A Mental Health Article by Daniel Hunt
Seeing those four letters together, in almost any context, will most likely bring to your thoughts an image or idea of what they mean. The challenge with that, like anything, is that the image or idea provided by your brain may not necessarily be an accurate one. The population’s experience with mental health concerns is subjective, and varies from person to person, so when someone who hasn’t directly experienced or witnessed something as complex as PTSD - from where do they draw their understanding? What about someone who is experiencing it, but their personal experience doesn’t align with their current perception? What is the first step in understanding an acronym that represents a complex and diverse levels of experience?
When looking at that acronym, I believe it’s important to know what it actually encompasses. On the off-chance you don’t know what it stands for, even if you’ve seen it before - Post Traumatic Stress Disorder.The word I want to focus on in this article is ‘traumatic’. At some point in their life, everyone has, or will, experience something that could be considered traumatic - whether that be the death of a pet, bullying, violence, near death experience - just to name a few. What is important to emphasise from the outset of this article is that the degree of the trauma will always vary, and the carry on effect it has on someone will differ from person to person. Trauma is a unique, subjective experience - it is intertwined with an individual’s personal perspective. For some, these events are considered ‘a part of life’, and whilst they aren’t necessarily wrong - attitudes towards traumatic events can be damaging when the person going through the negative experience is told that their trauma doesn’t constitute as something that someone else would consider ‘traumatic’. In my life, I’ve seen attitudes like that quite often. One individual’s idea of ‘character building’ may not be the same for another, and when someone having mental or emotional difficulty is told that they haven’t got a good enough reason to feel or think that way - that “you haven’t got it that bad” attitude can actually exacerbate problems. People holding others against standards to which they don’t hold themselves isn’t a new thing, but I also believe that this isn’t enough of an explanation as to why it happens - mental health and social dynamics are far more complicated than that. I do believe that double standards is one reason why it may happen, but if I was to draw from my personal experience from the military - the most common idea of PTSD, and mental health in general, was that certain criteria needed to be met before it was considered “real”. That an experience must match the current diagnostic checklist of what something is meant to look (whether this checklist is representative or not) like before it was acknowledged as real. This idea wasn’t just placed onto others, but onto the believer as well.
I understand drawing from my own experiences is entirely anecdotal in nature, but the reason I want to bring experiences from my days in the military into this is because of the concerning statistics found within the serving and transitioned military community. My perspective has changed a lot since transitioning out of the military, which according to the statistics, is consistent with most others who have done the same. I will admit that whilst serving, my idea of mental health was strongly influenced by the hive-mind like view held by those I directly or indirectly encountered. Unfortunately, this view was quite narrow minded, and followed the general outline of:
1) Get deployed
2) Experience combat
3) Come home and struggle to integrate back into normal life
I can’t stress enough just how general that outline is, because I understand that summarising the life-changing experiences people have suffered into three points could be seen as inconsiderate. What I want to achieve through that summarization is to express what a lot of military personnel consider fair ground for trauma. Even if it is put down to three points, this shouldn’t be surprising - as you have a demographic of people who experience PTSD, depression , anxiety and more, and are the people that have been affected by their time on military operations. Again, I want to emphasise the role of perspective. It can be difficult for someone who has limited personal experience with mental health to believe that, for example, an individual may experience a similar level of pervasive trauma after witnessing a car crash as an individual who witnessed a friend die in an explosion. That may or may not be true, but when it comes to these things, there’s no scoreboard. When looking at another person’s experience of trauma (even if the definition may differ from your own), consideration must move beyond simply recognising what they have experienced, and acknowledging the effect that the event or events has on their life.It can be I understand that it’s natural for people to want to know the root of the problem when they hear that these issues are present, however, the severity of a traumatic experience cannot be judged solely on the event itself. Asking about and acknowledging the event is a way in which we can begin to understand what has happened, but anyone asking should understand that someone may not be comfortable answering. If trauma is causing a person difficulty sleeping, unwarranted emotional outburst or dissociative tendencies - are they not both entitled to the same consideration and help, regardless of the catalyst?
