Wednesday, April 17, 2024

Can You Have Ptsd Without Combat

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Adherence To Cpap Therapy

Adherence to CPAP therapy is less common than doctors would like, simply because sleeping with the mask on can feel uncomfortable. Individuals with PTSD are to use CPAP therapy consistently, often due to masking discomfort, nightmares, and claustrophobia. Nightmares in particular are associated with higher resistance to CPAP therapy. Individuals with PTSD use CPAP therapy for a shorter amount of time only 3.5 hours on average and on fewer nights overall.

A study of veterans found that among those without PTSD, 70% adhered to CPAP therapy. Among veterans with PTSD, that adherence rate dropped to less than 50 percent.

Non-adherence to CPAP therapy has serious consequences. One study of individuals with PTSD and OSA found that those who followed their CPAP therapy experienced a 75% improvement in PTSD symptoms. For those who didnt, their symptoms got 43 percent worse.

Studies show the more frequently a person uses their CPAP therapy, the more their PTSD symptoms improve. CPAP therapy has an even stronger positive effect among those with severe PTSD, as opposed to mild to moderate symptoms.

Specifically, CPAP therapy can significantly reduce the frequency of nightmares and the distress they cause for individuals with PTSD. CPAP therapy also relieves the daytime sleepiness symptoms of PTSD, improving quality of life.

Emotional And Psychological Trauma

If youve experienced an extremely stressful eventor series of eventsthats left you feeling helpless and emotionally out of control, you may have been traumatized. Psychological trauma often has its roots in childhood, but any event that shatters your sense of safety can leave you feeling traumatized, whether its an accident, injury, the sudden death of a loved one, bullying, domestic abuse, or a deeply humiliating experience. Whether the trauma happened years ago or yesterday, you can get over the pain, feel safe again, and move on with your life.

Ptsd In Veterans Recovery Step 1: Get Moving

Getting regular exercise has always been key for veterans with PTSD. As well as helping to burn off adrenaline, exercise can release endorphins and improve your mood. And byreally focusing on your body as you exercise, you can even help your nervous system become unstuck and move out of the immobilization stress response.

Exercise that is rhythmic and engages both your arms and legssuch as running, swimming, basketball, or even dancingworks well if, instead of continuing to focus on your thoughts as you move, you focus on how your body feels.

Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. Many veterans with PTSD find that sports such as rock climbing, boxing, weight training, and martial arts make it easier to focus on your body movementsafter all, if you dont, you could injure yourself. Whatever exercise you choose, try to work out for 30 minutes or more each dayor if its easier, three 10-minute spurts of exercise are just as beneficial.

The benefits of the great outdoors

Pursuing outdoor activities in nature like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing can help challenge your sense of vulnerability and help you transition back into civilian life.

Does Ptsd Cause Sleep Apnea

Does PTSD cause sleep apnea, or is it the other way around? Its hard to say. Individuals with more severe OSA are more likely to have more severe PTSD. At the same time, the more severe their PTSD, the more severe their OSA. Specifically, for each clinically significant increase in PTSD symptom severity, a veterans risk of OSA increased by 40 percent.

The disturbed sleep caused by sleep apnea can contribute to sleep deprivation that worsens PTSD symptoms, making recovery more difficult. Even if a sleeper doesnt wake up while experiencing OSA symptoms, sleep apneas arouse the sympathetic nervous system, decreasing overall sleep quality. The resulting sleep deprivation can impair mood and decision-making reducing a persons likelihood of using CPAP therapy, the common treatment for sleep apnea.

What Are The Signs Of Post

Ptsd Without Combat

Now that we understand what PTSD is and how it dramatically differs from regular stress, we must understand its signs and symptoms. According to the Mayo Clinic, PTSD signs are put into 4 groups: Intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions.

Intrusive Memories

If a person experiences nightmares, flashbacks, and continuous thoughts of a tragic event, this may be a sign of PTSD. This can cause extreme emotional duress as well as physical reactions like shaking, panic attacks, and heart palpitations.


