Sunday, November 14, 2010

Mental and Physical Disability: PTSD and Physical Impairments


Soldiers are trained to be tough and hard-skinned, but not trained much about the emotions and mental stress they are going to experience during training, combat, and returning home.  I have heard more and more about the increases in Post-Traumatic Stress Disorder (PTSD) among soldiers and veterans that have served or are serving in Iraq, Afghanistan, etc.  In my opinion, it is because there is a negative stigma attached to people with disabilities, both physical and mental, as well inadequate mental training, with a focus only on the physical.  People are embarrassed  to be diagnosed with physical or mental disabilities because it is seen as a sign of weakness, minority status, and dependence, when in reality physical and mental disabilities are very common.  As stated in  The Canadian Press (2008), PTSD has tripled since 2002 and is still expected to increase .  However, I am not sure if this increase is because it is now more acceptable to be diagnosed with PTSD, or if more cases of PTSD are now occurring.  Either way, soldiers and veterans still feel they are supposed to stay strong and not talk about their emotions even if they are having a very hard time.


PTSD needs to be taken more seriously among soldiers and veterans and we should not be waiting for them to realize they have PTSD by themselves; there needs to be training before combat, and screening and follow up afterwards no matter what.  Soldiers and veterans may not want to admit they are experiencing flashbacks, guilt, and other negative mental health issues, as well as physical impairments.  One study found that almost 87% of veterans who currently have PTSD also suffer from severe physical pain that was often more severe than neuropathic pain and cancer pain (Poundja, Fikretoglu, Guay, & Brunet, 2007). Not only will they think their mind is weak, they will have the feeling that they cannot cope with physical pain, which is what the military has taught them.  Admitting they have a "weak" mind and body is not something anyone wants to do, especially a soldier or veteran.

On the other side of the spectrum, not only does PTSD cause physical impairment, but 23% of soldiers with traumatic physical injuries in combat develop PTSD (Zatzick, Rivara, Nathens, Jurkovich, Wang, Fan, Russo, Salkever, & Mackenzie, 2007) because the injury serves as a constant reminder of the trauma they have experienced.

In the news segment at the beginning of this post, they offer support and encouragement for soldiers with PTSD to come forward and ask for help (2009).  It is an encouraging start for eliminating PTSD and all the negative issues that accompany the illness, but is it enough?  I feel the only way to possibly change the view of PTSD as a weakness is to start training soldiers about PTSD as soon as they start their physical training.  This way, they know how common it is, they know how damaging it is, and they know lots of other soldiers will go through it as well and will be there for support.  Many soldiers take their lives because of the stressful mental and physical pain they were not trained to deal with, or they never wanted to admit they had a mental and physical problem.  As stated in the CTV news segment, this is hopefully going to change and soldiers will have both the knowledge and resources available before and after combat (2009).


References:

CTV.ca News Staff. (2009, June 28). Military reaches out to soldiers with PTSD [Television
Broadcast]. Retrieved November 14, 2010, from

Poundja, J., Fikretoglu, D., Guay, S., & Brunet, A. (2007). Validation of the French version
of the brief pain inventory in Canadian veterans suffering from traumatic stress. Journal of Pain and Symptom Management 33(6), 720-726.

The Canadian Press. (2008, February 29). Reported PTSD cases triple among soldiers since '02. Retrieved November 14, 2010, from http://www.ctv.ca/CTVNews/Health/20080229/ptsd_soldiers_080229/

Wikipedia. (2010). Neuropathic Pain. Retrieved November 14, 2010, from http://en.wikipedia.org/wiki/Neuropathic_pain

Wikipedia. (2010). Posttraumatic stress disorder. Retrieved November 14, from

Zatzick, D. F., Rivara, F. P., Nathens, A. B., Jurkovich, G. J., Wang, J., Fan, M., Russo, J., Salkever, D. S., & Mackenzie, E. J. (2007). A nationwide US study of post-traumatic stress after
hospitalization for physical injury. Psychological Medicine 37, 1469-1480.

