Veterans Dealing with Post Traumatic Stress Disorder (PTSD)
An estimated 1.6 million troops deployed in Iraq and Afghanistan during Operation Enduring Freedom (OEF) and Operation Iraq Freedom (OIF) have completed their deployment duty and returned home. A significant number of servicemen returning from these military deployments suffer from various problems including physical disabilities and trauma resulting from combat-related activities (Angkaw 1044). However, of all the experienced problems, Post traumatic stress disorder (PTSD) has proven to be the worse problem plaguing most servicemen and women. PTSD has an estimated prevalence rate of 14% percent measured by the number of veterans from OEF and OIF deployments seeking PTSD treatment (Angkaw 1044). Notably, this is a conservative estimate because some studies have shown prevalence rates of up to 21% for all servicemen and women that meet PTSD criteria even though they do not seek medication (Angkaw 1045). These prevalence rates are a reason for concern because the percentages translate to hundreds of thousands of PTSD patients that add on to the earlier affected servicemen and women from other deployments including the Vietnam War.
How are Veterans Affected?
Effects of PTSD vary among veterans and their impact on quality of life also varies widely with some victims displaying more symptoms and problems with life than others. Broadly speaking, PTSD effects include physiologic problems such as hypertension, insomnia, sexual dysfunction, impaired memory, concentration and cognition as well as psychosocial problems such as emotional numbing, depression, aggression and substance abuse (Paulus, Argo & Egge 169; Ray & Vanstone 840; Asnaani, Reddy & Shea, 2014; Angkaw et al. 1044; Barrera 1.)
Perhaps the most significant of all these problems emerge from the psychosocial dysfunction which results from PTSD. According to Ray and Vanstone (840), veterans with PTSD often experience anger and emotional numbing characterized by the inability to express or experience emotional feelings. Such psychosocial problems not only affect the veterans, but also their families (Ray & Vanstone 841). The emotional numbing often leads to withdrawal from family and avoidance, which severs family help required for successful recovery, and thus often leading to family and marital problems and emergence of further problems such as violence and distress among family members of the affected veterans (US Department of Veteran Affairs 1).
According to Angkaw et al (1044), PTSD significantly increases cases of suicidal ideation and even actual cases suicide. Self harms behaviors and suicidal ideation are thus additional psychiatric problems that emerge from PTSD. In a study highlighted by Angkaw et al (1044), depression symptoms accurately predicted occurrence of suicidal thoughts, whereas PTSD symptoms correctly predicted the desire to cause self-harm among veterans with PTSD.
Paulus and others (169) and Barrera (1), note in their literary works about PTSD that the recurrent mental re-enactment of traumatic events from war often causes a constant arousal and release of adrenaline that characterizes the fight-or-flight mechanism of war, which makes it hard for veterans with PTSD to maintain an even mood or emotional state. According to Paulus et al. (169), this recurrent hyperarousal is common in PTSD and is the major cause of other resultant problems such as hypertension, sleep disturbances, hypervigilance, impaired concentration and attention as well as loss of memory and sleep.
Hyperarousal characterized by increased heart rate often leads to hypertension (Paulus et al. 169). A study assessing veterans seeking PTSD care compared their systolic and diastolic blood pressure and heart rate to others without PTSD, and the results clearly indicated that all three parameters were significantly higher among veterans with PTSD when compared to other patients (Paulus et al. 169). This study shows that PTSD may cause hypertension and other related conditions such as sexual dysfunction and cardiovascular diseases that result from high blood pressure/hypertension (Paulus et al. 169; Barrera 1).
Finally, all these problems result into a big financial burden for PTSD veterans and their families, which have to pay for their care. Treating injuries from violence and aggression and possibly attending to law suits is also a potential financial problem for veterans with PTSD. The presence of these negative effects of PTSD also makes it more difficult for these veterans to acquire and maintain a job. As a result, most veterans with PTSD find that they also have financial problems and some are even homeless.
How is the Government Helping?
Though criticized for not doing enough, the US government has taken various measures to ensure that veterans with PTSD live comfortable lives. Perhaps the first and most important government initiative has been the establishment of the Veteran Affairs (VA) department and the National Centre for PTSD whose main role is to research and educate on matters relating to PTSD (US Department of Veteran Affairs 1). The centre ensures that the latest findings in PTSD therapy reach those affected and they have also established PTSD programs and clinics that aid veterans with PTSD.
