While it’s something that many people don’t want to talk about, sex matters to people. Sexual function and sexual desire can be important parts of a person’s life, particularly if he or she is in a relationship. And, unfortunately, what we know is that combat posttraumatic stress disorder (PTSD) affects a veteran’s sexual desire and sexual function in negative ways. In fact, some studies have showed such a correlation between sexual dysfunction and PTSD that some have proposed making it an official, diagnostic criteria.
Sexual desire, is, of course, one’s desire for sexual relations and whether one has a partner or not, this can be important. In a 2014 study, Problems in Sexual Functioning among Male OEF/OIF Veterans Seeking Treatment for Posttraumatic Stress, 63% of male veterans in the study reported sexual desire problems. Of those with partners, 72% reported a lack of sexual desire. According to the study, white race, combat exposure, social support, and avoidance/numbing symptoms predicted a lack of sexual desire. The 2008 study Sexual Functioning in War Veterans with Posttraumatic Stress Disorder, found that veterans with PTSD had significantly reduced sexual activity including sexual fantasies, foreplay, oral sex, and intercourse, in the previous month. Veterans cited their own health problems as the reason for reduced sexual activity.
It’s not clear why veterans with combat PTSD experience a loss in sexual desire but I suspect the above study may have hit on one main reason: the PTSD symptoms of avoidance/numbing. These symptoms often produce a lack of emotional intimacy in relationships and it only stands to reason that sexual intimacy would also be reduced.
Several studies have focused on physical, sexual dysfunction in combat PTSD veterans. In Problems in Sexual Functioning among Male OEF/OIF Veterans Seeking Treatment for Posttraumatic Stress, an official erectile dysfunction diagnosis was present in 12% of male combat veterans while sexual arousal problems were present in 62% of partnered veterans.
In the 2002 study Sexual Dysfunction in Combat Veterans with Post-traumatic Stress Disorder, “patients [combat veterans] with PTSD had poorer scores on overall satisfaction and orgasmic function and showed trends toward poorer scores on intercourse satisfaction and erectile function.” In this study, erectile dysfunction rate was 85% in veterans with PTSD while it was 22% in veterans without PTSD.
It is not known why sexual desire and sexual function are so impeded in veterans with combat PTSD but part of the reason may be medication-related. Antidepressant therapy is common in combat PTSD treatment and this medication may impact desire, arousal, and sexual functioning.
Medication can address some sexual dysfunction issues and if the sexual function or arousal is being impacted due to a PTSD medication, a change in medication can often solve the problem. Many choices of medication exist so, in general, veterans should not have to live with this side effect.
Additionally, there is research that suggests that treating the underlying combat PTSD will correct the problems in sexual desire and function. This makes perfect sense. As other PTSD symptoms lessen, so do these ones.
Psychotherapy for combat PTSD is also often helpful in addressing these types of issues.
However, none of this help can be employed if the combat veteran is not open about what is happening for him or her so my biggest piece of advice for veterans experiencing reduced sexual desire or functioning is to be open with his or her healthcare provider so that you can look for a solution together. And remember: this, too, can be a symptom of combat PTSD and is not your fault.
Source: What is a Healthy Identity?
Mission: We are patriotic citizens committed to serving our wounded, injured and ill combat veterans. We support Veterans and their families by building relationships and identifying and supporting immediate needs and interests. We are dedicated to promoting public awareness of the many sacrifices made by our Armed Forces.
Target demographics: wounded, injured, and ill veterans and their families
Geographic areas served: the United States of America
Programs: Morale, welfare, and recreation expenses to improve the morale of wounded soldiers. Activities include meals, cookouts, and trips to the movies for the soldiers.
assistance for individual wounded soldier’s expenses including clothing, airline tickets, mortgage payments, and car repairs.
Source: Identity Crisis Among Veterans
This brief self-test for post traumatic stress disorder provides a general assessment of where you might be emotionally and can help you to decide whether you could benefit from treatment.
