What is Post Traumatic Stress Disorder (PTSD)?
PTSD is a stress disorder caused by exposure to psychological trauma, such as combat, sexual assault, or other life-threatening events. Veterans with PTSD experience symptoms such as:
painful dreams and memories intense anxiety and depression disturbed sleep suicidal and hostile impulses difficulty getting close to others numbing of emotions social isolation trouble working or finding meaningful activities The passage of time alone usually does not heal the wounds of trauma. The natural desire to withdraw from others and not talk about problems related to traumatic experiences may actually make matters worse for veterans suffering from PTSD. Symptoms of PTSD improve with treatment that usually includes counseling, medications, and assistance with finances, housing, and employment.
Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Charles W. Hoge, M.D., Carl A. Castro, Ph.D., Stephen C. Messer, Ph.D., Dennis McGurk, Ph.D., Dave I. Cotting, Ph.D., and Robert L. Koffman, M.D., M.P.H.
Abstract: Background The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans.
Methods We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments.
Results Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.
Conclusions This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.
Source: New England Journal of Medicine Volume 351:13-22 July 1, 2004 Number 1
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