SCHWEINFURT, Germany - Soldiers returning from a war zone often have difficulty adjusting to life at home.
They are easily irritated, react suddenly and unexpectedly to loud noises, or become withdrawn and unwilling to communicate. Understandably, this can be frustrating for family members. But the situation usually improves with time.
If it doesn't, then it may be time to seek professional help.
People who experience a frightening, traumatic event - such as many do during war - often react with heightened levels of arousal and fear. Memories of the event are painful, and may trigger a fear response similar to that caused by the original event.
"It's normal" and adaptive to experience these heightened fear responses, said social work care manager Rick Thompson. "But most people, over a period of time, usually around three months, get back to normal."
Post Traumatic Stress Disorder, or PTSD, occurs when a person gets "stuck" in the grip of that fear. The cause, though not completely understood, appears to be both neurobiological - a result of chemical reactions in the brain - and also related to the way the patient thinks.
The chemical aspect of the disorder may be treatable with medications, but the thought processes that foster and perpetuate the disorder are often difficult to change.
"A Soldier thinking that their symptoms are related to weakness: That's the kind of belief that isn't going to be helpful, and tends to keep you stuck," Thompson said.
PTSD symptoms and some minor Traumatic Brain Injury (mTBI) symptoms overlap, and tests designed to uncover one, such as the Automated Neurobiological Assessment Metrics for mTBI, often detect Soldiers suffering from the other, said Lt. Col. Daniel Duecker, the Schweinfurt health clinic commander.
To further complicate matters, many psychological disorders, such as PTSD or major depression, have overlapping symptoms, and making the correct diagnosis becomes complicated.
"With PTSD, you have to have some sort of scary event history, and there has to be some sort of re-experiencing symptoms," Thompson said.
This re-experiencing most often occurs as intrusive memories.
"With some people it's flashbacks, but it's not all that common. With a lot of people, it's nightmares … That symptom category is something that does not happen with mTBI or depression," Thompson explained.
In years past, seeking treatment for PTSD was often stigmatized, but the military community is changing. Programs such as Battlemind Training have been worked into reintegration schedules, and screening for PTSD is conducted as well.
"The Battlemind program helps reframe the types of training and thinking that were required for Soldier survivability in a war zone" in a way that will help the Soldier cope with life outside of that area, Thompson explained.
For example, in a war zone, emotional suppression may be necessary in dangerous situations. Continuing to deny expression can be maladaptive once outside of the war zone, causing the Soldier to become detached or seem uncaring. This can lead to problems in coping, and exacerbate any existing post-traumatic reactions.
Altering those thought patterns is one step toward avoiding or healing PTSD.