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Why Don't More Veterans Suffer From PTSD?
Even at the end of an hour of conversation, I often have as many questions as I have answers. Last week after our program on post-traumatic stress disorder I wondered why one person can suffer intensely from PTSD while another person with similar experiences does not. The National Institutes of Health estimates that about a third of people who have spent time in war zones experience PTSD. What about the other two-thirds?
So I emailed James Sardo, the miliatary psychologist who manages the PTSD Clinical Team at the Portland Veterans Affairs Medical Center and was a guest on the show. He wrote back to say it's a combination of factors - starting with a person's genetic disposition to respond to threats. He says other stressors happening at the same time play a big role.
For example, I worked with many Soldiers who were going out on combat patrols while their personal lives were crumbling (spouses leaving, kids sick, losing homes, etc.) The degree to which this undermined their previous ability to manage these traumatic experiences cannot be underestimated. The amount of support they have awaiting them at home is vital and has been shown to play an important role in mitigating the effects of combat stress.
He also says the more time a person spends in a war zone, the higher the chance of PTSD.
The aggregation of trauma cannot be underestimated. We know for example from data dating back to WWII that as you increase the interval of time spent in a war zone, you increase the likelihood of psychiatric casualties. I think the WWII data suggested that the rates remained fairly steady until you hit 180 continuous days a which point psychiatric casualties shot up dramatically.
Perhaps his most interesting note though, was that the meaning people assigned to the traumatic events they experienced could affect how dehabilitating stress later became.
For many folks, the ability to endure great hardship appears to be, in part, related to how they interpret the event. People don?t tend to personalize tornados and earthquakes for example like the do War or violent assaults. This in turn appears to mitigate the degree to which they experience long term symptoms. People who believe strongly in what they do and for whom the events continue to retain their importance and meaning tend to do better. (Spirituality and religious faith/beliefs play a role here.)
If you've spent time in a war zone and avoided PTSD, what do you credit? What did you do differently from people you know with PTSD?