Combat PTSD: What are the Symptoms?

If you're a returning combat veteran having some difficulty readjusting to civilian life, you may be wondering what's going on. Why am I angry all the time? Why am I feeling detached?

If this sounds like you, you may want to review the following list of some of the general symptoms associated with post-traumatic stress disorder (PTSD).

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The following is a composite of PTSD symptom descriptions culled from the Journal of Clinical Psychology Expert Clinical Guidelines Series; the always informative National Center for PTSD website; and the Vietnam Veterans Association of Australia.


What You Need to Know

• Traumas happen to many competent, healthy, strong, good people. No one can completely protect him- or herself from traumatic experiences.
• Many people have long-lasting problems following exposure to trauma. Up to 8% of individuals will have PTSD at some time in their lives.
• People who react to traumas are not going crazy. They are experiencing symptoms and problems that are connected with having been in a traumatic situation.
• Having symptoms after a traumatic event is not a sign of personal weakness. Many psychologically well-adjusted and physically healthy people develop PTSD. Probably everyone would develop PTSD if they were exposed to a severe enough trauma.
• When a person understands trauma symptoms better, he or she can become less fearful of them and better able to manage them.
• By recognizing the effects of trauma and knowing more about symptoms, a person is better able to decide about getting treatment.

PTSD Symptoms/Signs

So, let's take a look at the symptoms or signs of combat-related PTSD. They generally fall into 3 main categories:

Intrusive - Re-experiencing of the traumatic event(s)

• Distressing recollections
• Flashbacks (feeling as if you're back in combat while awake)
• Nightmares (frequent recurrent combat images while asleep)
• Feeling anxious or fearful (as if you're back in the combat zone again)

Because trauma survivors have these upsetting feelings when they feel stress or are reminded of their trauma, they often act as if they are in danger again. They might get overly concerned about staying safe in situations that are not truly dangerous. For example, a person living in a safe neighborhood might still feel that he has to have an alarm system, double locks on the door, a locked fence, and a guard dog. Because traumatized people often feel like they are in danger even when they are not, they may be overly aggressive and lash out to protect themselves when there is no need. For example, a person who was attacked might be quick to yell at or hit someone who seems to be threatening.

Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience. These symptoms are automatic, learned responses to trauma reminders. The trauma has become associated with many things so that when the person experiences these things, he or she is reminded of the trauma and feels that he or she is in danger again. It is also possible that re-experiencing symptoms are actually a part of the mind's attempt to make sense of what has happened.

Avoidant - Drawing inward or becoming emotionally numb

• Extensive and active avoidance of activities, places, thoughts, feelings, memories, people, or conversations related to or that remind you of your combat experiences
• Loss of interest
• Feeling detached from others (finding it hard to have loving feelings or experiencing any strong emotions)
• Feeling disconnected from the world around you and things that happen to you
• Restricting your emotions
• Trouble remembering important parts of what happened during the trauma
• Shutting down (feeling emotionally and/or physically numb)
• Things around you seem strange or unreal
• Feeling strange and/or experiencing weird physical sensations
• Not feeling pain or other sensations

Because thinking about the trauma and feeling as if you are in danger is upsetting, people who have been through traumas often try to avoid reminders of the trauma. Sometimes survivors are aware that they are avoiding reminders, but other times survivors do not realize that their behavior is motivated by the need to avoid reminders of the trauma.

Trying to avoid thinking about the trauma and avoiding treatment for trauma-related problems may keep a person from feeling upset in the short term, but avoiding treatment means that in the long term, trauma symptoms will persist.

Hyperarousal - Increased physical or emotional arousal

• Difficulty sleeping
• Irritability or outbursts of anger
• Difficulty concentrating or thinking clearly
  
• An exaggerated startle response (triggers bring you back to a certain combat zone event)
• Hypervigilence, being overly angry or aggressive (feeling as if you need to defend yourself from danger)
• Panic attacks

Triggers can include any of the following:

• Specific scenes - crowded streets, sunsets, sunrises, familiar clothing
• Movement - someone rushing towards the individual
• TV - even if the story is unreal, the subject or the environment may cause thoughts which act as a trigger
• Sound - helicopters, songs, unexpected loud noises
• Smell - jungle or bush, rain, smoke, blood, cordite or explosives
• Reading - or discussion about subjects of trauma
• Touch - gun metal, webbing, blood
• Situational - being crowded, walking across open spaces, feeling vulnerable or not in control

Just Remember

Although you may be overwhelmed by your symptoms, you do have many resources available to you. Please make use of them. If you need immediate help, please get it. If you'd like to talk to someone about what you're going through, there are a lot of people and organizations you can turn to you may not be aware of. If you'd like to learn more, there are a wide variety of PTSD resources waiting to be explored by you.

And if you're seeking professional help, you've a lot of options to help you find relief and resolution to your PTSD.