Post-Traumatic Stress Disorder

The U.S. Veterans

Fast Name and Last Name

Class

Date
 1

Introduction

Post-traumatic stress disorder is a mental dysfunction that evolves in some people who

have witnessed or experienced a traumatic event in their lifetimes. Some people may have

difficulty adjusting after going through such traumatic experiences, but they get better with

proper and timely self-care. However, if the symptoms develop and persist for a more extended

period, such as months or years, patients may be diagnosed with PTSD. The prevalence of Post-

traumatic stress disorder among the United States veterans has increased significantly over the

past years. Research conducted in 2018 by Armenta et al. revealed that the intensity of which

veterans have been exposed to combat in recent Afghanistan and Iraq war is the dominant risk

factor for the tenacious PTSD1. PTSD not only affects the soldier but their entire families as well.

This paper will discuss the impact of Post-traumatic stress disorder to the Soldiers and their

families as well as the strategic treatment measures for PTSD patients.

PTSD is one of the most typical health conditions among veterans in the United States. It

was estimated that out of 2.7 million U.S. soldiers deployed to the Iraq and Afghanistan war

since 2001, about 5-20% screened positive for the PSTD. PSTD represented the principal

diagnosis in the Department of Veterans Affairs medical settings between 2006 and 20122.

However, many veterans were found to underestimate the effect of PTSD, thus ignoring the need

for treatment. Others avoided the PTSD treatment due to the fear of being weak. The increased

prevalence of PTSD can be attributed to extreme exposure to the high intensity of combat.

1
Armenta, Richard F., Toni Rush, Cynthia A. LeardMann, Jeffrey Millegan, Adam Cooper, and Charles W. Hoge.
"Factors associated with persistent posttraumatic stress disorder among US military service members and
veterans." BMC psychiatry 18, no. 1 (2018): 48.
https://bmcpsychiatry.biomedcentral.com/track/pdf/10.1186/s12888-018-1590-5
2
Ibid, 1
 2

Research has shown that soldiers who were deployed without encountering fights shown high

chances of screening negative for PTSD as compared to those encountered battles3.

The development of PTSD varies; in some cases, persistent symptoms have lasted for

years or even a lifetime. When the symptoms become persistent, patients may manifest changes

in their neurobiology. Such changes can result in an extreme impact on the mental and physical

functioning of the patients. These impacts may influence patients’ physical and psychological

health. They can also impact the behavioral pattern of the patients and reduce the patients’

quality of life. Extreme cases of PTSD may manifest in the form of tertiary diseases such as

hypertension, cardiovascular diseases, immunity disorders, obesity, and even Mortality4. PTSD

not only affects the servicemen, but it impacts the lives of family and close relatives to the

patients.

One of the most critical manifestations of PTSD is anger. There is a salient connection

between PTSD symptoms and the violence reported by the military men. However, the anger

response by the servicemen with PTSD may vary depending on individual characteristics.

Nonetheless, manifested anger may have a significant effect on the patients’ relationship with

families and relatives. Research has revealed that there is a high prevalence of partner abuse

among the veterans exhibiting PTSD symptoms. A study conducted on veterans to establish the

interrelationship between PTSD manifestation and domestic violence revealed trait anger as the

primary cause of psychological aggression and assaults5. In this context, PTSD manifestation

3
Ibdi, 4
4
Ibid 2
5
Taft, Casey T., Amy E. Street, Amy D. Marshall, Deborah J. Dowdall, and David S. Riggs.
"Posttraumatic stress disorder, anger, and partner abuse among Vietnam combat veterans." Journal of
family psychology 21, no. 2 (2007): 270.
https://www.researchgate.net/profile/Amy_Marshall5/publication/6231196_Posttraumatic_Stress_Disorder
_Anger_and_Partner_Abuse_Among_Vietnam_Combat_Veterans/links/5659bc6908aefe619b22eebb.pdf
 3

through violence leads to abusive behaviors to the close relatives of the military veterans

deployed to the wars.

Partners of the military men diagnosed with PTSD are the most affected by the disorder.

According to the United States Department of Veteran Affairs, male veterans with PTSD have

reported high rates of parenting problems as well as marriage problems6. Veterans with PTSD

symptomatology experience challenges such as intimacy-related issues, they do not share

thoughts and feelings with their partners. In some cases, they may express lower sexual interest,

thus leading to dissatisfaction with their partners. As a result, Military veterans with PTSD are

twice likely to experience divorce than those without PTSD. Nonetheless, families of veterans

with PTSD have reported high rates of verbal, physical aggression, which damages their

relationship substantially7.

