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Posted: Monday, December 19, 2011 12:00 pm

By Rose L. Thayer

Killeen Daily Herald

While the hope during the holidays is to create a season of joy and happiness, for veterans suffering from combat-related illnesses, the holidays can exacerbate symptoms.

"The bottom line is, for anybody who's suffered a loss in their life or prior trauma, the holidays can become particularly problematic," said Dr. Harry Croft, a psychiatrist in private practice.

For the past 10 years, Croft has conducted disability evaluations for 7,000 service members through contracts with the U.S. Department of Veterans Affairs. He also served three years as an Army psychiatrist at Fort Sam Houston in San Antonio.

"It's not the holidays that produce the symptoms, it's everything around the holidays that make the symptoms more likely to appear," said Croft. "It's not because the veteran hates the holidays, it's because this particular time of the year is more likely to trigger the condition that already exists."

Croft said about 10 to 20 percent of veterans returning from combat will develop post-traumatic stress disorder. "The key to understanding this is that PTSD is PTSD," he said. "It's not that at the holidays it gets worse. It's that the holidays bring about a set of factors that cause the PTSD to worsen."

Lt. Col. Ben Phillips, a psychiatrist at Carl R. Darnall Army Medical Center, agreed that symptoms of the disorder can intensify during the holidays.

"I think there's some anxiety many times for people who suffer severely from PTSD because they know there are demands that may be placed on them," he said. "But not everybody falls under the same category. There are many folks who are looking forward to (the holidays) and experience symptoms unexpectedly."

Communication, Phillips said, is the key to getting through the season successfully. PTSD sufferers need to speak with loved ones about what they can do, and friends and family members need to let them know it's OK if they don't want to go to the mall to shop or to a large Christmas party.

"It puts the service members at ease to know it's OK to do what they feel comfortable doing, and they don't have to do things just for the family," said Phillips.

Croft said certain aspects of the holiday season can trigger the disorder at its three core areas: the re-experience, the avoidance and the arousal.

"The symptoms are very explainable," said Croft. "During the holidays, there's a lot that can do it. For example, the sounds of kids. It reminds Iraq veterans of the sounds of screaming kids when a suicide bomb goes off."

The re-experiencing, he said, can trigger the avoidance symptoms, where the PTSD sufferer might withdraw from situations.

"Here's Aunt So-and-So asking a bunch of questions about a deployment," said Croft when describing another scenario. "The veteran doesn't know that the avoidance symptoms are making him not want to talk about it, so he gets pissed off at the aunt."

Arousal symptoms, he said, can be seen expressed as a hyper vigilance. "It's scanning the environment," said Croft. "So think of a holiday party now with a bunch of people and you can't scan and then some kid brings a balloon that pops. The next thing you know the veteran is on the floor. He's looking back in embarrassment. How does he handle that? Never go to a party like that again."

Phillips said putting a plan in place for when symptoms arise is a positive action.

"Have those strategies of what helps them reduce their anxiety, instead of sitting there and trying to suck it up," he said. "They can develop breathing techniques or some type of anxiety reduction method so that they can actually reduce anxiety while staying in that situation."

Tips to make holidays more manageable for veterans

Dr. Harry Croft, a psychiatrist and author of "I Always Sit With My Back To The Wall" offers these tips for making the holidays more manageable for veterans suffering from combat-related PTSD:

Talk to your family and friends. Explain to them why you feel the way you do this time of year and why it's difficult for you to become involved in certain things.

Establishing new traditions is a good idea. If being around people bothers you as it does many sufferers, start a tradition with your family to go camping or somewhere quiet where enjoying the holidays will be easier for you.

When attending a holiday party or gathering, have a signal between you and your spouse when your anxiety or anger levels become too high. That way when you have to leave the party for a little bit, and they will know why. Taking two cars will also give the sufferer more control because he or she will feel there's an out and can escape if the need occurs.

Returning to normal everyday life for a veteran with PTSD is extremely difficult because anything can potentially trigger a violent and terrifying flashback. Give your spouse or partner as much support as needed but also know when to back off and not force anything on the sufferer.

Look for local support groups in your area. Trying to cope with the disorder alone makes it much more difficult. Also make sure you are working with a qualified psychiatrist and/or psychologist who specializes in combat-related PTSD.

Veterans who need immediate medical assistance because of PTSD symptoms should visit the emergency room or the Resilience and Restoration Center. Soldiers also can call the chaplain's hotline, 287-CHAP (2427).

Contact Rose L. Thayer at rthayer@kdhnews.com or (254) 501-7463. Follow her on Twitter at KDHreporter.

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