Combat-Related Post Traumatic Stress Disorder -- or Combat PTSD -- is a serious but poorly understood condition that affects hundreds of thousands of American military veterans. Along with Traumatic Brain Injury (TBI) and Clinical Depression, PTSD can be one of the most pervasive "invisible injuries" faced by veterans who have been wounded physically, psychologically, or both.
According to Amy Marshall, associate professor of psychology at Penn State, when people suffer from Combat PTSD, there may be major changes in behavior and personality with no outward change in their appearance. Symptoms can include recurring nightmares and flashbacks of events, insomnia, feelings of anger or numbness, and the sense of being constantly on guard. Some studies suggest that twenty percent or more of soldiers returning from Iraq and Afghanistan suffer from PTSD; however, most researchers acknowledge that the stigma of mental illness, among other factors, makes accurate PTSD statistics difficult to obtain. Nevertheless, with an estimated twenty veterans committing suicide daily, there is a sense of urgency about finding solutions.
Are we getting better at understanding and treating Combat PTSD? Marshall is cautiously optimistic. "Our understanding of how to treat PTSD has evolved considerably over time," she explains. "Currently, cognitive-behavioral therapies have the greatest degree of support for their efficacy." This approach includes exposure therapy, where the patient is exposed to repeated experiences of the stressful stimuli, and cognitive processing therapy, which teaches patients to identify their trauma-related beliefs that influence emotions and decision-making, so they can gain control over angry and impulsive responses. Along with medication and virtual-reality simulations, there are more therapeutic tools now than ever before to help those with PTSD.
The scope of the problem has to be understood in context, Marshall notes. "Most people have been exposed to potentially traumatic events, but only a small percentage develop PTSD" she says. "In the general population, two to four times more women have PTSD than men, and military service results in an extremely small proportion of cases, even though military servicepersons are at high risk for developing PTSD given the nature of their work."