Article originally published on MFed Inform.

Posttraumatic stress disorder (PTSD) is an increasingly important topic and issue within the U.S. military, across all Services. With thousands of counselors around the globe providing health and wellness care on military installations, Magellan Federal has a wealth of knowledge on PTSD and we would like to raise awareness around the symptoms, causes, and share some of the resources available to those who suffer from it.

Get to Know PTSD

PTSD is a medically diagnosed mental health condition that can develop after experiencing, witnessing, or learning the details of a traumatic event. Common causes include:

• Combat
• Threat of injury or death
• Terrorist attack
• Serious accident
• Sexual assault
• Physical assault
• Natural Disaster
• Childhood sexual or physical abuse

There are four different categories of symptoms that must be present for a diagnosis of PTSD:

1. Intrusions: recurring distressing memories, dreams, or flashbacks
2. Avoidance: staying away from people or places that remind them of the trauma
3. Persistent negative mood or thoughts: inability to experience positive emotions; excessive blame, fear, shame and/or guilt; detachment from others
4. Arousal or reactivity: irritability, hypervigilance, difficulty concentrating, self-destructive behaviors

PTSD became a mental health diagnosis in 1980 with the influence of social movements, such as veteran, feminist, and Holocaust survivor advocacy groups. Research about veterans returning from combat was a critical piece to the creation of the diagnosis. So, the history of what is now known as PTSD often references combat history.[i]

Prevalence in Service Members

According to the Defense Health Agency, between 2016–2020, 93,346 Service members received care for PTSD in the Military Health System and 74,232 of those Service members were diagnosed during or following deployment.[ii]

Available Programs and Resources for Service Members

While individual, trauma-focused psychotherapy is the first line of treatment recommended for PTSD, non-clinical support is also important and available to enable the healing process.

Magellan Federal helps deliver the Defense Health Agency’s Warrior Care Recovery Coordination Program (WC-RCP) to proactively support Recovering Service members (RSMs) who have been wounded, ill, and injured – including those with PTSD – in their recovery and reintegration into military service or transition to civilian life through non-clinical specialized programs and resources that also include support for their families and caregivers. Some of these programs and resources include:

Recovery Coordination Program (RCP): Under this program, available to all branches of service, Recovery Care Coordinators (RCCs) work closely with each Service member to develop a non-medical plan for recovery. Service members who may be suffering from PTSD are eligible to receive the support of an RCC.

RCCs are available at military treatment facilities and installations across the country. You can access assistance through your military services’ wounded, ill, and injured programs including:

• S. Army Recovery Care Program (ARCP)
• S. Navy Wounded Warrior – Safe Harbor (NWW)
• S. Air Force Wounded Warrior Program (AFW2)
• S. Marine Corps Wounded Warrior Regiment (USMC WWR)
• S. Special Operations Command (USSOCOM) Warrior Care Program
• S. Army Reserve Recovery Coordination Program

Military Caregiver Support: Provides resources and information for military caregivers who assist RSMs with activities of daily living. Since 2013, DoD’s support for military caregivers has positively impacted thousands of lives by addressing key issues that affect caregivers in the short and long term. These issues often include mental and physical health, finances, transportation, maintaining a strong family, navigating through legal issues, and housing. In partnership with the National Resource Directory (NRD), the new electronic Caregiver Resource Directory (e-CRD) is also available. The e-CRD is a live document that is searchable, ready to download, and updated weekly to populate the most current vetted caregiver-specific resources available.

Military Adaptive Sports Program (MASP): This program provides opportunities for all RSMs to participate in adaptive sports and reconditioning activities to improve their physical and mental quality of life throughout the continuum of recovery and transition. MASP is designed to enhance recovery by engaging RSMs early in individualized physical and cognitive activities outside of traditional therapy settings. Through MASP, Service members also have access to the Healing Arts, which support both physical and psychological recovery and rehabilitation from visible and invisible wounds of war including PTSD, traumatic brain injury (TBI), and others.

National Resource Directory (NRD): This website provides access to tens of thousands of vetted services and resources at the federal, state, and local levels that support recovery, rehabilitation, and community integration for Service members, wounded warriors, veterans, and their families/caregivers. There are over 300 resources readily available regarding PTSD, such as:

• PTSD Foundation of America
• Brain Injury Network
• National Center for PTSD
• National Veterans Wellness & Healing Center
• And many more…

When to Ask for Help

Remember, PTSD affects people differently and treatment is not one size fits all. If you think you or someone you know is possibly experiencing signs or symptoms of PTSD, no one has to cope alone. Help is out there in an array of forms from a variety of sources to meet anyone’s unique needs, whether it be clinical, non-clinical, or a combination of both.

