By Betsy Reed Special Projects Coordinator West Michigan Community Health System The US has been fighting the Global War on Terror for over 13 years. It's no surprise that the American public is talking more and more about veterans and post traumatic stress. The US Department of Veterans Affairs' National Center on Post Traumatic Stress Disorder (http:\/\/www.ptsd.va.gov\/) is a global authority on the effects of trauma. According to their website, combat trauma can include both typical wartime scenarios like seeing others hurt or killed and military sexual trauma (MST), which includes sexual assault and harassment and can happen to both men and women. Additionally, the stress of being away from home for long periods and the associated problems on the home front can exacerbate the effects of combat trauma. Almost all people who experience combat trauma or other kinds of trauma have some symptoms for a short period of time. Most of the time symptoms resolve without needing treatment. People who experience a very severe trauma, have a history of other traumatic events, have other mental health problems, lack support of family and friends, and experience other risk factors have a higher than average likelihood of developing Post Traumatic Stress Disorder (PTSD). Symptoms of PTSD are grouped into four categories: reliving the event (through bad memories, nightmares, or flashbacks), avoidance (staying away from situations or people that trigger memories of the trauma), negative changes in beliefs and feelings, and hyperarousal or feeling "keyed up" (having trouble sleeping and concentrating, being easily startled or jittery, needing to have one's back to the wall in a restaurant or waiting room). PTSD is a mental illness and must be diagnosed by a heath care provider or mental health professional. PTSD can take a toll families and relationships. It can be difficult to live with someone who is easily startled, has nightmares, and avoids social situations. Besides general relationship problems, families of people with PTSD are more likely to experience domestic violence, substance abuse, and behavior problems in children. The good news is that, like other mental illnesses, PTSD is treatable. Counseling can help people change how they react to memories of the trauma. Medications can be helpful along with counseling. An interesting treatment that has been found to be successful for combat veterans with PTSD is eye movement desensitization and reprocessing therapy (EMDR). Kay Marble, LCSW, ACSW, a Ludington native now living in Clarksville, Tenn., has used EMDR to treat people who have experienced trauma. Marble explained that EMDR is a very structured protocol involving an eight-step treatment process. The "Eye Movement" referred to in the treatment's name is really about bilateral (both sides of the body) stimulation or movement used during one of the treatment steps. Marble compared the brain functioning of a person living with PTSD to a train that continually gets stuck at the same spot on the track. The person's brain process won't allow him or her to move past that point, and his or her daily functioning suffers. EMDR helps repair the track so that the train can go where it needs to go. Marble has seen clients make significant gains with the use of EMDR. The Department of Defense and US Veterans Administration have named it as a front-line treatment for management of post-traumatic stress. As with the general public, stigma is probably the biggest barrier to treatment for people in the armed services. The Office of the Secretary of Defense is making efforts to reduce stigma in the military, including sponsoring a 2014 study by the Rand Corporation to recommend stigma reduction strategies that in turn will encourage more service men and women to seek treatment. With over 2 million service men and women serving overseas in the past 13 years, a military culture that supports mental health treatment may be more important than ever.