I’ll give some silver lining here - if someone has personal or professional criteria that they think needs to be met for another person’s trauma to be meaningful, then they believe that these issues do exist. That’s an excellent starting point to expand someone’s understanding of a subject that isn’t as simple or straightforward as we’d like it to be.
Looking at the statistics presented in the study referenced above, among members who have transitioned from the ADF, a quarter (24.9%) were estimated to meet criteria for PTSD.
If it were up to certain people, that 24.9% would need to meet the three outlined points I mentioned above. Most wouldn’t, to the despair of some career soldier who can’t get to work without sips from a whiskey flask (alcohol abuse is a real issue). Of course some would, others may meet one or two of the points, and others none at all. According to a mental health professional, however, they did meet sufficient criteria for a diagnosis. I don’t need to tell anyone that the professional opinion of a mental health specialist is more meaningful than that of someone without relative qualifications and experience, because if you don’t believe that then you’re arguing against evidence-based science.
Some symptoms usually associated with traumatic stress are (but not limited to): flashbacks, vacant stares and falling to the ground as if being shot at when surprised by a loud bang (military specific). Individuals may feel ‘on edge’, sensitive to the sights or sounds around them, or completely disconnected from the world around them.
You may have seen some of those symptoms in yourself or others, portrayed in movies or other forms of media, and obviously that’s because they’re very real and common indicators among individuals living with PTSD. There’s more that are just as common but less obvious, such as avoiding reminders of a traumatic event, or emotional numbness. Less noticeable, but just as important to recognise for people who have experienced traumatic events - regardless of what the event was.
So, is there criteria for PTSD?
Of course. Mental health specialist assess and diagnose clients they work with, and they must have something that they draw on to justify that diagnosis. The signs and symptoms associated with mental illnesses are the closest any of us non-qualified people can get to clear cut criteria. It’s important to note, however, that a complex disorder like PTSD isn’t just one be-all diagnosis. There are different shades of experience - with varying degrees of severity and presentation, just like heat burns do. I’ll include those below, as I think that they’re not only interesting, but important to know - not only for general information, but for the applicability in life. With a better understanding of PTSD and it’s forms, one can better help themselves and others in recognising signs and seeking methods to cope and improve. Especially for those who work or live within a demographic where mental health is prevalent. A greater level of understanding can not only make a positive difference to help-seeking, but also assist in changing prevalent attitudes and stigma surrounding PTSD and seeking support.
I recently spoke to Dr. Kevin Kraushaar about the subject of PTSD when planning to write this article, and he advised me that the stress disorder can be broken into three levels of severity. These levels include: Adjustment Disorder, Acute Stress Disorder, and PTSD.
Due to the fact that I’m not a psychologist, I won’t personally try to explain any of these, instead I’ll include information on these down below, which I have pulled from reliable sources. If you want to follow up on these sources and do further reading to develop your own understanding - the references are attached below.
Adjustment disorders are a group of conditions that can occur when you have difficulty coping with a stressful life event. These can include the death of a loved one, relationship issues, or being fired from work. While everyone encounters stress, some people have trouble handling certain stressors.The inability to adjust to the stressful event can cause one or more severe psychological symptoms and sometimes even physical symptoms. There are six types of adjustment disorders, each type with distinct symptoms and signs. Adjustment disorders can affect both adults and children.These disorders can be treated with therapy, medication, or a combination of both - and therapeutic support strategies are tailored to the needs of the individual. With help, you can usually recover from an adjustment disorder quickly. The disorder typically doesn’t last more than six months, unless the stressor persists.
