“In war, there are no unwounded soldiers.” This quote by Argentinian writer and aphorist Jose Narosky carries a great deal of truth–veterans put their lives on the line to protect others, often at great personal sacrifice.
War can cause psychological trauma, which has been observed throughout history. Even the ancient Greeks recognized soldiers could experience emotional symptoms after traumatic events.
While soldiers have been affected by the horrors of war for centuries, it wasn’t until 1980 that doctors officially recognized Post-Traumatic Stress Disorder (PTSD) as a real diagnosis.
In the past, soldiers would suffer from nightmares, physical and emotional wounds and other mental health issues, but there were no real options for diagnosis or treatment. Many often fought in silence because of the belief that they should “tough it out.”
It wasn’t until the mid-20th century that doctors began recognizing PTSD as a real disorder.
Researchers made great strides toward treating Holocaust survivors and identifying concentration camp syndrome.
Unfortunately, it wasn’t until the Vietnam Era that PTSD became more widely accepted.
The impact of PTSD in veterans can be significant, affecting all aspects of their day-to-day-lives. It’s critical to understand and find effective treatments to help aid in recovery.
While many veterans still struggle with this disorder and it remains one of the most common disabilities reported, there have been a variety of exciting advancements in treatments over the last few years and even more still on the horizon.
Let’s take a look of some of the tried-and-true methods and some of the newer options out there.
What Causes PTSD in Veterans?
Post-Traumatic Stress Disorder (PTSD) is a common condition that affects veterans who have experienced severe trauma or a life-threatening event.
It has also been referred to in the past as shell shock or combat stress, and occurs when the nervous system becomes “struck” and is unable to return to its normal state of balance.
There are two automatic ways the nervous system responds to stress: mobilization or fight-or-flight, and immobilization.
While mobilization helps defend and survive dangerous situations, immobilization occurs when too much stress has been experienced, and the nervous system is unable to cope.
Recovering from PTSD involves helping the nervous system become “unstuck” and transitioning out of the mental and emotional war zone.
Symptoms of PTSD may develop immediately or may surface months or years later, and they include four symptom clusters:
- Recurring and intrusive memories of the traumatic event, which can include distressing thoughts, nightmares and flashbacks that make it feel like an event is occurring again. These reminders of the trauma can cause extreme emotional and physical reactions, such as panic attacks, uncontrollable shaking and heart palpitations.
- An intense avoidance of anything that triggers memories of the traumatic event, such as certain people, places, thoughts or situations. This can lead to social withdrawal, loss of interest in activities and isolation from friends and family.
- Negative alterations in thoughts and mood, such as having an overly negative outlook of yourself or the world around you, and persistent feelings of fear, guilt and shame. Additionally, it may be hard to experience positive emotions.
- Constant vigilance, hypervigilance (heightened alertness), being easily startled and emotionally reactive behavior, indicated by irritability, anger, reckless behavior, difficulty sleeping, trouble concentrating and overall state of being on-guard.
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Traditional PTSD Treatment for Veterans
There are four main types of traditional therapy that can help individuals deal with PTSD:
- Cognitive Processing Therapy (CPT)
- Prolonged Exposure Therapy
- Eye Movement Desensitization & Reprocessing (EMDR)
- Stress Inoculation Training (SIT)
Cognitive Behavioral Therapy (CBT)
CBT is a type of talk-therapy that focuses on identifying and changing negative thought patterns and behaviors that may be contributing to mental health problems.
It is often used to treat depression, anxiety disorders and PTSD. CBT typically involves working with a therapist to develop coping strategies and problem-solving skills, and may include homework assignments to practice new behaviors and thought patterns outside of therapy sessions.
Prolonged Exposure Therapy
Many people with PTSD avoid painful memories, objects or situations that remind them of their past trauma.
Prolonged exposure therapy does the opposite of this, by intentionally placing you in a position where you have to explore your traumatic experience.
Prolonged exposure therapy typically requires 8-15 weekly sessions that last between 60-90 minutes per session.
Eye Movement Desensitization & Reprocessing (EMDR)
EMDR therapy doesn’t involve talking to your therapist in a traditional way you may think about therapy.
You’ll still focus on specifics of your past trauma but during EMDR sessions, you’ll recall your experience while your therapist performs some mechanical action–like flashing a light, moving the hands or creating sound.
The goal is to “reprocess” how you think about your experience so it can become less painful. It typically requires 3 months of weekly sessions.
