The war within

US Civil War

During the Civil War common diagnosis was nostalgia.

The first military hospital for the insane was established in 1863.

The government made no effort to deal with the psychiatrically wounded after the war and the hospital was closed.

World War I

Soldiers emerged from the trenches stuttering, crying, trembling and at times were even paralyzed and blind.

Those in charge were convinced these soldiers were cowards or malingerers who deserved stern discipline or to be court-martialed.

World War II

Soldiers who were traumatized by witnessing extreme violence were pulled out of the front lines for treatment. This involved supportive counseling with the aim of getting them back to their fighting comrades within three days to a week.

Iraq and Afghanistan

Repeated and extended deployments to Iraq and Afghanistan are driving psychological injuries upward, say military and civilian doctors, despite a spectrum of new government programs aimed at preventing and treating them.

With the advent of the wars in Iraq and Afghanistan, the Army started programs to teach soldiers how to identify signs of PTSD, prepare mentally for combat, and remove the stigma of seeking help

Through trial and error, they've found that antidepressants help calm soldiers down enough to stay and finish their tours.

PTSD defined

a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents or violent personal attacks.

Symptoms

Flashbacks, nightmares, depression, anxiety, removing yourself from

activities you once enjoyed, becoming emotionally numb and difficulty

maintaining close relationships are just some of the symptoms of Post-

Traumatic Stress Disorder (PTSD).

Today, more than 150,000 veterans of the Iraq and Afghanistan wars have been officially diagnosed with PTSD. The number likely is higher because of the stigma attached to the disorder and also because some service members have sought out private treatment rather than through the Defense Department or Department of Veterans Affairs

How are our soldiers being treated for this disorder

today?

College of Psychology

Course listings from the top ten psychology colleges in the US only one has a specialized seminar that is specific to PTSD. None of the schools offer courses in dealing with military personnel beyond treating depression, anxiety and sleep disorders

Chaplain

•Ecclesiastical endorsement •Bachelor’s degree •Not less than 36 hours must be in theological/ministry and related studies, consistent with the respective religious tradition of the applicant •Pass a military commissioning physical •Pass a security background investigation •Ability to work in the Department of Defense directed religious accommodation environment.

Tricare – the military's insurance care company

The following quote is the statement of RADM Christine S. Hunter, USN, Deputy Director of Tricare Management Activity:

Our efforts to reduce the stigma associated with seeking mental healthcare have been accompanied by an increase in providers to meet the growing demand. Together with the Surgeons General and our TRICARE contractors, we’ve added over 1900 providers to the military hospitals and clinics, and more than 10,000 added to the networks. Visits have increased dramatically, with 112,000 behavioral health outpatients now seen every week. In addition, service members and their families can access the TRICARE Assistance Program for supportive counseling via Webcam from their homes, 24 hours a day.

Tricare declined comment when asked by what criteria they contract professional psychologist and psychiatrist.

In Theater

Medicating soldiers in war brings up a host of difficulties not faced by doctors back in the States. The brigade psychiatrist, Dr. Randal Scholman, said he finds himself making more informal or nontraditional diagnoses. Deployed soldiers are in a particularly stressful environment, and often it's hard to tell if a problem is temporary, he said.

The most common drugs he prescribes are sleeping pills, followed by antidepressants. Often, he gives a soldier Prozac or Paxil to treat what he and his colleagues call "combat operational stress reaction." The disorder — which is not formally recognized — includes symptoms like sleep problems, irritability and propensity to anger. Soldiers describe it as being "on edge, keyed up, jumpy, things like that," he said.

Through trial and error, they've found that antidepressants help calm soldiers down enough to stay and finish their tours.

The Golden HourThe Golden Hour

R Adams Cowley, M.D., explained in an R Adams Cowley, M.D., explained in an interview: "There is a golden hour between life interview: "There is a golden hour between life and death. If you are critically injured you have and death. If you are critically injured you have less than 60 minutes to survive. You might not less than 60 minutes to survive. You might not die right then; it may be three days or two weeks die right then; it may be three days or two weeks later -- but something has happened in your body later -- but something has happened in your body that is irreparable." that is irreparable."

But is there a “Golden But is there a “Golden Hour” for those that Hour” for those that are injured mentally?are injured mentally?

Civil service agents, depending on departmental protocols, are removed from service to meet with a psychologist/psychiatrist after being involved with a shooting.

Soldiers go through suicide and depression briefings before they are deployed and when they reach the country, in which they are deployed in, though most are never introduced to the mental health care provider or councilor. They are left to their own conscious to seek mental health care support. There is no mandatory protocol that states that a soldier must meet with a mental health care provider or group therapy session after any mission.

Speaking to commanding officers Speaking to commanding officers and non-commissioned officers, and non-commissioned officers, if they are told that a soldier is if they are told that a soldier is feeling or showing suicidal or feeling or showing suicidal or depression tendencies the depression tendencies the soldier is put on suicidal watch soldier is put on suicidal watch and then taken to medical and then taken to medical professionals. When deployed, if professionals. When deployed, if military personnel has issues military personnel has issues with a situation there are with a situation there are psychologists, psychiatrists and psychologists, psychiatrists and pastoral councilors to help. pastoral councilors to help. When speaking to the soldier, When speaking to the soldier, most say that there is no most say that there is no professional help, save medical professional help, save medical doctors or pastoral counselors, doctors or pastoral counselors, to talk to. Most soldiers do not to talk to. Most soldiers do not seek help due to the stigma of seek help due to the stigma of having a mental disorder. having a mental disorder.

Having closed off and numbed themselves in order to survive, soldiers are then faced with the task of working their way back toward humanity.

The struggle is to “re-experience himself as a vital human being.” However, it is not all that easy, for “one’s human web has been all too

readily shattered, and in rearranging one’s self-image and feelings, one is on guard against false

promises of protection, vitality, or even modest assistance. One fends off not only new threats of

annihilation but gestures of love or help.” - Robert J. Lifton

If schools are not training psychologists and psychiatrists to help those with post-traumatic stress disorder, along with treating the anxiety, depression and sleeplessness it causes, then why is the US Government contracting and referring these professionals to US military personnel?