Acute Stress Disorder
Acute stress disorder is characterized by the development of severe anxiety, dissociation, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor (e.g., witnessing a death or serious accident). As a response to a traumatic event, the individual develops dissociative symptoms. Dissociative symptoms involve a detachment from physical or emotional experiences, and can have a pervasive impairment on an individual’s daily life. Individuals with acute stress disorder have a decrease in emotional responsiveness, often finding it difficult or impossible to experience pleasure in previously enjoyable activities, and frequently feel guilty about pursuing usual life tasks. A person with acute stress disorder may have difficulty concentrating, feel detached from their body, experience the world as unreal or dreamlike, or have increasing difficulty recalling specific details of the traumatic event (dissociative amnesia). In addition, at least one symptom from each of the symptom clusters required for posttraumatic stress disorder is present. First, the traumatic event is persistently re-experienced (e.g., recurrent recollections, images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the event, or distress when exposed to reminders of the event). Second, reminders of the trauma (e.g., places, people, activities) are avoided. Finally, hyperarousal in response to stimuli reminiscent of the trauma is present (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, an exaggerated startle response, and motor restlessness).
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a set of reactions that can develop in people who have experienced or witnessed a traumatic event that threatens their life or safety (or others around them). This could be a car or other serious accident, physical or sexual assault, war-related events or torture, or a natural disaster such as bushfire or flood. Other life-changing events such as being retrenched, getting divorced, or the death of a family member are very distressing, and may cause serious mental health concerns , but are not considered traumatic events that can cause PTSD. In the first days and weeks after a traumatic event, people often experience strong feelings of fear, sadness, guilt, anger, or grief. Generally these feelings will resolve on their own, however if the distress continues, it may mean that the person has developed PTSD or another mental health condition. It is worth noting that PTSD can lie dormant for weeks to months, and can present itself some time after the actual event has occurred.
Anyone can develop PTSD following a traumatic event, but people are at greater risk if:
the event involved physical or sexual assault
they have had repeated traumatic experiences, such as sexual abuse or living in a war zone
they have suffered from PTSD in the past.
The aim of deconstructing the ‘PTSD’ acronym is to emphasise that this stress disorder has more layers than initially thought - that understanding the different shades of individual experience is key to furthering the efforts to make mental health issues a more open and accepted topic. Education and awareness are important steps towards positive change in attitudes or stigma associated with PTSD (or mental health experiences in general). If someone experiencing difficult negative emotions can identify that while they may not meet the criteria of a very severe case of PTSD, their feelings are still relevant - and still qualify as something that they and others should recognise as detrimental if left untreated. PTSD is not a ‘one size fits all’ diagnosis - it doesn’t always look the same for everyone surviving trauma. Personal perspective and experiences of trauma need to be considered within the context of an individual’s life. This extends to people witnessing someone else struggling to deal with an event or experience. If you encounter someone, be it a stranger, friend or relative, with signs indicative of a mental health issue, you can use that knowledge to assist that individual. So whatever your understanding of PTSD, depression, anxiety, or any other mental health issue is, be open to learning more about it. An important reminder - experiences of trauma and mental health are real, and they can seriously impact an individual’s life. Seeking help and sharing vulnerability is not weakness - and even if it might be challenging, have the hard conversations. With the prevalence of self-harm in the modern world, it may just save someone.
If you, or someone you know is going through a hard time, or if anything in this article has brought up mental health concerns you want to talk about - don’t be afraid to reach out. The following services are available for mental health & crisis support:
Lifeline 24/7 Crisis Line - 13 11 14
Lifeline Textline - 0477 13 11 14
Beyondblue - 1300 659 636
MensLine - 1300 78 99 78
Open Arms - Veterans & Families Counselling - 1800 011 046
Defence Family Helpline - 1800 624 608
Or check out our Mental Health Resources Page for more information: https://anviltd.com/pages/ves-australian-mental-health-resources
Anvil Training and Development is a group of Australian veterans who care about the physical and mental health of veterans and emergency service workers. We’re passionate about ongoing education and working with others to implement positive change.
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