Walter Reed National Military Medical Center, BETHESDA, Md.  –   PTSD Awareness Month is observed during June to help spread the word that currently in the United States, approximately 12 million people (about six of every 100) live with PTSD, according to the U.S. Department of Veterans Affairs (VA). Treatment for PTSD works, and help is available at Walter Reed National Military Medical Center and throughout the Military Health System.

WHAT is PTSD?

PTSD stands for post-traumatic stress disorder.

U.S. Navy Cmdr. (Dr.) Jonathan Kerr, a Walter Reed psychiatrist, explained that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides the “most straightforward” definition for PTSD, including it in trauma- and stressor-related disorders.

The DSM-5, used globally by health care professionals as the authoritative guide for the diagnosis of mental disorders, focuses on the behavioral symptoms that accompany PTSD to help define the condition.

Those behaviors include “re-experiencing, avoidance, negative cognitions and mood, and arousal” to a terrifying or traumatic event. PTSD may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions, according to the DSM-5.

Kerr shared that the question of what PTSD is, “could be answered from a number of perspectives that would change the information sought or given.” He shared that those perspectives include psychological (ideas of “psychological trauma”), neurophysiological (conditioned fight or flight response), historical (post-American-Vietnam War addition to DSM in 1980), and political (post-American-Vietnam War context).”

The Defense Health Agency (DHA) explains that after a traumatic event, it is common to have reactions that could include “upsetting memories, jumpiness or trouble sleeping,” but if these reactions don’t go away, it could be associated with PTSD.”

The DHA added that PTSD symptoms usually occur within three months [of the traumatic event], but they may appear six months or years later.
The VA states the types of traumas that can cause PTSD include war and combat, violence and abuse, and disaster and mass violence. This is reiterated by the DSM-5, which lists the criteria for PTSD in adults, adolescents, and children over 6 years old. These include:

• Exposure to a traumatic event that involves actual or threatened death, serious injury, or sexual violence. The exposure can be direct, by witnessing the event, or by learning about it happening to a close friend or relative.

• Symptoms from four symptom clusters (intrusion, such as recurrent, involuntary, and distressing memories of the event; avoidance of thoughts, feelings or memories of the event; negative alterations in cognitions and mood; and alterations in arousal and reactivity).

• Symptoms lasting for more than one month.

• Symptoms must not be attributable to a substance or co-occurring medical condition.

• Assessment of functioning

Kerr stated that while PTSD may have some similarities to anxiety and depressive disorders, PTSD is vastly different from schizophrenia, bipolar disorder, addiction and OCD (obsessive-compulsive disorder).

CHILDREN AND PTSD

While children and teens can have extreme reactions to traumatic events, their symptoms may not be the same as those seen in adults, according to the DSM-5. In children younger than age 6, symptoms may include:

• Bedwetting after having learned to use the toilet.

• Forgetting how to talk or being unable to talk.

• Acting out the scary event during playtime.

• Being unusually clingy with a parent or other adult.

Older children and teens usually show symptoms more like those seen in adults. They also may develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilt over not preventing injury or death or have thoughts of revenge.

“Children would be treated through the Child and Adolescent Clinic at Walter Reed,” said Kerr.

SEEKING HELP

“We are living in a post-stigma culture,” Kerr stated, explaining the importance of seeking help for PTSD and other behavioral health challenges. The DHA has stated that being diagnosed with PTSD won’t automatically affect a security clearance.”

“PTSD treatment works,” the VA states. “Those who have gone through trauma can learn to feel safe in the world and cope with stress,” the VA continues, adding that, “There is no one treatment that is right for everyone.”

Treatment for PTSD can include talk therapies and/or medication, Kerr added.

For more information regarding PTSD, contact DHA’s Psychological Health Resource Center at 866-966-1020. It’s 24/7 and confidential. Also, if you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at https://988lifeline.org. In life-threatening situations, call 911.