PTSD is terrifying but speed of UK veterans seeking help is promising

The transition to civilian life can be a difficult time, not just for the veterans but for their families as well. Everyone is different, but after being discharged, veterans have to cope with a loss of role and identity. 

In service, those things are there, and they are taken care of. They have a sense of who they are. Their whole support and social network is around them, so when they leave, they often have problems adjusting to civilian life. 

Many of the veterans we see are presenting with depression, or alcohol or drug misuse. They may have lost the support of family or friends; 6% are homeless. They require welfare as well as clinical services to help them get back on track. 

Exposure to combat is the biggest risk factor in terms of the significant minority who will be diagnosed with post-traumatic stress disorder. It tends to be multiple exposures to combat rather than singular events, so those who have served in the infantry tend to make up the biggest proportion of the people who have PTSD.

For those veterans, it's a bit like having a film of something awful that has happened being stuck in your mind. This film may not be on play permanently but if you are walking down a street and see something that looks similar to the traumatic event, it will trigger a memory. 

If this is unprocessed trauma memory, there will be a strong physiological response. Your heart rate will increase and you will start sweating and you will feel under threat. It may be something that has happened in the past, but the body responds like it is happening now. 

The person will be experiencing it in their mind, and it will be terrifying. For some, delayed-onset PTSD can happen years after they leave the forces. They may seem to have coped very well, and then something will happen 20 years later, such as the loss of a partner or a car crash, and that will trigger PTSD. 

It will take them back and the memories will be vivid. In some ways, the big increase in referrals of Afghanistan veterans last year is promising. If you look at the figures across all conflicts, it takes on average about 13 years before a veteran seeks help for a mental health illness. 

For Afghanistan, it is about 18 months before they present themselves. People are coming to us more quickly. It gives us hope that we can try to prevent some of the issues of relationship breakdown and other problems that affect veterans. 

We would expect the increase in referrals to continue. The troops withdraw from Afghanistan this year and there is a danger that once the conflict is over, veterans will be forgotten. 

Dr Nicola Sorfleet is in charge of psychological therapies at Combat Stress's treatment centre in Leatherhead, Surrey

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