PTSD is a psychiatric condition that is classified as a trauma and stressor-related disorder by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). PTSD involves re-experiencing an extremely traumatic event (this event is referred to as the “stressor”) and is usually accompanied by increased arousal, nightmares, flashbacks, difficulty sleeping, difficulty concentrating, and difficulty with memory among numerous other symptoms. A traumatic event is a life-threatening event such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood. Symptoms of PTSD usually start soon after the traumatic event, but might not become apparent for weeks, months, or even years after the traumatic event. Some common symptom patterns of PTSD include:
- Developing PTSD symptoms soon after returning from war, with those symptoms lasting into old age.
- Developing severe PTSD symptoms right after their traumatic experience that decrease in severity over the years, and then worsen again later in life.
- Developing PTSD symptoms later in life rather than soon after returning from war.
As the last two patterns suggest, PTSD symptoms may worsen later in life, and might not even develop until later in life. A study published by the VA contains some insight into why veterans are having more problems with PTSD symptoms as they age. This study explained how older veterans are faced with different factors which impact PTSD. Some of these factors include:
Retirement
Many veterans throw themselves into work upon returning home from serving as a way to cope with traumatic experiences they may have had. Work can be used as a way to keep the mind occupied. However, as the veteran gets older, retirement comes into the picture. Retirement can result in less structure, and more free time to think then the veteran had while they were distracted with work. Retirement can also be stressful because it might trigger feelings of different types of losses such as identity, activities, and/or income.
Increased health problems
With age comes increased medical problems. PTSD has been associated with other health problems such as cardiovascular disease, obesity, diabetes, and sleep apnea. These health problems then, in turn, can make the PTSD worse. It’s a cycle of PTSD causing secondary problems, and those secondary problems then impacting the PTSD. Another health problem that is of concern for older veterans is dementia. Veterans with dementia experience more severe PTSD symptoms and PTSD is a risk factor for dementia. So, the two can sometimes go hand in hand just like other health problems that impact the severity of PTSD.
Unhealthy methods of coping
It’s common for veterans to self-medicate with drugs or alcohol as a way of coping with traumatic experiences they went through in service. Years of substance abuse can wreak havoc on the body both physically and mentally forcing a veteran to give up alcohol and/or drugs. When this happens, the veteran no longer able to ignore the reality of their PTSD symptoms, and can see an increase in flashbacks, nightmares, or hypervigilance.
Social isolation
Oftentimes, veterans with PTSD may struggle with isolating themselves. This isolation can become an even bigger problem for older veterans. An article titled “The 2030 Problem: Caring for Aging Baby Boomers” states social connections are closely related to mental health and cognition. The article goes on to explain how “persons who had no social ties were twice as likely to experience cognitive decline compared to those persons with five or six social ties,” and approximately 6.4 million elderly people are socially isolated to a point that their health is at risk.” So, as a veteran gets older they are more likely to become isolated. Combine this with the fact that PTSD also makes someone more likely to become isolated, and it’s clear how a veteran with PTSD may see their symptoms increase with their age.
What does all of this mean for your VA disability claim? As mentioned above, sometimes PTSD does not develop until later in life. If you have been denied service connection for PTSD because the VA says your diagnosis is too far removed from your service, a psychiatrist or psychologist may be able to provide their independent medical opinion explaining how, and why, your PTSD did not develop until years after the in-service traumatic event. Also, if you have already been service connected for PTSD, it is important to note any changes in your symptoms as time goes on. If your PTSD symptoms get worse as you get older (for example, after retirement), you may need to file a claim for an increased rating.