Post-traumatic stress (PTS) is a condition that can develop after witnessing or experiencing a tragic or traumatizing event. The Department of Veterans Affairs (VA) estimates that seven out of every 100 veterans will experience PTS at some point in their lives, compared to six out of 100 non-veteran adults. The condition is also more common among female former service members: 13% are expected to have PTS in their lifespan compared to 6% of male veterans.

As we observe PTS Awareness Month, it’s a great time to explore how it impacts our nation’s veterans and ways we can better support them. Moreover, it’s an opportunity to highlight current gaps in mental health support and care for former service members that can create hurdles in treatment.

In this article, we’ll explore the following questions:

• What is post-traumatic stress (PTS)?
• Are veterans at higher risk for PTS?
• How many veterans are experiencing PTS in 2023?
• What PTS treatments are available for veterans?
• How can we support veterans experiencing PTS?

Overall, veterans are experiencing PTS at higher rates than the general public, and there’s more that can be done by the VA and lawmakers to provide former service members with adequate, comprehensive assistance. At the same time, we must negate harmful notions around veterans’ mental health. As individuals, we can help by dispelling inaccurate stereotypes and pointing veterans with PTS — something anyone, including civilians, can experience after trauma — to helpful resources for mental health care.

What is post-traumatic stress (PTS)?

Post-traumatic stress (PTS) is a mental health condition that can develop after going through or seeing traumatic events such as a natural disaster, car accident, explosion, abuse, etc. It’s a common and often adaptive response to an abnormally stressful situation. Veterans are considered to have a higher risk of developing PTS than the general public due to unique stressors associated with combat and military life. Symptoms of post-traumatic stress may include:

• Flashbacks — memories of the traumatic event that come back suddenly and unexpectedly
• Nightmares — dreams about the traumatic event that occur over and over again
• Avoidance — avoiding places, activities, or people associated with the trauma
• Physical reactions — exhibiting physical signs of stress, such as a racing heart, sweating, anxiety, and nervousness.

Although symptoms of PTS can subside within weeks after the event, it’s recommended that anyone exhibiting these reactions speak with a healthcare provider to be evaluated for appropriate treatment and support.

Post-Traumatic Stress (PTS) vs. Post-Traumatic Stress Disorder (PTSD)

PTSD has become somewhat of a catchall term for all types of post-traumatic stress symptoms, but there are important differences between PTS and PTSD that should be understood.

PTS is a normal, and at times adaptive, response to trauma. It’s not a mental illness but something that many people — not just service members and veterans — experience after facing an extremely stressful event in their lives. Common occurrences like a sports accident or clumsy fall can trigger PTS, as well as more unusual events like war tragedies or an assault. Unlike PTSD, PTS is not chronic, and people can usually find relief in the short term.

PTSD is a medically-diagnosed condition and should be treated by a clinician. Symptoms can be chronic — lasting a year or more and requiring ongoing medical attention. PTSD symptoms typically develop within one month, and, though similar to symptoms of PTS (flashbacks, nightmares, racing heart, etc.), they can be more intense and long-lasting. According to the VA, about 10% of male veterans and 19% of female veterans who used VA healthcare in fiscal year 2021 were diagnosed with PTSD.

The term PTS is also used instead of PTSD by some (including Mission Roll Call) to alleviate the stigmas around having a “disorder” and to dispel myths of “broken veterans.” For example, a 2021 study by the University of Cincinnati looked at common stigmas veterans face and found that “depictions of veterans in news media and pop culture often carry negative associations such as poor mental health or violence.”

Facing these preconceived notions can make veterans reluctant to share their mental health challenges with friends and family or seek help. As such, the term PTS will be used in most cases throughout the rest of the article.

Are veterans at higher risk for PTS?

While PTS is a psychological injury that can affect anyone who experiences trauma, veterans are more likely to develop PTS than non-veterans. The VA estimates that at least seven out of every 100 veterans will experience PTS at some point in their lives. And RAND Center for Military Health Policy Research data has found that up to 20% of service members returning from the Global War on Terror (GWOT) have experienced PTS.

Combat experience in particular can make a person more sensitive to loud noises or bright lights, trigger insomnia and trouble sleeping, and make everyday situations feel more stressful than they did beforehand.

What’s more, veterans may face distinct barriers to accessing adequate mental health treatment. Research shows that less than half of veterans in need of mental health services receive treatment, and of those who do — for PTS and major depression — less than one-third receive evidence-based care.

There are also links between PTS and high suicide rates among veterans.

While suicide should not only be looked at through the lens of mental health — since a variety of other factors can play a role, the VA’s data shows the veteran suicide rate is 52.3% higher than non-veterans. America’s Warrior Partnerhip’s research even suggests the rate may be higher than the VA’s estimate, with their 2022 interim report pointing to at least 40-44 former service members dying every day by suicide or self-harm.

These concerning statistics highlight the need for comprehensive mental health care that takes a holistic approach to veterans’ needs. More than that, service members must be given proper resources and information on health benefits prior to military separation. Specifically, they should be provided with clear roadmaps for identifying symptoms and finding treatment for PTS and other mental health challenges.

PTS Rates Among Veterans in 2023

According to the VA, 7% of veterans will experience PTS at some point in their lives.

Veteran PTS rates are often categorized by service era, and prevalence among post-9/11 veterans tends to be higher, with 15% experiencing PTS in the last 12 months and 29% expected to experience it at some point in their lives.

