The meaning of “December 7” may be different for those of us not
old enough to remember WW II and the attack on Pearl Harbor. It happens to
be a day that reminds us of the many Americans now at war, particularly an
increasing number of women.
We know that the US Defense Department now bans women from
participating in ground combat (although there is now a federal lawsuit to
overturn this ban). But with about 14% of our military personnel being
women, a disturbing new finding is that women in general are more likely to
develop post-traumatic stress disorder (PTSD) than men. Up to twice as
likely, some researchers posit.
Post-traumatic
stress disorder did not exist as a “formal” diagnosis until 1980, when it was
added to the Diagnostic and Statistical Manual of Mental Disorders. Prior
to this, the terms shell shock, battle fatigue, or post-Vietnam syndrome were
names given to various and severe adjustment problems experienced by recent war
veterans.
A recent study at the San Francisco VA Medical Center found that
women and men “learn” to fear differently. This “fear conditioning” is
vital to our safety, but in people with PTSD, a simple stimulus might trigger
this stress or fear response. Trash on the side of the road, or the smell
of gasoline or fire may get associated with an actual traumatic military
experience. When female and male veterans were tested for reactions
ranging from increased heart rate to rapid breathing when shown disturbing or
violent images – and several of the images were paired with a slight electric
shock, women had more significant reactions. The researchers
believe this demonstrates that women may learn fear responses from different
mechanisms, which may make them more susceptible to PTSD.
Patricia Resick and other researchers in the Women’s Health
Sciences Division of the National Center for PTSD at Boston University are also
seeking answers. The group has linked significant diagnoses of PTSD to
the types of trauma military women experience. “In general, sexual trauma
is a more significant risk for PTSD than combat or the types of trauma males in
the military experience,” she reports. “Combats, car accidents, or fights
are impersonal events; when women are traumatized, it is often caused by the
people who are supposed to love or protect them.” When a fellow officer
or commanding officer attacks a woman, the result is much more severe.
Sexual assault and severe sexual harassment - collectively
known as military sexual trauma (MST) - is nearly epidemic in the armed service
today . Amy Street, an assistant professor of psychiatry who leads a VA support
team devoted to the issue, says that VA screenings for MST, mandated since 1992
for every veteran, reveal that 20% of servicewomen report sexual assaults
or severe, threatening harassment, compared to 1% percent of men. And the
numbers, she says, are most likely a gross underestimate.
Many women veterans report that the sense of betrayal is
compounded, and the trauma and shame intensified, when the chain of command
fails to act on a reported incident, minimizes it, or even punishes women who
report assaults. Even reservists, the military part-timers who serve two
weeks a year and one weekend a month, experience “high and impactful” rates of
MST, among both women and men. “So even people who had other lives
outside of the military tended to experience a lot of harassment and assault,”
Resick notes, “and even 10 or 20 years later, those experiences were associated
with higher rates of depression, poorer functioning, and higher rates of PTSD.”
There’s
much more to learn about the compounded effects of PTSD on both women veterans
and women in the general population. Because
society doesn’t yet know how to understand the symptoms of PTSD in women, it’s
much harder for them to find equilibrium. And even with support from
home, many female veterans also struggle because many do not see them as “real”
veterans.
Since PTSD, its symptoms, diagnosis, and treatment may be
very different for women than for men, it’s our work to raise awareness about
this and other issues facing women and girls today. Thank you for being a
leader in this effort.
