Hyperarousal is what is known in French as “l'hyperactivité neurovegetative”. It is one of the groups of symptoms that are part of the diagnosis. These symptoms include sleep disorder, problems concentrating, hypervigilance, irritability, and so on. Obviously, this kind of hyperactivation can mean that the person is constantly on the lookout. The simple fact of finding oneself in complete silence at bedtime or when in bed—silence in itself—can recall certain aspects of the trauma. It may cause a person to relive the trauma he experienced, to feel anxiety and to have depressogenic thoughts.
If, on average, they waited seven or eight years before receiving services and the post-traumatic stress has become chronic, there is a good chance they will have developed comorbid major depression. According to the Statistics Canada survey, more than half of Canadian Forces personnel experience major depression, and it is the same thing in the civilian population. People present with secondary depression and, very often, they will take antidepressants. It is also important not to overlook the effects of depression on mental health or on soldiers' general quality of life.