For the most accurate results, please answer each of the following questions as truthfully as possible:
1. Have you experienced or witnessed a life-threatening event that caused helplessness, fear, or horror?
2. Do you have recurrent distressing dreams or memories?
3. Do you have difficulty falling or staying asleep out of fear or anxiety?
4. Do you experience distressed recollections of the event including images, thoughts or perceptions?
5. Do you experience bodily reactions, which resemble an aspect of a specific traumatic event? ( Ex: Sight, sense, smells)
6. Do you have trouble concentrating or recalling events?
7. Do you overreact to certain situations or people easily?
8. Do you avoid certain types of places that remind you of your past?
9. Do you have trouble connecting with people?
10. Do you tend to avoid conflict in your life?
11. Do you get startled easily?
12. On more days than not, do you experience feelings of sadness or guilt?
13. Have you experienced changes in your eating habits? Either increase or decrease in appetite?
14. Have you recently experienced chronic fatigue, headaches or tension that have lasted longer than a few days or weeks?
15. Is it difficult for you to imagine your future, such as career, marriage, children, or a normal life span?
16. Are you losing interest in normal daily activities in your life?
17. Do you find yourself increasing your alcohol or drug use during social situations?
18. Are you experiencing big gaps in memory when you think about your childhood?
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Source: Men’s Loneliness
Post-traumatic stress disorder (PTSD), sometimes known as shell shock or combat stress, occurs after you experience severe trauma or a life-threatening event. It’s normal for your mind and body to be in shock after such an event, but this normal response becomes PTSD when your nervous system gets “stuck.”
Your nervous system has two automatic or reflexive ways of responding to stressful events:
Mobilization, or fight-or-flight, occurs when you need to defend yourself or survive the danger of a combat situation. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowering your heart rate and blood pressure, and winding back down to its normal balance.
Immobilization occurs when you’ve experienced too much stress in a situation and even though the danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its normal state of balance and you’re unable to move on from the event. This is PTSD.
Recovering from PTSD involves transitioning out of the mental and emotional war zone you’re still living in and helping your nervous system become “unstuck.”
While you can develop symptoms of PTSD in the hours or days following a traumatic event, sometimes symptoms don’t surface for months or even years after you return from deployment. While PTSD develops differently from veteran to veteran, there are four symptom clusters:
It’s common for veterans with PTSD to experience suicidal thoughts. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, weak, or flawed.
If you are thinking about taking your own life, seek help immediately. Please read Suicide Help, talk to someone you trust, or call a suicide helpline:
As well as helping to burn off adrenaline, exercise can release endorphins and improve your mood. By really focusing on your body and how it feels as you exercise, you can even help your nervous system become “unstuck.”
Pursuing outdoor activities in nature like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing can help challenge your sense of vulnerability and help you transition back into civilian life.
PTSD can leave you feeling vulnerable and helpless. But you have more control over your nervous system than you may realize. When you feel agitated, anxious, or out of control, these tips can help you change your arousal system and calm yourself.
Mindful breathing. To quickly calm yourself in any situation, simply take 60 breaths, focusing your attention on each out breath.
Sensory input. Just as loud noises, certain smells, or the feel of sand in your clothes can instantly transport you back to the combat zone, so too can sensory input quickly calm you. Everyone responds a little differently, so experiment to find what works best for you. Think back to your time on deployment: what brought you comfort at the end of the day? Perhaps it was looking at photos of your family? Or listening to a favorite song, or smelling a certain brand of soap? Or maybe petting an animal quickly makes you feel calm?
Reconnect emotionally. By reconnecting to uncomfortable emotions without becoming overwhelmed, you can make a huge difference in your ability to manage stress, balance your moods, and take back control of your life. See our Emotional Intelligence Toolkit.