To learn more about PTSD, visit https://health.mil/Military-Health-Topics/Total-Force-Fitness/Psychological-Fitness/Post-Traumatic-Stress-Disorder or https://www.ptsd.va.gov/index.asp.

To learn more about WC-RCP programs and resources, visit https://warriorcare.dodlive.mil/.

[i] Friedman MJ, MD, PhD. Department of Veterans Affairs. PTSD: National Center for PTSD. History of PTSD in Veterans: Civil War to DSM-5. Available online: https://www.ptsd.va.gov/understand/what/history_ptsd.asp

[ii] Defense Health Agency, Military Health System. PTSD 101 Infographic (May 2021). Available online: https://www.health.mil/-/media/Images/MHS/Infographics/June-Toolkit-2021/PTSD-101-Infographic.ashx

Anyone who has gone through a traumatic event can develop symptoms of stress disorders such as post-traumatic stress disorder (PTSD).  Although the COVID-19 pandemic in general would not meet the criteria for formally causing a stress disorder, many of the same issues can result from such a widespread and overwhelming event.

The pandemic could be viewed as a long-term stress event.  It has become life-changing for the whole world.  As COVID-19 spreads across the globe, people may experience increased anxiety and fear triggered by the pandemic and constant news. In addition, the pandemic can be traumatizing for others: healthcare workers, people who have lost friends and loved ones, and people whose lives have drastically changed.

What are stress-related disorders?

Stress-related disorders can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening. These symptoms can change your behavior and how you live your life.

How can reaction to the COVID pandemic be similar to a stress disorder?

When you struggle with a stress disorder, it can be hard to anticipate when anxiety or depressive symptoms may flare up. Although it may appear that symptoms come out of nowhere, in most cases they are cued by factors called triggers. Internal triggers are the feelings, thoughts, memories, emotions, and bodily sensations that you feel or experience. External triggers are the people, places, and situations that can bring back memories of the traumatic event.  In the current environment this could be caused by news reports, social media or discussion with friends or family.

The first thing to realize is that many fears are unwarranted; anxiety may arise when you are in a completely safe environment. When you begin to despair or your fears consumer you, try to remember that your worries and fears may be extreme because of previous experiences and not current facts. Once you’ve realized what may trigger these fears and anxiety, you can begin to try to deal with them.

How to cope with stress-related symptoms amid COVID-19

• Cultivate ways to be calmer. It’s understandable to feel anxious and worried about what may happen. While circumstances may be stressful and beyond your control, you can try to offset them with positive, calming activities. Practice slow, steady breathing and muscle relaxation, as well as any other actions that are calming for you (yoga, exercise, music, keeping the mind occupied).
• Understand what is within your control. Accept circumstances that cannot be changed and focus on what you can do. Evaluate your risk of contracting the virus, practice social distancing and follow clinical guidance on other practices. If you are in quarantine or isolation, do things that can support your mental health.¹ Focusing on what you can control and do can help you deal with the unknown.
• Remain hopeful. Keep a long-term perspective. Look for opportunities to practice being more patient or kind with yourself, or to see the situation as an opportunity to learn or build strengths. Celebrate successes, find things to be grateful about, and take satisfaction in completing tasks, even small ones. Remember that this will not last forever.
• Lean on your network. Make the most of technology and stay in touch with colleagues, friends and family via phone calls, texts, social media and video conferencing. Consider joining a free support group online to stay connected.² If you have a therapist, try to continue your treatment by phone or online.
• Focus on the potential positives. Try and focus on the things that can be viewed positively such as spending more time with family and a experiencing a potential to grow. Many times, going through a stressful time like this can lead to post-traumatic growth. This growth can be seen as though the stressful event was a trial or challenge that you conquered, something you learned from and became more resilient through. Sometimes stress can stimulate personal growth and improved overall coping.

For more information and tips, www.MagellanHealthcare.com/COVID-19.

Overview

Post-traumatic stress disorder (PTSD) is a mental health disorder. Many people believe things about mental health disorders that aren’t true. Here are some myths about PTSD.

Myth: PTSD is in your head. It does not exist.

PTSD does exist. It is a recognized mental health problem that has been studied for many years. You may get PTSD if you have lived through a traumatic event that caused you to fear for your life, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

PTSD has not always had the same name. It also has been called combat fatigue or shell shock.

Myth: Only soldiers or people in war zones get PTSD.

Anyone who sees or goes through a traumatic event can develop PTSD. A traumatic event is a horrible and scary experience. During this type of event, you think that your life or others’ lives are in danger. You feel that you have no control over what is happening. These events include violent crimes, sexual assaults, childhood neglect or abuse, and natural disasters such as hurricanes or earthquakes. Your job also could expose you to traumatic events. First responders at a traumatic event, such as firefighters and police, can develop PTSD.