Stress Inoculation Training (SIT)
Stress Inoculation Training (SIT) is another type of cognitive behavioral therapy that involves 3 months of sessions and can be individual or group therapy.
This type of therapy focuses on breathing techniques, meditation and other methods for combating negative thought patterns associated with post traumatic stress disorder or other anxiety disorders.
There are also a variety of prescription medications for PTSD treatment, which can be used along with therapy.
However the goal of therapy is to teach individuals how to anticipate, recognize and cope with their symptoms and hopefully rely less on pharmaceuticals for the long-term if at all possible.
Limitations for Traditional PTSD Treatments
Unfortunately, traditional treatments for PTSD, such as medications and therapy, are not always effective for all veterans and can sometimes come with unwanted side effects.
One of the biggest limitations is their limited efficacy.
For example, medications such as antidepressants and anti-anxiety drugs may provide some relief and can be effective, but they do not work in all cases.
Additionally, they can take time to be effective and some veterans may experience unwanted side effects.
Talk therapy, such as cognitive behavioral therapy (CBT), is another common treatment for PTSD. Again, it can be effective for some veterans, but it can also have high dropout rates–meaning that some veterans may discontinue treatment before they fully complete it.
This can be due to any number of reasons, but should also be considered.
New and Innovative Methods of Treatment for PTSD
Although traditional treatments like medications and talk therapy can be effective for some, it’s important to consider alternatives when necessary.
Fortunately, there are a lot of new and innovative approaches being developed to help veterans overcome the debilitating effects of PTSD.
In this section, we’ll explore a variety of new ideas that are being used to treat PTSD in veterans, including virtual reality therapy, equine therapy and nature therapy, among others.
Virtual Reality Therapy
Virtual reality therapy is an innovative and increasingly popular form of therapy that utilizes immersive digital environments to help patients overcome a variety of mental health challenges, including PTSD.
The use of virtual reality treatment for PTSD typically involves patients wearing a headset that transports them into a simulated environment that triggers the same types of stimuli that they might encounter in real life.
This allows the patients to gradually confront and work through the traumatic memories and triggers that contribute to their symptoms.
One of the key advantages of virtual reality therapy for PTSD is that it allows patients to do so in a controlled and safe environment, without the risk of exposure to triggers that might occur in the real world.
This can be especially helpful for military veterans who may struggle with symptoms related to combat trauma.
There have been a number of studies that have shown virtual reality therapy is effective for helping treat PTSD.
A 2017 study published by the Journal of Anxiety Disorders found that virtual reality exposure therapy was just as effective as in-person exposure therapy in reducing PTSD symptoms.
Another study, published in the journal Depression and Anxiety in 2021, found that virtual reality therapy led to significant reductions in PTSD symptoms.
While virtual reality therapy is still relatively new, the early results have been promising and experts believe it could become an increasingly important tool in the treatment of PTSD and other mental health conditions.
Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain. This technique has been used for years to treat depression, but in more recent studies suggests it may also be effective in reducing the symptoms of PTSD.
TMS involves an electromagnet that is placed over specific points on the skull, creating a powerful magnetic field that can positively affect brain cells.
One of the major advantages of TMS therapy is that it is noninvasive and does not involve any surgery or sedation. Patients can receive treatment while fully conscious and alert.
The procedure is relatively painless, although some patients may experience side effects such as headaches and lightheadedness. The treatments typically last 45 minutes in duration, but researchers are trying to find ways to reduce the time-frame.
According to a study published in the Journal of Clinical Psychiatry, veterans with PTSD who underwent TMS therapy showed significant improvements in symptoms, with response rates of 50% and remission rates of 32%. Additionally, the study found that TMS therapy was well-tolerated by veterans and did not result in any serious adverse events.
TMS is an exciting and innovative treatment option for veterans suffering from PTSD, and is likely to play an increasingly important role in helping veterans regain their health and well-being.
Psychedelic-assisted psychotherapy and Ketamine Treatments
Psychedelics like psilocybin, MDMA, and ketamine are being researched for their potential benefits in treating serious mental health conditions such as depression, addiction, and anxiety.
Studies have shown that psilocybin, found in magic mushrooms, can be an effective treatment for major depressive disorder and can reduce depression and anxiety in patients with life-threatening cancer.
According to a study published in The Lancet Psychiatry, participants who received MDMA-assisted therapy had a greater reduction in PTSD symptoms compared to those who received a placebo.
