At first sign of PTSD, seek medical help

Story and photo by Chuck Roberts
Landstuhl Regional Medical Center Public Affairs

***image1***Persistent chest pain, difficulty breathing and high fever are symptoms that normally prompt people to seek medical help.

Anger, apathy, irritability and insomnia can also be symptoms alerting Soldiers they may need medical treatment, said Lt. Col. (Dr.) Gary Southwell, an Army psychologist at Landstuhl Regional Medical Center.

For Soldiers redeploying from downrange, such symptoms can often be normal reactions to abnormal situations encountered in Afghanistan or Iraq. When Soldiers find themselves struggling to cope, Colonel Southwell encourages seeking help.

“Just look at it as a checkup,” Colonel Southwell said. “If you’re feeling odd, it doesn’t hurt just to get checked out. Just come on in and say, ‘This is what I’m going through,’ and we can help sort it out.”

When they do seek medical help, Soldiers often learn they are experiencing normal symptoms and are going through a normal recovery.

For those requiring more extensive help, there are a variety of avenues for treatment, such as anger management classes and individual or group therapy. In some cases, a physical problem may be discovered during a behavioral health examination, he said.

Thanks in part to increased awareness and strong backing from the Army chief of staff and leadership down the chain, more Soldiers view seeking such help as a normal and positive thing, Colonel Southwell said.

“People now feel like it’s an acceptable condition just like any other medical condition,” Colonel Southwell said. “It’s one of the hazards of war, and problems such as Post Traumatic Stress Disorder need to be evaluated and treated just like any other medical condition.”

However, some Soldiers remain reluctant to seek help for reasons such as fear of being seen as weak, or concerns that coming forward may be a career killer in regards to security clearances. Behavioral health is part of the security clearance coordination, but Colonel Southwell said anyone’s record of seeking treatment is viewed as a positive indicator.

“If you seek help, you get better,” Colonel Southwell said. In order to help Soldiers better recognize their need for help, the military has established a Post Deployment Health Reassessment given to Soldiers six months after returning from deployment.


The PDHR has proven a beneficial tool, Colonel Southwell said, because it helps identify problems that may arise months after taking a similar assessment immediately following redeployment while a Soldier may still be experiencing the euphoria of coming home.

In some cases, however, a Soldier may need the help of family or friends to help identify possible symptoms of PTSD or Traumatic Brain Injury and to suggest they seek help. That can be true especially with chronic PTSD when a Soldier is more likely to internalize his or her problems and become emotionally distant, Colonel Southwell said.

“We know for sure there are still a lot of Soldiers who are not coming forward, who have not been identified, and some who have been misidentified,” he said.

Although early detection is more advantageous, lengthy delays in seeking treatment are still overcome. About one year ago, Colonel Southwell began treating a Soldier who felt he had PTSD from Operation Iraqi Freedom and was concerned he was scarred for life. However, a year later he is almost completely recovered and is expected to make a full recovery, and all the while being able to remain on the job.

But, if treatment is never sought, the pain can continue forever, he said.

“The door is open for people to get help. If you feel you are having problems and need someone to talk to, please let someone know and seek help,” Colonel Southwell said.

Signs and symptoms of PTSD

The three groups of symptoms that are required to assign the diagnosis of PTSD are:

•recurrent re-experiencing of the trauma (for example, troublesome memories, flashbacks that are usually caused by reminders of the traumatic events, recurring nightmares about the trauma and/or dissociative reliving of the trauma)

•avoidance to the point of having a phobia of places, people and experiences that remind the sufferer of the trauma and a general numbing of emotional responsiveness

•chronic physical signs of hyperarousal, including sleep problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, increased tendency and reaction to being startled and hypervigilance to threat.

The emotional numbing of PTSD may present as a lack of interest in activities that used to be enjoyed (anhedonia), emotional deadness, distancing oneself from people and/or a sense of a foreshortened future (for example, not being able to think about the future or make future plans, not believing one will live much longer).

At least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned.

PTSD is considered of chronic duration if it persists for three months or more.