A Pew Research study found that 36% of post-9/11 veterans believe they have suffered from PTS. And, being more likely to have been deployed and to have seen combat than veterans of other eras, nearly half said they had “emotionally traumatic or distressing experiences related to their military service.”PTS is also more common among female veterans, as 13 out of every 100 are expected to have PTS in their lifespan compared to six out of every 100 male veterans.

The following data is provided by the VA and was compiled from a large study of veteran demographics across the U.S.

Interestingly, former service members who use the VA healthcare system are more likely to be diagnosed with PTS than those who use community health services. This could be partly due to the fact that the VA screens all patients for PTS symptoms. Veterans who have been deployed and experienced combat during their service are also more likely to develop PTS than those who have not. Other scenarios that can exacerbate risks are: discharging a weapon, witnessing a death, being attacked, lack of support in transitioning from the military, and losing a sense of camaraderie and purpose post-deployment.

PTS Rates Among Veterans of the Global War on Terror

PTS has come to be known as the “signature wound” of veterans who served in the Global War on Terror (GWOT).

The VA reports that 29% of veterans who served in Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) – in Iraq and Afghanistan – will exhibit PTS symptoms at some point. And the Wounded Warrior Project’s 2022 survey of post-9/11 veterans found that 75.9% reported experiencing PTS; 49.8% reported moderate to severe symptoms of two or more mental health conditions, such as depression and anxiety; and 28.3% reported having suicidal thoughts in the last 12 months. The survey consistently shows that these veterans experience PTS at a much higher rate than the VA estimates as well.

The GWOT also saw a rise in improvised explosive devices (IED) and traumatic brain injury (TBI) impacting service members. Coupled with the war’s protracted length, all of these circumstances can play a role in elevating the risk of PTS and other mental health challenges for veterans.

What PTS treatments are available for veterans?

Therapy is usually regarded as a “first-line approach” for veterans with PTS. The success of PTS treatment depends on the severity of symptoms and how long they have been present. For long-term conditions, typically associated with PTSD, treatment often also includes medication and lifestyle changes. Only 50% of veterans — around 9 million — are enrolled in VA healthcare or affiliated with a veteran service organization. And of the 6 million veterans served by the VA healthcare system in fiscal year 2021, about 10% of men and 19% of women were diagnosed with PTSD.

Without the support they need, in the VA or their community, many veterans may turn to self-destructive coping mechanisms. A holistic approach is needed to combat the feelings of isolation, depression, and potential suicide ideation that can come with PTS. It is important for veterans to have a strong network during this process; having people to check in with, spend quality time with, or who serve as mentors can be a vital source of encouragement.

In the case of PTSD diagnosis, the VA offers three forms of therapy: cognitive processing therapy (CPT), prolonged exposure therapy, and eye movement desensitization and reprocessing (EMDR). Over 50% of patients who receive one of these three therapies will find relief, according to the National Center for PTSD. Or with medication alone, 42% have been found to achieve remission — though there have been concerns in the veteran community about negative side effects associated with some prescribed medications.

Ensuring positive outcomes must also include improving VA mental health services with practitioners that specialize in veterans’ care; implementing increased community care provisions as outlined in the MISSION Act, so that veterans can find quality care within a reasonable timeframe or distance; rightsizing disparities in VA healthcare facilities in underserved areas; and improving transition assistance programs to ensure veterans are fully aware of the healthcare benefits available to them upon exiting the military.

How can we support veterans experiencing PTS?

Mission Roll Call 2022 annual research survey on Americans’ attitudes on a range of veterans’ issues found 60% believe veterans deal with post-traumatic stress (PTS) a lot more than their civilian counterparts. And nearly half (46%) of U.S. adults believe the federal government has “not been very effective” in dealing with veteran healthcare, including mental health support. Considering this, there is ample room for individuals to play a role in supporting our nation’s veterans, especially those experiencing PTS.

We can point veterans in our lives to helpful resources and information on healthcare benefits they may be eligible for. The VA provides general and specialty mental health services, including treatment for PTS and other conditions. Moreover, if you have a veteran in your life showing symptoms of PTS, you can:

• Learn as much as you can about PTS. Knowing how it affects people may help you better understand how to support your loved one or friend.
• Encourage them to speak to healthcare providers who specialize in veterans’ needs and help them find a therapist if recommended by a doctor.
• Participate in physical activities with them. Consistent exercise is important for overall health, and activities like jogging, taking walks, or going for a bike ride can help improve mental health.
• Provide a listening ear and let the veteran know that you are there for them if they need to talk about their experience.
• Help them connect with other veterans in the same situation (via online forums, Facebook groups, etc.).

Good relationships can have a positive impact on veterans’ mental and physical health. Organizing support groups, spending quality time with a veteran experiencing PTS, or volunteering for a veteran-serving organization are all great ways to show support. The VA’s National Center for PTSD also has information for veterans, service members, families, and providers, and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury offers fact sheets and resources on PTS care as well.

Finally, you can encourage veterans you know to share their stories with Mission Roll Call, as we make ongoing efforts to present and advocate for the needs of veterans across America.

Conclusion

PTS is a condition that can affect veterans’ quality of life at higher rates than the general population. This month, as we raise awareness around PTS, let’s make it a point to learn more about how it impacts our veterans. There are many treatment options available that can help relieve symptoms and feelings of isolation. It’s important to remember that PTS is not a sign of weakness or brokenness but an adaptive psychological response to trauma. Therefore, we must ensure our brave veterans — who have selflessly served our nation — are not met with stigmas and barriers but instead have access to the best care, support, and resources.