Should PTSD be confined to one specific event?

SSG Demetrius Davis — Fri, 11 Sep 2015 10:56:52 -0400

Should the criteria of a specific event be expanded to include a cumulative event? Although not being shot, not being inside a vehicle as it exploded, or not being sexually assaulted, etc. should a veteran who has an anxiety disorder not have that disorder recognized as service connected?

Response by SPC Jan Allbright, M.Sc., R.S. made Sep 11 at 2015 10:59 AM

SPC Jan Allbright, M.Sc., R.S. — Fri, 11 Sep 2015 10:59:14 -0400

No fricken way!
There are two distinct flavors of PTSD.
One from a single traumatic event.
The other is from a constant grind over time.
Who is even suggesting this?

Response by SGT Ben Keen made Sep 11 at 2015 11:00 AM

SGT Ben Keen — Fri, 11 Sep 2015 11:00:34 -0400

As someone that the VA has identified as having PTSD, I would say that my anxiety disordered started after one specific event. However, because everyone is wired differently, its very hard to say how one's mind will react. Plus, one's PTSD could be a result of the combination of events. Event A might happen and the person is fine but than event B, C, D, and E happen and its the combination of all them that causes the brain to react differently. Just my two cents.

Response by MAJ Jack Horn, LPC, NCC, CCMHC, CCTP, CCTP-II, CCFP, CDBT made Sep 11 at 2015 11:14 AM

MAJ Jack Horn, LPC, NCC, CCMHC, CCTP, CCTP-II, CCFP, CDBT — Fri, 11 Sep 2015 11:14:28 -0400

I'm not familiaf enough with VA's service connection criteria to answer that part (I'm not sure the VA is either, frankly.) However, the question of discrete event vs. cumulative trauma is one that is bouncing around the clinical realm now and was a hot topic during the rewrite of the DSM 5. I am aware of people with valid PTSD disgnoses who suffered from multiple discrete incidents, each of which would meet adequately Criterion A (precipitaing event.) The issue of cumulative sub-threshold trauma causing PTSD in the aggregate is still being argued, not so much for combat veterans, as for for first responders, law enforcement, and health care professionals. And abused children. Part of the difficulty in reaching consensus has to do with differing views on the etiology (origins) and mechanisms underlying PTSD. There are other, related anxiety disorders (e.g. Adjustment Disorder) that can look essentially like PTSD in their symptomology, but fail to meet the specific, discrete Criterion A activating event threshold. My own, personal opinion, based on my own understanding of the PTSD mechanism, is that chronic, low-level (sub-threshold) in combination with other environmental, social, and psychological factors, can lead to a "perfect storm" situation in which an event that otherwise would not result in PTSD, would do so. Often, reductions in social and family cohesion can result in lower resiliency, higher vulnerability, and PTSD, when otherwise that specific event would not.

Response by MAJ Ken Landgren made Sep 11 at 2015 12:33 PM

MAJ Ken Landgren — Fri, 11 Sep 2015 12:33:33 -0400

I think so. Soldiers who deploy often have a great chance of getting PTSD.

Response by MAJ Ken Landgren made Sep 11 at 2015 4:13 PM

MAJ Ken Landgren — Fri, 11 Sep 2015 16:13:58 -0400

Yes when we go downrange many will feel relatively sleepless nights, and enormous amount of stress, anxiety, adrenalin, and fear. I emphatically believe they will alter your chemistry. It becomes hard to turn them off.

Response by CW4 Private RallyPoint Member made Sep 11 at 2015 4:24 PM

CW4 Private RallyPoint Member — Fri, 11 Sep 2015 16:24:45 -0400

SSG Demetrius Davis, it can be and has been proven as such, but it has also been studied and proven that multiple traumatic events can fester and grow and then ultimately reach a point where the symptoms and conditions of PTSD can thrive. Medical professionals should be the only ones who can determine how each persons mind works in relation to social and physical acts of stress. People show symptoms of PTSD for various reasons isn't just contained within the Military or combat operations. Normal everyday civilians with regular jobs can suffer from PTSD. There is still so much to learn about PTSD and the human brain.

Response by SPC Larry Boutwell made Sep 11 at 2015 5:19 PM

SPC Larry Boutwell — Fri, 11 Sep 2015 17:19:26 -0400

I have chronic anxiety and clunical depression......but thats not the same thing as ptsd....according to the va.....guess thata why i have 0 rating for both those things....isnt life great

Response by SMSgt Tony Barnes made Sep 14 at 2015 12:42 PM

SMSgt Tony Barnes — Mon, 14 Sep 2015 12:42:01 -0400

Most PTSD diagnosis I see in my work in the Army Wounded Warrior program are based upon a culmination of combat carnage witnessed over a period of time.

Response by SGT David T. made Sep 14 at 2015 12:46 PM

SGT David T. — Mon, 14 Sep 2015 12:46:18 -0400

This question is best left up to the mental health professionals. As I am not one, I cannot say yes or no to this.

Response by CW3 Eric W. S. made Sep 14 at 2015 12:55 PM

CW3 Eric W. S. — Mon, 14 Sep 2015 12:55:56 -0400

When I was diagnosed with it, there were numerous combat related events that lead the Dr. to make the determination that he did. I am sure that with only 1 specific event, I would have had a different series of questions and responses. I have had to fill out surveys for the Army that years later brought up many of the initial feelings of regret and survivor's guilt. It is the individual's mind that has as much to do with the progression of the details as much as the event(s) itself.

Response by SGT Private RallyPoint Member made Sep 14 at 2015 1:19 PM

SGT Private RallyPoint Member — Mon, 14 Sep 2015 13:19:48 -0400

The traits that you are describing do not indicate having PTSD. The four main characteristics of PTSD are: 1.)avoiding places that remind you of the event and feeling upset by things that remind you of what happened
2.)Having nightmares, vivid memories, or flashbacks of the event that make you feel like it’s happening all over again
3.)Feeling emotionally cut off from others
4.)Feeling numb or losing interest in things you used to care about
However, while some of what you describe may seem that it fits,those same traits fit with depression and anxiety. The DSM (which is the manual that behavioral health providers use for diagnostic criteria) has many diagnosis traits that overlap, but it is very specific in the number of items /behaviors/ actions that need to be replicated before and if a diagnosis may be reached.
I can sympathize with wanting to now what caused this change in you, but regardless of the diagnosis, positive coping strategies, a good support system and hard work on improving yourself will help you be who you want to be.
I hope this helps. I worked with Combat Stress for 7 years and if you have any questions, please don't hesitate to ask.

Response by SFC Wesley Arnold, Jr made May 24 at 2019 3:03 AM

SFC Wesley Arnold, Jr — Fri, 24 May 2019 03:03:41 -0400

Blah, Blah, Blah ... I stopped reading after about the first five or six comments; if you’re not DR quit the BS know it all !!!
I have PTSD, yes from multiple events and from ‘survivors guilt’ ... and yes that is by medical definition. You Adjustment Disorder that is so wildly used is an easy deversion from the problem for the DR and instant red light for VA, do pass go & don’t collet $200 ... by definition in DM5 an ‘Adjustment Disorder’ only actively impaires an individual for 6 months. At which time if the symptoms still present a new diagnosis must be made. The is the catcher VA will drag there feet unless you push for reevaluation. I retired in 2008 and was denied, misdiagnosed, appealed, had hearing with appeals board before approval in 2018. Bottom line is don’t take no for an answer and continue to seek treatment and therapy the entire time of your appeal .... Best of luck. - PS I used VFW advocacy to help with my appeal and board proceedings