Post-traumatic stress disorder (PTSD) is a trauma- and stressor-related mental disorder. It can be caused by experiencing stressful – traumatic – events. The stressful experiences can be of short or long duration. In most cases, they are of such an exceptionally threatening or catastrophic nature that they can cause lasting psychological distress in almost anyone.
Traumatic events that may lead to PTSD include:
Post-traumatic stress disorder describes a range of psychological symptoms that can occur in response to a traumatic event.
PTSD encompasses four main symptom groups:
Not everyone who experiences or witnesses trauma automatically develops post-traumatic stress disorder. Psychological distress usually occurs shortly after the traumatic event. It is then possible to experience symptoms of PTSD.
When remembering the event, those affected are often confronted again and again with their own painful memories and great sadness. Many report strong feelings such as anger, fear, guilt and horror. The symptoms often subside after a few days, weeks or months, and there are no lasting psychological effects.
For some people, the experiences from the traumatic event cannot be fully processed within a reasonable period of time and the symptoms persist. In such cases, there is a risk that normal trauma reactions will develop into longer-lasting PTSD symptoms.
Some sufferers try to avoid painful memories of the traumatic experience. Such an avoidance strategy is understandable. However, it prevents sufferers from learning to deal with their memories and the triggers of those memories in an appropriate manner and from finding a meaningful place for them in their personal life story.
Whether a person develops PTSD depends on many factors. Personal performance or resilience alone is not decisive. For British Armed Forces soldiers, foreign deployments carry an increased risk of developing PTSD or other post-traumatic stress disorders.
Post-traumatic stress disorder manifests itself slightly differently in each person affected. In most cases, effective treatment started at an early stage has a positive effect on the course of the disorder.
It is impossible to predict how long PTSD will last or how severe its effects will be. Those affected experience phases in which the symptoms remain relatively stable for a longer period of time, but are then characterised by severe fluctuations. The symptoms intensify particularly during times of increased stress or at times that are reminiscent of the trauma. This is the case, for example, on anniversaries of the event.
The sooner professional treatment begins after the traumatic experience, the shorter the treatment period will generally be. Nowadays, there are good and effective treatment methods for PTSD.
Nevertheless, it is possible for PTSD to last a lifetime. But even then, professional treatment can contribute significantly to a marked improvement in symptoms.
Certain factors increase the likelihood of a person developing PTSD after a traumatic experience. These include the circumstances of the person affected prior to the trauma, the nature of their personal experience of the traumatic event, and their ability to process the trauma after the event.
Before a traumatic event
During a traumatic event
After a traumatic event
No one wants to have PTSD. Soldiers in particular find it difficult to properly assess their state of mind after a traumatic experience, to accept it and to seek help when they themselves can no longer cope.
After returning from a foreign deployment, it is not uncommon for soldiers to exhibit changes in behaviour and emotional life as a result of the extreme stress they experienced in the country of deployment.
Soldiers must expect these reactions after serving abroad:
Many of the issues that arise among soldiers in the first six to twelve weeks after returning from overseas deployment can be considered normal adjustment reactions. Initially, they are not a cause for concern. After the traumatic events they have experienced in the country of deployment, participants must readjust to life in their home country.
Life at home has a different rhythm, the demands of everyday life are different from those of deployment, and family routines need to be re-established after a long period of separation. During this phase, it is important for mental health that interactions with one another are characterised by understanding and patience.
Using a number of criteria relating to the severity of stressful symptoms, those affected can initially assess their own mental health themselves.
Minimal impairment
If the traumatic experience occurred less than three months ago and does not significantly affect the person concerned in their service, at work, in relationships or at school, it may be sufficient for the person concerned to simply observe the symptoms initially to see if they improve on their own.
Significant impairment
If symptoms have not improved three months after the traumatic experience, affected soldiers should urgently contact the military doctor or a specialist examination centre for psychiatry and psychotherapy in order to initiate any necessary support measures.
If symptoms persist after the transition period or even worsen, urgent action is required. Anyone who suspects they may be suffering from PTSD or another psychological disorder resulting from their deployment should consult a doctor or psychotherapist immediately.
Many soldiers do not do this. They wait and see what happens. Some try to deal with their problems on their own or with support from family and friends. Such social support is very important, but on its own it usually does not lead to the desired success. Even if loved ones mean well, this type of support is usually not enough to maintain or restore the mental health of soldiers after trauma.
The following behaviours or sensitivities are an indication that professional help is urgently recommended:
There are now multiple treatment methods for PTSD. These include various psychotherapy methods, or a combination of psychotherapy and medication.
The psychotherapeutic treatment of traumatised soldiers is carried out mainly about three forms of therapy, which we will briefly introduce below. All three forms of therapy are suitable for treating PTSD and other trauma-related disorders. Their positive effectiveness is scientifically proven.
Depth psychology-based psychotherapy (TP)
The treatment focuses on the patient's unconscious and past (childhood and adolescence). Together with the therapist, the patient attempts to identify and work through the often repressed cause of the disorder.
Duration of treatment: 25 to 50 sessions.
Behavioural therapy (BT)
This involves treating the patient's current disorders. One of the most important basic assumptions in this form of therapy is that behaviour associated with the disorder has been learned and can also be unlearned. The aim of the therapy is to help patients help themselves.
Duration of treatment: 25 to 45 sessions.
Analytical psychotherapy (AP)
The treatment focuses on the patient's unconscious and on the past (childhood and adolescence). It is based on psychoanalysis and its further development. The focus is often on the patient's personality structure, which is reflected in patterns of thought, behaviour and movement.
Duration of treatment: approximately 100 sessions.
Treatment with medication
In some cases, medication, known as psychotropic drugs, may be prescribed alongside psychotherapy to treat PTSD. However, the use of medication is carefully considered in trauma therapy.
Shortly after experiencing trauma, it is almost impossible for those affected to imagine that they will ever overcome their suffering. A Trauma-specific counselling helps Those affected then, open up perspectives and facilitated the Transition back to normal life.
In retrospect, many of the soldiers affected are grateful that they took advantage of such assistance.
Treatment for PTSD or other psychological disorders resulting from military service is largely free of charge for active soldiers and reservists wounded in service as part of the free military medical care (utV) programme.
The costs of outpatient, inpatient and psychotherapeutic treatment in civilian facilities are also largely covered by the Armed Forces, provided that the prescribed procedures are followed.
c/o Psychological Trauma Centre of the German Armed Forces
13 Scharnhorst Street
10115 Berlin
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