-Avery F

8 comments:

  1. Interesting topic! I think there is a projected image of the typical tough, invincible, "army guy" when reality is war is traumatizing to everyone involved. I agree that attitudes need to change, and it needs to be acceptable enough for army personnel to know both the physical and mental risks of combat.

    -Erin Roche

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  2. Very interesting post. I really enjoyed it. I do agree that men and women who wish to join the army need to be made aware of the possible consequences after combat, such as PTSD. So many soldiers do survive the field of combat but when they come back they struggle more than ever. Nobody at home can understand what they are going through so it is important for them to be aware and make use of the resources available. A friend of mine is considering joining the Canadian forces in hopes of going to Afghanistan to help the injured. So this post was a good reminder for me. Thanks

    Dana W

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  3. Avery, I agree with you in that I think we have to make an effort to compile as much information on PTSD as possible and provide that information to soldiers. As well I think we need to provide awareness of available resources in regards to the effects of PTSD.
    Also, I like how you touched on the fact that some war veterans do take their own lives as a result of the haunting memories of war. The fact that some soldiers find life so unbearable that they kill themselves speaks of the war these people probably experience within themselves long after war is over.
    I have heard talk of Canadian forces pulling out of Afghanistan come 2011, if this is true emotional and psychological training may not be needed. But who's to say this was not just here-say. Even so, I think the knowledge about PTSD will benefit those currently in the armed forces the most. Awareness of PTSD has the capability to lessen the sting of war. On the other hand, I feel that soldiers who have been living with the horrific feelings of war for decades may not be as resilient or hopeful as the present generation of soldiers. I think society has to respect the contribution veterans made during the war but also the life they sacrificed afterwards.

    -Brooke Davison

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  4. Thank you! Yes I think it is very important for all soldiers entering any training or combat to be taught all about the risks of PTSD. PTSD is so harmful that some soldiers that have never even been in any real combat, just training, can develop PTSD because training is so realistic; sometimes soldiers even get killed while training.
    This is important because Stephen Harper just announced today that Canadian troops will be staying in Afghanistan for extended training. Even though it is not war or combat, there is still risk for PTSD to develop and there should be adequate training to try to prevent as much as possible against the development of PTSD
    among Canadian soldiers.
    This is definitely a social work/ethics issue because these people have the right to know all the risks involved with the career they are entering into.

    -Avery F

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  5. Avery, it's good that you talked about this topic, I recall seeing something on the news in the last few years about soldiers who have returned from war and were experiencing difficulties. It reminds of the movie Forest Gump where he has a friend who returns from war maimed and suffering from PTSD and how he was finding it difficult to cope and I think he eventually took his own life. And I agree that there should be training about PTSD and take a preventative measure, preparing the soldiers through education/training which may give them a better capacity to cope and perhaps lessen the affects of PTSD.

    -Priscilla

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  6. I agree with the fact that people wanting to enter the army should be made aware of the after effects. I know this man who went and came back it seemed as a different man. He had issues that were beneath the skin and it was almost as though he didn't notice anything different about himself. PTSD can be a very scary thing and it really does effect these soldiers. There definitely should be a training session on PTSD and how you can prevent it and what you can do to help your self if you realize that you have it. It is very dangerous and it needs more attention brought to it. I really liked that you added a video to your post! -Brittany L

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  7. There’s is a stigma to those who complain after willingly enlisting, as they were told prior of the possible consequences of warfare. It was my understanding that military training is in essence to help prepare you for battle and wipe the civilian out of you. Training your mind to think logically or judiciously over emotionally. Post Traumatic Stress is seen as an emotional weakness, that I don’t think the military itself wants to acknowledge and support, because they connect it to a weak military.
    Holly L

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  8. Very interesting post. It is very unfortunate the amount of soldiers who develop PTSD but sadly I am not surprised. War is a very depression place to be, no matter what your position is. I agree that not only should soldiers be screened when they finish their terms, but also they should be prepared emotionally and mentally for what they are about to endure before they go off to war. It is also to be considered that not only are soldiers facing the depression of battle, but they are also away from their homes, family, and friends for long periods of time, which is depressing in itself. I think our soldiers are so strong and heroic for going off to fight in war, the least our military training programs can do is prepare them for it.

    -Marina R

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