If youve ever met a person who has experienced PTSD, you may find they avoid discussing the trauma. They may even exhibit these behaviors:

  • Avoid people who were involved,

  • Unable to participate in events that are at the specific location in which the trauma originated,

  • Unable to recall any details from the event,

  • Emotionally numb and detached,

  • Unable to be intimate or express any affection toward others.

Changes In Thinking and Mood

PTSD has the ability to take over a persons thoughts and feelings in a detrimental way. Some may be unable to have positive thoughts at all. Negative thinking and massive mood changes occur frequently. This would include persistent feelings of dread, guilt, and shame as well as:

  • The feeling they can’t trust anyone.

  • The feeling of the world being unsafe.

  • The feeling that nobody understands.

Changes In Physical and Emotional Reactions

Ptsd Networks Of Veterans With Combat Versus Non

The PTSD networks for combat and non-combat index trauma were moderately similar.

Negative emotion was a highly central symptom in both PTSD networks.

Detachment was a relatively more central symptom in the combat trauma network.

Negative emotion was more strongly related to blame in the combat trauma network.

What If A Veteran Exhibits Symptoms Of Two Ptsd Ratings

Where two evaluations may apply, the VA must grant the higher evaluation if the disability picture is closer to that higher rating. Otherwise, the VA will assign the lower rating. If a veteran fits criteria for both the 50% and 70% ratings, the VA should grant the 70 percent rating.

Similarly, there is the issue of IU and PTSD. If a veteran has a 70% PTSD rating and does not meet the 100% rating, his PTSD could cause IU. If that is the case, then the VA should grant 100% through IU for the PTSD.

Symptoms that the VA considers when rating PTSD include, but are not limited to:

  • impairment in thought processes or communication
  • grossly inappropriate behavior

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Stressors Related To Fear Of Hostile Military Or Terrorist Activity

An additional category of PTSD cases that do not require corroborating evidence of an in-service stressor is where a veteran has a PTSD diagnosis from a psychiatrist or psychologist based on the veterans fear of hostile military or terrorist activity. VA regulation states that this means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran of others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veterans response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. In such instances, no corroborating evidence is required to establish the occurrence of the stressor, provided that the stressor is consistent with the veterans service and there is no clear and convincing evidence to the contrary.

Symptoms And Signs Of Ptsd In Men

To receive a PTSD diagnosis, the NIMH says a mental health professional must confirm that youve experienced the following for at least a month:

  • At least one intrusive or re-experiencing symptom, such as flashbacks, reliving the traumatic events, bad dreams, or persistent thoughts about the traumatic event.
  • At least one avoidance behavior where you take steps to avoid potential triggers that could remind you of the traumatic event. This can also include changing your daily routine.
  • At least two arousal and reactivity symptoms, such as frequently feeling on edge or on high alert, and having trouble managing your day-to-day tasks.
  • At least two cognition and mood symptoms. For example, you might have strong feelings of guilt or personal blame for what happened, lose interest in activities that you used to enjoy, and be unable to remember significant details about the traumatic event.

In particular, men with PTSD often experience more difficulty controlling their anger and regulating their mood, compared to women with PTSD.

Substance use is more often seen in men with PTSD compared to women, as is withdrawal from friends and family.

Rape Or Sexual Trauma

The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone, or plagued by nightmares, flashbacks, and other unpleasant memories. But no matter how bad you feel right now, its important to remember that you werent to blame for what happened, and you can regain your sense of safety, trust, and self-worth.

Can Civilians Get Ptsd

Individuals may develop Post-Traumatic Stress Disorder when they experience, witness or learn about an event involving actual or threatened death, sexual violation, or serious injury. Non-Combat PTSD can affect all ages, genders, income levels, ethnicities and lifestyles.

READ:  How do I spend my summer vacation paragraph for Class 4?