The Veteran Affairs (VA) department has three branches, which deal with unique problems that plague veterans with PTSD. The first division is the (VHA) “Veterans Health Administration division,” which offers healthcare for kinds of problems as well as regional medical centres and community-based outpatient centres that serve the veterans (US Department of Veteran Affairs 1).
The second division is the VBA (“Veterans Benefits Administration”), which is tasked with registering veterans, determining their eligibility for benefits and providing various forms of benefits including compensation and pension, survivors’ benefits, Education, vocational rehabilitation, insurance, employment and home loan guarantees. This division mainly addresses the financial problems that veterans experience due to PTSD such as the inability to secure jobs (US Department of Veteran Affairs 1).
Finally, the third division, which is the “National Cemetery Administration,” is tasked with offering memorial and burial benefits and the care for cemeteries where veterans are laid to rest (US Department of Veteran Affairs 1).
The government has also gone further and enacted legislative measures that protect veterans against possible discrimination that may make it difficult for them to secure jobs. Veterans with PTSD could possibly be discriminated at the workplace, especially if their symptoms may affect integration into the workplace. In order to avoid such situations the federal government enacted the USERRA Act (“Uniformed Services Employment and Reemployment Rights Act”) and ADA (“American with Disabilities Act”). Both laws ensure that veterans are not discriminated against at the workplace even when they have PTSD or other disabilities (US Equal Employment Opportunity Commission 1).
The VA department has also made an initiative to end homelessness among veterans both with and without PTSD by providing financial means to meet the needs of a home for homeless veterans (US Equal Department of Veteran Affairs 1).
Relation of the Highlighted Context to Ernest Hemingway’s Short Story-“Soldier’s Home”
Hemingway’s short story titled, “Soldier’s Home” gives a classical representation of the effects of war on a young soldier-Kreb-that returns late from World War I (WWI). Kreb becomes withdrawn emotionally and physically from family and people in his hometown and finds it hard to share his war experiences because no one seemingly pays attention to him (Hemingway 1). His numbed feelings make Kreb avoidant of any romantic relations, yet in war he had relations with foreign ladies as depicted by photos mounted in his home. Kreb avoids romantic relations because he feels he cannot bear the emotional toll of loving (Hemingway 2). The characteristic lack of emotional attachment that plagues PTSD veterans becomes apparent in Kreb when he even openly declares to his mother that he does not love her (Hemingway 6). He even further states that he does not love anything. The story ends with even further detachment as Kreb goes to seek for employment in Kansas (Hemingway 7). Kreb is totally dissociated and does not seem to appreciate anything about family, a characteristic common in PTSD veterans experiencing emotional numbing, avoidance and emotional withdrawal.
Angkaw, C. A. Ross, S. B. Pittman, E. O. J. Kelada, Y. A. Valencerina, M. A. M. & Baker, G. D. “Post-Traumatic Stress Disorder, Depression, and Aggression in OEF/OIF Veterans” Military Medicine Journal, 178.10 (2013): 1044-1050. Print
Asnaani, A. Reddy, K.M. & Shea, T. M. “The impact of PTSD symptoms on physical and mental health functioning in returning veterans” Journal of Anxiety Disorders, 28.3 (2014): 310-317. Print
Barrera, S. “How PTSD Affects Veterans,” February 23, 2014. Web. 12th March, 2015
Hemingway, E. “Soldier’s Home,” Our Time, 1925. Web. 12th March, 2015
Paulus, J. E. Argo, R. T. & Egge, J. A. “The Impact of Posttraumatic Stress Disorder on Blood Pressure and Heart Rate in a Veteran Population” Journal of Traumatic Stress 26.1 (2013): 169-172. Print
Ray, L. S. & Vanstone, M. “The impact of PTSD on veterans’ family relationships: An interpretative phenomenological inquiry.” International Journal of Nursing Studies, 46.6 (2009): 838-847. Print
US Department of Veteran Affairs, “Benefits,” January 1, 2015. Web. 12th March, 2015
US Equal Employment Opportunity Commission, “Veterans and the Americans with Disabilities Act (ADA): A Guide for Employers.” January 3, 2015. Web. 12th March, 2015