Moreover, partners living with PTSD patient veterans have reported cases of caregiver

burden to the family. Spouses often carry out a larger share of household roles, such as

housework as well as paying bills. They play a primary role in taking care of children as well as

the extended family. Additionally, partners face the challenge of taking care of their husband and

attending carefully to their problems. These attributes are likely to impact the quality of life of

the family members of Veterans with PTSD. For example, such families exhibit lower happiness

levels, low morale, as well as inadequate satisfaction. Spouses often report stress in coping with

their partners with PTSD symptoms8. This can result in secondary traumatization. Nonetheless,

there is no cure for PTSD; thus, researchers have developed a biblical perspective in an attempt

to help the patient in coping with PTSD manifestation.

6
United States Department of Veteran Affairs. “Partners of Veterans with PTSD” PTSD: National Center for PTSD.
(2019) https://www.ptsd.va.gov/family/effect_partners_vets.asp
7
ibid
8
ibid
 4

Biblical Insights on PTSD

The Bible is the most unified approach to PTSD. Through theology, new insights can be

shed on the patients as well as the pastoral caregivers and how they may connect and reduce the

PTSD symptomology and consequences. The Bible offers practical as well as theoretical

knowledge about its combat veterans who existed and won the battles and was able to overcome

psychological disorders. The Biblical theories illustrate the Veterans and the trauma which can

be used in the pastoral care of the servicemen from more recent battles. Military veterans can

gain insights about how prominent Biblical characters managed their darker sides after the war as

well as how their spiritual and moral wellbeing was impacted in relationship to God and other

people9. These insights also illustrate the biblical veterans’ commitment to military roles, loyalty

to their colleagues as well as the challenges in readjustment after the war. Some of these insights

include the stories of Saul, David, Joab, and Uriah10.

The Story of Saul

Saul was the first king of Israel after his anointment by God. During this time, the

Israelites were highly oppressed by the Philistines, thus needing a king. Saul led the fights

against the rivals from Ammon, Moab, and Edom. Saul also led successful combats against the

Amalekites and defeated their warriors. At some points, Saul disobeyed God’s command and

fought against the Philistines with his son Jonathan. Soul demonstrated disloyalty to God and the

duty as the commander of the troops. As such, the Holy Spirit left Saul, and he developed a

feeling of possession by evil spirits as enshrined in the book of Samuel (1 Sam. 10:17–24

9
Grimell, Jan. "Contemporary insights from Biblical combat veterans through the lenses of moral injury and post-
traumatic stress disorder." Journal of Pastoral Care & Counseling 72, no. 4 (2018): 241-250.
https://journals.sagepub.com/doi/pdf/10.1177/1542305018790218
10
Ibid, 256
 5

[NJKV])11. As such, the servants of Saul sort David to play harp music to him whenever he was

possessed by the evil spirits that occurred.

In this story, the condition of Saul after multiple combats and the disobedience to God

can be analyzed in a different perception. In the PSTD lens, it can be asserted that the condition

perceived by Saul’s servants as evil spirit possession, was stress attack and panic which occurred

over and over profoundly impacting his life. Due to high exposure to war and killings, Saul

developed PTSD, whereby he experienced unwanted memories leading to frequent emotional

distress. The harp music played by David was an adaptation measure that redirected the

memories once they occurred. Over time Saul exhibited worsened conditions of PTSD, which

manifested informs of distress, irritability, negative thoughts, exaggerated insecurity, and

harmful behaviors. At some point, Saul attempted to kill David after his successful combat with

the enemy Goliath. Saul’s condition can be described as complex PTSD, especially when he

almost killed his son Jonathan in a rage attack. Saul later decided to end his life in a battlefield

after getting an arrow injury.

Resources Available for PTSD Veterans

PTSD is among the first challenges faced by the Military veterans who served in the Iraq

Afghanistan war. As such, the United States Federal government has established measures and

resources to combat PTSD through the Department of the Veterans Affairs (VA) and the

Department of Defense (DoD). Both the two departments have extensive healthcare system

equipped with many programs and services to diagnose, screen, treat, and prevent Post

Traumatic Stress disorders. The departments are also endowed with facilities to rehabilitate the

veterans diagnosed or at risk for PTSD. DoD and VA have established a more collaborative

health provision system called DoD/VA Integrated Mental Health Strategy (IMHS) (DoD/VA,
11
1 Sam. 10:17–24 (NJKV)
 6

2011)12. This strategy employs a public health model to develop and uphold the health standards

of the Veterans, service members, as well as their families.

