PTSD and Older Veterans
A National Center for PTSD Fact Sheet
From the time of Homer's ancient story of the battle between the Trojans and
the Greeks, and the times of the Bible and Shakespeare, military personnel have
been confronted by the trauma of war. Recent books and movies have highlighted
the impact of war trauma on veterans of the Vietnam War and the Persian Gulf
War. However, the traumas faced by veterans of World War II and the Korean
conflict have been publicly acknowledged in the media less often and less
clearly. The recent movie, "Saving Private Ryan," showed the reality
of war trauma during World War II. World War II was terrifying and shocking for
hundreds of thousands of American military personnel. For most World War II
veterans, memories of the war can still be upsetting more than 50 years later,
even if the memories arise only occasionally and for brief periods. For a
smaller number of World War II veterans, the war trauma memories still cause
severe problems, in the form of Posttraumatic Stress Disorder, or PTSD.
How does war affect "normal," "healthy" military
personnel?
War is a life threatening experience that involves witnessing and engaging
in terrifying and gruesome acts of violence. Most military personnel also feel
that participating in war is their patriotic duty, and they do so to protect
and defend their country, their loved ones, their values, and their way of
life. The trauma of war is the shocking confrontation with death, devastation,
and violence. It is normal for human beings to react to war's psychic trauma
with feelings of fear, anger, grief, and horror, as well as with emotional
numbness and disbelief.
Many studies have shown that the more prolonged, extensive, and horrifying a
soldier's or sailor's exposure to war trauma, the more likely it is that she or
he will become emotionally worn down and exhausted. This happens to even the strongest and healthiest of individuals,
and often it is precisely these soldiers who are the most psychologically
disturbed by war because they endure so much of the trauma. Most war heroes
don't feel brave or heroic at the time, but they do their duty, despite often
feeling overwhelmed and horrified, in order to protect others.
It is, therefore, no surprise that when military personnel have had severe
difficulty recovering from the trauma of war, their psychological difficulties
have been described as "soldier's heart" (in the Civil War),
"shell shock" (in World War I), or "combat fatigue" (in
World War II). After World War II, psychiatrists realized that these problems
usually were not an inborn mental illness like schizophrenia or manic
depressive illness but were a different form of psychological dis-ease that
resulted from too much exposure to war trauma.
This form of psychological dis-ease is known as "traumatic war
neurosis" or Posttraumatic Stress Disorder (PTSD). Although most war
veterans are troubled by war memories, many were fortunate enough either to
have not experienced an overwhelming amount of trauma exposure or to have immediate
and lasting help from family, friends, and spiritual and psychological
counselors so that the memories have become manageable. A smaller number,
probably about one in twenty World War II veterans, had so much war trauma and
so many readjustment difficulties that they now suffer from PTSD.
How is it possible to have PTSD 50 years after a war?
Because most World War II veterans received a hero's welcome and a booming
peacetime economy when they returned to the states, many were able to make a
successful readjustment to civilian life. They coped, more or less
successfully, with their memories of traumatic events. Many had disturbing
memories or nightmares, difficulty with work pressure or close relationships,
and problems with anger or nervousness, but few sought treatment for their
symptoms or discussed the emotional effects of their wartime experiences.
Society expected them to put it all behind them, forget the war, and get on
with their lives. But as they grew older and went through changes in the patterns
of their lives-retirement, the death of spouse and friends, deteriorating
health, and declining physical vigor-many experienced more difficulty with war
memories or stress reactions. Some had
enough trouble to be diagnosed with a delayed onset of PTSD symptoms, sometimes
with other disorders like depression and alcohol abuse. Such PTSD often occurs
in subtle ways. For example, a World
War II veteran who had a long successful career as an attorney and judge and a
loving relationship with his wife and family might find upon retiring and
having a heart attack that he suddenly felt panicky and trapped when going out
in public. Upon closer examination, with a sensitive helpful counselor, he
might find that the fear is worst when riding in his car, and this may relate
to trauma memories of deaths among his unit when he was a tank commander in
World War II.
How can I help an older military veteran who may have PTSD?
First, if one feels emotional about past memories or experiences some of the
normal changes associated with growing older (such as sleep disturbances,
concentration problems, or memory impairment), it does not necessarily mean
that person has PTSD. If a World War II or Korean conflict veteran finds it
important, but emotionally difficult, to remember and talk about war memories,
help him or her by being a good listener, or help find a friend or counselor
who can be a good listener.
Second, get information about war trauma and PTSD. The Department of
Veterans Affairs' Vet Centers and Medical Center PTSD Teams offer education for
veterans and families, and they can provide an in-depth psychological
assessment and specialized therapy if a veteran has PTSD. Books such as
Aphrodite Matsakis' I Can't Get Over It (Oakland: New Harbinger, 1992)
and Patience Mason's Home from the War (High Springs, Florida: Patience
Press, 1998) describe PTSD for veterans of all ages and other trauma survivors
and PTSD's effect on the family.
Third, learn about the specialized therapies available at Vet Centers and VA
Medical Centers. These include medications to help with sleep, bad memories,
anxiety, and depression; stress and anger management classes; counseling groups
for PTSD and grief (some particularly designed to bring together older war veterans
to support one another in healing from war trauma or prisoner of war experiences);
and individual counseling. It is important that family members be involved in
the veteran's care and in their own individual care.
Related Fact Sheets
Coping with traumatic stress
Discussion of behaviors that are helpful for coping with traumatic stress reactions
Homecoming reactions
Homecoming after deployment: Dealing with changes and expectations
Help for
veterans with PTSD
Answers to some questions about PTSD and service-connected disability that
are frequently asked by veterans and their families
Treatment of veterans
General treatment considerations and care returning soldiers from the Iraq
War
Veterans returning
from war
The returning veteran of the iraq war: Background issues and assessment guidelines
This fact sheet was based on:
Bonwick, R.J., & Morris, P.L.P. Post-Traumatic Stress Disorder in
elderly war veterans. International Journal of Geriatric Psychiatry 11,
1071-1076.
Hyer, L., Summers, M.N., Braswell, L., & Boyd, S. (1995). Posttraumatic
Stress Disorder: Silent problem among older combat veterans. Psychotherapy
32(2), 348-364.
Schnurr, P.P. (1991). PTSD and
Combat-Related Psychiatric Symptoms in Older Veterans. PTSD Research
Quarterly 2(1), 1-6.
Snell, F.I. & Padin-Rivera, E. (1997). Post-Traumatic Stress Disorder
and the elderly combat veteran. Journal of Gerontological Nursing 23(10),
13-19.
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