Thousands of combat veterans suffer from the symptoms and deleterious consequences of posttraumatic stress disorder (PTSD). It is a trauma-related disorder, which develops in response to a serious traumatic event (Vujanovic, Niles, & Abrams, 2016). The nature and complexity of such traumas will vary, depending on the unique circumstances of each case. However, it is clear that involvement in military activities, combat experiences, and the memories of human losses as a result of war lead to irreversible changes in the human psyche. Most people cannot secure themselves from the deadly impacts of trauma, but only few of them will develop PTSD. Participation in combat activities is one of the most critical factors behind the development of PTSD. Even decades after resigning from military service, veterans keep experiencing the effects of PTSD on their daily activities. Given the limits of the conventional pharmacological therapies, nursing approaches to managing PTSD in veterans should incorporate holistic modalities such as meditation and mindfulness, which have the potential to relieve the burden of PTSD symptoms in military personnel.
The importance of introducing new treatment modalities for PTSD is justified by the growing scope of the problem among veterans. According to Gates et al. (2012), the current knowledge of PTSD epidemiology is insufficient and inconclusive, which is why nurse professionals may experience difficulties trying to develop a comprehensive picture of the problem and its ramifications for public health. Nevertheless, Harpaz-Rotem et al. (2016) estimate that nearly 300,000 U.S. combat veterans who served in Iraq and Afghanistan have PTSD. 43 percent of combat veterans are assumed to have PTSD or similar anxiety and trauma-related disorders (Harpaz-Rotem et al., 2016). It would be fair to say that postdeployment PTSD is one of the most characteristic health features of combat veterans who return to their homes in the U.S. after months and years of service in conflict zones.
One of the greatest problems with PTSD is that its symptomatology and disease sequelae continue to persist for years and even decades. Although the incidence and prevalence of PTSD in combat veterans gradually decline, many of them still meet the threshold criteria for PTSD, even 40 years after the war ended (Marmar et al., 2015). For example, the veterans of the Vietnam War often display the symptoms and experience the negative consequences of PTSD (Marmar et al., 2015). This being said, questions emerge as to whether the current state of nursing treatment provided to veterans with PTSD is effective enough to prevent the development of unnecessary comorbidities and reduce its public health burden.
Most veterans diagnosed with PTSD receive pharmacological treatment. As Harpaz-Rotem et al. (2016) note, 80 percent of veterans with PTSD receive some kind of pharmacological support, and 79 percent of them use antidepressants to reduce their symptoms. The latter remain the only class of medications that have been approved by the U.S. Food and Drug Administration for treating postdeployment PTSD (Harpaz-Rotem et al., 2016). Besides, Veterans Administration insists that only evidence-based pharmacological agents be used to treat PTSD in combat veterans (Kearney et al., 2012). These are serotonin-reuptake inhibitors and some other psychotropic preparations, which have proved to be effective in managing other trauma- and anxiety-related disorders (Kearney et al., 2012). However, the reality is that “although there is some evidence to suggest a limited positive effect of a number of psychotropic medications on the remediation of some depressive and anxiety symptoms associated with PTSD, the prescription of antipsychotics to individuals diagnosed with PTSD in the absence of psychosis or a bipolar disorder diagnoses remains highly controversial” (Harpaz-Rotem et al., 2016, p. 286). Large prospective trials have found little, if any, evidence that antipsychotic drugs can relieve the symptoms of PTSD (Harpaz-Rotem et al., 2016). The absence of evidence-based medications for PTSD leaves nurses in a kind of evidence-based vacuum. However, it also necessitates the use of alternative measures to treat PTSD.
Today, a new consensus is emerging that alternative holistic nursing modalities could contribute to treating PTSD in combat veterans. Meditation and mindfulness are among the most popular ones. The results of the latest studies confirm the utility of meditation and mindfulness in reducing the symptoms of PTSD and improving the wellbeing of veterans (Seppala et al., 2014). King et al. (2013) also confirm these results. Combat veterans who comply with the required regimen and attend all meditation and mindfulness-based sessions display significant reductions in their PTSD scores (King et al., 2013). The current research also suggests that longer mindfulness-based interventions can yield even more significant improvements in veterans’ health and wellbeing. More importantly, it implies that nurses could change the popular assumptions about the chronicity of PTSD and give combat veterans a new chance to live a normal, self-fulfilling life (King et al., 2013). Unfortunately, many nurses are unfamiliar with the benefits of mindfulness and meditation in treating PTSD. Yet, such modalities could at least reduce some PTSD symptoms and provide a fertile ground for the gradual emotional and psychological recovery of combat veterans when they return to the U.S.
