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Posttraumatic Stress Disorder in the Military

One of the major topic of debates between the republicans and the democrats before the November 2016 US general elections was the issue of posttraumatic stress disorder (PTSD) among the veterans and the burning lack of care and interest from the governments. This problem has sparked concerns recently due to the rising number of suicidal deaths associated with United States ex-servicemen. Therefore, PSTD caused by the impacts of combat in the military is worrying and needs to be addressed as soon as possible. This paper looks at the issue of PTSD from a historical perspective, addresses the prevalence of PTSD amongst military members and veterans, as well as the likely indicators of PTSD, and treatment for PTSD.

Historical Perspective of PTSD

Matthew Friedman dates the occurrence of PTSD back to the American Civil War and the Franco-Prussian War in the mid-19th century. Medics viewed PTSD as a psychological disorder that had its roots in the effects of traumatic experiences, such as combat or accidents. Austrian physician Josef Leopold was the first to record military-based mental disorders, and he described it as nostalgia amongst soldiers. Some of them reported missing home, feeling sadness and anxiety and having sleep issues after exposure to combat. Jacob Mendez Da Costa, who was a doctor in the United States in the 19th century, introduced a model named ‘Da Costa’s Syndrome,’ which he attributed to the Civil War soldiers having anxiety episodes, increased pulse rate and troubled breathing. Charles Dickens also recorded cases of anxiety and lack of sleep as a result of trauma that resulted from an accident. The term ‘Shell Shock’ was what described PTSD in the aftermath of World War I. The term presupposed having sleep issues and panic; usually, doctors meant by it a latent damage to the brain due to the effect of the massive guns. ‘War Neuroses’ was another term to describe soldiers who had the said symptoms but were nowhere close to the explosions. By 1945, the Shell Shock became more known as Combat Stress Reaction (CSR) or simply ‘Battle Fatigue.’ About half of the soldiers in World War II suffered from CSR. Interestingly, one can find various records of the CSR in many literary works, and Red Badge of Courage by Stephen Crane is one of them.

History of PTSD Diagnosis

The American Psychiatric Association developed DSM-I in 1952 to diagnose stress disorder cases in people involved in accidents or combat. DSM-II came into effect in 1968 after DSM-I failed to provide a proper diagnosis. Research further led to the development of DSM-III rooted in the veterans of Vietnam amongst other affected groups. DSM-III developed into DSM-III-R, DSM-IV, DSM-IV-TR and lastly DSM-5 as a result of continued research. DSM-5 developed in 2013 is the latest model that tries to diagnose possible cases of PTSD.

The Prevalence of PTSD in the Military

In their article, Gates and colleagues explain that people suffering from military-related PTSD in the US are the veterans of the current US operations in Afghanistan and Iraq. The article refers to the study by Richardson et al., according to which, in 2010 there were 4-17% cases of PTSD amongst the veterans. The period between 2002 and 2008 saw 21.8% of the 289,328 cases of OEF/OIF veterans diagnosed with PTSD. A report by the RAND Corporation in 2008 showed 14% of the 1965 OEF/OIF veterans suffering from PTSD. The report further showed that about 226000 of the OIF/OEF veterans as of 31 October 2007 had PTSD. In other nations, such as the UK, the veterans from the Iraqi-Afghanistan war who developed PTSD range between 3.4% and 6%. Women may be exposed to fewer combat scenarios than their male counterparts, but they are exposed more to cases of sexual trauma-oriented PTSD. The OEF/OIF studies indicate a 13% male prevalence against an 11% female prevalence. Scientists did not record any significant difference based on race as black veterans having PSTD constitute 14% of all veterans, while their Hispanic counterparts make up 13%. According to Shannon (2016), over 50% of veterans with PTSD do not seek treatment and about 22 veterans commit suicide daily because of the effects PTSD has on them, especially on young males below 30 years.

Treatment for PTSD

During World War I, treatment ranged from rest, daily activity, hydrotherapy, and electrotherapy alongside hypnosis. During World War II, doctors treated CSR using the Proximity, Immediacy, Expectancy (PIE) principles, which called for prompt treatment and rest for casualties before returning to war. Today, the VA has over 200 programs to treat PTSD. PTSD treatment may involve therapy, or medication, or both. It could incorporate talk therapy which, could last for up to four months, Prolonged Exposure Therapy, which exposes the patient to situations and feelings they have been avoiding, to make the patient less afraid of their memories. The Cognitive Processing Therapy helps the patients identify and change the negative and self-blame thoughts they may have had about an ordeal. Eye Movement, Desensitization, and Reprocessing help the patients process the upsetting memories by focusing on sounds or movements as the patients talk about the traumatic ordeal. All these therapies aid the brain in dealing with traumatic memories. The Stress Inoculation Training teaches the patients the skills to handle stressing situations and help them manage PTSD. Among the conventional medications used are Selective Serotonin Reuptake Inhibitors and the Selective Norepinephrine Reuptake Inhibitors that raise the level of the chemicals in the brain responsible for lowering stress levels are making the patients feel better. However, some drugs, such as Benzodiazepines, are addictive and should be limited.

Conclusion

In summary, PTSD in the military is the issue that has appeared in the US during the foundation of the nation, and it is now all the more concerning due to the detrimental manifestation of the subject today. As the studies show, PTSD is a rather widespread health problem amongst the veterans that sometimes leads to the suicidal deaths. Fortunately, there are a number of various programs aimed at helping those veterans suffering from Posttraumatic Stress Disorder. Hopefully, some more actions will be taken to address the effects of PTSD in the military.

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