  • Triggers-such as events, experiences or thoughts- that may make your symptoms worse and what you did to make them better
List your medical information. Include any:
  • Physical or psychological concerns
  • Names and dosage of medications or supplements

  • What‘s causing my symptoms?
  • What treatments, if any, do you recommend?
  • Where can I find more information about coping with my symptoms?

Your provider may give you a lot of information during your first appointment. You may feel overwhelmed by everything you learned, which can make it hard to remember all that was said. Ask a family member or friend to go with you or plan to take notes to keep track of all the information you receive.
Not sure how to start talking about a traumatic event?Use this checklist as a guide. Fill it out and show it to your health care professional during your visit.

Talking about your psychological health can be challenging, but getting help early can improve your chances of a full recovery. Reaching out is a sign of strength and talking with a professional can help. If you or a loved one needs additional support, contact the DCoE Outreach Center to speak confidentially with trained health resource consultants 24/7 by calling 866-966-1020, by using the Real Warriors Live Chat or by emailing resources@dcoeoutreach.org. Watch video profiles to learn about service members who have successfully used the Military Health System and other psychological health resources for support.

The Department of Veterans Affairs National Center for PTSD provides print and digital educational resources to promote understanding and awareness of PTSD. This PTSD Awareness Month, visit the AboutFace portal where veterans, their family members and health care professionals can learn more about common concerns associated with PTSD treatment and care through personal stories.