Apart from the government bodies, several private entities offer care and support to

veterans with PTSD symptomology. Military OneSource is a non-governmental organization that

offers free guidance and counseling to service members with PTSD, either through online or

face-to-face advice13. PTSD United is another network that provides support for Veterans

diagnosed with PSTD. It offers a platform for military men to connect with others who have

experienced trauma, thus allowing the patients to heal through shared interaction. Moreover, the

PTSD Foundation of America is another nonprofit organization dedicated to providing

mentorship to both the military men and their families undergoing PTSD14. The organization

provides peer mentoring and counseling and raises awareness about the challenges faced by

military families coping with PTSD.

PTSD patient Referral

The largest groups of healthcare professionals that come in contact with the military

veterans are the “Registered Nurses.” These professionals are at a high position of making

significant impacts on the life of PTSD patients. In several cases, the RNs meet PTSD patients in

healthcare or social groups (community setting)15. When presented with such patients, the nurse

should first inquire if the patient has served in the military. This is followed by a psychological

12
Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder, and Institute
of Medicine. Treatment for posttraumatic stress disorder in military and veteran populations: Initial assessment.
National Academy Press, 1900. https://www.ncbi.nlm.nih.gov/books/NBK224878/pdf/Bookshelf_NBK224878.pdf
13
Ibid
14
Ibid
15
Hanrahan, Nancy P., Kate Judge, Grace Olamijulo, Lisa Seng, Matthew Lee, Pamela Herbig Wall, Sandy C.
Leake et al. "The PTSD Toolkit for Nurses: Assessment, intervention, and referral of veterans." The Nurse
Practitioner 42, no. 3 (2017): 46-55.
https://www.nursingworld.org/~48e191/globalassets/foundation/the_ptsd_toolkit_for_nurses__assessment.99783.pd
f
 7

assessment of trauma and stress symptoms with the help of PTDS Toolkit. In this context, the

nurse should establish the severity of the condition before referring the patient for help.

The PTDS Toolkit is designed to enhance the RNs’ knowledge about the Psychological

consequences of PTSD among military servicemen. After the assessment, a referral should be

made specifically for the veteran. After completion of the screening, the Nurse practitioner

should refer the patient to the resources that offer care for military men with PSTD. As discussed

above, these resources include the DoD, VA, as well as private clinicians. It is recommended that

the NPs involve the patients in choosing the most preferred referral resource16.

Offering Help and Counsel

Nonetheless, nurses and caregivers should take precautions when handling Veteran PTSD

patients. Caregivers should provide social support to the patients; they should avoid pressuring

the patients into talking about the traumatic experiences17. In this case, counselors and caregivers

should demonstrate patience and expect mixed feelings from the patients. This can be achieved

through seeking education to understand the symptoms, effects, and the therapeutic options to

move along better with the military patients.

The caregiver should be good listeners; if the patient decides to share the

caregiver/counselor should listen emphatically without judgments18. In this context, caregivers

should demonstrate an interest in the care of the patient. It is essential to respect the reactions and

feelings of the patients; disapprovals from the caregiver will prevent the patients from opening
16
Hanrahan, Nancy P., Kate Judge, Grace Olamijulo, Lisa Seng, Matthew Lee, Pamela Herbig Wall, Sandy C.
Leake et al. "The PTSD Toolkit for Nurses: Assessment, intervention, and referral of veterans." The Nurse
Practitioner 42, no. 3 (2017): 46-55.
https://www.nursingworld.org/~48e191/globalassets/foundation/the_ptsd_toolkit_for_nurses__assessment.99783.pd
f
17
Smith, Melinda and Robinson, Lawrence. “Helping Someone with PTSD: Helping a Loved One While Taking
Care of Yourself” Help Guide. (2019) https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-
ptsd.htm
18
Ibid,
 8

up. Moreover, caregivers should anticipate triggers; these could be loud noises that resemble

gunfire or encounter with other combat colleagues. Internal triggers can also lead to the

manifestation of symptoms of PTSD.

Traumatic events can change the way people perceive the world; most victims view the

world as perpetually dangerous19. It also impacts the patients’ ability to trust other people.

Therefore the counselor and caregiver should help in rebuilding the feeling of security in the

patients. This can be achieved through the expression of commitment to a relationship, especially

if the caregiver is a spouse, creation of routines to enhance security and stability, and keeping the

promises. Spouses can also encourage their PTSD veteran partners to join support groups as well

as make plans for their families.

Ministry practices to prevent PTSD

Prevention of PTSD is a compelling strategy to mitigate the symptomatology of the

disorder. The federal government of the United States has enforced numerous measures to

minimize the effects of PTSD among the Veterans who served in the Iraq and Afghanistan wars.

