PTSD is a common condition we see among many of our veterans. Oftentimes, veterans have a difficult time recognizing the symptoms but still find it debilitating and do not know how or when to seek help. Getting PTSD service-connected is also not as easy as one would hope. Let’s dig a little deeper into finding out more about what PTSD is and the process of getting it service-connected.
PTSD is very common, particularly among Vietnam veterans. This is thought to be because during the Vietnam War, the military experience, entry into the military, rotation to and from combat duty, and return to society, were all experiences veterans endured alone. It was a personal war of survival for each veteran that served. This differed from previous wars where cohesive units trained, fought, and went into combat zones together. The experience of most service members was what they went to Vietnam without public support, and returned home to an indifferent or hostile reception from friends and family. It was also common for veterans to be in combat one day and home with their family the next day, leaving no time to decompress, which is said to be a cause of high incidence of PTSD among Vietnam veterans. It is also common that veterans are reluctant to seek help because of the stigma attached to mental illness. The VA has dedicated a website for a PTSD Information Center that contains in-depth information for veterans and their families on PTSD and its treatment at http://www.ptsd.va.gov/.
PTSD stands for post-traumatic stress disorder; it is a mental disorder characterized as an anxiety disorder. The VA characterizes PTSD under the definition of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-V). It uses the World Health Organization Disability Assessment Schedule (WHODAS) to determine the impact that the mental illness has on the affected individual. You can learn more about the WHODAS in the DSM-V here.
We will look at the following aspects of PTSD, which are really what you need to get it service-connected: A) Medical Diagnosis B) In-service Stressor C) a link between the diagnosis and the stressor. Just like other claims for service connection, you want to show that it is as likely as not that each of these three factors exists. We will look at each aspect individually.
Medical Diagnosis- What is PTSD?
PTSD is the development of characteristic symptoms following exposure to an extreme traumatic stressor. The veteran has to have a current diagnosis of PTSD from a medical expert that is competent to diagnose it. The diagnosis should conform to the diagnostic criteria of the DSM-V. So what do you need for a diagnosis?
- The stressor
A stressor is usually a traumatic experience that can be either:
- The direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity, OR
- Witnessing an event that involves death or serious injury or threat to the physical integrity of another person, OR
- Learning about the unexpected or violent death, serious harm (or threat of death or injury) experienced by a family member or other close person.
For example, while in combat, a veteran may have personally experienced actual or threatened harm, or may have witnessed the death or serious harm of a close friend in service.
- The response
Upon the occurrence of the stressor, the veteran should have one of the following three responses:
- Intense fear
- Helplessness, or
- The symptoms
The typical characteristic symptoms of PTSD are:
- Re-experiencing the traumatic event
- Avoiding stimuli associated with the event
- Numbing of general responsiveness
- Increased arousal
A lot of these symptoms may be common for anyone who experiences a distressing or upsetting event; the difference is if the symptoms persist and you cannot adjust, PTSD may result. Symptoms may begin to show right after the traumatic event occurs but they don’t have to, it could be weeks, months, or even years after the traumatic event. The way you know when it is PTSD is the symptoms have to cause significant distress or impairment in social or occupational functioning and be present for at least one month.
One common symptom is feeling emotionally numb, which is a common way of blocking out strong emotions about the event. But these symptoms may vary for each person; some veterans may not feel numb at all while for others this feeling of numbness can last for weeks, months, or years. Then other symptoms or feelings may develop:
- Guilt about surviving when others did not
- Anxiety or nervousness
- Depression or deep sadness
- Nightmares or flashbacks, where the veteran re-experiences the traumatic event
- Jumpiness, especially to sounds that remind the veteran of the traumatic event (such as car horns honking, or fireworks)
- Trouble getting close to other people at work or in social or family situations
- Trouble sleeping
- Trouble concentrating
- Avoiding certain memories
- Self-medication- trying to calm oneself with alcohol or drugs.
For more on PTSD, click here and keep an eye out for the next post.