Posttraumatic stress disorder (PTSD) does not occur only to soldiers. PTSD can occur as a result of any number of traumatic experiences including violent assault, school bullying, and natural disaster. There are a large number of civilians who suffer from PTSD.
Nonetheless, PTSD has become a serious and prevalent problem among military personnel. At the height of the war in Iraq the number of suicides related to PTSD among soldiers sometimes exceeded the number of combat deaths for a given week. The Department of Veterans’ Affairs (VA) reports that PTSD is the number one reason for claiming veteran’s benefits for disability, and that among those who claim disability the majority list PTSD as their primary disability.
The Military Response to PTSD
In response to this situation the military has taken a proactive stance in the study and treatment of PTSD. Military programs have taken the lead in dealing with PTSD and may be viewed as both an experiment and a model of how best to treat PTSD. The military has increased its staff devoted to treating soldiers with PTSD and has commissioned a five year study of the condition. It is going to great lengths to diagnose the condition early in order to prevent the most serious and tragic consequences, including suicide.
Early diagnosis is one of the most important aspects of PTSD treatment, and includes watching for common symptoms including sleep disorders, substance abuse, dream disturbances, re-experiencing of the event, and thoughts of suicide.
A Model for PTSD Treatment
A model program for the treatment of PTSD has been implemented at the Landstuhl Regional Medical Center (LRMC) in Germany. Dr. Daphne Brown, chief of the Division of Behavioral Health at LMRC, speaks of adopting a “kitchen sink” approach to PTSD treatment, utilizing “all the evidence-based treatment for PTSD that we know about” including cognitive behavioral therapy (CBT), exposure therapy, anxiety avoidance, relaxation techniques such as yoga and meditation, eye movement desensitization and reprocessing (EMDR), individual and group therapy, and anger management. The program also employs techniques designed to help with the specific issues common to PTSD including smoking cessation, pain management, self-esteem building, and help with relationship issues.
The LMRC program has been designed with the benefit of the knowledge gained in treating PTSD by Walter Reed Army Hospital, the VA and private practitioners throughout the U.S. Joseph Pehm, chief of Medical Social Work at LMRC, calls the program “holistic” and considers this approach necessary due to the nature of PTSD, which typically impacts all areas of the person’s life, and is not simply a medical or psychological issue.
Ideally recovery will progress in stages. Initially patients are helped to cope with the tangible effects of PTSD. This initial stage of treatment may be thought of as “damage control” or symptom management. Often the most important issue at the beginning of treatment is helping the patient to cope with depression and avoid the possibility of suicide.
Secondary stages of treatment will help the patient to cope with other everyday issues affected by PTSD. Over time more introspective aspects of therapy such as CBT will help the patient to confront and deal with the traumatic experience at the heart of the condition. Eventually the patient should be able to leave the past behind and move forward.