Coping with Veteran Posttraumatic Stress Disorder (PTSD)

Before continuing to read this blog entry, I highly encourage you to go to take 3 minutes and watch The Present Trauma on Project Green Light found at the following link:

The video eerily depicts the thoughts, behaviors, and actions of a combat Marine veteran who clearly is struggling with Posttraumatic Stress Disorder (PTSD) from his time spent in either Iraq or Afghanistan. The Marine is a husband and a father who has been kicked out of his home by his wife because of his PTSD. In the video the husband and wife can be seen talking to one another about him being around his son more but the wife states only if he begins to take his medications again. While in the park, his son spots a stray marked up pit-bull that appears to have been in a fight. The son would like to take him home and his mother instinctively says no. The father reaches out to the pit-bull to show his wife that the dog is harmless despite his marks and his breed. On his son’s birthday the father goes to the house where he and his wife have an altercation once again over their son and visitation. What happens next is heart wrenching. The father has a very nasty flashback to war in his tiny apartment and he picks up a loaded gun and begins aiming it around the room. His wife and son show up at the apartment and his son opens his door to find him pointing the gun at the wall. The wife closes the door as she walks in and pushes their son out. Despite desperate please, the wife is unable to break her husband from his flashback. He then takes the gun and places it under his chin – dropping to his knees. She continues to plead but the please continue to fall on deaf ears. At that moment the pit-bull runs up, starts licking the Marine’s face, and it breaks him out of his flashback where he sees his wife and then asks for help. The final scenes show the family driving to the hospital where he will be able to receive the proper care and treatment.

PTSD develops after the individual has experienced a traumatic event in their life that has either caused physical harm to the person, or there was an extreme threat to cause physical harm (National Institute of Mental Health (NHIM), 2014). A person can also develop PTSD by witnessing a traumatic event take place where physical harm was done not just to the individual’s loved ones, but even strangers (NHIM, 2014). Traumatic events that can cause PTSD include, but are not limited to, the following: car accidents, sexual assault, natural disasters, bombings, torture, child abuse, and robbery (NHIM, 2014). One of the biggest forerunners to PTSD and most likely one of the widest known causes of PTSD today, was also the first reason to break into the public attention sphere is veteran PTSD dating back to the Vietnam War (NHIM, 2014).

The commentary this week stated that one of the key factors for applied social psychologists is stress when they are engaged in working on problems related to health. Stress is a natural process that aids us as humans to cope with events in our lives that challenge us, but what happens when the natural process of our “flight or fight” response is damaged and broken? With persons suffering from PTSD, this process is often times severely damaged and broken which creates the feeling of being constantly stressed or frightened even when the individual is not in any real danger, or there is no threat of physical harm (NHIM, 2014). An example of this would be when the Marine veteran in the video is safe in his apartment but his flashback creates the illusion that he is in danger and his life is being threatened.

In Lazarus and Folkman’s transactional model of stress, there are four stages that each individual goes through to generate positive health outcomes; 1) Identifying stressors, 2) appraising the stressors, 3) coping with the stress, and 4) health outcomes. Applying this model to a veteran suffering from PTSD would almost look like the following in his/her mind:

1) Identifying the stressors:
Flashbacks can happen at any time and can be triggered by a magnitude of things: fireworks, vehicle exhaust backfire, a loud banging noise, loud noises in general, etc. Anxiety can occur in loud areas, around many people, having to think about going to the store, etc.

2) Appraisal:
Stressors are perceived as harmful, and their stress is continuous.

3) Coping:
Drug abuse. Alcohol abuse. Isolation. Aggressive behavior.
The coping mechanisms applied here are quite common to veterans who are suffering from PTSD, but obviously are not helpful.

4) Health Outcomes:
Suicide.
In a report released by the Department of Veterans Affairs, 22 veterans commit suicide a day which equates to one veteran every sixty-five minutes (VA, 2013). To make that an even clearer picture – in two days and nine hours we lose 53 veterans to suicide which is an entire National Football League team, and in two months, two weeks, three days, and two hours we lose 1,696 veterans to suicide which is the total amount of players in the entire National Football League.

Veteran Suicide Rate

22 a day is too many. How can we change the coping aspect for a veteran so that we can save his/her life? The stigmatization that is associated with seeking help for depression needs to be addressed and changed first and foremost. In the military you are trained to be tough. You are trained that sadness is a sign of weakness. Through the years, however, these thoughts have been attempted to be changed through suicide prevention classes, but are they effectively working? With suicides on the rise in the active force and with veterans, I am not so sure.

Other programs and resources need to become more readily available to our national heroes suffering from PTSD in an attempt to change their coping behaviors as well. One program that is triumphing in helping our veterans cope with PTSD is the Paws4Vets program based out of Wilmington, NC. The program screens and works with veterans suffering from PTSD to “bump” (place) them with trained psychiatric service dogs for free once the service member has completed successfully the necessary training with their service dog.

Martin Seligman developed the learned helplessness model of depression after an experiment with dogs who became depressed also became psychologically helpless (Schneider, Gruman, & Coutts, 2012). Helplessness is a factor in veterans suffering from PTSD. The Paws4Vets program aids in reducing the helplessness factor through the use of the psychiatric service dogs by creating a shift in the veterans’ state of mind so that they can change their circumstances. The dogs are attentive to their needs and aid them in reducing stress, and anxiety which allows the veterans to work towards becoming functional parts of society once again.

Unfortunately, the dogs come with a heavy price tag to train – $30,000 per dog to be exact. The program runs on donations but is unable to solely provide service dogs to all of those in need. Other programs have developed for training service dogs to place with veterans as well. The Department of Veterans Affairs has just kicked off a random control trial to effectively test the use of psychiatric service dogs and hopefully in the near future the VA will be able to place psychiatric service dogs with veterans suffering from PTSD.

Lastly, I close this blog with the below photograph from Paws4Vets containing the following quote because I believe it goes hand in hand with the coping stage of the transactional model of stress :

“Strength doesn’t come from what you can do. It comes from overcoming the things you once thought you couldn’t.”

Paws4Vets Strength to Overcome

References:

Kemp, J., & Bossarte, R. (2013). Suicide Data Report, 2012. Retrieved September 28, 2014 from http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf

National Institute of Mental Health (2014). What is Post-Traumatic Stress Disorder? Retrieved September 28, 2014 from http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml.

Schneider, F.W., Gruman, J.A., & Coutts, L.M. (2012). Applied Social Psychology Understanding and Addressing Social and Practical Problems (Second ed.). Thousand Oaks, CA: SAGE.

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