Is anyone  really suprised that acute stress reactions are very high in troups in Iraq?  I would think not. But the issue of  a PTSD diagnoses  is another matter altogether.   In my opinion PTSD  is a diagnosis in vogue these days that is overused (similar to  Bi-Polar disorder) .  I do not believe you do  justice to a person returning from combat by  labeling (and burdening) them with a diagnosis too quickly.

Persons returning from War need time to heal. They need a  few months of reduced stress and expectations,  a place to  talk if they want, information on  how to deal with common problems,  help with reestablishing relationships (with very stressed family) and contact with others who have some idea of  what they are going through.   Lets give them the support and the time they need.  This is what  VA and communities should provide, not just another label. Ongoing support will provide prevention for PTSD, allow healing and time to identify those who are not doing so well.

When looking at the criteria to make a PTSD diagnosis having experienced a major stressor is only one criteria needed for the diagnosis to be made. 

Any life-threatening event

• Combat
• Natural disasters
• Accidents
• Assault

 Most survivors of trauma return to normal given a little time. Some will have stress reactions that linger or  even get worse over time. These individuals may develop PTSD.

Signs and Symptoms that last over a month ( this seems unrealistically brief to me.)

• Reliving the trauma (thinking about it with full emotional reactions)
• Becoming angry or upset  with a  thought or reminder of the trauma
• Avoiding places or people that bring memories of the trauma,
• Spending lots of time alone avoiding others.
• Lack of feelings or complaints of feeling numb.
• Feelings of being on guard (hypervigalent),  irritable, and being easily startled.

1. Getting lots of physical exercise

2. Using active coping skills

3. Remaining positive in your outlook

4. Identifying and living you basic values and principles 5. Getting a little help from your friends6. Being open and flexible about your thinking and behavior

There are many things we are not able to control in life, and we cannot totally avoid stress and crisis. We do however have the ability to make ourselves more stress resistant. We can become more able to deal with that stress and move past it with a little self-awareness and planning.

 I will discuss each of these points individually  and specifically with “how tos” in future blogs. I hope others will join with their ideas.

Reference:  Haglund, Cooper, Southwich, Charney. 6 Keys to resilience for PTSD and everyday stress. Current Psychiatry, April 2007

Check out my book Behavioral First Aid For lots of practical information  and advice on stress related topics.

 Intentional traumas

•  War 
• Abuse, sexual and physical
• Personal assault
• Hostage
• Terrorism
• Kidnapping
• Victim Crime
• Witness to violence (murder/ suicide)

 Unintentional traumas and natural disasters

• Fires

• Accidents

• Sudden death of a loved one

• Storms of all types

Risk Factors for PTSD

• 25% of people exposed to trauma will develop PTSD

• Women are at twice the risk of getting PTSD then men.

• Biochemical makeup 

• Childhood abuse may sensitive the nervous system to future PTSD with minimal stress

• Guilt may increase the risk of PTSD

• Mixed feelings about the stress (such as in combat) may increase the risk of PTSD

 Watch for future discussion of what you can do to avoid PTSD.