How civilians or even the enemy to the

How can the effects of
PTSD be minimised in military veterans?


EPQ- Introduction
draft 1:



PTSD is a mental
health disorder caused by a traumatic, stressful, frightening or distressing
event. Within a war zone military personnel experience many life threatening
and traumatic situations. These range from the death of friends, civilians or
even the enemy to the horrific sites of destruction leaving civilians lives
torn apart. Some of these persons may re-experience these in months or possibly
years time through flashbacks, nightmares or images. These sensations may come
with an immense reality and affect the daily life of a military person once
returned from the war zone, leading to hyper arousal, depression and possibly
substance abuse.



The symptoms of PTSD
are often categorized into:

a vivid reliving of the event, in the form of: flashbacks, nightmares,
distressing images or sensations, or physical sensations.

or emotional numbing.  This involves
trying not to be reminded of the experience in any way. Often the person will
avoid certain people, places or talking of the experience at all. Some people
may try to relieve this feeling through attempting to ‘feel nothing’ at all,
this is known as emotional numbing. Emotional numbing will lead to the person
becoming isolated and withdrawn from society.

arousal, this is the feeling of being on edge. The person will constantly feel
the need to be aware of any possible threats. This often leads to irritability,
anger outbursts, concentration difficulty or sleeping problems.


The symptoms will also
often lead the person to develop depression, resort to alcohol or drug abuse to
alleviate the suffering. Or become distanced from family and loved ones, which
may break down relationships within their life further affecting them





Chapter 1: Causes of


There are many
possible experiences that may cause PTSD. Any event that is traumatic to a
person or that causes them to feel an extreme amount of anxiety and fear can
later develop into PTSD. What different individuals find traumatic varies
largely from person to person depending on their personality, personal beliefs
or values and the individual’s previous experiences. Usually the event will be
threatening leaving helpless fear in the individual. There is no clear and
definite description as to why these events cause PTSD however there are some
suggested possible reasons.


One of these
suggestions is that it is a form of survival mechanism. This says that the
symptoms may be part of an instinctive mechanism that aims to help you survive
potential traumatic experiences that could occur in the future. The feeling of
hyperarousal may develop so that they can react quicker and respond faster in
another situation, which is similar to the first. This mechanism is supposed to
help you be better prepared in this situation. However, in reality this is not
so helpful, hyperarousal means that you cant move on and properly process the
situation, leaving you with more long-term emotional anxiety.


Another possible
suggestion is the high level of adrenaline produced by suffers of PTSD. During
a dangerous situation, like one which may cause PTSD, the body produces high
levels of adrenaline. This is known as the “fight or flight” reaction, which
helps the body to deaden senses and reduce pain so they can escape danger.
Research has shown that people with PTSD continue to produce these high levels
of adrenaline (“fight or flight” hormones) even when there is no possible
danger present. This may be a possible reason for the symptoms that are shown
by people who have PTSD.


The final possible
reason as to why PTSD is triggered is changes in the brain. When people who
have PTSD have had brain scans, some of the parts of the brain involved in
emotional processing appear different. An example of this is the hippocampus
appears to be smaller. The hippocampus is responsible for memory and emotions.
These changes could be a related to the fear and anxiety, memory problems and
the flashbacks experienced by people suffering from PTSD. A further issue to
the malfunctioning hippocampus is that it can restrict the proper processing of
flashbacks or nightmares, this means that the anxiety that is caused by these
does not reduce over time.


Why does military
combat cause PTSD?

Veterans trauma often
relates to combat duties, any mission they may have undergone under stressful
conditions or being in the danger of a warzone. A lot of the time spent within
a warzone the soldiers are under high levels of stress and fight in gruesome
and horrific combat, exposing many to traumatic and disturbing scenes. Many
believe that veterans that may have caused harm to a civilian will have an
increased chance of developing PTSD from the specific event.


Treatments for PTSD
aim to allow the person to properly process the negative memories and feelings,
these means that over time the flashbacks or nightmares should be reduced and
then eventually disappear.












Chapter 2: main
treatments used for ptsd.


There are many
treatments available for PTSD, with varying levels of research into different
types. The most researched and medically supported treatment is trauma-focused
therapy. These treatments focus on the memory itself or the meaning behind
their flashbacks, with the aim to help the sufferer process the experience.
Trauma-focused therapy can be split into 3 main forms. The first is prolonged
exposure. This will involve talking to a counsellor about the memory and
progressively getting the patient to restart doing things that they have
avoided doing since the event happened. By doing this it should teach the
patient to gain control and be able to face their negative feelings. The next
from of trauma-focused therapy is cognitive processing therapy. This also involves
talking to a counsellor about the incident, however, also will involve short
writing assessments about the event and what they have talked about. This form
of therapy aims to teach the patient to refrain from the negative thoughts that
they have linked to the event. The third form of trauma-focused therapy is
eye-movement desensitisation and reprocessing (EMDR). EMDR involves the patient
recalling the traumatic experience whilst receiving a bilateral sensory input
(a visual or auditory stimuli occurring in a side to side motion). Using this
treatment should help the patient learnt to process and remove the negative
feelings experienced whilst thinking about or being reminded of the experience.


Another form of
treatment for PTSD with strong supporting evidence is the use of antidepressant
medication. Specifically SSRIs (selective serotonin reuptake inhibitors) or
SNRIs (serotonin-norepinephrine reuptake inhibitors). Serotonin and
norepinephrine affect mood and act in response to stress. These drugs stop the
reuptake of serotonin and norepinephrine so therefore they remain in
circulation around the brain for longer. This will reduce anxiety and improve
mood. There are four medications recommended for the use for PTSD: Sertraline,
Paroxetine, Fluoxetine and Venlafaxine. These are the most effective and
beneficial to patients suffering from PTSD.


There are some other
treatments that don’t directly focus on the event but instead, focus on
managing the symptoms and reactions that the patient has to the event. However,
research backing these treatments is less thorough, so therefore arguably may
be less effective. The first of these is stress inoculation training. This is a
cognitive-behavioural therapy, which teaches techniques or the skills that can
allow the patient to manage their stress and reduce anxiety. The next type of
this style of treatment is present-centred therapy. This therapy focuses on the
current life problems, which are related to PTSD, that the patient is
experiencing since the traumatic experience. The final form of this therapy is
interpersonal psychotherapy. This focuses on how the trauma has affected the
personal relationships that the patient has with others. It aims to help the
patient strengthen relationships which may have broken down and to help them
reduce their social anxiety.


As well as these
treatments people who have PTSD use some techniques to help them cope with
their trauma. These can be helpful in different ways for different people. Some
examples of possible strategies are establishing a daily routine; this will
help the person feel they have more control. This can also be achieved through
setting small and manageable goals. By doing this you can help to focus on and
tackle obstacles that they face during their day-to-day life. Other coping
strategies include getting support from family and friends when you need it.
Sharing experiences with people close to you can help them to help them
understand and support you better. Sharing your experiences with other people
who understand your situation is often helpful, you can do this by joining a
support group who focus on PTSD.