67% of the participants in the MDMA-assisted therapy group no longer met the diagnostic criteria for PTSD after 2 months, compared to 32% in the placebo group.
The US Food and Drug Administration has designated MDMA as a breakthrough therapy for PTSD, which has led to clinical trials to test its effectiveness.
Scientists are researching the use of psychedelics to treat mental illness, but they are not a quick fix.
They have been shown to have lasting effects, but sometimes psychedelics can be intense and frightening.
Researchers caution that patients with severe illnesses like PTSD should be carefully monitored during treatment.
It is hoped that psychedelics can become a successful therapy for many patients, but more research is needed to determine who will best benefit.
Yoga and Mindfulness Meditation
Yoga is a physical practice that involves breathing techniques, poses, and meditation, and has been shown to have numerous benefits for mental and physical health, including reducing symptoms of depression and anxiety, improving sleep, and increasing overall well-being.
A 2017 study published in the Journal of Traumatic Stress found that veterans who participated in a 12-week yoga program reported significant reductions in PTSD symptoms, depression, and anxiety.
Many yoga classes for veterans are specifically designed to address the unique challenges they face, such as PTSD and chronic pain.
Mindfulness meditation is another practice that has been found to be helpful for veterans, particularly those with PTSD. Mindfulness involves bringing attention to the present moment and observing thoughts and emotions without judgment.
A 2019 study published in the Journal of Traumatic Stress found that veterans who completed an eight-week mindfulness-based stress reduction program showed significant reductions in PTSD symptom severity, depression, anxiety, and overall distress.
This practice can help reduce symptoms of anxiety and depression, improve mood, and increase overall resilience. Many programs exist specifically to help veterans learn mindfulness, and some VA medical centers even offer mindfulness-based stress reduction classes.
Neurofeedback
Neurofeedback treatment is another option for veterans suffering from PTSD.
Neurofeedback is a type of biofeedback that uses real-time displays of brain activity to teach self-regulation of brain function.
This treatment can be tailored to each individual’s unique brainwave patterns, making it a highly personalized approach.
Studies have shown that neurofeedback therapy can be effective in reducing symptoms of PTSD in veterans.
One study found that veterans who received neurofeedback therapy experienced significant reductions in PTSD symptoms, depression, and anxiety, and these improvements persisted at follow-up assessments six months later.
Another study showed that neurofeedback therapy resulted in significant improvements in PTSD symptoms and quality of life in veterans.
Neurofeedback treatment shows promise as a non-invasive and medication-free treatment for veterans with PTSD.
The therapy helps to regulate the brain’s electrical activity and has shown significant reductions in symptoms of PTSD, including intrusive thoughts and hyperarousal.
While further research is needed to determine the full potential of this treatment, the evidence so far is encouraging.
With its potential to improve quality of life and overall mental health outcomes, neurofeedback therapy is a promising avenue for veterans seeking PTSD treatment.
Nature-Based Therapy
Nature-based therapy has been found to be a useful treatment for veterans with PTSD.
Studies have shown that exposure to nature, such as outdoor activities, can reduce symptoms of anxiety and depression in individuals with PTSD.
Additionally, research has shown that gardening and horticultural therapy can improve mood and decrease symptoms of PTSD.
A study conducted by the University of Minnesota found that gardening therapy led to a significant reduction in PTSD symptoms in veterans, and another study conducted by the Veterans Affairs San Diego Healthcare System found that outdoor recreational therapy led to a reduction in symptoms of PTSD in veterans.
Nature-based therapy can provide a sense of peace and relaxation, as well as a feeling of connection to something greater than oneself, which can be particularly helpful for veterans who may feel disconnected from others or struggle with feelings of isolation.
Additionally, nature-based therapy can provide a safe and controlled environment for veterans to confront their fears and anxieties, as well as an opportunity to learn new skills and engage in physical activity.
There are various evidence-based treatments available for veterans who are struggling with PTSD.
From traditional forms of therapy to alternative and innovative treatments, options are available that can provide much-needed relief and help individuals lead more fulfilling lives.
It’s essential for veterans to know that seeking help is a sign of strength, and there is no shame in asking for support.
With the right treatment and resources, individuals can work towards healing and moving forward. It’s crucial to remember that recovery is a process, and it takes time, patience, and dedication.
By utilizing the different treatment options available and working with qualified professionals, veterans can overcome PTSD and reclaim their lives.
