The Connection Between PTSD and Military Service

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur after experiencing a traumatic event. It affects around 6.8% of the U.S. adult population, but it tends to occur at higher rates among those who have been in the military. According to the U.S. Department of Veterans Affairs (VA), the prevalence of PTSD among veterans was between approximately 12% and 30%, depending on the conflict where soldiers served.

This article explores some of the reasons why PTSD is more common among those in military service. It also covers some of the factors that increase the risk of developing PTSD after trauma related to military service.

History of PTSD Among Soldiers

War and conflict have existed for millennia. So has the trauma that such experiences inflict on the people affected by such experiences.

However, post-traumatic stress disorder is a relatively young diagnosis. It was not until 1980 that PTSD was recognized as a distinct condition in the "Diagnostic and Statistical Manual of Mental Disorders," the manual that healthcare providers and therapists use to diagnose mental health conditions.

While PTSD may not have had an official name until fairly recently, throughout history, people have recognized that exposure to combat situations can have a profound negative impact on the minds and bodies of those involved in these situations. In fact, the diagnosis of PTSD originates from observations of the effect of combat on soldiers.

PTSD Rates in Military Soldiers

It is not surprising that high rates of PTSD have been found among soldiers from World War II, the Vietnam War, the Persian Gulf War, and the war in Iraq and Afghanistan.

According to the VA, the prevalence of PTSD among military veterans depends on the combat where they served. 

• Vietnam War: The most recent research on PSTD among Vietnam veterans was conducted during the mid-to-late 1980s. Those results found that 15.2% of men and 8.1% of women had PTSD when the study was conducted. The lifetime prevalence of PTSD among Vietnam veterans was 30.9% for men and 26.9% for women.
• Gulf War (Desert Storm): Approximately 12% of veterans of the first war in Iraq report having PTSD in any given year.
• Operation Iraqi Freedom (OIF) and Enduring Freedom (OEF): One study found that the prevalence rate among veterans who served in these conflicts in Iraq and Afghanistan was approximately 13.8%.

PTSD Not Due to Combat

Prevalence statistics suggest that PTSD stemming from combat exposure is quite common. However, people in the military may also be at risk of experiencing other types of traumatic events.

Among veterans who use VA healthcare services, 23% reported experiencing a sexual assault while in the military. Around 55% of women and 38% of men reported experiencing sexual harassment while serving in the military. 

Effects of War on a Soldier's Family

Not only is war difficult for military soldiers, but it is also incredibly difficult for their families. War can have a tremendous impact on the mental health of a soldier's loved ones.

Some common reactions that family members might experience include:

• Anger
• Avoidance
• Depression
• Health problems
• Guilt
• Negative feelings
• Sympathy

Social support can play a critical role in both preventing and treating PTSD. Because of this, interventions that address the entire family and work to repair communication and improve family dynamics can be beneficial.

Causes of PTSD in Soldiers

PTSD occurs after a person has experienced a traumatic event. This can include combat stress, severe trauma, or life-threatening situations. 

When faced with a stressful event, the body first mobilizes to deal with the danger. The fight-or-flight response is activated, which prepares people to defend themselves or flee the situation. It causes a cascade of physiological effects including increased heart rate, rapid breathing, dilated pupils, and increased muscle tension.

After the threat has passed, the relaxation response helps return the body to its previous state of equilibrium. People with PTSD, however, are unable to fully leave the state of heightened awareness and readiness. This can then result in a range of symptoms associated with PTSD.

What Increases Risk for PTSD?

People serving during wartime are likely to be exposed to numerous traumatic or highly stressful events. However, not everyone eventually goes on to develop PTSD.

A number of factors that have been linked to an increased risk of PTSD include:

• Age: PTSD tends to be more common in younger age groups, but research suggests that the condition is more persistent in older veterans born prior to 1980.
• The intensity of combat exposure: Combat intensity is particularly associated with the persistence of the condition.
• Having another psychological or physical health condition: Co-occurring conditions such as depression or physical symptoms are associated with an increased risk for persistent PTSD.
• Sleep problems: Those who report sleeping less are more likely to experience PTSD. This may be a multidimensional relationship since PTSD often causes sleep problems and sleep difficulties also have a bidirectional relationship with other mental health conditions.
• Lack of social support: Supportive social relationships play an important role in determining symptoms severity. Those with social connections are more likely to be able to talk about their feelings, stick to their treatment plan, and cope better with their intrusive symptoms.

Some people may be more vulnerable to developing PTSD after coming into contact with a traumatic event, whereas others may be more resilient. Other factors can also increase the risk that a person will develop PTSD following a traumatic event.

PTSD Treatment

There are treatments available for PTSD that can help alleviate symptoms. Getting treatment is important since untreated PTSD can interfere with a person's ability to function and the condition may become chronic.

One study of PTSD among military veterans found that it often becomes a chronic condition. At the outset of the study, 47% of participants were identified as having PTSD. When retested six years later, over 70% of those individuals still had PTSD.

Fortunately, help is available for those suffering from PTSD. A number of treatments have been developed and shown to effectively treat PTSD. Some options that are often recommended include:

• Medications: Antidepressant medications include selective-serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are often prescribed to help manage some of the symptoms associated with PTSD. 
• Psychotherapy: A number of different types of psychotherapy can be helpful for relieving symptoms of PTSD. A few of these include cognitive behavioral therapy (CBT), cognitive processing therapy, and eye movement desensitization and reprocessing (EMDR) therapy.

A Word From Verywell

The effects of war can be far-reaching. People in the military, especially during wartime, may be at high risk for PTSD. A soldier's family may also experience high levels of stress. However, help is available, and there are a number of resources for military soldiers and their families trying to cope.​