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Post Traumatic Stress Disorder is often associated with combat veterans and military service but it can affect any person of any age and any demographic.

Dr. Cybele Pacheco, who is the director of senior-focused care at Geisinger, said PTSD is a diagnosable mental health condition that is triggered by a traumatic or frightening event that is experienced, witnessed or perceived.

“It triggers a fight or flight reaction that the person stays in, a person is triggered to have the same emotional response as if the person just experienced the event again,” said Pacheco. “The event is replayed over and over and over in one’s head. At different stages, it can be re-triggered to go back to the same emotional response that you had at the time of event.”

The traumatic or frightening event can be wartime combat, but also a car accident, being a victim of a violent crime, witnessing a tragic event, or even fear of public speaking, she said.

PTSD doesn’t affect everyone, even those experiencing the same event. Different people react in different ways to outside stimuli, said Pacheco.

“It comes down to the circuitry of the brain, genetics, family history and personal history of mental health. The last bucket is idiopathic: nobody knows why that person is having that response. There’s really no rhyme or reason. There’s no correct answer on that.”

Pacheco also noted that the senior population is difficult to treat as well due to medication therapy in the population. There needs to be more care to older adults so not to mix medications.

PTSD in veterans vary

The number of veterans with PTSD varies by service era, according to the U.S. Department of Veterans Affairs.

According to the VA, 11-20 out of every 100 veterans (or between 11-20%) who served in either Operations Iraqi Freedom (OIF) or Enduring Freedom (OEF) have PTSD in a given year. About 12 out of every 100 Gulf War veterans (or 12 percent) have PTSD in a given year.

About 15 out of every 100 Vietnam Veterans (or 15%) were currently diagnosed with PTSD at the time of the most recent study in the late 1980s, the National Vietnam Veterans Readjustment Study (NVVRS). It is estimated that about 30 out of every 100 (or 30 percent) of Vietnam Veterans have had PTSD in their lifetime, according to the VA.

Four types

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions.

Experiencing PTSD can result in nightmares, flashbacks, depression, anxiety, unwanted memories of the trauma, uncontrollable thoughts that affect a person’s day-to-day activities, and avoiding the triggers that bring back that feeling of trauma, said Pacheco.

“They all co-mingle with each other,” said Pacheco. “It’s not exclusive of the other.”

A person may avoid the location of the traumatic event to avoid the trigger. A person can also avoid large crowds, she said.


Treatments are available, including medications, cognitive behavioral therapy and eye movement desensitization and reprocessing (EMDR), said Pacheco.

Cognitive behavioral therapy focuses on the relationship among thoughts, feelings, and behaviors; targets current problems and symptoms; and focuses on changing patterns of behaviors, thoughts and feelings that lead to difficulties in functioning, according to the American Psychological Association.

EMDR is a new structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories, according to the American Psychological Association.

‘Any traumatic event’

About 45 percent of Americans who serve in the military have some form of PTSD, said Rick Hamp, special assistant to the deputy adjutant general at the state Department of Military and Veterans Affairs (DMVA) and the state lead for the Governor’s Challenge to Prevent Suicide Among Service Members, Veterans, and their Families.

He said everyone touched by military service has a tendency to be affected by mental health and behavioral health of veterans.

“We are very family-centric in the military,” he said. “The spouse, the children of the veteran or service member are affected by the unique things that are part of the service. We have separation, the potential for deployment, training events, clearly there are traumatic events that could occur that are part of military service. Just about every service member has been part of some kind of training or event that could lead to PTSD.”

PTSD can occur from overwhelming, frightening, and/or life-threatening events, said Hamp.

“It doesn’t mean necessarily the person is broken,” said Hamp. “They are just affected by the experience. A lot have never been deployed. You don’t have to be deployed into a warzone to be affected by PTSD. It could be a car accident. Any traumatic event that has a lasting effect on you could be a cause of PTSD.”

Pacheco said those experiencing symptoms of PTSD should seek medical treatment.

“Nobody has to live with this, but it is a difficult one,” she said. “It is solely within the person and their response to the situation. They don’t have to suffer in silence or alone.”

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