FIRST, THE GOOD NEWS: U.S. combat deaths in Afghanistan are on the decline for a number of reasons, including better protective gear for servicemembers and advanced medical techniques.
The bad news is, although servicemembers increasingly are surviving IED explosions and other attacks, the number of life-changing injuries has risen. In many cases, combat scars are psychological rather than physical. Fortunately, those invisible wounds are treatable; the biggest challenge mental health professionals often face is convincing service-members to seek treatment.
The statistics are sobering: It’s estimated one out of every five military personnel returning from war has post-traumatic stress disorder (PTSD), yet the condition wasn’t even recognized by the American Psychological Association until 1980.
“PTSD is a lingering psychological condition produced by experiences that overwhelm the person’s mind and brain capacities for processing and understanding what has happened,” explains Dr. Arthur S. Blank Jr., a psychiatrist who served in Vietnam. “It always involves a serious threat to life or bodily integrity.”
During World War I, the condition was known as shell shock; in World War II, it was war neurosis. “As recently as the Civil War, it was considered to be cowardice,” says Army Col. Charles C. Engel, M.D., M.P.H., director of DoD’s Deployment Health Clinical Center. “We’ve come a long way since then, but we still have a long way to go.”
Pushing past perceptions
Whether the stigma has decreased in the armed forces, however, is debatable. “It runs right smack into military culture,” says Engel. “People in the military are taught to put the team first, to put your own needs second as a soldier.” Another key factor is the perceived harm to career. “We have to convince people that treatment is part of the solution, not part of the problem.”
Engel emphasizes seeking help is critical because of the havoc PTSD can wreak on a person’s life. The condition often is marked by vivid flashbacks to a traumatic event. These flashbacks can last for minutes or even days and are accompanied by a racing heart, sweating, and frightening thoughts. Nightmares also are common, leading to sleep deprivation and exhaustion. Those affected often develop memory problems and find it difficult to concentrate, sometimes becoming emotionally numb or overwhelmed by feelings of hopelessness.
Family members are often the first to notice personality changes, such as irritability and anger. Self-destructive behavior is another indicator of PTSD, as an individual attempts to self-medicate with alcohol or drugs. A pervading sense of guilt also is common, as are startle reactions and even hallucinations. Those with PTSD often will avoid places, people, or events that remind them of traumatic events.
A widespread issue
PTSD is by no means an exclusively military problem. It’s estimated at least half of the civilian population has experienced the condition at some point, as a result of auto accidents, domestic violence, natural disasters, and a host of other factors. Research conducted by entities such as the VA’s National Center for PTSD gradually is providing clues to the roots of the problem as new and more effective therapies and medications are sought. Predicting who will develop PTSD and who will not, however, still eludes researchers.
Save the Date
MOAA and the National Defense Industrial Association’s 2013 Warrior-Family Symposium, with a focus on mental health care challenges, is Sept. 12 in Washington, D.C. Look for more details in future issues of Military Officer and on MOAA’s Web Base,
www.moaa.org. To read the transcript from last year’s event, visit
www.moaa.org/wfs.
56 MILITARY OFFICER APRIL 2013
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