It should be noted that mindfulness and meditation can serve a variety of functions and address more than one clinical and symptom dimension of PTSD in combat veterans. Vujanovic et al. (2016) write that these practices reinforce present-centered awareness in veterans, thus empowering them to recognize the problem and take actions to solve it. Meditation and mindfulness have proved to reduce anxiety, stress reactivity, and physiological arousal in combat veterans with PTSD (Vujanovich et al., 2016). They enhance veterans’ psychological flexibility, while making them more empathic, sensitive, and compassionate to others (Vujanovich et al., 2016). These changes speed up the holistic recovery of combat veterans with PTSD. They also create optimal conditions for achieving the best psychological and emotional outcomes. Although the effectiveness of pharmacological treatment for PTSD has yet to be proven, nurses can readily combine pharmacological and psychological/emotional interventions for better treatment and recovery results. Besides, both mindfulness and meditation are likely to have fewer side effects on combat veterans with PTSD, as compared with psychotic drugs.
Today, nurses working with veterans who have been diagnosed with PTSD need to refine their awareness of the holistic treatment modalities that are available to such patients. Apparently, the use of solely pharmacological treatments may not bring the desired emotional and physical relief. Mindfulness and meditation can become a relevant option for thousands of veterans, who suffer from PTSD and experience its deleterious effects on their routines. Broader nursing campaigns could be developed to enhance nurses’ understanding of PTSD in veterans and motivate them to seek effective evidence-based treatments beyond pharmacology. Although both mindfulness and meditation require further analysis, the current evidence is robust enough to inform their incorporation into nursing practices for veterans with PTSD.
In conclusion, hundreds of thousands of combat veterans suffer from postdeployment PTSD. Medical and veteran services organizations emphasize the importance of using only proven evidence-based medications to treat PTSD in veterans. However, evidence that pharmacological preparations could reduce the burden of PTSD in military professionals is scarce. Nurses should turn their heads to alternative treatment modalities and accept their promise to reduce the scope of PTSD in veterans. Mindfulness and meditation are emerging as the two potentially effective strategies for treating PTSD in military professionals. Combat veterans experience a whole spectrum of deleterious consequences of their trauma. Nurses could readily translate the latest research evidence into comprehensive non-pharmacological treatment plans, thus allowing combat veterans to improve their health and wellbeing.
- Gates, M.A., Holowka, D.W., Vasterling, J.J., Keane, T.M., Marx, B.P., & Rosen, R.C. (2012). Posttraumatic stress disorder in veterans and military personnel: Epidemiology, screening and case recognition. Psychological Services, 9(4), 361-382.
- Harpaz-Rotem, I., Rosenheck, R., Mohamed, S., Pietrzak, R., & Hoff, R. (2016). Initiation of pharmacotherapy for post-traumatic stress disorder among veterans from Iraq and Afghanistan: A dimensional, symptom cluster approach. BJPsych Open, 2, 286-293.
- Kearney, D.J., McDermott, K., Malte, C., Martinez, M., & Simpson, T.L. (2012). Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. Journal of Clinical Psychology, 68, 101-116.
- King, A.P., Erickson, T.M., Giardino, N.D., Favorite, T., Rauch, S.A., Robinson, E., Kulkarni, M., & Liberzon, I. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder. Depression & Anxiety, 30(7), 638-645.
- Marmar, C.R., Schlenger, W., Henn-Haase, C., Qian, M., Purchia, E., Li, M. … Kulka, R. (2015). Course of posttraumatic stress disorder 40 years after the Vietnam War: Findings from the National Vietnam Veterans Longitudinal Study. JAMA Psychiatry, 72(9), 875-881.
- Seppala, E.M., Nitschke, J.B., Tudorascu, D.L., Hayes, A., Goldstein, M.R., Nguyen, D.T., Perlman, D., & Davidson, R.J. (2014). Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: A randomized controlled longitudinal study. Journal of Traumatic Stress, 27, 397-405.
- Vujanovich, A.A., Niles, B.L., & Abrams, J.L. (2016). Mindfulness and meditation in the conceptualization and treatment of posttraumatic stress disorder. In E. Shonin (ed.), Mindfulness and Buddhist-derived approaches in mental health and addiction, pp. 225-246. Zurich, Switzerland: Springer.