Proving A Ptsd Stressor When Ptsd Is Diagnosed After Service

As you may have guessed, the evidentiary rules that apply to proving an in-service PTSD stressors when PTSD is first diagnosed after service depend on the facts of a veterans case. The first set of rules that will be discussed below apply to in-service stressors that occurred during combat. The second set of rules apply to stressors based on a fear of hostile military or terrorist activity. The third set of rules apply generally apply to non-combat PTSD stressors. The fourth and final set of rules apply to a subset of non-combat PTSD stressors involving assault including military sexual trauma.

No matter theory a veteran intends to rely on in order to prove the occurrence of an in-service PTSD stressor, triggering the VAs duty to assist with the verification of the alleged in-service stressor is an important first step. The duty to assist is triggered if the veterans own statement about the stressor event, without consideration of any other record evidence, is not inherently incredible. In most cases the veterans own statement will not be inherently incredible, so a lay statement from the veteran detailing the stressor is an important place to start.

Is Your Memory Out Of Whack Is Your Mood Off

Yes, You Can Have PTSD Even if You Weren

Feeling threatened and unsafe causes memories to be formed and stored differently than regular events. Sometimes people dissociate, or check out, while the event is going on. Inability to access memories of the event is a feature of PTSD.

Likewise, negative beliefs about the world can be indicative of PTSD. For example, its easy for me to believe that the world is unsafe and people should not be trusted. While there are many cynical people out there, my belief system is rooted in childhood trauma.

Blame, negative emotions , lack of interest in activities that were enjoyable pre-trauma, isolation, and the in ability to experience positive emotions are also symptoms of PTSD.

These cognitive and emotional symptoms are among the most confusing and are the reason PTSD is often misdiagnosed.

Think about it: You feel sad, dont like to hang out with people, think the world is a bad place, and have few activities you actually like doing. Sounds like depression, right?

Ready To Make A Claim 3 Steps To Presenting A Strong Va Ptsd Claim

Now that you know how the VA rates PTSD, its important to understand some best practices for making a claim. Keep in mind that PTSD claims can complicate the already confusing and murky claims process. Even with the new regulations passed in 2010 that make it easier for veterans with PTSD to qualify for VA benefits, a veteran with a PTSD claim will face unique challenges.

There are three requirements that make up a claim for :

  • A current diagnosis
  • A link between the current diagnosis and stressor
  • So, you can make a strong claim by presenting these three requirements.

    Private Mental Health Provider

    To access a private mental health provider, your best place to start is with your GP, who can provide you with a referral to a psychiatrist, psychologist, mental health social worker, or mental health occupational therapist, according to your need. The following information may be of assistance:

    Helping A Veteran With Ptsd

    When a loved one returns from military service with PTSD, it can take a heavy toll on your relationship and family life. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who wont open up, or even deal with anger or other disturbing behavior.

    Dont take the symptoms of PTSD personally. If your loved one seems distant, irritable, angry, or closed off, remember that this may not have anything to do with you or your relationship.

    Dont pressure your loved one into talking. Many veterans with PTSD find it difficult to talk about their experiences. Never try to force your loved one to open up but let them know that youre there if they want to talk. Its your understanding that provides comfort, not anything you say.

    Be patient and understanding.Feeling better takes time so be patient with the pace of recovery. Offer support but dont try to direct your loved one.

    Try to anticipate and prepare for PTSD triggers such as certain sounds, sights, or smells. If you are aware of what causes an upsetting reaction, youll be in a better position to help your loved one calm down.

    Take care of yourself. Letting your loved ones PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. Make time for yourself and learn to manage stress. The more calm, relaxed, and focused you are, the better youll be able to help your loved one.

    Get more help

    International Classification Of Diseases

    The International Classification of Diseases and Related Health Problems 10 classifies PTSD under “Reaction to severe stress, and adjustment disorders.” The ICD-10 criteria for PTSD include re-experiencing, avoidance, and either increased reactivity or inability to recall certain details related to the event.

    The diagnostic description for PTSD contains three components or symptom groups re-experiencing, avoidance, and heightened sense of threat. ICD-11 no longer includes verbal thoughts about the traumatic event as a symptom. There is a predicted lower rate of diagnosed PTSD using ICD-11 compared to ICD10 or DSM-5. ICD-11 also proposes identifying a distinct group with complex post-traumatic stress disorder , who have more often experienced several or sustained traumas and have greater functional impairment than those with PTSD.

