The Unseen Consequences of War: PTSD and Homelessness in Veterans
According to the Department of Veteran Affairs (VA), approximately 7 to 8 percent of the US population will experience Post-Traumatic Stress Disorder (PTSD) at some point in their life. The statistics show that this rate is substantially higher for those who have served in the military, and the exact number usually depends on the type of combat they faced and where they were located.
For instance, those individuals who served in Operations Iraqi Freedom (OIF) and Operations Enduring Freedom (OEF), have a likelihood of around 11 to 20 percent chance of developing PTSD. While over 30 percent of Vietnam War veterans have developed or will potentially develop this mental health disorder. The lifetime prevalence of PTSD is around 10% for veterans of the Gulf War.
What is Post-Traumatic Stress Disorder (PTSD)?
The National Institute for Mental Health (NIMH) defines Post-Traumatic Stress Disorder (PTSD), as “a disorder that develops in some who have experienced a shocking, scary or dangerous event.” For military personnel, these types of events tend to revolve around their experiences in war, where they find themselves face-to-face with their own mortality, and that of their fellow comrades as well.
PTSD triggers an individual's “flight-or-fight” response in a situation that may not necessarily require it. To be officially diagnosed with PTSD, a veteran will experience the following symptoms for at least a month:
- At least one avoidance symptom. This essentially means that a veteran will want to stay away from triggering things that remind them of the traumatic experience (be it places, events or objects). They may avoid talking about war, or even staying away from those who served in the military altogether.
- At least one re-experiencing symptom. “Flashbacks” are an example of this, where a veteran will experience physical symptoms like elevated heart rates and frightening thoughts, as well as feeling in immediate danger when there is no actual threat.
- At least two cognitions and mood symptoms. The veteran will have negative feelings/emotions about themselves and the world around them.
- At least two arousal and reactivity symptoms. Some of these might include things like startling easy, feeling tense, sleeping issues, etc.
How Veteran Homelessness Correlates with the High Risk of PTSD in the Population
In 2022, the US had a homeless population of 582,000 people, with 33,000 of those being veterans of the armed forces.
The increased rates of PTSD among the veteran population may play a part in explaining why they are overrepresented in the homeless population within the United States. While veterans represent roughly 11% of the total population, they also represent almost 13% of the homeless population.
Studies show that common causes of homelessness among the veteran population include:
- Disabilities - physical injury and mental illness
- Substance abuse - drug abuse or alcoholism
- Family breakdown
- Joblessness and poverty
- Lack of low-cost housing
- Post-traumatic stress disorder
Among all of the aforementioned causes, PTSD may be the top reason for veteran homelessness. Veterans who have experienced a traumatic brain injury (TBI) also have an increased risk of developing PTSD.
Feelings of social isolation can also lead veterans who have PTSD to destructive methods of self-medication (substance abuse, alcoholism, etc.) A lack of treatment often makes it seem like they are without help. Many research studies have also indicated that a lack of support and isolation that people with PTSD experience is a direct link to homelessness.
PTSD Treatment for Veterans: Effective Approaches that Would Help Combat Homelessness
Recent research suggests that psychotherapy is the most effective “first-line” approach to treating PTSD. Psychotropic medications may also be helpful, particularly when combined with talk therapy approaches. Additionally, some studies indicate that veterans with PTSD may benefit from coping methods that they can practice independently, without clinicians present.
Trauma-Focused Therapy Approaches
The following psychotherapy approaches are strongly recommended by either the American Psychological Association (APA.org) or the U.S. Department of Veterans Affairs (VA.gov) as PTSD treatment options.
- Cognitive Behavioral Therapy (CBT): This approach emphasizes how thoughts, feelings, and actions influence one another. The goal is to develop new patterns of thoughts, emotions, and behaviors pertaining to the traumatic experience and related subjects. Cognitive therapy, a related approach, focuses specifically on altering painful memories and evaluations related to the trauma that hinder daily functioning.
- Cognitive Processing Therapy (CPT): This modality aims to help individuals develop new, more helpful understandings of their traumatic experiences through critical reflection.
- Eye Movement Desensitization and Reprocessing (EMDR): This form of therapy involves recalling the trauma while paying attention to a back-and-forth movement or sound controlled by the clinician.
- Prolonged Exposure (PE): This approach emphasizes incrementally challenging negative feelings and altering patterns of avoidance stemming from one’s trauma.
Other therapeutic interventions may also prove effective in specific cases, so veterans should seek the clinical expertise of a mental health professional if you are interested in learning more.
Appropriate clinicians to contact regarding PTSD treatment include counselors, social workers, psychologists, psychiatrists, and nurse practitioners specializing in psychiatry.
Medications for PTSD
Some psychotropic medications have been demonstrated to be effective treatment options for people with PTSD. These prescription medicines can be combined with psychotherapy in a multifaceted approach to PTSD treatment.
The four medications with the strongest clinical support belong to the class of pharmaceuticals termed “antidepressants.” They include the following medications:
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Venlafaxine (Effexor)
If a veteran is interested in medication to treat PTSD, contact a qualified medical professional for additional guidance. Please note, however, that medication is typically recommended in conjunction with other mental health services.
Coping Methods for Managing PTSD Symptoms
Beyond formal mental health care approaches, several “self-help” methods may prove valuable in managing PTSD symptoms. These practices are widely recommended by mental health experts as solutions that veterans can utilize in their spare time or when exposed to particular stressors. These techniques may be suggested as a complement to ongoing mental health treatment.
- Physical activity: Exercise can help relieve stress and elevate one’s mood.
- Aromatherapy: Certain smells, such as orange essential oil, may mitigate negative emotions associated with PTSD.
- Mindfulness practices: From formal meditation to simply noticing one’s senses, practicing being present can reduce trauma reactivity.
- Deep breathing:This seemingly simple technique can be surprisingly effective, and is available anytime, anywhere.
PTSD is a very difficult and intimidating mental health disorder that affects many veterans. Not only does it disrupt their life in many ways, but it also can lead to devastating circumstances, like homelessness.
The research is clear that there is indeed a correlation between veterans PTSD struggles and the homeless population. Between feelings of isolation and lack of support, many drive to methods that pull them further away from society.
If someone you know is a veteran and is struggling with PTSD, there is support and treatment available to them. The sooner they get help, the greater chance there is of overcoming many of the symptoms that they are facing.
Look to some of these resources for more supportive services for veterans suffering from PTSD: