Post-traumatic stress disorder is a major threat to soldiers returning home from Afghanistan and Iraq. Here’s what we can do to help.
___
Whatever your feelings about the wars in Iraq and Afghanistan, there is no denying that it has had a significant impact on the health of returning troops: since 2001, over 2.7 million soldiers have served in either Iraq or Afghanistan (or both), and while this number includes around 283,000 women (who have also served their country with distinction), the burden of service still rests with men. Longer and multiple deployments, nature of the warfare itself and other factors have lead to unprecedented rates of suicide, substance abuse, motor vehicle accidents, and, at home, higher rates of divorce, domestic violence and child abuse and neglect.
Many of these poor outcomes can be linked back to the phenomenon of post-traumatic stress disorder. And while Veterans Affairs (VA), largely after some very harsh criticism on their lack of responsiveness to veterans’ needs, has stepped up their game to make PTSD treatment for accessible, many believe that more should be done. The National Academy of Sciences, in a recent report, noted that, while the VA has improved its services, barriers to these services still include patient reluctance to seek treatment for fear of damaging their careers, difficulty of travel to and taking time off for care, poor training on the part of healthcare providers, restrictions on care, such as when and how long PTSD drugs can be used.
Characteristics of PTSD
Part of the problem is the complexity of PTSD itself, which is defined as a mental health disorder triggered by a traumatic event or series of events. While it is natural for people to feel frightened or experience a whole range of other emotions after something violent, dramatic or frightening has occured, there are those who are not able to recover from these experiences naturally and develop PTSD.
- PTSD can express itself in a variety of ways, range from mild to severe, and different patients will have different signs and symptoms. These can include any of the following:
- Flashbacks or recurring memories, nightmares or unwanted, violent thoughts
- Feelings of numbness, guilt, depression or stress/anxiety
- Difficulty remembering or attempting to avoid reminders of the traumatic event
- Physical symptoms like fatigue and loss of appetite
- Loss of interest in life
- Angry or violent outbursts
These symptoms can make it difficult or impossible for soldiers to readjust to civilian life — and the human and economic toll of these problems is great.
Where the VA Stands Now
In the past, the VA has drawn sharp fire from the press and from politicians for its inadequate meeting of the psychological needs of returning troops. This has lead to the VA implementing a comprehensive program of PTSD specialists who work at each VA medical center. There are also some 200 specialized PTSD treatments centers across the country and some of the VA community-based outpatient centers also include PTSD care programs. The form that this care can take includes medications, counseling for individuals and for families and group therapy. Depending the need, these services take place on either an outpatient or more intensive in-patient setting.
The purpose of these programs and services is to help soldiers who have been emotionally traumatized by their experiences in war to be able to re-adjust successfully to civilian life. In spite of this, though, there are still many who think that there should be changes to the approach the government takes to care for returning soldiers with PTSD.
What More Should be Done?
There are a wide variety of suggestions about other ways that the VA could help to care for soldiers returning home with PTSD.
A Shift Away from “PTSD” Treatment to More Holistic Care. While PTSD has been widely accepted as a diagnosis, some, particularly in the psychiatry community, worry that the label “PTSD” itself might actually be interfering with the care that emotionally/psychologically wounded veterans need. Critics believe that PTSD does not have the firm biological basis/scientific evidence of other mental health diagnoses and that instead of trying to treat this “amorphous” disorder, treatment should focus on:
- Immediate post-traumatic interventions to help soldiers begin immediately to deal with what they have experienced
- Intensive treatment of the conditions that often accompany PTSD, including alcohol and drug use and depression, anxiety and stress disorders
- Programs which help to alleviate the environment that these soldiers are coming from, including ones to alleviate family dynamics issues, poverty and homelessness
The worry here is that “the shortcomings of the current PTSD diagnosis jeopardizes the treatment of the terrible aftermath of this war’s emotional trauma.”
Implement Programs that Make the Most of the Talents and Experience of Returning Veterans. The question of the need to support wounded veterans — including those who have been psychologically wounded — is not in doubt. However, some criticize the government for its broad-based program of granting disability to soldiers that can become permanent. Critics point out that many of these troops are educated, talented and experienced individuals who have a lot to offer society upon their return to civilian life and while some will definitely need permanent disability, there are other who would benefit from programs which can match their talents up with jobs that can make the most of their special abilities. This can encourage their independence and not rob them of their right to pursue full, active and healthy lives, even as they deal with the issues of their wartime service.
Better Analyze the Efforts of New V.A. Programs. The Institute of Medicine issued a report that the V.A., in order to improve its access to care, needs to analyse its program more carefully by tracking the treatments that its clients receive and to link it to certain patient outcomes and parameters. This is to evaluate the overall effectiveness of the program and to provide opportunities for research and to spread the information on whether or not those who need the services the most are actually receiving it.
To sum up, post-traumatic stress disorder is a major threat to the health of the soldiers returning home from conflicts in Iraq and Afghanistan. While the VA has tried to implement and improve their responsiveness, critics from different walks of society believe that there are a variety of ways to make care for PTSD patients even better and more effective.
___
The role of men is changing in the 21st century. Want to keep up? Get the best stories from The Good Men Project delivered straight to your inbox, here.
Photo credit: Getty Images
You offer some excellent advice,Dr. Wu. I’ll share this with a friend who runs a PTSD group.
Earlier this month, we posted an article about a NFP grass roots agency called Guitars for Vets that provides guitar lessons to vets with PTSD and guitars when they graduate. VA volunteers are involved as are others from local communities. More, here: https://goodmenproject.com/featured-content/guitars-for-vets-heals-military-ptsd-with-music-lbkr/