Combat-Related Post Traumatic Stress Disorder (or Combat PTSD) is not just something that happens to a soldier when they have to kill someone (though that can play a part). It’s about what happens, physically and psychologically, inside of a soldier’s brain when they are faced with weeks, months, and years of constant fear, death, adrenaline, and danger. This enormous, prolonged stress literally changes the way their brain looks and functions.
HIPPOCAMPUS - The hippocampus is a section of our brain that plays an important part in short-term memory and the regulation of our emotions. Researchers, using Magnetic Resonance Imaging (MRI’s), have been able to determine that the hippocampus of veterans with PTSD has actually suffered damage. They believe this damage may be under stress.
PREFRONTAL CORTEX – Our Prefrontal Cortex helps us decide how we experience and react to an emotion and resolve conflicts. It also tells our brain when a threat has passed. People with PTSD have altered blood flow to this area of their brain (the more change in flow, the more severe the symptoms of PTSD). This decrease in function causes their brain to sort of be stuck in a permanent fear mode, because it doesn’t relay the “all clear” message.
ADRENALINE RESPONSE – When we’re in danger, our brain flips into “fight or flight” mode, a place where it is primed to decide whether or not we should run or engage a threat. Our bodies make two handy hormones that cause this response: noradrenaline that handles fight, and adrenaline which is responsible flight. In “normal” brains, these hormones are released by a current threat (i.e., when someone is standing face to face with a bear). But, in a brain affected by PTSD, these hormones are triggered not by actual threats but by reminders of threats that occurred months or years before.
GRAY MATTER – The gray matter section of our brain is responsible for processing information from our body (sensory neurons) and sending information to our body (motor neurons). Veterans have 5% - 10% less gray matter after developing PTSD. This means their neurons (their communication signals) have been damaged.
Psychological / Mental Changes
HOSTILITY / AGGRESSION – Veterans with PTSD exhibit significantly higher levels of hostility and aggression than the general public, or even than other soldiers who have experienced combat. Since they have lived for a long period of time where they needed to aggressively react at a moment’s notice in order to stay alive, this way of acting has become an ingrained habit. Spouses often joke that it is not safe to wake a sleeping veteran from anywhere close by. This is because, when startled awake, the vet can react with an unbelievably strong amount of aggression because he believes he is responding to an unknown threat. On a wider scale, it is very common for individuals with PTSD to get into fights, drive aggressively, become angry at insignificant things, and drastically overreact to any sort of challenge.
GUILT – The guilt associated with post traumatic stress disorder is often called survivor’s guilt. The veteran feels a great deal of guilt because he survived an attack when a comrade did not. He feels guilty because a friend lost his legs in an explosion while he remained mostly untouched. He feels guilty that he is at home in safe surrounding while others he fought with are in harm’s way.
DEPRESSION / SUICIDE – People with post traumatic stress disorder are seven times more likely to be depressed than someone in the general population. It is one of the most complaints associated with PTSD. And, unfortunately, this depression goes hand in hand with high rates of suicide among our nation’s returning heroes. As of April, 2010 (the last time data was published), eighteen of our nation’s heroes were committing suicide each day.
PARANOIA – In Iraq, a paranoid soldier is a soldier who stays alive. Every item in his environment, from a pothole to a child carrying a backpack, must be regarded as a potential threat. When that same soldier, whose mind has been changed by PTSD, returns home, he is often unable to shut off his vigilant behavior. Veterans will often almost constantly “patrol” their homes to check for intruders, insist that they sit with their backs to a wall and facing the door so that they can analyze every person who enters a room, or even drive off the road in order to avoid discarded trash (because this often indicated an Improvised Explosive Device or IED in combat).
LACK OF TRUST – This change in a veteran with PTSD is also caused by his time in combat. While in Iraq or Afghanistan he had to assume that everyone he met, even those who were called allies, were possible enemies. The only people he knew he could rely on in order to stay alive were himself and those in his immediate group - people who had proven themselves to each other in combat. After that same Veteran returns home, he feels alone and without the protection of his battle-tested counterparts. He doesn’t trust anyone else (even people he’s known for his entire life) to be able to watch out for him. He feels that he, alone, is the only one he can count on or trust.
POOR COPING SKILLS - Due to the physical and mental changes Veteran with PTSD has, they are often unable to cope in what most people would consider “normal” circumstances. They are easily overwhelmed by too much noise, too many people, too many changes, or too much stimuli of any sort. Dealing with post traumatic stress disorder and all of its symptoms takes most of their energy and concentration. Anything else, especially something that is unexpected, can cause a violent reaction or simply cause the Veteran to shut down.
Understanding these changes helps many people understand for the first time just how “real” post traumatic stress disorder is. Unfortunately, hidden wounds (like PTSD), are often hard for people to grasp and empathize with. Hopefully, after learning more about the “mechanics” behind PTSD, you will be better able to talk about PTSD and the real impact it can have on the life of a Veteran and on those who love and care for him or her.
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