Recognizing the Invisible Wounds of PTSD

'You look fine to me.' These five words haunt countless veterans living with PTSD, highlighting a fundamental misunderstanding about trauma. While physical wounds command immediate attention and sympathy, the psychological impacts of trauma often go unrecognised, especially in military communities where stoicism is prised above vulnerability.

As someone who has lived with complex PTSD, I've learned that the most damaging aspect isn't the condition itself—it's the constant pressure to prove its existence. This piece isn't just another overview of PTSD symptoms. Instead, I want to challenge how we think about trauma, particularly in military contexts where our current approaches may be doing more harm than good.

The Many Faces of Trauma: Beyond the Textbook Definition

Picture this: A veteran flinches at a car backfiring in a shopping centre. A colleague notices but says nothing. Later that day, the same veteran calmly leads a team meeting, appears 'perfectly normal', and even jokes with coworkers. This isn't a contradiction—it's the complex reality of living with PTSD.

While medical definitions matter—yes, PTSD is a psychiatric disorder that can occur after traumatic events—these clinical descriptions often fail to capture the day-to-day reality. The American Psychological Association's official criteria don't tell you about the exhaustion of maintaining a 'normal' façade at work, or the guilt of cancelling social plans because your hypervigilance is particularly bad that day.

The Military Paradox: When Strength Becomes a Barrier

The military teaches us to be resilient, to push through pain, to put the mission first. These values save lives in combat. But they can become deadly when applied to mental health. Consider these statistics:

Why? Because in military culture, admitting to PTSD often feels like admitting defeat. This stigma isn't just uncomfortable—it's lethal.

Beyond Basic PTSD: The Complex Reality of Military Trauma

The traditional PTSD model doesn't fully capture the military experience. Complex PTSD (C-PTSD), recognised by the World Health Organisation but still underacknowledged in many military settings, better describes the impact of prolonged exposure to trauma.

It's crucial to understand that PTSD in military members isn't exclusively combat-related. While combat exposure is one pathway to trauma, military service itself—whether in peacetime or war—can create conditions for PTSD. What makes military trauma unique is its multifaceted nature:

This broader understanding of military trauma is essential because it validates the experiences of all service members—from combat veterans to peacekeeping forces, from support staff to medical personnel. Each role carries its own potential for trauma, and each deserves recognition and support.

The Hidden Cost of Invisibility

The 'invisible wound' metaphor, while well-intentioned, might actually contribute to the problem. It suggests that PTSD is something that can't be seen or understood by others. But the signs are there—we're just looking in the wrong places:

These aren't invisible wounds—they're visible adaptations to trauma that we've failed to recognise.

Breaking the Silence: What Actually Works

Recent research challenges traditional approaches to PTSD treatment in military populations. The RESTORE trial in Australia demonstrated that intensive exposure therapy over two weeks can be as effective as months of traditional treatment. This matters because:

A Call for System Change

Instead of asking veterans to prove their wounds are real, we need to:

Moving Forward: Practical Steps

A Final Note

The next time someone says 'you look fine,' remember: PTSD isn't about looking unwell. It's about learning to live with experiences that changed you fundamentally. The goal isn't to become who you were before—it's to build a life that honours both who you were and who you've become.