Friday, January 4, 2019

Treating Mental Illness In The Military

PTSD
Most Americans will never know what it is like to see a good friend die in their arms; grasp the sensation of being shot at; and, we will never understand what is like to get into a military transport with the risk of driving over an improvised explosive device. Trauma, and what follows from it, is not unique to servicemen and women; but, those who serve knowingly put themselves in harm's way for something more significant. A decision to pit courage against fire puts a person at significant risk of losing life, limb, or sanity. For the latter, those who survive war only to fight an internal struggle for years to come potentially, mental illness becomes their enemy.

Mental illnesses, like post-traumatic stress disorder or PTSD, are all too common in the armed services. Moreover, men and women affected by such ailments are conditioned to keep their illness to his or herself; many understand that acknowledging mental disease, and seeking help, could mean the end of a career or a significant setback at least. The stigma that surrounds mental illness affecting the general public is just as insidious in the military, if not more damaging. Additionally, people who come back from war with indelible scars often have a harder time acquiring evidence-based treatment compared to the average citizen.

So, if you can’t talk about what you are dealing with, and adequate help is difficult to acquire even if you do, then what option does that leave you? For some, the only choice is silence and having to contend with illness in secret; an avenue that is often unsafe to both the individual and those they love. In many cases, the need for relief is so great that active members and veterans alike will turn to drugs and alcohol as a means of coping with symptoms. Substance use, or in this case self-medication, is a sure path to more issues including addiction.

Mental Illness In The Military


Functional impairment, substance abuse, suicidal ideation, impulsivity, and violence are common symptoms of people living with PTSD. The condition manifests differently from one person to the next, but all who are affected do not fare well without treatment. Of the more than 2 million men and women who have served in Iraq and Afghanistan, nearly a third of all service-persons are living with a mental health condition, according to data published in JAMA. A recent article appearing in Psychiatric Times written by Jeffrey Lieberman, MD, Chairman of the Columbia University Vagelos College of Physicians and Surgeons Department of Psychiatry, makes some excellent points about mental illness in the military.

Dr. Lieberman rightly highlights the lack of support provided for individuals coming home from foreign wars and their families. He acknowledges that effective treatments exist, but more research is needed involving not just the military but also the National Institutes of Health (NIH). The Lawrence E. Kolb Professor stresses the importance of early intervention and how it can increase functional capacity, rapid symptom recovery, prevention of maladaptive coping behaviors, and prevention of chronic PTSD and other psychopathology.

In his article, Dr. Lieberman lays out why he thinks more has not been done for the brave Americans who are willing to sacrifice everything. Then, he follows his observations with how things can change. Lieberman writes:
 

I believe there are three reasons why the same has not been done for the psychological wounds of war. First, the idea of psychological weakness is antithetical to military culture with its ethos of strength and invulnerability. Thus, military leaders were disinclined to recognize and accept the possibility of psychic injury. As a result, many soldiers were accused of cowardice and in some cases punished, even executed, for their infirmity. Second, mental disorders are not tangible and have no visible physical signs or diagnostic tests by which they can be confirmed. Hence, they are not seen as real, and are thus minimized—you don’t get a Purple Heart for PTSD. Third, PTSD was considered a military problem and thus the responsibility of the Defense Department and Veteran’s Administration. Consequently, the NIH did not see this as within the scope of their mission and thus the best and the brightest biomedical researchers at academic medical institutions were not engaged in the research effort to address PTSD. 

Dr. Lieberman believes a cure can be found for PTSD and finding it will require a Manhattan Project-esque approach to understand the pathophysiology better and develop more effective treatments. He says it is impossible, but success will hinge on:
  • The government creating “a task force of leading scientists to develop a strategic plan for research on the pathological basis of PTSD and develop treatments.”
  • Congress allocating “funding to support the necessary research to be carried out under the auspices of the National Institutes of Health in partnership with the VA and Department of Defense.”
  • Establishing “a network of medical centers in addition to the VA Hospitals to provide specialized mental health services for veterans, and mechanisms for reimbursement.”

 

TRICARE Addiction Treatment


At Hemet Valley Recovery Center, we are committed to assisting active duty service members and veterans in achieving long-term recovery. We are proud to accept TRICARE insurance so that those who have dedicated their lives to serving and protecting others can access affordable addiction and co-occurring disorder treatment. Please contact our recovery specialists to get a better understanding of your benefits and to learn more about our programs.

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