Recognizing the Invisible Wounds of PTSD

Recognizing the Invisible Wounds of PTSD

lived-experience #PTSD #mental health #personal journey #healing

'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:

  • 8% of currently serving Australian Defence Force members have PTSD
  • This number jumps to 17.7% among ex-serving members
  • Yet, studies show that less than half seek help within the first year of experiencing symptoms

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:

  • Repeated exposure to life-threatening situations (in combat and training)
  • Moral injury from difficult decisions (both in combat and non-combat roles)
  • Witnessing or handling aftermath of accidents, deaths, or disasters
  • Sexual trauma and harassment within service
  • The weight of constant responsibility for others' lives
  • Loss of unit cohesion after service or posting changes
  • The jarring transition from military to civilian life, regardless of role

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:

  • The high-performing veteran who never takes holidays because routine feels safer
  • The ex-service member who excels at crisis management but struggles with intimate relationships
  • The former soldier who maintains a spotless home but can't sleep without checking the locks multiple times

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:

  • It fits better with military mindsets (clear objective, defined timeframe)
  • It reduces the burden of long-term treatment commitments
  • It acknowledges that traditional civilian-focused approaches might not suit veterans

A Call for System Change

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

  • Reform military mental health screening to account for C-PTSD
  • Create trauma-informed workplaces that recognise PTSD adaptations as strengths
  • Develop peer support programmes that leverage, rather than fight against, military culture
  • Challenge the notion that seeking help compromises operational readiness

Moving Forward: Practical Steps

If you're struggling with PTSD:

  • Document your experiences—not to prove them to others, but to validate them for yourself
  • Connect with peers who understand military culture AND mental health
  • Consider intensive treatment programmes designed specifically for veterans
  • Remember: Seeking help is a tactical decision, not a surrender

If you're supporting someone with PTSD:

  • Don't say 'you look fine'—ask 'how can I support you?'
  • Learn about military-specific trauma responses
  • Advocate for better workplace accommodations
  • Understand that recovery isn't linear

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.

Disclaimer

I am not a health professional, and this post is based on personal experiences and research. For personalised advice or support, please consult a qualified health professional.

Resources for Veterans

  • Open Arms – Veterans & Families Counselling: 24/7 support for Australian veterans and their families. Phone: 1800 011 046
  • Lifeline Australia: Crisis support and suicide prevention. Phone: 13 11 14
  • Beyond Blue: Mental health support for all Australians. Phone: 1300 22 4636
  • Soldier On: Support services for Australian veterans and their families.
  • Veterans Crisis Line (USA): For US veterans. Phone: 1-800-273-8255 (Press 1) or text 838255
  • Combat Stress (UK): Support for UK veterans. Phone: 0800 138 1619

Sources

  1. American Psychological Association: PTSD Overview.
  2. Journal of Psychiatric Research: PTSD's Long-Term Impacts.
  3. National Centre for PTSD: Social and Psychological Aspects of Trauma.
  4. Australian Institute of Health and Welfare: PTSD and Mental Health in Australia.
  5. Department of Veterans' Affairs: PTSD Prevalence in the ADF.
  6. Phoenix Australia: RESTORE Trial Overview.
  7. Military Medicine: Combat-Related PTSD Studies.