PTSD Awareness: How to Recognize and Treat Symptoms in Veterans
Post-traumatic stress disorder (PTSD) is a condition that can develop after experiencing or witnessing a traumatic event.
For veterans, these events can stem from combat exposure, trauma, or other highly stressful, life-threatening situations experienced during service. While anyone can develop PTSD, veterans face unique risk factors that can make the condition more complex and persistent.
The symptoms of PTSD can affect daily life, relationships, career, and overall well-being. It’s a complex condition that is often silent and unseen.
In its recent Warrior Survey*, Wounded Warrior Project® (WWP) found that 77% of warriors report PTSD.
Left untreated, PTSD can be debilitating, but it can also be managed with the right support, treatment, and intervention. WWP™ is committed to helping veterans manage the symptoms of PTSD, build connections with others, and thrive for a lifetime.
What is PTSD?
PTSD is a mental health diagnosis that can occur after a person has experienced a traumatic event. While emotional aftershocks of trauma are natural, PTSD involves symptoms that persist for weeks, months, or even years and interfere with daily functioning.
The American Psychiatric Association formally introduced PTSD as a diagnosis in 1980. Since then, understanding of the condition has evolved through ongoing research, especially in military and veteran populations.
The Department of Veterans Affairs (VA) recognized PTSD as a signature wound of the wars in Afghanistan and Iraq. In fact, the National Center for PTSD estimates that up to 20% of veterans who served in these post-9/11 conflicts may experience PTSD.
Causes of PTSD in Veterans
While every veteran’s experience is different, certain events may trigger PTSD. These include:
- Witnessing death or physical injury
- Acts of war
- Sexual abuse
- Accidents
- Natural disaster
- Physical violence
- Moral injury
Combat Exposure and PTSD in Veterans
Combat exposure is one of the most recognized causes of PTSD among veterans. Experiencing life-threatening situations, seeing death, or being exposed to acts of war can create lasting psychological impacts. Many service members can develop PTSD symptoms after returning home, and intrusive memories begin to resurface.
Military Sexual Trauma and PTSD in Veterans
Military sexual trauma (MST), which includes any sexual harassment or sexual assault that occurs while a service member is in the military, can cause PTSD. In WWP’s most recent Warrior Survey*, 1 in 8 WWP warriors are MST survivors; 53% are female, and more than 3% are male.
Moral Injury and PTSD in Veterans
Moral injury refers to the emotional and psychological distress that occurs when a service member experiences, witnesses, or participates in actions that violate their personal moral or ethical code. This type of trauma can cause deep feelings of guilt, shame, or betrayal and can contribute to the development of PTSD.
Other Traumatic Events and PTSD
Other traumatic experiences, such as training accidents, physical assaults, or natural disasters during service, can also lead to PTSD. This means that service members do not need to be in combat to develop PTSD.
“While PTSD is often associated with military service, it’s important to remember that the condition can affect anyone,” said Erin Fletcher, Psy.D., who serves as the Warrior Care Network director for WWP. “Not everyone who witnesses or experiences a traumatic event will develop PTSD.”
Symptoms of PTSD in Veterans
Symptoms of PTSD can challenge daily activities and overall quality of life. These can disrupt relationships and a veteran’s ability to function, affecting their livelihood.
Symptoms of PTSD vary but may include recurring memories or nightmares and intense physical reactions to reminders of trauma. Negative changes in mood or thinking may occur.
“Recognizing symptoms and getting an accurate diagnosis is key to effective treatment,” said Dr. Fletcher, noting that PTSD may occur in tandem with other health conditions, such as depression, anxiety, and traumatic brain injury (TBI). PTSD typically involves four primary types of symptoms:
- Intrusion: Reliving the traumatic event through flashbacks, nightmares, and frightening thoughts that can result in physical symptoms such as racing pulse, sweating, pain, feeling sick, and tremors.
- Avoidance: Intentionally avoiding thoughts, situations, people, places, activities, objects, or feelings that trigger recall of the traumatic event.
- Hypervigilance and reactivity: Feeling “on edge,” always “on alert,” tense, jittery, and anxious, resulting in irritability, trouble sleeping, being easily startled, angry outbursts, difficulty concentrating, self-medicating, or self-destructive behaviors
- Negative thoughts or mood: Experiencing negative thoughts and feelings about oneself, the event, or others; loss of interest in hobbies; and frequent feelings of guilt, shame, or blame
Other FAQs about Veteran PTSD
Below are some other common questions about PTSD in veterans.
How many veterans have PTSD?
