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PTSD Questions & Answers
Joyce Boaz & Dr. Frank Ochberg, M.D.

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Veterans & PTSD: Seasonal PTSD & Anniversary Reaction.

Q: Dear Frank, Here is an email from a website viewer.

I am the girlfriend of an Iraq War Veteran and had some questions regarding PTSD and if it affects people more during the anniversary of the event or events that triggered them to have PTSD. Specifically, my boyfriend seems to display heightened symptoms around the months of April, May, and September. He started his first tour in Iraq around April or May in 2003 and his second tour in September 2005. Is there a correllation between the start of his combat tour and his PTSD getting quite severe during these months? I'm having trouble finding information related to this question. I thought it might have something to do with Seasonal Affective Disorder but the material I found said SAD related to weather conditions.

APRIL is the cruellest month, breeding
Lilacs out of the dead land, mixing
Memory and desire, stirring
Dull roots with spring rain.

T.S. Eliot The Wasteland.

A: Dear Joyce, I am so glad that Ms. G asked these questions - first because any one who cares about our Iraq War Veterans should pay attention to their emotional wounds and learn about the significance of symptoms. Many veterans have understandable difficulty gathering information about PTSD. Trauma memories, particularly memories about fellow soldiers who were maimed or killed, can be easily triggered, causing one to feel as though the event is recurring. A loved one can learn about these symptoms and be a voice of comfort and reason, when the veteran chooses to seek such comfort and reason. Ms. G notes that her boyfriend served at least two tours (serving multiple tours increases the risk for PTSD), and she notes that each tour began in months that may be significant.. April and September are months when seasons change -the spring and fall equinox. They tend to be pleasant months in our country and times when one would want to be with friends and family. It could be that Ms. G's boyfriend associates these months with separation from home and also with the immersion in a life that included too much death. T.S. Eliot's famous line, "April is the cruellest month," signified just that confusion of feeling, being full of life and death at once. If the veteran was exposed to horror and tragedy in a particular month, he or she could have what is called an "anniversary reaction." This means that without needing to think about it, his or her body remembers something horrific. The season comes around to that time of year, the leaves come out on the trees -or the leaves turn red and fall- and suddenly the adrenalin flows, a memory springs from nowhere, and a person feels transported from Florida to Fallujah where comrades were killed. I wouldn't call it an anniversary reaction if Ms G's boyfriend suffers in spring and fall only because those were seasons of deployment. Deployment itself is not a traumatic stress. Yes, it is traumatic in the general sense of the word. But the kind of trauma that causes a PTSD anniversary reaction is something that causes the person to feel horror or terror or helplessness at the time -often all three feelings at once, and to an extreme degree.

SAD, seasonal affective disorder, is a form of depression, not a form of PTSD, and it comes when days are short and there isn't enough morning light to stimulate certain brain centers. People prone to depression often find the winter months particularly difficult. If they suffer from this "SAD" condition, they need artificial, intense light for 30 to 60 minutes in the morning. It helps!

So I would say that Ms. G's boyfriend has a form of seasonal PTSD, but not SAD. PTSD symptoms include unwanted recollections of traumatic events, feeling numb and detached, and also being anxious, with difficulty sleeping, concentrating, and controlling anger. It makes sense to me that these feelings would be worse during the months of deployment and initial separation from home.

Gift From Within has many articles with information and encouragement and networks for partners of those with PTSD. PTSD affects veterans and civilians the same way. It causes normal people to feel abnormal, isolated and embarrassed. It shouldn't separate friends, family and loved ones. The best way to overcome the tendency to drift apart is to do just what Ms. G is doing - seek information, learn about the condition, and do not be ashamed to say, I have a boyfriend with PTSD. PTSD means having the courage to survive danger and the honesty to suffer inevitable consequences.


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