What is PTSD?
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. PTSD symptoms fall into four categories:
- Intrusion: Intrusion symptoms are symptoms that cause the veteran to relive or re-experience the traumatic event. Examples include nightmares, flashbacks, and distress or physical reactions to triggers that remind the veteran of their traumatic event.
- Avoidance: Avoiding people, places, thoughts, feelings, or activities that are closely associated with the traumatic event. Avoiding crowds is a common avoidance symptom. Veterans might also try to keep busy or avoid seeking help in order to avoid thinking about the traumatic event.
- Negative Alterations in Cognitions & Mood: This category of symptoms includes staying away from relationships and viewing the world as completely dangerous because no one can be trusted.
- Alterations in Arousal & Reactivity: Also called hyperarousal, these symptoms include difficulty sleeping, trouble concentrating, always feeling on alert, and feeling jittery or easily startled.
Studies have found a high incidence of Post-Traumatic Stress Disorder (PTSD) among Vietnam veterans. Even decades after the war, there are still approximately a quarter of a million Vietnam Veterans that are suffering from PTSD. Today, we will look at the possible explanations for this high incidence, as well as some tips on preparing a PTSD claim.
High Incidence of PTSD in Vietnam Veterans
Over the years, PTSD has been referred to as many different things such as “shell shock,” “combat fatigue,” and “war neurosis.” PTSD was even commonly called “Vietnam Stress,” and “Vietnam Syndrome.” PTSD first became a recognized disorder in 1980, according to the National Institute of Mental Health. The VA did not recognize PTSD as diagnosable disorder until 1980 when it was added to the VA’s Schedule for Rating Disabilities. Even though PTSD because recognized as a real medical condition, the culture has been to avoid talking about PTSD because of social expectations to just move on from negative experiences. This expectation is especially common with veterans who may feel as though talking about PTSD is a sign of weakness.
Many mental health professionals attribute the high incidence of PTSD in Vietnam veterans to a lack of “decompression” time. During the Vietnam War, it was not uncommon for veterans to be in combat one day and back home with their family a couple of days later due to the availability of jet travel that was not present in previous wars. Additionally, there was a lack of public support for the Vietnam War compared to previous wars, and many of these veterans returning home were met with indifference or even hostile feelings from family, friends, and neighbors. Veterans would return home to antiwar marches and protests rather than homecoming parades.
Also, there was a very individual aspect associated with the Vietnam War. Tours in Vietnam were often solitary, individual tours. After the first few years of the Vietnam War, it was uncommon for whole units to be simultaneously sent to the war zone. The individual aspect of the Vietnam War affected unit morale, unit cohesion, and unit identification.
What was unusual about the rate of psychiatric symptoms associated with the Vietnam War was the large number of veterans that reported psychiatric problems after the war rather than during the war. Many Vietnam veterans still experience PTSD symptoms that vary from veteran to veteran including flashbacks to combat, feelings of alienation, depression, loneliness, drug and/or alcohol problems, even suicidal feelings. Another factor unique to Vietnam Veterans is the fact that at the end of the Vietnam War, the VA did not recognize PTSD as a disorder. Therefore, it was impossible for veterans to get service-connected for PTSD. Adding to that problem was the fact that obtaining treatment for psychiatric symptoms through the VA was very difficult.
Tips for Your PTSD Claim
There are three requirements for establishing a claim based on PTSD. These include:
- Current Diagnosis: A qualified mental health practitioner must diagnosis a veteran with PTSD in order to show that the veteran is currently suffering from PTSD. The diagnosis must meet the VA’s specific criteria that can be found in 38 C.F.R. § 4.125.
- In-Service Stressor: A veteran must show that a traumatic event occurred during their service. There are different rules for combat veterans vs. non-combat veterans. If a veteran can prove they were in combat, they may not have to provide as much evidence of the traumatic event.
- Nexus: The nexus is the link between the current diagnosis and the in-service stressor. A veteran must provide evidence showing that it is “at least as likely as not” that their current diagnosis is a result of the in-service stressor.
Evidence that will be helpful to a PTSD claim includes service records (such as unit assignments or any combat awards received), buddy statements showing a change in the veteran’s behavior after service, and information about the details of the in-service stressor (people involved, dates, location, and a description of the event). It is also very important to have established treatment for your PTSD in order to document the severity of your symptoms and ensure a more accurate rating from the VA.