VA estimates that at least 7% of all veterans will have PTSD during their lifetime. In Wounded Warrior Project's most recent Warrior Survey*, 77% of the veterans WWP serves report PTSD.
Do all combat veterans get PTSD?
No, not all combat veterans get PTSD. While combat is a risk factor, not everyone will develop PTSD.
Are there other health issues or lifestyle risks that can impact PTSD?
Lack of quality sleep, chronic pain, and substance use can make symptoms of PTSD, depression, and anxiety worse, said Dr. Fletcher. WWP’s Warrior Survey shows that financial strain, loneliness, and not having a support network may also impact mental health symptoms. .
Is treatment available for PTSD if I (or a loved one) has another condition?
Yes. Most veterans have co-occurring conditions like depression, anxiety, substance use, or chronic pain. Some veterans also have traumatic brain injury (TBI). Treatment is available and can be customized for veterans to help manage their PTSD symptoms and other challenges.
Is it true that it will take years for PTSD to improve?
No. This is a common misconception. Effective treatment helps reduce PTSD symptoms, and sometimes noticeable improvements can appear within a few weeks.
How can I help a veteran with PTSD?
PTSD doesn’t occur in a vacuum. Dr. Fletcher offers the following advice to loved ones of those who have PTSD:
● Learn about PTSD and its effects.
● Be willing to listen without trying to fix them.
● Encourage them to seek treatment and participate in activities. Find support for yourself, too.
● Recognize symptoms, even in yourself. Living with someone with PTSD can sometimes result in a condition called secondary PTSD.
This can occur when a partner or family member feels symptoms that are similar to PTSD.
When was PTSD first diagnosed in veterans?
Historians have documented accounts of military trauma throughout history. Hippocrates detailed a soldier's experience returning home from battle in a poem as early as 50 B.C. The American Civil War (1861-1865) and the Franco-Prussian War (1870-1871) marked the start of formal medical attempts to address the problems faced by military veterans exposed to combat.
Can loved ones or family members also experience PTSD?
Yes. Living with someone with PTSD can sometimes result in a condition called secondary PTSD. This can occur when a partner or family member feels symptoms that are similar to PTSD. There is support and resources to help both the veteran and their loved one(s).
When is PTSD Awareness Month?
June is PTSD Awareness Month. It began in 2010 when the U.S. Senate designated June 27 as National PTSD Awareness Day. In 2014, the observance expanded to cover the entire month.
PTSD Treatment Options for Veterans
“In the past, we didn’t always know how to identify PTSD, so treatment was very limited. The old solution was to ‘shove the feelings down’ and stay busy. We now know that doesn’t work,” said Dr. Fletcher.
“PTSD is now treatable thanks to many years of research, new innovations, and advances in care. PTSD no longer has to be a lifelong burden,” she added. “Today, we now have a wide range of options that meet veterans where they are.”
There are several levels of care for PTSD. The three most common are:
- Outpatient therapy: Weekly sessions with a licensed mental health provider.
- Residential programs: Intensive inpatient care.
- Alternative therapies: This includes several activities, from physical activity to mindfulness, journaling, art therapy, equine therapy, and more.
“There’s no one-size-fits-all approach,” Dr. Fletcher said. “Some veterans thrive with outpatient therapy, while others benefit from immersive programs.”
Individualized Intensive Treatment for Every Veteran
Recognizing that each type of treatment has value – but that each veteran is unique – WWP launched Warrior Care Network (WCN) in 2015 to provide individualized, evidence-based PTSD treatment for veterans.
The accelerated brain health treatment program integrates clinical support with alternative therapies to offer a personalized approach to healing. The two-week program, which is available at no cost to veterans, is hosted by four nationally known medical centers:
- Emory Healthcare Veterans Program
- Home Base (Massachusetts General Hospital)
- Operation Mend (UCLA Health)
- The Road Home Program (RUSH University Medical Center)
Among the services Warrior Care Network offers:
- Individual and group therapy sessions.
- Family support and resources.
- Fitness and nutrition education.
- Alternative therapies such as yoga, art, tai chi, and equine therapy.
Dr. Fletcher said another unique aspect of WCN is that veterans don’t need to “fail” other treatments to qualify.
“Warrior Care Network meets them where they are. We don’t offer a cookie-cutter approach to care. It’s about helping each individual veteran find their path to healing. That’s what makes the program so special," she said.
For instance, other programs may require participants to have completed treatment for substance use before receiving care for PTSD. “At Warrior Care Network, substance use does not have to be a barrier to PTSD treatment. We will work with veterans to create a treatment plan that addresses their unique situation."