Myth: You should be able to move on after a traumatic event.

The strong emotions you may feel during the traumatic event can create changes in your brain that result in PTSD. You may not be able to “move on” because of this. It’s important to remember that PTSD is a medical condition. People with other health conditions, such as cancer, deal with the condition as best they can. The same is true for PTSD.

Myth: PTSD always happens right after the traumatic event.

PTSD symptoms can develop at any time after a traumatic event. Your symptoms may start soon after the event, or you may not have them until months or years later. They may come and go over many years.

Myth: People with PTSD cannot function.

PTSD can cause severe symptoms, but counseling, medicines, and support all help people adjust. People with PTSD have jobs and relationships. They enjoy life and are active members of their communities.

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Post-traumatic stress disorder (PTSD) can be a challenge for you and your family. Your family may find it hard to accept some of the changes PTSD can bring to your life. By talking and supporting one another, you and your family will be better prepared for these changes.

Family support

Your family is an important part of your recovery. They can be there to listen and to help you through rough times.

It’s also important that you help your family understand PTSD. They may not always know how to respond when they see you hurting. They may feel scared, sad, guilty, or even angry about your condition.

Talking about PTSD can help you and your family cope. Talk about your symptoms and what triggers them. Discuss different treatments and how they can help you recover. When you open up, your family can better understand what you’re going through.

Family therapy can help. This is a type of counseling that involves your whole family. A therapist can teach you how to work through problems and communicate better.

Talking with your kids about PTSD

Teaching your kids about PTSD is important. They may not understand why you’re feeling bad or why you get angry sometimes. This can be scary for kids at any age. They also may blame themselves for things that aren’t their fault. Make sure your kids understand that they aren’t to blame for your PTSD. When talking with your kids about PTSD:

• Be honest and listen to what they have to say.
• Tell them it’s okay to ask questions. Ask them how they’re feeling, and let them know that their concerns are important.
• Make sure they feel safe, secure, and loved. They may be afraid that something bad is going to happen.
• Provide information about PTSD. Let them know what it is, how you got it, and how you can recover.
• Encourage a good support system of friends outside your family. Get them involved in school activities or youth programs in the community.
• Don’t promise that your PTSD is going to go away soon. Instead, talk about how treatment can help you feel better. It’s okay if you don’t have all the answers.
• Be as positive as you can. Your kids will notice how you react in difficult situations, which can influence their reactions.

Triggers Things that suddenly remind you of your traumatic event are called triggers. Triggers can bring up stressful feelings or cause you to have flashbacks, which means you feel like you’re reliving the event all over again.

Trying to avoid triggers is a common reaction. It’s normal to stay away from things that cause you stress. Because of this, you may feel like you can’t do the things you used to enjoy. This may be hard on you and your family.

Talk with your family about your triggers. They need to know what causes you stress. By being aware of your triggers, your family can help you find ways to cope with them.

Some common triggers include:

• Places, social events, or even smells and sounds. For example, smoke may trigger memories in someone who was hurt in a fire. Or a car that backfires may remind a veteran of gunfire.
• Being around others who were involved in your traumatic event. This may happen when veterans have a reunion.
• The anniversary of your traumatic event. Try to plan enjoyable activities on and around the anniversary date. It may help to be with friends or family.

Coping with holidays

Big holidays like Christmas and New Years can be stressful. The holidays can be a painful reminder of past times when life seemed better. Big groups of family and friends are often part of the holidays.

This may be stressful because:

• Groups tire you out or make you feel overwhelmed.
• You feel pressure to join family activities when you’re not up for it.
• You feel like you have to act happy when you’re not.

Your loved ones also might ask you questions about your life or about PTSD. You may not feel comfortable answering these questions. Keep in mind that your family may feel some of the same pressures.

You can cope with holiday stress by:

• Setting limits. Don’t join activities for longer than you can handle. You can choose when you want to be a part of the group.
• Taking breaks. Go for walks, or set aside a place where you can be alone for a while. This can keep you from feeling overwhelmed.
• Getting plenty of rest. Take naps if you feel like you’re not getting enough sleep at night.
• Talking with your family about how you feel. Your family can help you. Be honest with them about your stress.
• Not drinking too much. Alcohol may make your symptoms worse or cause you to have problems with your family.

For family members If you are the spouse or family member of someone with PTSD, here are some tips for helping your loved one during the holidays:

• Accept the mixed feelings your loved one may have about the holiday.
• Respect and support your loved one’s choices about being involved in the celebration.
• Plan ahead of time how you will cope with stress. This may mean talking about how your loved one will answer questions about PTSD, or deciding how long you will stay at a party.
• Remember to take care of yourself. Do things for yourself to relieve stress.
• Keep your expectations realistic.