WASHINGTON, August 27, 2014 – The more combat situations a soldier experiences, the greater is his or her chance of acquiring post traumatic stress disorder (PTSD).
Many of us consider that to be stating the obvious, but there are statistics that make the obvious concrete.
A study assessing the incidence of PTSD in troops leaving Iraq found that soldiers not involved in fighting had a PTSD incidence rate of 4.5%. For those in intense combat once or twice, the incidence rate more than doubled to 9.3%. The number is 13% for troops in three to five combat situations. More than five exposures and the occurrence rate of PTSD shoots up to 20%.
The study’s “silver lining” is that after five or more combat experiences, 80% of the troops studied did not report symptoms of PTSD. Still, the number of troops with them is significant. The Military Health System reported 39,365 troops in Iraq and Afghanistan between 2003 and 2007 were given a diagnosis of PTSD.
Symptoms of combat-related PTSD involve emotional numbness, hyper-arousal (easily startled), irritability, flashbacks, nightmares, and memories both intrusive and disturbing. However, the effects do not stop there.
PTSD: Intrusive memories and flashbacks
PTSD is also correlated with physical health issues, interpersonal problems, reduced daily functioning, and lower overall quality of life.
Maintaining employment can be difficult or impossible.
This diagnosis is often accompanied by depression, panic disorder, and because drugs and alcohol are a means of self-medication, substance abuse.
Many with symptoms use avoidance or isolating behaviors to cope.
Combat troops are faced with experiences that are horrifying, foreign, and beyond comprehension. They must find a way to add these unacceptable memories to the story of their life. Having to digest the indigestible to return to “normal” goes against reason, but for well-being after warfare, it is necessary.
Though soldiers with PTSD might have returned home, part of them never left the war zone. Because they cannot meld the war experience into their life-so-far history, they live in two worlds, one intruding upon the other. To integrate the two, some people are helped by medication, or a medication and therapy combination.
Cognitive therapy helps PTSD clients look at and adjust beliefs and thoughts that made sense on the battle field, but are debilitating in civilian life (i.e., “I am always in danger”). Exposure therapy helps clients integrate memories by re-experiencing them either situationally or by visualization. As the client tolerates their discomfort over increasing periods of time, it eventually diminishes.
With EMDR, or eye movement desensitization and reprocessing, people recall difficult memories and feelings while their eyes are moving rapidly back and forth. This process helps people incorporate even the worst memories minus the associated traumatic emotions.
There are other therapies that can help, but the three mentioned above are the most widely accepted and used. Unfortunately, what helps some people has little effect on others. For most people with PTSD, treatment is a long process of trial and error and finding what works.
Standing in Their Boots, Barely
Many of use have had a taste of what PTSD is like. After being in a fender bender car accident, though no one was hurt, the incident can consume our thoughts for hours or days. Our mind relives the scenario over and over trying to find a way out of what already happened. We think, “Was it really my fault? I just looked down for half a second.
That other guy was driving too slow, anyway.”
If you take the fender bender experience and multiply it by the brutal, terrifying, and alien environment of combat, it is not hard to imagine how difficult assimilating such memories can be.
Garske, Gregory G. (2011). Military-Related PTSD: A Focus on the Symptomatology and Treatment Approaches. The Journal of Rehabilitation, 77 4, 31+.
Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023-1032.
Reprinted with permission from Jacqueline Marshall