What was PTSD called in the past? - 1. Soldier's Heart: physiological signs, increased HR, chest pains,
panic, sense of doom
2. Shell Shock: concussive or vacuum effects of exploding artillery shells and trench warfare
What is PTSD? - psychiatric disorder that can occur following the experience or witnessing of a life-
threatening event such as military combat, natural disasters, terrorist incidents, serious accidents, or
physical or sexual assault in adult or childhood
What is "dialing-up"? - as you progress through mobilization toward deployment, anxiety gradually
increases: you are mentally and physically preparing yourself for this new deployed environment
What is "dialing-down"? - anxiety begins to decrease as you adjust to being at home but will not
necessarily return to how it was before deployment (post-traumatic growth)
During deployment all Warriors experience change? - Yes, everyone is impacted including families at
home
How does deployment physically effect the body? - 1. sleep deprivation during sustained operations
2. being on guard almost all of the time
3. physical threats
4. maintaining emotional control
5. extreme physical stress and exhaustion
6. carrying heavy loads, wear and tear on muscles and joints
7. injuries, including concussions/mTBIs and combat trauma
What is Post-traumatic stress (PTS)? - aka combat stress
typical expected reactions to deployment stressors; everyone who deploys will experience at least a
mild form of one or more of the signs at some point or points during their transition home
,the sooner warriors seek help, the better the outcome
Will dialing-down combat physiology take time? - Yes
time, work, effort
Do all service members experience PTS? - Yes
What is the goal of resilience training? - to provide soldiers with adaptive skills to deal with any
challenge to not just survive but thrive in the face of adversity
Risk-taking Behavior (red flags) - the start or increase in frequency of behaviors that may endanger
health and the health and safety of those around them
signs and symptoms are seen as "triggers"
Anger Problems (red flags) - returning warriors can be easily angered or have uncontrolled anger; anger
has been found to be a prominent symptom of traumatic exposure
Sleep Problems (red flags) - returning warriors may have difficulty falling asleep or staying asleep, some
may wake early and not be able to get back to sleep and have frequent nightmares (getting 7-8 hours of
continuous uninterrupted sleep is extremely important)
Alcohol (or other substance abuse) Problems (red flags) - half of all PTSD diagnosed warriors have
associated alcohol problems, many of whom have not previously been "problem" drinkers
Relationship Problem (red flags) - 25% of warriors report stress reactions that may interfere with their
ability to trust and be emotionally close to others
What is the key to preventing psychological trauma from further developing into a physical disorder? -
recommend talking to experts (BH/chaplain)
,What physical disorder must be ruled out with a warrior demonstrating behavioral change? - everyone
experiences PTS but not everyone experiences PTSD
Signs and Symptoms/Triggers of behavioral health problems - 1. behaviors/reactions that impair
performance or jeopardize training
2. persistent problems with sleep
3. reckless or dangerous behaviors
4. drinking too much alcohol, misusing substances
5. severe guilt or hopelessness
6. withdrawals from buddies, friends or family
7. rage, threatening statements
8. talking/joking about not wanting to be alive
Goal of Successful Transition - to minimize "collateral damage" such as damage to relationships or
careers, and general self-destructive behavior; they must learn how to transition from deployed mindset
back to the "home front" and it will take time, work and effort
Broken Tail Light - when a warrior does not realize that he or she has a problem; TAIL can be used to
help friends with transition problems
TAIL - T: tell them you're concerned
A: all are impacted by deployment
I: insist that they talk with someone
L: look for ways to help
What are the 3 things Medics are expected to do? - 1. identify those warriors in your platoon/unit who
are at-risk
2. talk to your soldiers and normalize their behavior
3. empower warriors to seek help because the sooner they get help the better the outcome
, *always recommend that warriors talk to the experts, whichever is more comfortable for them; your
role is to help them get the help they need
Important Points about PTSD - 1. can be caused by exposure to a traumatic event
2. significantly impacts functioning (victims can no longer consistently perform duties of daily tasks)
3. is a diagnosis that requires a group of symptoms to be present for an extended period of time
4. must be diagnosed by a medical professional
What percent of soldiers are actually diagnosed with PTSD? - only around 3-5% are diagnosed with PTSD
*most soldiers DO NOT develop PTSD as a result of their deployment experiences*
Which soldiers are at a higher risk of having serious stress-related problems? - 1. genetic predisposition
2. early-life trauma
3. no strong social support system
4. regularly engaged in frequent or intense combat
5. witnessed injury or death
6. involved in a serious event where they felt they had no control, esp if they felt there was a mistake,
poor leadership or negligence
Why are concussions hard to diagnose? - mild TBIs can sometimes go undetected from the start and can
be difficult to distinguish from moderate or severe brain injuries
*make sure warrior takes a break (take a knee) even if they insist they are feeling fine*
When to get a medical evaluation for concussions - 1. within 50m of a blast
2. direct blow to the head or LOC
3. vehicle involved in blast event
4. collision or rollover
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