In Barack Obama’s State of the Union speech last week, the president discussed his goal of withdrawing nearly all US troops from Afghanistan by the end of 2014, essentially ending American combat operations in the Middle East. With more than 35,000 US troops currently in Afghanistan, this means that if Obama’s plan is executed, tens of thousands of veterans could be returning to the United States this year.
This could mark an important time during which mental illness, especially PTSD and other anxiety disorders, finally comes into the spotlight. In any given year, 33% of veterans suffer from some type of anxiety, and there is bound to be a great deal of attention given to the topic of how to best serve returning soldiers’ mental health needs.
The Impact of Combat on Mental Health
Troops serving in a combat zone are subjected to countless extreme stressors every day, no matter what the war. But with improvised explosive devices, suicide bombers, and a hard-to-identify enemy, the realities of the recent wars in the Middle East are particularly horrific.
As the soldiers return home after long deployments, readjusting to everyday life can be difficult and compound the stress they already feel. In addition to anxiety disorders, veterans face relatively high rates of substance abuse, depression and suicide as well.
According to the US Department of Veterans Affairs (VA), certain factors increase the likelihood of PTSD in veterans returning from the Middle East. Some of these include:
- Female gender
- Hispanic ethnicity
- Being unmarried
- Long deployment time
- Less schooling
- Being a member of the National Guard or Reserves (who make up about half of those serving in Iraq and Afghanistan)
- Prior traumatic experience
- More severe injury or traumatic brain injury (in fact, early results from a four-year study of Marines show that brain trauma may be the No. 1 predictor of PTSD in returning veterans)
Obstacles to Treatment
Fortunately, PTSD is treatable – it’s just a matter of actually getting sufferers into treatment and ensuring they receive adequate care once they’re there. VA services, which are available to nearly all combat veterans, include PTSD specialists and specialized PTSD programs. However, there are sometimes obstacles that stand in the way of veterans receiving the care they need.
Stigma over anxiety disorders is still very real, and oftentimes the sufferer is afraid to admit the problem to others — especially if he or she suspects it will be perceived negatively by loved ones who don’t understand mental illness.
And even for those who do initially receive treatment, for that treatment to succeed, it can be a significant commitment. A 2010 study showed that fewer than 10 percent of PTSD-diagnosed Iraq and Afghanistan veterans completed the recommended 10-12 weekly treatment sessions.
The same study also identified groups who were less likely to receive adequate PTSD treatment:
- Those under age 25
- Veterans living in rural areas
- Veterans who received their diagnoses in primary care settings
Hope for Veterans with PTSD
While challenges still remain, the issue of trauma in our veterans (as well as trauma among the population as a whole) is finally starting to receive at least some of the attention it deserves. New studies related to PTSD make headway all the time, and I’m planning to keep covering these findings on this blog.
One such study, conducted by the Michael E. DeBakey VA Medical Center in Houston, found that a proper and specific diagnosis is an important factor in veterans receiving adequate care. When Terri L. Barrera, Ph.D., and her team examined records of veterans with anxiety, they saw that nearly 40% received an initial diagnoses of anxiety non-specified (NOS).
“Unfortunately, our results suggested that only 12 percent of the patients with an initial anxiety NOS diagnosis received a specific anxiety diagnosis within the year,” Barrera said.
What the researchers found is that of the veterans who were given a specific anxiety diagnoses, 60-67% received treatment, compared to only 32% of NOS patients.
“While anxiety is a problem for all who suffer from it, getting the correct treatment is especially important for veterans,” Barrera said.
My hope is that we’ll see great leaps forward in treatment options and availability as the medical and scientific communities continue their important PTSD research.