An Unlikely Source of Military PTSD

As a Marine combat veteran who has personally navigated the challenges of PTSD, I want to share an important perspective during PTSD Awareness Month that often goes unrecognized, one that could change how we understand and address military PTSD and trauma.

What is PTSD?

Post Traumatic Stress Disorder is a mental health condition that develops after someone experiences a traumatic event. While PTSD affects all populations, military personnel face unique risks that extend far beyond combat exposure.

In the military, traumatic stressors occur during combat, training accidents, military sexual trauma (MST), and various off-duty incidents. But here’s what most people don’t realize: military personnel are predisposed to greater risk of developing PTSD through an unlikely source—military training itself.

The Military Training Paradox

Dr. Nic Fothergill, an Australian psychologist and Vietnam War veteran, identified this connection years ago through his educational program with Australia’s Department of Veterans Affairs. I completely agree with his assessment here.

From the moment we enter boot camp, we’re systematically exposed to conditions that mirror PTSD symptoms:

We train under traumatic conditions:

• Realistic gunfire and explosions
• Casualty collection exercises
• Severe wound care scenarios

We’re taught thought patterns that mirror PTSD:

• Overly negative assumptions about the world
• Exaggerated self-blame for failures
• Suppression of positive emotions

We develop hyperarousal responses:

• Instant aggression when provoked
• Constant hypervigilance
• Sleep disruption from prolonged work hours
• High-risk, potentially destructive job requirements

Before we even report to our first duty station, we’re essentially primed for PTSD. The military does teach us to control these responses to some degree, but the foundation is already laid.

Why Some Develop Military PTSD and Others Don’t

Research by Sukhmanjeet Kaur Mann and colleagues provides a crucial insight:

Individuals who have a well-established support system are less likely to develop PTSD after a traumatic event. Individuals who feel isolated after trauma or have a poor social support system are more likely to develop acute stress disorder and/or PTSD.

Here’s the tragic irony: despite being part of tight-knit military units, most service members feel completely alone when it comes to mental health challenges. We’re conditioned to view mental health issues as weakness or character flaws. We don’t dare share our symptoms with each other for fear of:

• Being seen as weak
• Facing judgment from peers
• Risk of medical discharge
• Lack of understanding from civilian family and friends

So we suffer in silence. I know this firsthand from my experience after returning from Iraq.

Breaking the Silence About Military PTSD

I’m sharing this perspective for two important reasons:

1. To educate both military/veteran and civilian populations about this often-overlooked aspect of military PTSD
2. To remind service members and veterans that help is not only available, it actually works

The Path Forward if you are dealing with Military PTSD

Understanding how military training predisposes us to PTSD doesn’t minimize our experiences or suggest we’re “broken.” Instead, it helps explain why so many of us struggle and emphasizes that seeking help is a logical response to a very real condition.

Recovery is possible. Treatment works. You are not alone.

If you or someone you know might be dealing with PTSD, please reach out for help:

• VA Crisis Line: 988, Then Press 1
• Crisis Text Line: Text 838255 
• Counseling and Wellness Center of Pittsburgh offers many therapeutic modalities to help treat PTSD.
• Contact us here to get started with a therapist who can help.

Reference: DSM-5 PTSD Criteria Summary

Criterion A (1 required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

• Direct exposure
• Witnessing the trauma
• Learning that the trauma happened to a close relative or close friend
• Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B (1 required): The traumatic event is persistently re-experienced, in the following way(s):

• Unwanted upsetting memories
• Nightmares
• Flashbacks
• Emotional distress after exposure to traumatic reminders
• Physical reactivity after exposure to traumatic reminders

Criterion C (1 required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

• Trauma-related thoughts or feelings
• Trauma-related reminders

Criterion D (2 required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

• Inability to recall key features of the trauma
• Overly negative thoughts and assumptions about oneself or the world
• Exaggerated blame of self or others for causing the trauma
• Negative affect
• Decreased interest in activities
• Feeling isolated
• Difficulty experiencing positive affect

Criterion E (2 required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

• Irritability or aggression
• Risky or destructive behavior
• Hypervigilance
• Heightened startle reaction
• Difficulty concentrating
• Difficulty sleeping

Criterion F (required): Symptoms last for more than 1 month.

Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required): Symptoms are not due to medication, substance use or other illness.

Sources:
Mann SK, Marwaha R, Torrico TJ. Posttraumatic Stress Disorder. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559129/

Written by: Michael Zimmerman, LCSW. Michael Licensed Clinical Social Worker and Marine combat veteran who specializes in trauma and PTSD treatment.