Page 45 - Total War on PTSD

become too intense to handle. Combat Veterans will often have nightmares about their most traumatic experiences. When these occur, because the body believes it is actually in that traumatic experience, the Veteran will experience fight/flight symptoms in their sleep. This can lead to them yelling out in their sleep, thrashing around in their beds, and even punching or swinging at people who share their beds, as they act out their dreams without awareness. Veterans will often wake up with their heart racing and feel frightened, disoriented, and soaked in sweat.
It is also not unusual for the combat Veteran to experience nausea and bed wetting with these fight/flight symptoms as well. When they awaken, due to the anxiety level the dream created, they will often get up and check their homes to ensure they are secure and even “clear the house” at times due to safety concerns. During the daytime, combat Veterans may have what seems almost like “short video clips” or pictures running through their mind uncontrollably of traumatic events. To those around them, their family and friends may notice the combat Veteran often stares off or seems inattentive when these images are occurring. When triggers are intense or unexpected, they can cause flashbacks, where the combat Veteran actually loses orientation to the environment and believes they are back in the traumatic event...they smell it, feel it, experience it...they are there for seconds to minutes or even longer in some instances. In extreme cases, Veterans can black out and have for longer periods of time and have no recollection of their actions. The Veteran is unaware this is happening at the time and often only recognizes this has occurred due to missing chunks of time or when other people inform them of behavior they do not remember doing. This is the brain’s way of protecting them from intolerable emotional states or triggers. Many Veterans will dissociate while discussing their trauma in my office and will need assistance grounding back to their current environment. Trauma congruent visual, auditory and sensory hallucinations are not uncommon with PTSD and individuals who have been in war may experience hearing people screaming, gunfire, mortars, etc. They may also see images of people who they have lost or harmed. It is not unusual for sensory experiences to occur when memories replay, such as physical pain when a memory of a personal injury replays or smelling blood when a scene where someone is hurt replays.
Altered Sense of Self:
45 of 1042