PTSD affects up to three in one hundred people in the UK over the course of their life, and out of these people, an estimated one in three of them have developed PTSD as the result of a traumatic experience. So why do soldiers develop PTSD?

To talk about the causes of PTSD in soldiers, we must first understand what PTSD is. PTSD (or post traumatic stress disorder) occurs after the body experiences a severe trauma or life-threatening event, says the NHS. This is a healthy response to these events; however, the issue comes when people get stuck in the shock of the event. There are two ways the nervous system responds to stressful events. One is mobilisation which is when you need to defend yourself against the immediate danger, but once the danger has passed this nervous response leaves and the body returns to normal. The second response is immobilisation, this is where the body gets overloaded with stress and gets stuck in the stress response. This is what triggers PTSD as the nervous system is unable to move past the event and return to the previous state.

When asked to identify a cause of PTSD, most people would talk about serving time in the armed forces. A study done in 2018 by the British Journal of Psychiatry found that an estimated 7.4% of UK veterans have PTSD compared to 4% of the public. PTSD in veterans who served in either Iraq or Afghanistan is higher still, with an average of 9%.

For veterans, the symptoms of PTSD can include having intrusive, recurring thoughts of the traumatic event which could be characterised as nightmares or flashbacks. These can induce uncontrollable shaking or panic attacks which can be extremely debilitating for the sufferer. Another symptom is avoiding situations that may remind them of the event, this could be places or people that remind them of the situation and trigger the body’s stress response once more. Additionally, low mood and negative thoughts are often common symptoms of PTSD, as a person’s beliefs about the world or self change drastically after experiencing a traumatic event, and veterans often have a more negative outlook on life. Finally, being jumpy or very reactive all the time is another indicator of having PTSD. This is due to being stuck in ‘survival mode’ so the adrenaline causes a person to be on high alert all the time to fight off any danger that may be coming their way.

Overcoming PTSD can be extremely difficult and will not happen immediately, veterans must be prepared to be committed to the process and should also consider the fact that often the severity of the PTSD will change the rate of recovery. One of the first steps in getting out of the mindset that was engrained in the brain at the time of the incident is exercising. Exercising is important to release endorphins and burn adrenaline, this all goes towards breaking the body out of the immobilisation response. One thing the NHS suggest for army veterans who suffer from PTSD is that they should focus on how their body feels, they suggest specifically focusing on the feeling of the wind on the body or the rhythm of a person’s breathing. These help with grounding the mind and are extremely helpful for flashbacks or nightmares. Other tips for dealing with PTSD include deep breathing to help combat the response of the nervous system and distracting yourself. Distracting yourself could be doing things that used to bring you comfort during the time in the army. Finally, the NHS suggests that connecting with others is an important way to deal with PTSD is to connect with other people. This could be online or in person but having people who will listen without judgement is extremely helpful when coping with PTSD.

One of the more common symptoms of PTSD, especially for veterans, is experiencing flashbacks or nightmares. These often involve feeling as though you are going through a repeat of the traumatic event in the present rather than remembering what it was like in the past. To cope with these flashbacks, it is suggested that people should aim to remind themselves that they are not currently experiencing the event and that they are in a different place. To do this, people could try to name things in the current area that they are in, e.g. Street names, furniture nearby, etc. This is to remind the brain that it is in a completely different place to where it thinks it is. Another tip is to shock the brain back to reality by splashing water on your face or pinching yourself. These are all important techniques as they help with grounding the mind and focusing on the current situation rather than what occurred in the past.

Another extremely common issue among veterans with PTSD is survivor’s guilt. Around 38% of veterans in the Nigerian Army who were hospitalised from 1990 – 1994 were found to have survivor’s guilt, in a study done in a Nigerian Army Hospital. Survivor’s guilt refers to the feeling of blaming oneself for surviving through an ordeal that others didn’t survive. Often survivor’s guilt is related to the thought that you could have done more in a situation or thinking about how a situation could have been handled differently so that people would not have lost their lives. This is a complicated thing to process as, with the benefit of hindsight, there are things that everyone would do differently about situations, however, for soldiers this can be extremely challenging as there will be people who have lost their lives as a result of the decisions that were made. Unfortunately, along side second guessing the actual decisions that were made, many veterans find themselves exaggerating the situation in their mind and wind-up pinning blame on themselves for situations that occurred naturally, as opposed to as a result of a decision made. To deal with survivor’s guilt, veterans may find it helpful to talk about what happened with other people who were there at the time, as guilt often changes your view on events and this would help the person understand that they are remembering the incident differently to how it actually occurred. Another way is to remind themselves that they did everything they possibly could at the time to ensure the safety of others. This is important because part of overcoming survivor’s guilt is allowing yourself to be ok with what happened and giving yourself the forgiveness you deserve.

PTSD comes in many different forms and is not the same for any two people. However, sufferers of PTSD are not alone, especially those who developed PTSD through experiencing active combat. There is support for those who suffer from PTSD such as counselling and lots of resources to deal with PTSD.

-Meredith McMillian Ward