    What Is Secondary Evidence For A Ptsd Non Combat Claim

    Thesecond evidence source is something called Secondary Evidence.

    The VA must review the following Secondary Evidence sources critically and carefully forinformation confirming participation in combat or to otherwise corroborate aclaimed in-service stressor when corroboration is required:

    • Buddy statements
    • Newspaper archives

    This next section is CRITICALLY important to remember:

    The VA may accept a Buddy Statement from a fellow Veteran as corroboration of a claimed in-service stressor if the statement is consistent with the time, place, and circumstances of the service of both the Veteran and the fellow Veteran making the buddy statement. 

    If you cant get at least one-buddy letter from a first-hand witness who can confirm these facts, youll almost certainly be denied service-connection for PTSD non-combat.

    Step 4: Take Care Of Your Body

    The symptoms of PTSD, such as insomnia, anger, concentration problems, and jumpiness, can be hard on your body and eventually take a toll on your overall health. Thats why its so important to take care of yourself.

    You may be drawn to activities and behaviors that pump up adrenaline, whether its caffeine, drugs, violent video games, driving recklessly, or daredevil sports. After being in a combat zone, thats what feels normal. But if you recognize these urges for what they are, you can make better choices that will calm and protect your bodyand your mind.

    Take time to relax.Relaxation techniques such as massage, meditation, or yoga can reduce stress, ease the symptoms of anxiety and depression, help you sleep better, and increase feelings of peace and well-being.

    Find safe ways to blow off steam. Pound on a punching bag, pummel a pillow, go for a hard run, sing along to loud music, or find a secluded place to scream at the top of your lungs.

    Support your body with a healthy diet. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed and fried food, sugars, and refined carbs which can exacerbate mood swings and energy fluctuations.

    What Is Primary Evidence For A Ptsd Stressor

    Primaryevidence is generally considered the most reliablesource for corroborating in-service stressors and should be carefully reviewedwhen corroboration is required.  It is typically obtained from theNational Archives and Records Administration or Department of Defense entities, such as service departments, the JSRRC, and the Marine CorpsArchives and Special Collections . 

    Primaryevidence includes:

    • Command chronologies and war diaries, and
    • Monthly summaries and morning reports.

    Step 1: Present A Current Diagnosis Of Ptsd

    Living with PTSD and TBI: National PTSD Awareness Day

    The first step to receiving VA benefits for PTSD disability requires the veteran to have a current diagnosis. A psychiatrist, psychologist, licensed social worker, or other mental health care practitioner must diagnosis the veteran with PTSD. Additionally, the diagnosis must conform to specific criteria.

    Its important that the diagnosing doctor provides a report that fully describes why they feel that the veteran has PTSD and how the veterans symptoms meet the specific criteria. All of this medical evidence must show that it is as likely as not that the veteran currently has disabling PTSD.

    Explain Ptsd: Your Primary Care Provider Wants To Help You Feel Better

    It can be challenging to explain PTSD symptoms and their impact on your life to your primary care doctor. However, the only way to make sure you are receiving the best care for your whole-self is to make sure everyone treating you knows about all aspects of your health, and that includes mental health. While there are stories of medical professionals who are judgemental and do not interact comfortably with patients who experience a mental illness, there is only one way to discover how comfortable your provider is with patients experiencing mental health issues. Don’t cheat yourself out of the best care possible. You’re worth it.

    Please let me know about your experiences with medical professionals and discussing your mental health with them. Are there things that make you uncomfortable or angry? How can they improve? I look forward to your comments.

    Treatment Options For Delayed

    The first step in treatment and recovery is to see a mental health care provider, preferably one who has experience with PTSD patients. Treatment typically includes , medication, or a combination of the two. The antidepressants Zoloft and Paxil are prescribed because they may help control some PTSD symptoms, like sadness, anxiety, and anger. Cognitive behavioral therapy can also be effective. This includes exposure therapy, which helps people remove the negative power of their experience by teaching them to revisit the memory more safely. CBT may also involve cognitive restructuring, allowing them to see the experience from a different perspective. This is conducive to the process of making sense of their memories and experiences. Stress inoculation training is also utilized, which helps patients deal with stressful situations and potential triggers in healthier ways.

    Group treatment may also be ideal for PTSD and Delayed-Onset PTSD sufferers because patients can receive help and support from people experiencing similar effects. They can also offer help and support to others. Group members benefit from telling their stories and facing the memory of the trauma, rather than avoiding it.

    Other treatment options may include family therapy and anti-anxiety medications.

    • Eat regularly, and eat well
    • Get exercise
    • Give yourself time and grace
    • Talk to someone: a friend, a family member, a professional, or a support helpline
    • Avoid drugs and alcohol

    Access To Supports And Treatments

    Early intervention and access to treatment are the first steps in the recovery process. If you have diagnosed PTSD, or any mental health condition, DVA may pay for your treatment, whatever the cause .

    DVA will pay for your treatment of any mental health condition before, during, or after you make a compensation claim or even if you never make a compensation claim. Call us on 1800 VETERAN  or find out if you are eligible and how to apply.

    Gold Health Card holders have access to DVA-funded treatment arrangements for all health conditions, including mental health. White Health Card holders have access to DVA-funded treatment arrangements for specific conditions, as well as any mental health condition under Non-Liability Health Care arrangements.

    Common Symptoms Of Ptsd

    PTSD is characterized by three main groups of problems. They can be classified under the headings of intrusive, avoidance and arousal symptoms.

    Intrusive symptoms

    Memories, images, smells, sounds, and feelings of the traumatic event can “intrude” into the lives of individuals with PTSD. Sufferers may remain so captured by the memory of past horror that they have difficulty paying attention to the present. People with PTSDreport frequent, distressing memories of the event that they wish they did not have. They may have nightmares of the event or other frightening themes. Movement, excessive sweating, and sometimes even acting out the dream while still asleep may accompany these nightmares. They sometimes feel as though the events were happening again; this is referred to as “flashbacks” or “reliving” the event. They may become distressed, or experience physical signs such as sweating, increased heart rate, and muscle tension when things happen which remind them of the incident. Overall, these “intrusive” symptoms cause intense distress and can result in other emotions such as grief, guilt, fear or anger.

    Intrusive symptoms of PTSD:
    • Distressing memories or images of the incident
    • Nightmares of the event or other frightening themes
    • Flashbacks
    • Becoming upset when reminded of the incident
    • Physical symptoms, such as sweating, increased heart rate, or muscle tension when reminded of the event

    Avoidance/numbing symptoms

    PTSD avoidance/numbing symptoms:

    Arousal symptoms

    You Don’t Have To See Combat To Get Ptsd From War

    Even though the Fort Hood shooter didn’t fight while in Iraq, he still could have developed posttraumatic-stress disorder.

    There are many details remaining about the gunman who opened fire at Fort Hood, Texas, killing four, including himself, and injuring 16 more. But here are some key facts about Spc. Ivan Lopez: He served four months in Iraq, he was being treated for undiagnosed posttraumatic-stress disorder, and he was not in combat during his deployment.

    In this type of situation, it might be easy to overlook someone who suffered mental anguish without actually seeing combat. But there are elements of war that are disturbing beyond shooting a weapon and being shot at.

    So can a soldier get PTSD without actually seeing combat?

    “Yes, you can,” says Craig Bryan, the executive director of the National Center for Veterans Studies. “It’s actually an issue the science in the last several years has been catching up with.”

    In the past year, the Diagnostic and Statistical Manual of Mental Disorders, which classifies mental disorders for the American Psychiatric Association, changed its criteria for PTSD to no longer require that a person must have been in a life-threatening situation.

    The APA found that many members of the military and veterans of the wars in Iraq and Afghanistan, even though they didn’t think they were going to die, manifested the problems associated with PTSD.

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