Veteran and Military Mental Health Issues
Catarina Inoue 1, Evan Shawler 2, Christopher H. Jordan 3, Christopher A. Jackson 4
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
2022 May 23.
Excerpt
As the United States faces two decades of continuous war, media and individuals with personal military connections have elevated public and professional concerns for the mental health of veterans and service members. The most publicized mental health challenges facing veterans service members are PTSD and depression. Some research has suggested that approximately 14% to 16% of U.S. service members deployed to Afghanistan and Iraq have PTSD or depression. Although these mental health concerns are highlighted, other issues like suicide, traumatic brain injury (TBI), substance abuse, and interpersonal violence can be equally harmful in this population. The effects of these issues can be wide-reaching and substantially impacts service members and their families. While combat and deployments are linked to increased risks for these mental health conditions, general military service can also lead to difficulties. There is no specified timeline for the presentation of these mental health concerns. Still, there are particularly stressful times for individuals and families, such as in close proximity to combat or when separating from active military service.
Current U.S. Census reports estimate roughly 18 million veterans and 2.1 million active-duty and reserve service members (
https://www.census.gov/newsroom/press-releases/2020/veterans-report.html). Since September 11, 2001, there have been 2.8 million active-duty American military personnel deployed to Iraq, Afghanistan, and beyond, leading to increasing numbers of combat veterans amongst the population. More than 6% of the U.S. population have served or are serving in the military. However, this statistic fails to capture the even greater number of family members affected by military service. Understanding military service and its relation to a patient’s physical and mental health can help providers improve their quality of care and potentially help save a patient’s life.
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) was first codified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 3 in 1980, driven in part by sociopolitical aftereffects of the Vietnam War. It has been alluded to in different forms throughout history, from “soldier’s heart” at the time of the Civil War, “shell shock” in the First World War, or “combat fatigue” around the Vietnam War. DSM criteria remained largely unchanged until the most recent update in 2013, although its classification continues to be debated. It is a complex and evolving biological, psychological, and social entity, making it challenging to study and diagnose. PTSD is often researched in war and disaster survivors but can affect anybody, including children. It is usually seen in survivors of violent events such as assault, disasters, terror attacks, and war, although it is also possible to experience PTSD from secondhand exposure, such as learning that a close friend or family member experienced a violent threat or accident. Many individuals exposed to trauma have transient numbness or heightened emotions, nightmares, anxiety, and hypervigilance but usually overcome symptoms within one month. In roughly 10 to 20% of cases, symptoms become persistent and debilitating. PTSD features intrusive thoughts, flashbacks, and nightmares regarding the past trauma, causing avoidance of reminders, hypervigilance, and sleep difficulties. Often, reliving the event can feel as threatening as inciting trauma. Symptoms can interfere with interpersonal and occupational function and manifest in psychological, emotional, physical, behavioral, and cognitive manners. Military personnel can be exposed to an array of potentially traumatizing experiences. Wartime deployments can result in witnessing severe injuries or violent death, sometimes occurring suddenly and not always on expected targets. Apart from the austere environment of deployment, active duty military members are at risk of experiencing non-military-related traumas such as interpersonal violence, physical or sexual abuse. Symptoms related to these traumas can sometimes be exacerbated in the deployed environment.
https://pubmed.ncbi.nlm.nih.gov/34283458/
