Last week I explained how Post Traumatic Stress Disorder (PTSD) can develop. Reacting to a traumatic event with alarm is normal, but when we overreact with alarm to any reminder or cue of the trauma to the degree that distress interferes with our daily lives, it’s time to take corrective actions.

PTSD is fairly common for people involved in farming because farming is one of the most stressful occupations and many of the factors that affect success or failure are beyond our control. When I use the term “farming,” I am also referring to ranching, working on a farm as a laborer and related jobs that involve the production of food, fiber and biofuel.

One of my first professional experiences with PTSD after completing training in clinical psychology involved helping a farmer who became emotionally paralyzed while undergoing farm foreclosure proceedings in court. He couldn’t sleep; he was unable to go about his daily chores on the farm; he became numb and was hardly able to speak.

PTSD among soldiers who completed tours of duty in Iraq and/or Afghanistan is also common. Recent estimates range from 2.5-35 percent among U.S. veterans returning Stateside (Richardson, Frueh & Acierno, 2010; Curry, 2012).

As might be expected, the prevalence of PTSD is positively correlated with the number of tours of duty and the number of exposures to firefights, bombs and other life-threatening events. Many returning U.S. military who originated from rural areas find that access to care for PTSD is an added burden.

Dr. Joel Kupersmith, M.D., chief research and development officer of the Department of Veteran Affairs, commented, “Providing comprehensive, high-quality health care to veterans in rural areas is a challenge.”

Of 5.6 million veterans who received care from the VA in 2006, about 40 percent lived in rural areas. Military personnel tend to originate in greater numbers from states that are rural, with Alaska having the highest number of military personnel on a per-capita basis.

States that comprise the High Plains, the Rocky Mountain region and portions of the Sun Belt tend to produce higher rates of military personnel than the Northeast and Midwest regions.

Military recruits who originate from these areas usually are excellent soldiers. Their practical orientation to work and discipline, and their rural backgrounds, incline them to be familiar with guns and to possess outdoor survival skills. American Indians are especially likely to choose to serve in the military.

But when these soldiers return home they often have limited access to the health care they need, especially behavioral health services. American Indians especially lack treatment services.

Dr. Kupersmith indicated the U.S. Department of Veterans Affairs is working to improve resources for all veterans who are dealing with PTSD and those who return to their rural locales.

Here are some PTSD resources for returning rural military personnel. Helpful websites include www.raconline.org/topics/veterans and www.ruralhealth.va.gov/native/programs.asp

A 24/7 hotline is available at 800-273-8255 or www.veteranscrisisline.net

PTSD seldom goes away on its own. The most effective help with PTSD is usually obtained from professionals and trained peer support counselors who understand the experiences of those struggling with PTSD.

There is considerable research with people who farm and with returning military personnel with PTSD, which indicates that understanding their culture and expectations is critical to providing effective services. Having “been there” offers credibility and bonding to those who are struggling with behaviors they can’t control. That is why most VA call centers and PTSD hotlines are staffed by Veterans.

Similarly, the farm crisis hotlines/ helplines with which AgriWellness, Inc. has been affiliated for many years are answered by people with farm and ranch backgrounds, for the most part.

Some resources are underutilized. Sweats, Talking Circles and other Native American rituals can help Natives and those who are not Indian. These rituals have been passed down for many generations because they provide confidential, safe, highly instructive opportunities for people struggling with maladjusted behaviors – and PTSD is a maladaptive response.

PTSD and farm crisis hotlines/ helplines are another underutilized resource. The website www.militaryonesource.com lists many types of assistance, including hotlines and helplines for military families.

Farmer-friendly hotlines/helplines serve nine states. These are listed on the website www.agriwellness.org – click on “helplines.” They can provide assistance to callers with military as well as farm backgrounds.

If you know of additional credible resources for our rural friends and neighbors who are struggling with PTSD, please send them my way. I am glad to publicize them.

And, thanks a lot.