Signs of PTSD in Military Service Members

Military service members who have just returned from combat are at an elevated risk of suffering from post-traumatic stress disorder (PTSD) as a result of traumatic events they may have witnessed or experienced directly. They may experience troublesome and intrusive symptoms, such as reliving the event (flashbacks), hypervigilance (being worried that something or someone is going to hurt them), avoiding situations that remind them of the event, or experiencing increased negative thoughts and feelings.1

Signs of PTSD in Veterans

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) there are 4 main groups of symptoms involved with PTSD, though how you experience these symptoms may vary compared with others. Some of the symptoms can occur right after the event, but sometimes, they may not develop until years later—there is no set timeframe—and in some cases, symptoms come and go.

Regardless of when they appear, symptoms that persist for longer than 4 weeks or create difficulties in everyday life can be a sign that you or your loved one has PTSD.

The main signs and symptoms of PTSD to look for include:1

  1. Reliving the event. Returning service members may re-experience the trauma in several ways. You may have nightmares of the event, flashbacks in which you feel like you are going through the trauma again, or you may have reactions to specific triggers, such as smells, news reports, or hearing loud noises that cause you to relive the trauma.
  2. Avoiding situations that remind you of the event. You may avoid people, situations, or places that bring up memories of the event. You might want to avoid talking or thinking about the trauma, and you may avoid situations that feel unsafe, such as being in crowds, driving, or watching films or television shows that are related to the event. You may also try to stay as busy as possible, avoid seeking help, or deny that you have a problem.
  3. Negative beliefs and feelings. People who have just returned from combat can seem different than they were before their deployment. You might seem more introverted and stay away from close relationships, and you may not appear to experience positive or loving feelings toward others. You may try to forget the trauma and avoid talking about it at all costs. You could also have increased feelings of fear about the world, feeling as though it is not a safe place, and you may feel unable to trust or rely on anyone.
  4. In the context of PTSD, this means being unable to sit still, having difficulty concentrating, experiencing sleeplessness, or being easily startled (for example, by loud noises such as sirens or a car backfiring).

Substance abuse, in particular, can be a warning sign that someone is struggling to cope with the trauma they experienced. If you notice your loved one regularly drinking excessively, abusing pain pills they may have been given for their injuries, or taking other drugs (e.g., marijuana, cocaine, heroin), consider these red flags.

Over time, this kind of regular abuse can develop into a substance use disorder (SUD), which not only compounds the problem of the trauma, but also necessitates appropriate treatment for the addiction as well.

War Veteran PTSD Statistics

As of 2016, there were nearly 20.4 million US veterans, with 7.1 million of them having served in the Gulf War era from 1990 to the present (which makes up the largest percentage of veterans in the country).2

In 2011, the US Government Accountability Office reported that around 2.6 million military service members had been deployed during the Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), which began in 2001 and continues to present day.3

The number of service members who develop PTSD varies by era of service, but the U.S. Department of Veterans Affairs reports that 11–20 out of every 100 veterans who served in a Gulf War develop PTSD in any given year.4

Another study showed that as of 2014, the percentage of veterans with PTSD averaged around 13.5% in a representative sample of OEF/OIF-era veterans.3

Pre-Trauma Risk Factors

There is nothing that can predict with 100% certainty who will and who will not develop PTSD as a result of combat. However, there are certain pre-trauma risk factors that can predispose someone to develop the disorder when placed in war-time situations. Those include:5,6

Risk Factors During and After Trauma

Specific risk factors that happen during and after combat can also affect a person’s chances of developing PTSD. Those include:5,7


Which PTSD Treatments Work Best?

There are several treatments and programs to help veterans with PTSD that are supported by research. These evidence-based approaches include:

Find Addiction & PTSD Treatment Near You

Learn about our specialized veteran track at American Addiction Centers.

Resources for Service Members

In addition to these forms of therapy, the following resources can be useful for service members and their families who want to receive more information about different types of PTSD treatment.

Contact your family doctor. The U.S. Department of Veterans Affairs advises veterans to consult their family doctor as one way of finding an experienced trauma-care provider.


  1. U.S. Department of Veterans Affairs. (2017). PTSD Basics.
  2. Bialik, K. (2017). The changing face of America’s veteran population.
  3. Walker, M. S., Kaimal, G., Gonzaga, A. M. L., Myers-Coffman, K. A., & DeGraba, T. J. (2017). Active-duty military service members’ visual representations of PTSD and TBI in masks. International Journal of Qualitative Studies on Health and Well-Being, 12(1), 1267317.
  4. U.S. Department of Veterans Affairs. (2016). How Common Is PTSD in Veterans?
  5. Xue, C., Ge, Y., Tang, B., Liu, Y.,… Zhang, L. (2015). A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans. PLOS One.
  6. Adams, R. S., Nikitin, R. V., Wooten, N. R., Williams, T. V., & Larson, M. J. (2016). The Association of Combat Exposure with Postdeployment Behavioral Health Problems Among U.S. Army Enlisted Women Returning From Afghanistan or Iraq. Journal of Traumatic Stress, 29(4), 356–364.
  7. Peterson, A., Luethcke, C., Borah, E., Borah, A., & Young-McCaughan, S. (2011). Assessment and Treatment of Combat-Related PTSD in Returning War Veterans. Journal of Clinical Psychology in Medical Settings, 18(2), 164–175.
  8. Cook. J. (2010). Cognitive Behavioral Therapy for Combat-Related PTSD: A Manual for Service Members.
  9. Lake, J. (2015). The integrative management of PTSD: A review of conventional and CAM approaches used to prevent and treat PTSD with emphasis on military personnel. Advances in Integrative Medicine, 2, 13–23.
Last Updated on Dec 15, 2022
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