Posttraumatic stress disorder

What is Posttraumatic stress disorder (PTSD)?

A person with PTSD has four main types of symptoms:

  • Re-experiencing the traumatic event through unwanted and recurring memories or vivid nightmares. You might get really upset when you’re reminded of what happened, or have intense physical reactions like sweating, pounding or racing heart, or rapid or irregular breathing.
  • Avoiding reminders of the event such as activities, places, people, thoughts or feelings associated with the traumatic event.
  • Negative thoughts or feelings. You might feel flat, numb, afraid, or angry a lot of the time, have unrealistic expectations of yourself or other people, lose interest in day to day activities like work or playing with your kids, or feel cut off from your family and friends.
  • Being overly alert or wound-up. You might have trouble sleeping or concentrating, feel irritable or short-tempered, become easily startled, or feel like you’re always on the lookout for signs of danger.

You are not alone

Traumatic experiences are common; about two thirds of Australians will experience at least one potentially traumatic event in their lives. In addition to traumas commonly faced by the general community such as car accidents and assaults, veterans can be exposed to a number of traumatic events during the course of their service. This places them at increased risk of developing PTSD than the general population. Between five and ten percent of the general community are likely to develop PTSD at some point in their lives [1],compared to between 5 and 20 percent of veterans (depending on the nature of their work and deployment history) [2] [3] [4]. Among current serving members, about 8 percent will suffer from PTSD in a given year, compared to 5 percent of the general community

Read Bell’s story...
I was jumpy, sometimes aggressive, withdrawn and with a kind of numbness. A lot of numbness. I found it really hard to connect even with the person I loved the most. Like, rightly so, Kerry’s going, ‘Hang on, this isn’t nice. I don’t like where this is going.’ And I’m saying, ‘I don’t like it either but I don’t know what to do about it.’There were nightmares and dreams. Constantly stressed, constantly wired, constantly depressed. Just always battling with life. I think that after something like Aceh, nothing else can get you excited anymore. Nothing else is interesting anymore; nothing else feels as intense and therefore it’s not as meaningful. Read more about Bell’s story - The important things (PDF, 1.88MB)

The impact of PTSD on family relationships

Living with or loving someone who has PTSD can be difficult. People with PTSD often avoid social situations, feel detached, and have trouble expressing their emotions. As a result, they might be less affectionate or withdrawn and refuse to go on social outings or to family get togethers. They may also show less interest in intimacy or parenting children.

People with PTSD can also be more irritable and jumpy. Family members often talk about ‘walking on eggshells’ and being afraid of an outburst. Family violence can be a problem for families of veterans with PTSD.

Research has shown that PTSD can also affect the mental health of members of a veteran’s family. Partners can experience anxiety, depression, social isolation and feelings of hopelessness, while younger children can develop behaviour problems such as acting out at school, and adult children are more likely to suffer from mental health problems. It is therefore important to seek support and treatment for PTSD as early as possible to minimise its impact on family members.

Find out more about resources and referral options for families.

PTSD and getting older

Some veterans first develop PTSD years after their traumatic experience, while others might find their existing PTSD gets worse as they age. There are a number of reasons for this happening.

For one thing, work and raising children can help distract from thoughts and feelings associated with the trauma. With more free time after retirement and once the kids have left home, it can be harder to avoid memories and easier to get into bad habits, like drinking too much. You might also find that strategies that used to help you cope with stress and push memories away aren’t working any more or are taking their toll. For example, you might find that alcohol no longer blocks out feelings.

The interaction between physical and mental health can also lead to PTSD getting worse with age. Over time, PTSD can have a negative effect on our physical health, and in turn, having to deal with more and more physical health issues as we get older can make us feel less able to cope. A small proportion of veterans will develop dementia as they age, which can result in unwanted memories of traumatic events becoming more frequent.

It is important to remember that PTSD can be treated, even if you’ve had it for a very long time. Find out more about where to go for help.

What treatments can help me?

Effective treatments for PTSD are available. These include both psychological therapy and medication. It is generally best to start with psychological therapy rather than use medication as the first and only solution to the problem, although your doctor may prescribe antidepressant and other medications to help you manage some of the feelings associated with PTSD.

The most effective treatment for PTSD is trauma focused cognitive behavioural therapy. This approach recognises that the way we think and act affects the way we feel. With the help of a therapist or counsellor, you will learn:

  • ways to help digest and confront painful memories, thoughts and images so they don’t continue to distress you.
  • strategies to help you get back into activities or visit places that you have avoided since the trauma because it has been too distressing.
  • tools to help you relax when you start getting too anxious or wound up.

Recovery after Trauma - A Guide for People with Posttraumatic Stress Disorder (PDF) provides more information about PTSD and its treatment.

Where do I get help?