Such measures include proper care and treatment of the veterans through the Department of the

Veterans Affairs (VA) and the Department of Defense healthcare programs. As such, veteran

patients diagnosed with the disorder are referred to the government-sponsored healthcare system

where they receive appropriate treatment for the dysfunction. However, more measures should

be established to reduce the impact of PTSD on Veterans.

The DoD should consider exposing the veterans to perceived or actual traumatic stimuli

that they are likely to encounter through realistic training. This includes exposure of military

trainees to mock captivity training, survival training, and live weapons mock, among others. This

is likely to tone down the level of arousal in case the military encounter such stimuli in the actual
19
Ibid,
 9

battlefield. On the same account, military people should be trained on the variety of stress coping

skills. This will equip the veterans with the ability to tolerate extreme stressful events. Training

should also involve dealing with actual traumatic exposure; this enhances the veterans’

expectations of the traumatic events.

Furthermore, there is a need to create a supportive environment network that is capable of

providing social support during and after the traumatic experience. This involves training the

families of PTSD patients about the conditions of the disorder and the treatment measures.

Families play a significant role in the support network of PTSD patients. Societies should also be

educated to accommodate and support PTSD veterans. Nevertheless, the government should

enhance ethical leadership in all levels of the organization to reduce the traumatization effects.

In conclusion, the prevalence of Post-traumatic stress disorder among the United States

veterans has increased significantly over the past years, especially with the Iraq and Afghanistan

wars. This disorder is manifested through behavioral, psychological, and even physical

symptoms. PTSD not only affects the veterans but impacts the families and the close relatives of

the patient substantially. Biblical insights about Bible military characters have been used

significantly to help the veterans cope with their traumatic experiences. The U.S. government has

established healthcare systems through the Department of Veterans Affairs and the Department

of Defense to provide healthcare service to the PTSD veterans. With the Iraq and Afghanistan

wars lasting more than 18 years, it is estimated that an additional 33% of soldiers returning home

from war will also have PTSD. Therefore, further ministry practices should be exercised to

prevent these traumatic effects.

 10

Bibliography

Armenta, Richard F., Toni Rush, Cynthia A. LeardMann, Jeffrey Millegan, Adam Cooper, and
Charles W. Hoge. "Factors associated with persistent posttraumatic stress disorder among
US military service members and veterans." BMC psychiatry 18, no. 1 (2018): 48.
Retrieved from https://bmcpsychiatry.biomedcentral.com/track/pdf/10.1186/s12888-018-
1590-5

Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress

Disorder, and Institute of Medicine. Treatment for posttraumatic stress disorder in
military and veteran populations: Initial assessment. National Academy Press, 1900.
Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK224878/pdf/Bookshelf_NBK224878.pdf

Grimell, Jan. "Contemporary insights from Biblical combat veterans through the lenses of moral
injury and post-traumatic stress disorder." Journal of Pastoral Care & Counseling 72, no.
4 (2018): 241-250. Retrieved from
https://journals.sagepub.com/doi/pdf/10.1177/1542305018790218

Hanrahan, Nancy P., Kate Judge, Grace Olamijulo, Lisa Seng, Matthew Lee, Pamela Herbig
Wall, Sandy C. Leake et al. "The PTSD Toolkit for Nurses: Assessment, intervention,
and referral of veterans." The Nurse Practitioner 42, no. 3 (2017): 46-55. Retrieved from
https://www.nursingworld.org/~48e191/globalassets/foundation/the_ptsd_toolkit_for_nur
ses__assessment.99783.pdf

Smith, Melinda and Robinson, Lawrence. “Helping Someone with PTSD: Helping a Loved One
While Taking Care of Yourself” Help Guide. (2019) Retrieved from
https://www.helpguide.org/articles/ptsd-trauma/helping-someone-with-ptsd.htm

Taft, Casey T., Amy E. Street, Amy D. Marshall, Deborah J. Dowdall, and David S. Riggs.
"Posttraumatic stress disorder, anger, and partner abuse among Vietnam combat
veterans." Journal of family psychology 21, no. 2 (2007): 270. Retrieved from
https://www.researchgate.net/profile/Amy_Marshall5/publication/6231196_Posttraumatic
_Stress_Disorder_Anger_and_Partner_Abuse_Among_Vietnam_Combat_Veterans/
links/5659bc6908aefe619b22eebb.pdf

United States Department of Veteran Affairs. “Partners of Veterans with PTSD” PTSD: National
Center for PTSD. (2019) Retrieved from
https://www.ptsd.va.gov/family/effect_partners_vets.asp