Since its launch a decade ago, WCN has provided over 300,000 hours of clinical care to more than 5,000 warriors nationwide, and the results are phenomenal.
“Ninety-six percent of warriors would recommend WCN to a fellow warrior,” Dr. Fletcher shared. “And 90% of warriors reported feeling better after completing the program. That’s what matters—it’s from the warriors themselves saying, ‘I feel better because I completed this program."
The Future of PTSD Care and Treatment
Technology is changing both the delivery and access to mental health care. Through its partnership with these academic medical centers, WWP helps narrow the gap between research and clinical PTSD treatment.
"It is through these collaborations that we can look at new treatment options for mental and brain care, so that all people, not just veterans, have hope for healing. We are constantly reviewing and identifying potential new therapies,” said Dr. Fletcher.
To date, WWP has invested more than $336 million in Warrior Care Network. “We are striving to provide the most effective treatment for all veterans,” said Dr. Fletcher. That’s why we’re investing in research that can be implemented quickly to benefit WWP warriors and the veteran population as a whole.”
Among the research underway at the academic medical centers within Warrior Care Network:
- Machine learning: A type of artificial intelligence that helps match each veteran with the right treatment at the right time, explained Fletcher.
- Virtual reality: Used in combination with prolonged exposure therapy to help veterans confront traumatic memories in a safe, controlled environment.
- repetitive Transcranial Magnetic Stimulation (rTMS): Non-invasive brain treatment used to address PTSD and also to treat depression. rTMS gained FDA approval in 2008 to treat depression, and the VA is actively researching its effectiveness in veterans.
- transcranial Direct Current Stimulation (tDCS): This technique relies on non-invasive electrical brain stimulation to target chronic pain, which often co-occurs with PTSD.
- Psychedelic-Assisted Therapy: Studies are underway to look at the effectiveness of certain drugs in combination with existing evidence-based treatments to treat PTSD and depression.
Life After Treatment: How Veterans Can Manage PTSD
Recovery doesn’t end when a program does. For many veterans, it marks the start of a longer journey, one focused on applying and maintaining skills they’ve learned, said Dr. Fletcher. “What you get from treatment are the skills and tools. Life still happens, but you are now better equipped to handle challenges.”
Dr. Fletcher shares several ways that can help veterans manage PTSD symptoms and maintain long-term well-being.
- Support and connection: Isolation is a common challenge for those living with PTSD. Through specific connection events and peer support activities, WWP offers many opportunities for veterans – and their loved ones – to connect with others who understand their experiences. In-person and virtual events are available.
- Building resiliency: Enhancing mental resilience can help veterans reduce stress and improve their well-being. WWP offers many activities that teach the principles of mindfulness as well as other healthy coping strategies and skill-building. “Programs like Project Odyssey®, for instance, which rely on adventure-based learning, help warriors gain confidence and grow their resilience,” Fletcher said.
- Emotional support: “Sometimes, you just want someone to talk to, so you can have support without judgment,” said Dr. Fletcher, noting the beauty of WWP Talk, a program that provides guidance and emotional support via a weekly phone call.
- Physical health: “The body and mind work in tandem, so improvements to physical health also support the mind,” said Dr. Fletcher. WWP’s Physical Health and Wellness programs support veterans with personalized plans for exercise, sleep, nutrition, and hydration.
Reclaiming the Future
The stigma around PTSD is fading, and with more awareness and understanding, more veterans are seeking help and finding hope. “Early intervention, education, and individualized care can help veterans reclaim their lives,” said Dr. Fletcher.
PTSD is a complex condition. It’s often silent and unseen, but effective treatment and support can offer a path toward recovery. Veterans don’t have to face it alone; connecting with resources and trusted professionals is a critical step.
If you think you or a loved one has PTSD, get connected with the WWP Resource Center by phone at 888.WWP.ALUM (997.2586), email, or live chat. Help is available.
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*Warrior Survey, Wave 3 (conducted June 15 - Aug. 24, 2023)
Contact: Cynthia Weiss – Public Relations, cweiss@woundedwarriorproject.org, 904.738.2589
About Wounded Warrior Project
Wounded Warrior Project is our nation’s leading veterans service organization, focused on the total well-being of post-9/11 wounded, ill, or injured veterans. Our programs, advocacy, and awareness efforts help warriors thrive, provide essential lifelines to families and caregivers, and prevent veteran suicides. Learn more about Wounded Warrior Project.
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