This condition wasn’t always understood properly by the medical or military community, and Department of Defense press releases often point to earlier attempts to identify PTSD symptoms in the wake of service in World War 2, Vietnam, and other conflicts.
PTSD Awareness Day is observed today, Saturday, June 27, 2020.
The History of PTSD Awareness Day
In 2010, Senator Kent Conrad pushed to get official recognition of PTSD via a “day of awareness” in tribute to a North Dakota National Guard member who took his life following two tours in Iraq.
Staff Sergeant Joe Biel died in 2007 after suffering from PTSD; Biel committed suicide after his return from duty to his home state. SSgt. Biel’s birthday, June 27, was selected as the official PTSD Awareness Day, now observed every year.
How Do People Observe Post-Traumatic Stress Disorder Awareness Day?
Much of what is done to observe PTSD Awareness Day involves encouraging open talk about PTSD, its’ causes, symptoms, and most important of all, getting help for the condition. When today, PTSD is often misunderstood by those lacking firsthand experience with the condition or those who suffer from it. PTSD Awareness Day is designed to help change that.
The Department of Defense publishes circulars, articles, and other materials to help educate and inform military members and their families about the condition. The Department of Veterans Affairs official site has several pages dedicated to PTSD, and when military members retiring or separating from the service fill out VA claim forms for service-connected injuries, illnesses, or disabilities, there is an option to be evaluated for PTSD as a part of the VA claims process.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder is a form of anxiety that can happen after experiencing or witnessing actual or near death, serious injury like car accidents or natural disasters, war-related violence, terrorism or sexual violence, according to the American Psychiatric Association. While most people typically connect this disorder to military veterans or refugees, it can happen to anyone.
Almost no other psychiatric diagnosis has generated as much controversy. The diagnosis is almost four decades old. PTSD is not a sign of weakness, and people can be affected by PTSD, even when they were not directly part of the traumatic event. The current American Psychiatric Association’s Diagnostic and Statistical Manual, DSM-IV, says PTSD can develop through a range of exposures to death or injury: direct personal involvement, witnessing it or, if it concerns someone close, just learning about it.
The specific nature of the trauma can and does vary greatly. Experts are quick to point out, while combat and combat-related military service can be incredibly challenging, and while witnessing or being a victim of an event that rips the fabric of daily life can be traumatic, not everyone responds the same way. Some may develop symptoms of PTSD, while others may be unaffected.
Post-Traumatic Stress Disorder: How Widespread Is It?
Some sources estimate that as many as 70% of all Americans have experienced a traumatic event sufficient to cause PTSD or PTSD-like symptoms. That does not mean that all 70% of Americans WILL suffer from PTSD. Using these statistics, some 224 million Americans have experienced a traumatic event. Of that number, some 20% will develop PTSD symptoms, roughly 44 million people.
Of that 44 million, an estimated eight percent experience active PTSD symptoms at any one time. An estimated 50% of all mental health patients are also diagnosed with Post-Traumatic Stress Disorder.
PTSD: Often Misunderstood and Misidentified
“Shell shock” and “combat shock” were earlier attempts to define and understand the symptoms of PTSD. Post-traumatic stress disorder was often stigmatized in popular culture after the Vietnam conflict, and many films and television shows featured antagonists or unsympathetic characters suffering from “Vietnam flashbacks” or other issues.
The misunderstanding of PTSD slowly began to change in 1980 when it was recognized as a specific condition with identifiable symptoms. It was then the disorder was listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).
This manual is a diagnostic tool for mental health professionals and paraprofessional workers in the healthcare field and is considered a definitive reference. The addition of PTSD to the DSM was a highly significant development.
Today, the symptoms of Post Traumatic Stress Disorder are better understood, treatable, and recognized by the Department of Veterans Affairs as a service-connected condition. PTSD is not exclusive to veterans or currently serving members of the United States military, but a portion of those who serve are definitely at risk for PTSD.
What Are the Symptoms of Post-Traumatic Stress Syndrome?
Some PTSD symptoms may seem vague and non-specific, others are more readily identified specifically as evidence of PTSD. In this context “non-specific” means that the symptoms may be related to other mental health issues and not specifically limited to Post-Traumatic Stress Disorder.
In the same way, more “specific” symptoms may be manifest outside PTSD, but when looking for specific signifiers, these issues are common “red flags” that indicate PTSD may be the cause of the suffering rather than a different condition. This is often circumstantial, and there is no one-size-fits-all diagnosis for the condition.
The 17 Signs of Post-Traumatic Stress Disorder
Signs of PTSD can range from flashbacks to nightmares, panic attacks to eating disorders and cognitive delays to lowered verbal memory capacity. Many trauma survivors also encounter substance abuse issues, as they attempt to self-medicate the negative effects of PTSD. The Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) cites 17 major signs of post-traumatic stress disorder.
Just as not every trauma survivor will develop PTSD, not every individual with PTSD will develop the same signs – and rarely do all 17 exist in one individual.
Suicidal thoughts or self-destructive acts are often a result of PTSD or related symptoms. Anyone experiencing thoughts or urges to self-harm should seek immediate care to prevent the condition from getting worse in the short-term. (See end of article)
That said, more non-specific symptoms include varying degrees of irritability, depression, and suicidal feelings. More specific problems-especially where veterans and currently serving military members are concerned-include something known as “hypervigilance” or “hyperarousal”.
Other symptoms include repeatedly experiencing the traumatic event(s) in the form of flashbacks, nightmares, persistent memories of the event(s), and intrusive thoughts about the traumatic event(s).
These symptoms vary in intensity depending on the individual and are not as ‘standardized’ as we all would like. They may come and go, or they may be persistent over a span of time. Sometimes PTSD sufferers can be high-functioning, other times they may be more debilitated by the condition.
Experts have created categories (or “clusters”) of PTSD symptoms grouping issues like re-experiencing the traumatic event, avoidance of reminders of the traumatic event and responses of hyperarousal. PTSD symptoms will generally persist for at least a month and for many survivors, these signs represent their first struggles with anxiety.
Some of the most common symptoms of PTSD include the following:
- Intense feelings of distress when reminded of a tragic event
- Extreme physical reactions to reminders of trauma such as a nausea, sweating or a pounding heart
- Invasive, upsetting memories of a tragedy
- Flashbacks (feeling like the trauma is happening again)
- Nightmares of either frightening things or of the event
- Loss of interest in life and daily activities
- Feeling emotionally numb and detached from other people
- Sense of a not leading a normal life (not having a positive outlook of your future)
- Avoiding certain activities, feelings, thoughts or places that remind you of the tragedy
- Difficulty remembering important aspects of a tragic event
DSM-V Signs and Symptoms of PTSD
In the most recent publication of the DSM, the DSM-V, PTSD symptoms are grouped into five different clusters. One or more symptoms are required from each of these clusters in order for a patient to receive a full diagnosis.
Those clusters include:
1. Stressor – (one required) The person was exposed to injury or severe illness that was life-threatening, which includes actual or threatened injury or violence. This may include at least one of the following:
- Direct exposure to the trauma
- Witnessing a trauma
- Exposure to trauma by being a first responder, such as police, firefighter, medic, or crisis counselor
- Learning that someone close to you experienced the trauma
2. Intrusion Symptoms (one required) – The person who was exposed to a trauma then re-experiences the trauma in one or more ways, including:
- Distressing and intense memories
- Distress or physical reactions after being exposed to reminders, known as “triggers”
3. Unpleasant Changes to Mood or Thoughts (two required) –
- Blaming self or others for the trauma
- Decreased interest in things that were once enjoyable
- Negative feelings about self and the world
- Inability to remember the trauma clearly
- Difficulty feeling positive
- Feelings of isolation
- Negative affect, and difficulty feeling positive
4. Avoidance (one required) – This occurs when a person tries to avoid all reminders of the trauma, including:
- Avoiding external reminders of what happened
- Avoiding trauma-related thoughts or emotions, sometimes through the use of drugs or alcohol
5. Changes in Reactivity (two required) – This occurs when a person becomes more easily startled and reacts to frightful experiences more fully, including symptoms of:
- Aggression or irritability
- Hypervigilance and hyper-awareness
- Difficulty concentrating
- Difficulty sleeping
- Heightened startle response
- Engaging in destructive or risky behavior
- Difficulty sleeping or staying asleep
Symptoms must have persisted at least one month, and they must be causing distress or functional impairment of some kind. These symptoms must not be related to any substance use, illness, or medications.
Get Treatment For PTSD
Those who experience symptoms of PTSD or PTSD-like issues should seek help immediately. Department of Veterans Affairs medical facilities, private care providers, counselors, and therapists can all be helpful in establishing an initial care regimen or refer those suffering from PTSD to a qualified care provider.
The Department of Veterans Affairs has more information on help for PTSD on its’ official site including help finding a therapist.
Those experiencing suicidal feelings or self-destructive urges should get help immediately. The Suicide Crisis Hotline (1-800-273-8255) has a specific resource for veterans and the Department of Veterans Affairs offers a Veterans’ Crisis Hotline confidential chat resource.