Shell shock, battle fatigue, combat stress. Post-traumatic stress disorder (PTSD) has been called by many different names throughout military history. Regardless of how it's described, PTSD is a debilitating mental health disorder. While you can have PTSD without going to war, this disease disproportionately affects our nation's Veterans who were deployed in wartime.
We know that post-traumatic stress disorder can develop as a result of any traumatic event, but our understanding of PTSD remains limited. An effort to learn about combat related PTSD symptoms, the mechanism by which PTSD develops, and PTSD risk factors was never made in earnest until the early 1990's. It was at this time that soldiers returning from deployment in the Gulf War began reporting mental health concerns and the Department of Defense took note.
Since then, there have been several studies aimed at determining a causal relationship between deployment factors and various aspects of PTSD as well as other mental health disorders. However, simply grasping the need for accurate data and accessing that data are two different challenges entirely.
Once the need for this information was established, it took many years of data collection and analysis to generate the valuable insights required to even begin understanding PTSD. Today, the U.S. has a good grasp on the need for accurate military mental health assessments and ratings both before and after deployments, and measures have been taken to ensure this information is obtained in ways that will hold up to scientific scrutiny.
Combat Exposure Increases Risk of PTSD
While you can have PTSD without combat exposure, many recent accounts of adverse mental health effects in Vets were presumed to be grounded in the experience of war. A substantial number of veterans who served in the middle east since 2001 are currently suffering with severe combat PTSD symptoms.
As such, a significant amount of research, including one collective review of over 185 individual studies, has looked at whether operational deployment results in a higher risk of chronic mental illness among military personnel and Veterans. Key findings indicate that this is the case.
A recent longitudinal study, evaluated members of the armed forces who served in the middle east and did not self-report PTSD or combat stress symptoms at the time of deployment. After returning home, both combat and non-combat PTSD symptoms were evaluated in these soldiers. It was found that those exposed to active combat had a risk of developing PTSD three times higher than those who were not.
It is important to note that exposure to "active combat" also includes exposure to other common wartime situations such as physical abuse, dead and decomposing bodies, severely injured soldiers or civilians, and prisoners of war. PTSD symptoms can arise simply from observing these horrific circumstances.
Furthermore, PTSD isn't the only psychological effect of war on soldiers. Many other mental health conditions arose in service members after deploying to the Middle East. In addition to PTSD in combat veterans, depression and substance abuse disorders were also common among those participating in the studies.
Potential Contributing Factors Identified
There is no denying that exposure to the atrocities of war impacts a service members' mental health. In recent years, additional findings involving factors that may contribute to getting diagnosed with PTSD have come to light, as well.
Like many mental health disorders which manifest emotionally, PTSD is associated with various changes in brain structure and chemistry. Because of this, researchers have begun to investigate whether other biological factors may influence the development of PTSD and whether they may impact severity or duration of PTSD symptoms.
Among the first variables researched has been gender assigned at birth, and some interesting results have emerged. Several studies have reported that deployed men are at an increased risk of developing PTSD than their female counterparts, while women are more likely than men to develop a major depressive disorder after returning from deployment.
Pre-Existing Mental Health Concerns
It's no surprise that deployed military personnel scored higher on physical health assessments than service members who are not deployed. And while PTSD without deployment is also common, it's not unexpected that those same service members returned higher scores on mental health assessments prior to deployment, as well.
What might surprise some is that among service members who have been deployed since 2001, those who scored lower on the mental health components of a 36 Item Short-Form Survey (SF-36) were more likely to develop PTSD during or after combat deployment.
Understanding PTSD – What's Next?
While the mystery of the mechanism relating to PTSD resilience or vulnerability is nowhere near unraveled, we're making progress. The question now becomes, what do we do about all of this? What's next?
It's important to acknowledge that the Department of Defense, the VA, and the public are collectively beginning to believe that combat induced PTSD and the emotional scars relating to trauma can be just as debilitating as some of the physical scars our service bring home from deployment. We must leverage this understanding of PTSD and mental health concerns as we strive to further it.
Destigmatize Mental Health Disorders
While there are millions of U.S. service members and Veterans living in the United States, they make up only a small fraction of our country's population. In order to ensure continued progress in our understanding of PTSD and the effects of PTSD on soldiers, civilians must speak up, too.
PTSD Awareness Month provides an excellent opportunity for the general population to raise their voices in support of our Military Veterans and PTSD victims. The greater the acceptance that many mental health disorders result from biological factors outside of a persons' control, the less stigmatized they will become.
Continue Funding Research
Public opinion is of utmost importance when it comes to funding research for mental health disorders. The less stigmatized these disorders and the more vocal the public, the action government officials will be forced to take. Research into PTSD, war time Veterans, and factors which influence service members' risk for developing mental health disorders, will be what turns the tide in favor of our Nation's Heroes.
To learn more about PTSD and how you can help, visit http://ptsd.va.gov.