  • A GP is always a good place to start when trying to overcome PTSD, as he or she can make referrals for specialists, and support your efforts with medications if necessary.

  • This website has information on a range of professional care that is available to current and former serving members.

  • Trauma Recovery Programs: DVA provides Trauma Recovery Programs for veterans with PTSD and related problems in hospitals across Australia. These programs treat current as well as former serving members and veterans. To find out more about these programs you can contact the hospitals directly and speak to the program coordinators. A list of the programs and relevant contact details are available here.

Self-help resources

There are a number of resources you can use on your own or preferably with your counsellor to help you address some of the symptoms of PTSD:

PTSD Coach Australia app: provides education, information and strategies to assist self-management of PTSD symptoms and is available to download free from Apple and Android products.

Take Action: Get Strategies to Manage PTSD Symptoms as they arise

The symptoms of PTSD are distressing and make it harder for you to go about your day to day activities.

Use the range of tools available in the PTSD Coach Australia app to help manage your symptoms. For example, use the Deep Breathing and Progressive Relaxation tool when you are feeling anxious. The RID tool can be used when you are feeling triggered by past trauma or the Take Time Out tool when you are feeling overwhelmed by emotions.

This app is best used when you are also receiving treatment for PTSD. Take the time to look through the tools when you are feeling calm and practice the ones that are most relevant for you. With practice you will be able to use the app to manage your symptoms as they arise.

Click here to download the PTSD Coach Australia app.

The High Res website offers a range of self-help resources that help serving and ex-serving ADF members and their families manage stress and build resilience. Check out some of the tools that you can use:

Take Action: Manage your PTSD symptoms by Improving Your Sleep

PTSD tends to have a negative impact on sleep, but there are some simple changes that you can make to help you to get the best possible sleep.

Use the Healthy Sleeping tool and answer the questions about your typical sleeping behaviours and get tailored advice and tips to improve your sleep and optimise your mental and physical functioning.

This tool is also available on the High Res app to use on the go.

Take Action: Manage your PTSD symptoms by Getting Active

Physical activity can help you to reduce stress and anxiety associated with PTSD and boost your mood.

Use the Physical Activities tool to find activities, set goals and plan how to deal with anything that could prevent you reaching from those goals.

When you’re starting out you might want to choose smaller activities that you find easier to do. Once you’re in the habit of being active you can try some more challenging activities.

This tool is also available on the High Res app to use on the go.

Take Action: Manage your PTSD symptoms by Relaxing Your Body and Mind and Slowing Your Breathing

PTSD can leave you feeling on edge and wound up all the time and this can lead to muscle tension, aches, pains and fatigue

Use the Progressive Muscle Relaxation tool to learn how to tense and relax each of the muscle groups in your body so you can calm down and think clearly when you’re feeling on edge or anxious. The Controlled Breathing tool teaches you how to slow your breathing rate. These tools will help you to feel calmer and release tension from your body.

When you’re starting out it’s best to practice one (or both) of these tools once a day, even when you don’t need it. Once you’ve learnt the skills you can use them to calm down when you are feeling tense.

These tools are also available on the High Res app to use on the go.

  • Mental health Online: An internet-based tratement clinic providing access to information, clinical assessment and treatment programs.
  • About Face: includes video interviews with American veterans discussing PTSD and their experiences of seeking treatment.
Read Mick's story...
Most of my life I thought people with mental problems were wimps or fakers who needed a good kick up the arse. I’m a soldier, that’s what I’m good at. Over the years I got promoted to warrant officer, had a lot of younger blokes looking up to me, expecting me to be a strong leader. And I was. I was bloody good. Until about a year ago."

[1] Phoenix Australia - Centre for Posttraumatic Mental Health (2013). Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder. Melbourne: Phoenix Australia.

[2] O'Toole, B. I., Marshall, R. P., Grayson, D. A., Schureck, R. J., Dobson, M., Ffrench, M., . . . Vennard, J. (1996). The Australian Vietnam veterans health study: III. Psychological health of Australian Vietnam veterans and its relationship to combat. International Journal of Epidemiology, 25, 331-339.

[3] Ikin, J. F., Sim, M. R., Creamer, M. C., Forbes, A. B., McKenzie, D. P., Kelsall, H. L., . . . Schwarz, H. (2004). War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War. British Journal of Psychiatry, 185, 116-126.

[4] Forbes, D., O'Donnell, M., Brand, R. M., Korn, S., Creamer, M., McFarlane, A. C., & ... Hawthorne, G. (2016). The long-term mental health impact of peacekeeping: prevalence and predictors of psychiatric disorder. Bjpsych Open, 2(1), 32-37

[4] McFarlane, A. C., Hodson, S. E., Van Hooff, M., & Davies, C. (2011). Mental health in the Australian Defence Force: 2010 ADF Mental Health and Wellbeing Study: Full report. Canberra: Department of Defence.