US PTSD

[El Prez]

This has just been posted on Leatherneck. I am surprised that there is no similar forum on their site comparable to this one.

Combat Stress Symptoms Vary Among War Vets

By Rudi Williams
American Forces Press Service

WASHINGTON, May 7, 2003 - Mental health experts don't know what combat stress reactions to expect from service members returning from the war in Iraq. And it's not just stress reactions from actual combat, according to Army Dr. (Lt. Col.) Elspeth Cameron Ritchie.

Some could be disturbed or demoralized by stressors from the consequences of combat, such as handling remains of civilians, enemy soldiers or U.S. and allied personnel. Or they could come from dealing with POWs, witnessing homes and villages destroyed by bombing or a number of other battlefield stressors.

"Combat stress reactions, which are psychological reactions to fierce combat or operations other than war, are both physical and psychological," said Ritchie, program director, DoD mental health policy and women's issues for the Office of the Assistant Secretary of Defense for Health Affairs. "Physical reactions are things like your hands sweating and trembling and your heart racing, or a need to go to the bathroom a lot."

The psychological reactions include things like anxiety, hypervigilance, difficulty concentrating, or sleeping, irritability and sadness. Ritchie emphasized that combat stress reactions are normal reactions to abnormally stressful or traumatic situations.

However, Ritchie, a psychiatrist, said, "If these reactions go on for long periods of time or get in the way of job performance, it's important to get treatment."

She said soldiers and Marines can recognize in themselves or their buddies the anxiety and irritability that combat stress reactions can cause. "When things get in the way of functioning, that's when a little more help is needed," Ritchie noted.

Some people returning from Operation Iraqi Freedom may not want to talk about what happened for a while, she pointed out. "But if you notice that one of your loved ones is having difficulty, maybe they're losing their temper a lot, or they are sort of detached and doesn't seem to relate, you should encourage them to seek mental health help," she said.

Even though the extent of psychological reactions service members might have from Iraq is unknown, Ritchie said, "What we may see is people who are repeatedly seeing the images of battle.

She pointed out that there's a lot of overlap between combat stress and the stress of everyday activity. "What differentiates combat stress is usually the intensity of what has happened," the doctor noted. "Sometimes you'll have repeated memories and intrusive thoughts focusing on what happened."

Long-term reactions to combat stress could lead to post traumatic stress disorder, she noted. "By definition, PTSD is supposed to happen a month or more after the event," Ritchie said. "There can be some similarities in the symptoms of combat stress and PTSD - nightmares, insomnia, anxiety, numbness, hypervigilance and intrusive thoughts."

Some service members may only have some symptoms of PTSD and by difficulty functioning. Some people maybe troubled by an occasional nightmare, which isn't classified as PTSD.

"But other folks might feel that they're so scared that they can't get to work," she said. "That is a problem and we want them to seek treatment."

However, she said some of these reactions are common; therefore, she doesn't advocate necessarily seeking treatment immediately. "However, if the symptoms keep going on, such as nightmares night after night, they should seek help," Ritchie said.

Some healthcare providers and family members make the common mistake of encouraging people to talk about everything that happened before the patient is ready to talk, Ritchie noted. "I wouldn't push the returning soldier or Marine to talk about what happened right away," she said. "But I would be there for him or her when he or she is ready to talk."

There's also concern about service member's reactions to changed family situations. Those returning from the battlefield often envision everything at home is going to be perfect, like a flawless honeymoon. But often things are a little bit different, Ritchie said.

She said, "The kids may have grown. They may not respect authority in the same way. The spouse may have more independence. He or she may have needed to make some decisions that the soldier or Marine weren't part of. So often there is some friction when the soldier or Marine gets home.

"Families should expect a little bit of friction so it doesn't spook them," she emphasized. "So they don't think, 'Oh, no! My marriage is coming apart!' It's part of the reintegration process."

Modern day transportation plays a major role in creating the problem, she noted. "In World War I and World War II and Korea, people came home by ship that took two or three weeks," Ritchie said. "They had a chance to get rested and talk to their unit about what had happened and prepare to reintegrate with the family.

"Nowadays, people have been on the battlefield one day and maybe at home or the shopping mall in a day or two. That reintegration is just a little bit too fast. In some cases, it could be jarring."

[harry hackedoff]

Rob, I thought that was typical of PTSD articles produced in the States, i.e. simplistic. It looks like a newspaper interview. I allso strongly do not agree with the opening statement. Mental health experts do know exactly what to expect.
I`m surprised, too, that Leatherneck doesn`t have a similar forum, as American Vets ( particularly from Vietnam) are much more clued-up about the subject, having fought long and hard for recognition in the U.S.
Aye, Harry

[Twenty One]

El Prez,I read this topic carefully a couple of times,and I got the distinct feeling that it was written with the media in mind! Combat stress comes in all forms of shapes and sizes,and affects individuals differently.What might be stressful too one serviceman/woman might be a normal reaction for another individual.To say that some could be disturbed or demoralised by stressors from the consequences of combat,I think that everyone would be affected in some way to combat,whether it is seeing a dead body
mutilated by the ordnance used and having to pick-up that persons remains and burying it or seeing families wiped out by either bombs or as a result of enemy action on the populace.

The individual serviceman/woman most probably can deal with it at the time,but it most probably kick in when they are out of theatre and away from the battlefield where they will have time to think.The psychological reactions would be building up over a period of time and as far as I have noticed from seeing PTSD in a few of our lads in Ireland other factors seem to kick in causing the stress,eg personal problems with families,kids,drinking, to name but a few.

The Armed Services are a close knit community and should be able to recognise the signs of stress very quickly.In the Army soldiers talk about their experiences all the time,but some don't like talking about it because they see it as a ghastly thing that should not be talked about.

My way of dealing with stress especially from my time in Borneo,Aden and NI was to talk about it among your mates who can deal with it jokingly or seriously,but the end product is that you/ they get it out of their system and move on to other things.

Getting someone to listen to our problems is a hard process especially in the Services, that is why they need a mechanism that can kick in at an early sign of PTSD and get treatment for the individual to assist him back into his normal routine.

Perhaps the training carried out by the services should be more realistic in order that recruits and trained soldiers fully understand what happens in combat situations and that people do get killed and wounded.In the last Gulf War the road to Basra was full of dead bodies,but the media did not show much on our screens,this is where the services come in and by filming the nasty side of war of the bodies burned, mutilated,etc could be shown to all in the services and prepare them for what will come when combat rears it's head.

[El Prez]

Yes I agree, it's simplistic and for media types. What I should have said is that Roger who is OC Leatherneck, is considering a proper forum for PTSD. They need it if that is the standard of understanding.

[harry hackedoff]

I don`t think that is the standard of understanding amongst US Vets. As I said, US servicemen are far more clued up about PTSD and are far more open to talking about the subject than this article implys."In combat one day, in a mall the next" etc. Again, this implies that the time scale between cause and effect is much shorter than actuality, twenty odd years shorter in some cases. The class action that we are seeing now in the UK would be old hat to some of the Vets organisations, Stateside, who went through this in the late Seventies and Eighties to have this disorder recognised.
Rojer should take a look at our Forum. I`m not saying he couldn`t do better than this, but he could certainly do a lot worse.
Aye, Harry