Commentary: Understanding PTSD, Getting Effective Treatment

By U.S. Army Lt. Col. Melissa Boyd, Licensed Clinical Psychologist, DHA Public HealthJune 25, 2024

PTSD is Treatable
Post-traumatic stress disorder, known as PTSD, is a mental health disorder that may develop following a frightening traumatic event in which a person is exposed to actual or threatened death, serious injury or sexual violence. Defense Health Agency Public Health experts say finding a support network or professional behavioral care immediately after a traumatic event can help individuals process their emotions and may reduce the chance of developing PTSD. (DHA Public Health graphic illustration by Andrew Leitzer) (Photo Credit: Andrew Leitzer) VIEW ORIGINAL

Post-traumatic stress disorder, known as PTSD, is a mental health disorder that may develop following a traumatic event in which a person is exposed to actual or threatened death, serious injury, or sexual violence. PTSD can be treated, and symptoms can be reduced. The military’s use of its updated 2023 PTSD treatment guidelines will further improve the outlook of PTSD patients.

While it is normal to experience fear during a traumatic event, people diagnosed with PTSD continue to experience disturbing feelings long after events and relive the experience through flashbacks or nightmares. Many people who have PTSD recover, especially when aided by effective treatments.

Who Can get PTSD?

Anyone can develop PTSD. This includes service members and civilians who have experienced or witnessed a traumatic event, such as a physical or sexual assault, abuse, disaster, terror attack, an accident, or other serious events. According to the National Institute for Mental Health, not everyone with PTSD has direct exposure to the event—for example, learning that a friend or family member experienced trauma can also cause PTSD.

Though the NIH and the Department of Veterans Affairs National Center for PTSD indicate that most people who experience a traumatic event will not develop PTSD, some factors may increase the likelihood of PTSD. For example, the VA indicates women are twice as likely to develop PTSD as men, in part due to the types of traumatic events that women are more likely to experience—such as sexual assault. Veterans are more likely to have PTSD than civilians. Veterans who deployed to a war zone are also more likely to have PTSD than those who did not deploy.

PTSD is also a concern among active duty service members. According to the Defense Centers for Public Health-Aberdeen’s 2022 Health of the Force report, PTSD was the fourth-leading reason for a temporary behavioral health profile, affecting 2,096 soldiers with an average of 51 days on profile.

What are Symptoms of PTSD?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, to meet the criteria for PTSD, a person must have symptoms for longer than one month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The current medical diagnosis for PTSD has the following four symptom clusters:

  • Re-experiencing
  • Unwanted upsetting memories
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Avoidance/numbing
  • Trauma-related thoughts or feelings
  • Trauma-related reminders
  • Negative cognitions and mood
  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing feelings of happiness
  • Hyperarousal
  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

How Can I Reduce the Impact of PTSD on My Life?

Finding a support network or professional behavioral care immediately after a traumatic event can help you process your emotions which may reduce your chance of developing PTSD. However, there are no proven actions to prevent PTSD. If you do develop PTSD, the best way to minimize the impact on your life and work is to ensure you get rapid and effective treatment. Some people diagnosed with PTSD can recover within six months, while others have symptoms that last for one year or possibly much longer. Fortunately, there are effective treatments for PTSD.

What are the Effective Treatments for PTSD?

Based on current PTSD research, the 2023 VA and Department of Defense evidence-based PTSD medical procedures, referred to as clinical practice guidelines, or CPGs, recommends treating PTSD using trauma-focused psychotherapies over medications. Trauma-focused psychotherapy uses cognitive, emotional, or behavioral techniques to help a service member process a traumatic event. There are three specific trauma-focused psychotherapies recommended by the DOD and VA to treat PTSD:

  • Prolonged exposure, otherwise known as PE: PE, sometimes referred to as exposure therapy, teaches patients to gradually approach their trauma-related memories, feelings, and situations to learn that trauma-related memories and cues are not dangerous and do not need to be avoided. PE includes both imagined and real-life exposure to safe situations that a patient has avoided because they elicit traumatic reminders. For example, people may think or write about the trauma or visit the place where it happened. The PE therapy is typically provided over about three months with weekly individual sessions, resulting in eight to 15 sessions overall.
  • Cognitive processing therapy, otherwise known as CPT: Sometimes, people remember an event differently from how it happened. They may feel guilt or shame about something that is not their fault. CPT, a form of cognitive behavioral therapy, focuses on challenging and changing unhelpful thoughts and beliefs about a traumatic event. In doing so, the patient creates a new understanding of the traumatic event, thereby reducing ongoing negative effects on their current life. CPT has been effective in reducing symptoms of PTSD across a variety of populations, including Veterans, sexual assault victims and refugees. CPT is generally delivered over 12 sessions.
  • Eye movement desensitization and reprocessing, otherwise known as EMDR: During a typical EMDR therapy session, a patient will briefly focus on a traumatic memory while simultaneously performing eye movements with both eyes. The eye movement activity reduces the vividness and emotion associated with the traumatic memories. EMDR is an individual therapy typically delivered one to two times per week for a total of six to12 sessions, although some people benefit from fewer sessions. Sessions can be conducted on consecutive days.

According to the Veterans Health Administration Office for Mental Health, these three recommended psychotherapies are equally effective; therefore, selecting a treatment often depends on aspects of the treatment, provider training and the specific needs of the individual. In addition, people with PTSD often have co-occurring conditions, such as depression, substance use, or other anxiety disorders—so treatments for these conditions may also be advised.

Learn more or find help:

  • What is PTSD Video: Watch a free video from the Uniformed Services University Center for Deployment Psychology that defines the causes, symptoms, and impact of PTSD.
  • Department of Veterans Administration:
  • National Center for PTSD: Learn more about veterans’ PTSD risks, often related to war zone deployment, training accidents, and military sexual trauma.
  • U.S. Department of Veterans Affairs Mobile Applications: Check out mobile apps for self-help, education, and support for people affected by PTSD and related concerns.
  • Military OneSource: Learn about confidential, nonmedical counseling, resources, and support for service members and their families to address a variety life's challenges.
  • Military and Family Life Counselors: Talk to licensed mental health professionals who provide free counseling to service members and their families.

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