COMMANDERS COMMANDERS GUIDE:GUIDE:

REACTIONS TO MILITARILY- REACTIONS TO MILITARILY- RELEVANT TRAUMATIC RELEVANT TRAUMATIC

EVENTSEVENTS 332332ndnd Expeditionary Medical Expeditionary Medical

GroupGroupLife Skills Support FlightLife Skills Support Flight

Lt Col Alan Peterson Lt Col Alan Peterson MSgt Kenneth Belinfante MSgt Kenneth Belinfante Capt Monty BakerCapt Monty Baker TSgt (S) Jaime Querido TSgt (S) Jaime Querido Capt Peter Johnson Capt Peter Johnson SSgt Earle HolderSSgt Earle Holder

Traumatic Events In The Traumatic Events In The Deployed EnvironmentDeployed Environment

• Seeing co-workers who are injuredSeeing co-workers who are injured– Work Related/Combat RelatedWork Related/Combat Related

• Death of Co-workerDeath of Co-worker• Seeing body parts or dead peopleSeeing body parts or dead people• Mortar/Rocket AttacksMortar/Rocket Attacks• IED/RPG/VBIEDIED/RPG/VBIED• Natural DisastersNatural Disasters

Can cause feelings of intense fear, Can cause feelings of intense fear, helplessness, and horrorhelplessness, and horror

Common Reactions To Common Reactions To Traumatic EventsTraumatic Events

• Dreaming about the eventDreaming about the event

• Recalling the eventRecalling the event

• Periods of difficulty sleepingPeriods of difficulty sleeping

• FearFear

• GuiltGuilt

• Fatigue/Loss of enthusiasmFatigue/Loss of enthusiasm

• Unexpected feelings (e.g., Unexpected feelings (e.g., getting angry with family or getting angry with family or peers)peers)

Positive Adapting/Coping Positive Adapting/Coping After TraumaAfter Trauma

• Strengthening family relationshipsStrengthening family relationships

• Religious activityReligious activity

• Positive changes in behavior Positive changes in behavior – Resolving to be a better parent or Resolving to be a better parent or

spousespouse

• HumorHumor

• Helping OthersHelping Others

• Doing healthy activitiesDoing healthy activities

• Talking with others about the eventTalking with others about the event

Negative Adapting/Coping Negative Adapting/Coping After TraumaAfter Trauma

• Denying event occurredDenying event occurred• AngerAnger• Social withdrawalSocial withdrawal• Losing normal emotional Losing normal emotional

responses to liferesponses to life• Doing things impulsivelyDoing things impulsively• Not sleeping enoughNot sleeping enough• Over-WorkOver-Work• Misusing alcohol (or other drugs)Misusing alcohol (or other drugs)

Post Traumatic Stress Post Traumatic Stress Disorder (PTSD) SymptomsDisorder (PTSD) Symptoms

• Re-experiencing the trauma over and over againRe-experiencing the trauma over and over again– Dreams, flashbacksDreams, flashbacks– Distress when exposed to something similar to the Distress when exposed to something similar to the

traumatic eventtraumatic event

• Avoiding things associated with the traumatic Avoiding things associated with the traumatic eventevent– Thoughts, places, peopleThoughts, places, people

• Being “on edge”Being “on edge”– Difficulty falling or staying asleepDifficulty falling or staying asleep– IrritabilityIrritability– Difficulty concentratingDifficulty concentrating– Very easily startledVery easily startled

PTSD DiagnosisPTSD Diagnosis

• Up to 20% of deployed Service members Up to 20% of deployed Service members experience some symptoms of PTSD experience some symptoms of PTSD – Does NOT mean they have PTSDDoes NOT mean they have PTSD

• Diagnosing PTSDDiagnosing PTSD– Symptoms must be present for at least one Symptoms must be present for at least one

monthmonth– Symptoms ordinarily begin within three months Symptoms ordinarily begin within three months

after traumatic eventafter traumatic event– Symptoms can sometimes begin long after the Symptoms can sometimes begin long after the

eventevent– May be more severe if begins long after the eventMay be more severe if begins long after the event

Acute Stress Acute Stress DisorderDisorder

• Symptoms similar to PTSD Symptoms similar to PTSD but but last less than 4 last less than 4 weeksweeks

• Have three or more of the following symptomsHave three or more of the following symptoms– Sense of numbnessSense of numbness– Emotional detachmentEmotional detachment– Things around the person don’t seem realThings around the person don’t seem real– Don’t remember the eventDon’t remember the event

• Keep re-experiencing the traumaKeep re-experiencing the trauma– Often will try hard to avoid anything that causes Often will try hard to avoid anything that causes

recollection of traumarecollection of trauma– Marked anxiety Marked anxiety – Easily excitedEasily excited

Leadership and PTSD Leadership and PTSD PreventionPrevention• Take time away from sceneTake time away from scene• Stick to set work shiftsStick to set work shifts• ““Grief leadership”Grief leadership”• Avoid alcoholAvoid alcohol• Get enough sleepGet enough sleep• Use chaplainsUse chaplains• Limit people in workplace if there are human Limit people in workplace if there are human

remainsremains• In-briefs and out-briefs recommendedIn-briefs and out-briefs recommended• Gathering places away from site of disaster workGathering places away from site of disaster work• Observe others and each otherObserve others and each other• ReassuranceReassurance• Rotate personnel and dutiesRotate personnel and duties• Awards and recognitionsAwards and recognitions

Resources For Airmen Who Resources For Airmen Who Experience Symptoms of PTSDExperience Symptoms of PTSD

• Family, friends, co-workersFamily, friends, co-workers

• ChaplainChaplain

• Life SkillsLife Skills

Early help can prevent long-term Early help can prevent long-term problems…problems…