Throughout the month of May, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE), is answering your questions about mental health and mental health in the military on its “living blog.” Below is a recent post that was published by Jayne Davis on May 1, 2014, but you can see the full living blog here.
Raise your hand if you’re searching for answers to questions about you or your loved one’s mental health. This month, mental health experts from Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) answer questions asked by service members, veterans, families and health care providers on DCoE social media. We’re devoting this time to encourage you to speak up about mental health concerns affecting you or your military family.
Are you feeling depressed or anxious?
Are you having trouble understanding behaviors of a loved one with posttraumatic stress disorder?
Caregiving puts tremendous stress on the caregiver; do you wonder how you can cope?
Do you have a comment to share that could inform or encourage others who may be reluctant to speak up?
We’re calling this month-long event a “Living Blog” because we’ll add questions and answers to it throughout the month. DCoE subject matter experts will work to provide answers within 24 hours of receiving your questions. We invite you to ask questions on any of these three platforms:
– Post a question to our wall
– Comment with your question on a related post
- Twitter and include:
– Our handle: @DCoEPage
– Hashtag: #AskDCoE
- DCoE Blog
– Scroll down to the comment section below and ask your question
If you submit your question through Facebook or Twitter, we’ll notify you when the question and answer is posted here. We’ll post questions and answers all month, so please check back frequently.
Reaching out for help requires strength and fortitude. The stigma of seeking help for mental health concerns keeps many from getting answers, let alone asking questions. Don’t let this be you. Break down those barriers. Start here:
Q: Does the DoD formally recognize moral injuries? – Puakiele
A: Yes. While moral injury is not clinically defined, nor captured as a formal diagnosis, it is recognized as real. The Defense Department provides a wide range of medical and non-medical resources for service members seeking assistance in addressing moral injuries. From a medical perspective, there are no clinical practice guidelines specifically for moral injury. However, DoD mental health providers often address moral injury in combination with treating psychiatric disorders. For example, during treatment for PTSD, depression or other mental health conditions, patients may disclose information that suggests they have experienced a moral injury (e.g., guilt from accidentally killing a civilian during a combat operation or some other dilemma) and clinicians will help patients explore their feelings of guilt, anguish or other troubling thoughts/feelings they have about the incident.
The military system also provides an extensive network of chaplain care. Chaplains understand how spirituality in the military intersects with war and trauma, and chaplains have various degrees of training in addressing moral dilemmas and the integration of experience and meaning.
Finally, DoD provides resources for service members to help address many mental health concerns, including moral injuries. The 24/7 DCoE Outreach Center provides psychological health and TBI information, resources and referrals for service members, veterans and their families by calling toll-free at 866-966-1020, or emailing firstname.lastname@example.org.
Military OneSource (http://www.militaryonesource.mil/) and the Military and Family Life Counseling programs provide service members and their families the opportunity to receive face-to-face non-medical counseling in a local community, by telephone or online using web-based secure chat at no cost. – Navy Capt. Anthony Arita, Deployment Health Clinical Center director
Q: How do we define mental health? – Richie
A: According to the Military Health System, “Mental health, or psychological health, encompasses the well-being of mind, body and spirit and contributes to overall health and resilience.” Read about tips for maintaining good mental health athttp://health.mil/Military-Health-Topics/Operation-Live-Well/Focus-Areas/Mental-Wellness/Mental-Health.
Q: If a person suffers a traumatic experience or injury and has all the markers of PTSD as well as other mental health issues like panic attacks, agoraphobia, and depression; How should they be diagnosed and treated? It seems most military mental health providers shy away from diagnosing non-combat PTSD. Why is that? – John
A: The symptoms you mentioned of panic attack, agoraphobia, and depressed mood can all be explained by PTSD, or possibly could be in addition to PTSD. It depends if the symptoms are associated with the traumatic event, if they were present before the trauma, or if they are caused by an unrelated event. If the symptoms are caused by PTSD, then standard treatment for this disorder is often the best way to go. If the symptoms are in addition to PTSD, VA/DoD guidelines recommend a clinician treats PTSD and other co-occurring mental health conditions concurrently through an integrated treatment approach. However, there may be exceptions based on the severity of the other disorder(s) and the patient’s preferences. Military mental health providers do not distinguish between non-combat and combat related trauma when they diagnose and treat PTSD. What is most important is the person meets the criteria for this diagnosis regardless of the trauma setting. As such, PTSD can occur after someone experiences traumatic events other than combat to include a terrorist attack, sexual or physical assault or abuse, a serious accident, or a natural disaster. – Cmdr. Angela Williams-Steele, USPHS psychologist
Q: Is post-concussion syndrome considered a mental health problem or is it based on the symptoms resulting from the TBI? – John
A: Post-concussion syndrome is, by definition, symptoms and signs that persist as the result of a concussion, or blow to the head. The most common symptoms are headache, dizziness, tinnitus (ringing of the ears), sleep disturbances, and memory problems. Post-concussion syndrome is not a mental health problem. While it does have some symptoms in common with posttraumatic stress disorder, such as sleep disturbances, the reasons for the sleep problems are very different. – Dr. Donald Marion, senior clinical consultant
Q: My spouse is showing a lot of signs of PTSD but refuses to get help, what should I do? – Brad
A: In many instances, a spouse is in the best position to notice changes in a service member. If your spouse is experiencing symptoms such as nightmares, irritability, a tendency to avoid situations that remind her of deployment, a fear of crowds, or an increase in the amount of alcohol she consumes, posttraumatic stress disorder or other trauma and stressor related disorders might be an explanation. It’s important to discuss your observations and concerns with your spouse when you both are calm and have minimal distractions. I recommend you give specific examples of how her behavior and/or mood have changed and the impact these changes have on you and the family. Additionally, it’s important to convey to your spouse that her symptoms are common and treatable. You may want to introduce her to the Real Warriors Campaign and suggest she access resources available at http://realwarriors.net and view profiles of service members like herself who struggled with psychological health symptoms and sought help. Lastly, it’s extremely important that you continue to take care of yourself and your family as you further support your spouse. – Dr. James Bender, psychologist
Q: Are most mental health issues that result from deployments treatable? – Ethan
A: The good news is that, yes, in most cases the behavioral health symptoms service members experience after deployments are treatable. And the best news is that treatment works. It’s normal to have a period of adjustment after returning home, but if symptoms linger and begin to notably impact daily functioning, it’s time to seek help. It’s important to understand some conditions won’t go away with time and require appropriate treatment. Evidence-based psychotherapy, medication, or a combination of both is used to effectively treat deployment related behavioral health issues. You can find more information about PTSD treatment options at dcoe.mil/PsychologicalHealth/PTSD_Treatment_Options.aspx. – Maj. Demietrice Pittman, Army psychologist