Connecting with others face to face doesn’t have to mean a lot of talking. For any veteran with PTSD, it’s important to find someone who will listen without judging when you want to talk, or just hang out with you when you don’t. That person may be your significant other, a family member, one of your buddies from the service, or a civilian friend. Or try:
Volunteering your time or reaching out to someone in need. This is a great way to both connect to others and reclaim your sense of power.
Joining a PTSD support group. Connecting with other veterans facing similar problems can help you feel less isolated and provide useful tips on how to cope with symptoms and work towards recovery.
You may feel like the civilians in your life can’t understand you since they haven’t been in the service or seen the things you have. But people don’t have to have gone through the exact same experiences to be able to offer support. What matters is that the person you’re turning to cares about you, is a good listener, and a source of comfort.
No matter how close you are to someone, PTSD can mean that you still don’t feel any better after talking. If that describes you, there are ways to help the process along.
Exercise or move. Before chatting with a friend, either exercise or move around. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.
Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Sit straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.
Without the rush of still being in a combat zone, you may feel strange or even dead inside and find it difficult to relax. Many veterans are drawn to things that offer a familiar adrenaline rush, whether it’s caffeine, drugs, violent video games, driving recklessly, or daredevil sports. However, the symptoms of PTSD can be hard on your body and mind so it’s important to put a priority on sleep, healthy food, and calming activities.
Take time to relax with relaxation techniques such as massage, meditation, or yoga.
Avoid alcohol and drugs (including nicotine). It can be tempting to turn to drugs and alcohol to numb painful feelings and memories and get to sleep. But substance abuse (and cigarettes) can make the symptoms of PTSD worse.
Find safe ways to blow off steam. Pound on a punching bag, pummel a pillow, sing along to loud music, or find a secluded place to scream at the top of your lungs.
Support your body with a healthy diet. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed and fried food, sugars, and refined carbs which can exacerbate mood swings and energy fluctuations.
Get plenty of sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for 7 to 9 hours of quality sleep each night.
Flashbacks usually involve visual and auditory memories of combat. It feels as if it’s happening all over again so it’s vital to reassure yourself that the experience is not occurring in the present.
State to yourself (out loud or in your head) the reality that while you feel as if the trauma is currently happening, you can look around and recognize that you’re safe.
Use a simple script when you awaken from a nightmare or start to experience a flashback: “I feel [panicked, overwhelmed, etc.] because I’m remembering [traumatic event], but as I look around I can see that the event isn’t happening right now and I’m not in danger.”
Describe what you see when look around (name the place where you are, the current date, and three things you see when you look around).
Try tapping your arms to bring you back to the present.
Tips for grounding yourself during a flashback
Movement – Move around vigorously (run in place, jump up and down, etc.); rub your hands together; shake your head
Touch – Splash cold water on your face; grip a piece of ice; touch or grab on to a safe object; pinch yourself; play with worry beads or a stress ball
Sight – Blink rapidly and firmly; look around and take inventory of what you see
Sound – Turn on loud music; clap your hands or stomp your feet; talk to yourself (tell yourself you’re safe, you’ll be okay)
Smell – Smell something that links you to the present (coffee, mouthwash, your wife’s perfume) or a scent that has good memories
Taste – Suck on a strong mint or chew a piece of gum; bite into something tart or spicy; drink a glass of cold water or juice
Feelings of guilt are very common among veterans with PTSD. You may have seen people injured or killed, often your friends and comrades.
Healing doesn’t mean that you’ll forget what happened or those who died. And it doesn’t mean you’ll have no regrets. What it does mean is that you’ll look at your role more realistically:
Honestly assessing your responsibility and role can free you to move on and grieve your losses. Instead of punishing yourself, you can redirect your energy into honoring those you lost and finding ways to keep their memory alive.
Professional treatment for PTSD can help you deal with the trauma you’ve experienced and may involve:
Cognitive-behavioral therapy (CBT) or counselling. This involves gradually “exposing” you to reminders of the event and replacing distorted thoughts with a more balanced picture.
Medication, such as antidepressants. While medication may help you feel less sad or worried, it doesn’t treat the causes of PTSD.
