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article imageAn army on antidepressants: US military dilemma as mental health issues rise

By Paul Wallis     Jun 8, 2008 in Health
The effects of protracted warfare have been generating some protracted arguments about mental health care. While the issues are fundamentally stress and combat-related, both the public and the troops’ expectations for care and treatment have risen.
Those expectations aren’t unreasonable. This is the 21st Century. Things are supposed to have got better than the days when people debated whether there was such a thing as shock. The standard of care in the mental health area for US troops is a very sore point with the families of service personnel.
Depression is a physical condition with severe effects on mental health. People with depression aren’t actually going nuts. The hormones balancing brain chemistry are out of whack, and that imbalance is what causes the problem. Many people who’ve had depression, (and I’m one of them) would say they’ve had physical injuries that were much less of a problem than depression, without adding a war to the situation.
TIME Magazine has this story, and it’s a rather large, grim assessment of the situation:
For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan. The medicines are intended not only to help troops keep their cool but also to enable the already strapped Army to preserve its most precious resource: soldiers on the front lines. Data contained in the Army's fifth Mental Health Advisory Team report indicate that, according to an anonymous survey of U.S. troops taken last fall, about 12% of combat troops in Iraq and 17% of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope. Escalating violence in Afghanistan and the more isolated mission have driven troops to rely more on medication there than in Iraq, military officials say.
Even this relatively straight narrative is debatable, medically. Constant trauma, stress, and fatigue don’t do much for anyone’s health. Depression often occurs in people who are physically debilitated by disease or stress.
If you’re getting hit by surges of adrenalin every day, combined with massive physical exertion, and more or less continuous levels of trauma, you can assume that you’re going to be feeling the effects. It’s probably fair to say that stress isn’t really relative to people, but it is relative to situations.
The increase in the use of medication among U.S. troops suggests the heavy mental and psychological price being paid by soldiers fighting in Iraq and Afghanistan. Pentagon surveys show that while all soldiers deployed to a war zone will feel stressed, 70% will manage to bounce back to normalcy. But about 20% will suffer from what the military calls "temporary stress injuries," and 10% will be afflicted with "stress illnesses." Such ailments, according to briefings commanders get before deploying, begin with mild anxiety and irritability, difficulty sleeping, and growing feelings of apathy and pessimism.
These are mean statistics for what would add up to a very large number of people. In fairness to the US military, troops are given some psychological preparation for combat, (to the extent it can be done) and the combat culture is based on mutual support.
It’s not an administrative issue that can be pinned down well, and it’s not exactly the best environment for treating a medical condition. So some conditions worsen:
As the condition worsens, the feelings last longer and can come to include panic, rage, uncontrolled shaking and temporary paralysis. The symptoms often continue back home, playing a key role in broken marriages, suicides and psychiatric breakdowns. The mental trauma has become so common that the Pentagon may expand the list of "qualifying wounds" for a Purple Heart — historically limited to those physically injured on the battlefield — to include posttraumatic stress disorder (PTSD).
There’s a terrible irony in equating PTSD and “qualifying wounds”, even if I’m sure nobody quite made that connection when they came up with the idea.
The military vocabulary includes quite a lot of acronyms, too many for a healthy conversation.
The worst are KIA, MIA, WIA and now PTSD.
They’re all a qualification for something…
The TIME article is explanation enough. Read the comments from service people about how treatment is organized, and see if you think these guys have something else to worry about.
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