1. COMMANDERS GUIDE: REACTIONS TO MILITARILY- RELEVANT TRAUMATIC EVENTS 332 nd Expeditionary Medical Group Life Skills Support Flight Lt Col Alan Peterson MSgt Kenneth Belinfante Capt Monty BakerTSgt (S) Jaime Querido Capt Peter Johnson SSgt Earle Holder

2. Traumatic Events In The Deployed Environment Seeing co-workers who are injured Seeing co-workers who are injured –Work Related/Combat Related Death of Co-worker Death of Co-worker Seeing body parts or dead people Seeing body parts or dead people Mortar/Rocket Attacks Mortar/Rocket Attacks IED/RPG/VBIED IED/RPG/VBIED Natural Disasters Natural Disasters Can cause feelings of intense fear, helplessness, and horror

3. Common Reactions To Traumatic Events Dreaming about the event Dreaming about the event Recalling the event Recalling the event Periods of difficulty sleeping Periods of difficulty sleeping Fear Fear Guilt Guilt Fatigue/Loss of enthusiasm Fatigue/Loss of enthusiasm Unexpected feelings (e.g., getting angry with family or peers) Unexpected feelings (e.g., getting angry with family or peers)

4. Positive Adapting/Coping After Trauma Strengthening family relationships Strengthening family relationships Religious activity Religious activity Positive changes in behavior Positive changes in behavior –Resolving to be a better parent or spouse Humor Humor Helping Others Helping Others Doing healthy activities Doing healthy activities Talking with others about the event Talking with others about the event

5. Negative Adapting/Coping After Trauma Denying event occurred Denying event occurred Anger Anger Social withdrawal Social withdrawal Losing normal emotional responses to life Losing normal emotional responses to life Doing things impulsively Doing things impulsively Not sleeping enough Not sleeping enough Over-Work Over-Work Misusing alcohol (or other drugs) Misusing alcohol (or other drugs)

6. Post Traumatic Stress Disorder (PTSD) Symptoms Re-experiencing the trauma over and over again Re-experiencing the trauma over and over again –Dreams, flashbacks –Distress when exposed to something similar to the traumatic event Avoiding things associated with the traumatic event Avoiding things associated with the traumatic event –Thoughts, places, people Being “on edge” Being “on edge” –Difficulty falling or staying asleep –Irritability –Difficulty concentrating –Very easily startled

7. PTSD Diagnosis Up to 20% of deployed Service members experience some symptoms of PTSD Up to 20% of deployed Service members experience some symptoms of PTSD – Does NOT mean they have PTSD Diagnosing PTSD Diagnosing PTSD –Symptoms must be present for at least one month –Symptoms ordinarily begin within three months after traumatic event –Symptoms can sometimes begin long after the event –May be more severe if begins long after the event

8. Acute Stress Disorder Symptoms similar to PTSD but last less than 4 weeks Symptoms similar to PTSD but last less than 4 weeks Have three or more of the following symptoms Have three or more of the following symptoms –Sense of numbness –Emotional detachment –Things around the person don’t seem real –Don’t remember the event Keep re-experiencing the trauma Keep re-experiencing the trauma –Often will try hard to avoid anything that causes recollection of trauma –Marked anxiety –Easily excited

9. Leadership and PTSD Prevention Take time away from scene Take time away from scene Stick to set work shifts Stick to set work shifts “Grief leadership” “Grief leadership” Avoid alcohol Avoid alcohol Get enough sleep Get enough sleep Use chaplains Use chaplains Limit people in workplace if there are human remains Limit people in workplace if there are human remains In-briefs and out-briefs recommended In-briefs and out-briefs recommended Gathering places away from site of disaster work Gathering places away from site of disaster work Observe others and each other Observe others and each other Reassurance Reassurance Rotate personnel and duties Rotate personnel and duties Awards and recognitions Awards and recognitions

10. Resources For Airmen Who Experience Symptoms of PTSD Family, friends, co-workers Family, friends, co-workers Chaplain Chaplain Life Skills Life Skills Early help can prevent long-term problems…