EMDR (Eye Movement Desensitization and Reprocessing). This incorporates elements of CBT with eye movements or other rhythmic, left-right stimulation to help you become “unstuck.”
When a loved one returns from military service with PTSD, it can take a heavy toll on your relationship and family life. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who won’t open up, or even deal with anger or other disturbing behavior.
Don’t take the symptoms of PTSD personally. If your loved one seems distant, irritable, angry, or closed off, remember that this may not have anything to do with you or your relationship.
Don’t pressure your loved one into talking. Many veterans with PTSD find it difficult to talk about their experiences. Never try to force your loved one to open up but let him know that you’re there if he wants to talk. It’s your understanding that provides comfort, not anything you say.
Be patient and understanding. Getting better takes time so be patient with the pace of recovery. Offer support but don’t try to direct your loved one.
Try to anticipate and prepare for PTSD triggers such as certain sounds, sights, or smells. If you are aware of what causes an upsetting reaction, you’ll be in a better position to help your loved one calm down.
Take care of yourself. Letting your loved one’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. Make time for yourself and learn to manage stress. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one.
More help for PTSD and trauma
PTSD Program Locator – Find specialized VA PTSD treatment programs near you. (U.S. Department of Veterans Affairs)
Veteran Combat Call Center – A 24/7 hotline where you can talk with another combat veteran: 1-877-WAR-VETS (1-877-927-8387).
Help for Veterans with PTSD – Learn how to earn how to earn how to enroll for VA health care and get an assessment. (National Center for PTSD)
24/7 Outreach Center for Psychological Health & Traumatic Brain Injury – Get help for traumatic brain injury and other psychological health issues. Call 1-866-966-1020 or connect through chat or email. (DoD’s Defense Centers of Excellence)
Vet Centers – If you are a combat veteran or you experienced sexual trauma during your military service, you can speak with a therapist at your local Vet Center for free, without an appointment, and regardless of your enrollment status with VA. Just bring your DD214. (U.S. Department of Veteran Affairs)
StartYourRecovery.org is a free, confidential tool that helps individuals take steps toward a healthy relationship with drugs and alcohol. It was developed with the input of leading clinicians, experts from the White House and SAMHSA, and people in recovery themselves.
Canadian veterans: visit Operational Stress Injury Social Support (OSISS) or call 1-800-883-6094 to talk to a peer who has been through similar experiences.
UK veterans: visit Combat Stress or call the 24-hour helpline 0800 138 1619.
Australian veterans: visit Veterans and Veterans Families Counselling Service (VVCS) or call 1800 011 046.
National Center for PTSD – A comprehensive, helpful resource for veterans with PTSD and their family members, from the U.S. Department of Veterans Affairs.
About Face – A website dedicated to improving the lives of veterans with PTSD. Learn about PTSD, hear real stories from other veterans, and get advice from experienced clinicians.
Make the Connection – Learn about PTSD in veterans and other related issues. Includes honest and candid descriptions from veterans about their experiences.
What Can I Do if I Think I Have PTSD? – Outlines the steps you can take if you think you may have PTSD, as well as the reasons to seek treatment early. (U.S. Department of Veterans Affairs)
Understanding PTSD Treatment (PDF) – Explore proven treatment and therapy options for PTSD, hear success stories, and debunk common treatment myths. (National Center for PTSD)
Dogs and PTSD – Learn more about service dogs and how they can help you manage PTSD symptoms and boost your emotional well-being. (National Center for PTSD)
Mindfulness and meditation training could ease PTSD symptoms, researchers say – Research shows that mindfulness meditation can help vets with PTSD. (The Washington Post)
Post-Traumatic Stress’s Surprisingly Positive Flip Side – This article explores the positive growth and resilience that can come as you work through PTSD. (The New York Times Magazine)
Sierra Club Military Outdoors – Sign up for outdoor trips and other services for veterans and their families in the U.S. (Sierra Club)