By Spc. Blanka Stratford
CAMP ARIFJAN, Kuwait -- From sounds of explosions blasting through the air to the heartbreaking loss of a dear comrade, the violent throes of war may at times have an overwhelming effect upon a service member's psyche.
As a consequence, the transition from front line to home front is often marked by periods of heightened stress, sensitivity and confusion -- just three of several symptoms associated with post-traumatic stress disorder, or PTSD. "PTSD is a medical condition attributable to exposure to a traumatic event," said Lt. Cmdr. Belina Alfonso, psychiatrist for Expeditionary Medical Force Portsmouth. "It arises when a person has experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury to oneself or others."A person's response to such a stressful situation would also involve intense feelings of fear, helplessness or horror, she said.
According to a recent New England Journal of Medicine study on PTSD, 19.5 percent of troops who served in Iraq had moderate or acute mental health problems. If less severe symptoms such as depression or anxiety are integrated, the number rises to 27.9 percent.The study groups included more than five thousand 82nd Airborne Division and 3rd Infantry Division Soldiers and more than eight hundred Marines from two battalions under the command of the 1st Marine Expeditionary Force. Marines and Soldiers in combat units like the 3rd Infantry Division were in the forefront of major combat operations in Iraq.
The service members" responses to the survey were obtained one week before deployment to the Middle East as well as one month after their return to the United States, allowing them time to complete leave, make the transition back to garrison work duties, and seek medical or mental health treatment, if needed.
"[These service members] were involved in life-threatening situations, making them more at risk to medical conditions like depression, anxiety and PTSD," said Alfonso. Alfonso, who is department head of Navy mental health at the Troop Medical Clinic in Camp Arifjan, Kuwait, said she deals with various levels of combat stress and other conditions on a day-to-day basis. In addition, hundreds of medical specialists and psychiatrists like Alfonso are scattered throughout the area of operations to maintain control over the number of psychiatric cases.
"The Navy uses Specialized Psychiatric Rapid Intervention Teams to make an intervention when a trauma occurs," said Alfonso. "These teams go through a series of steps to process the tragedy and help people understand that the reactions they are experiencing are normal reactions to an abnormal situation."The Army, on the other hand, dispenses teams from combat support hospitals to various hotspots throughout Iraq where they deem Soldiers to be more susceptible to psychiatric risk. Alfonso said there are currently about 250 mental health assets in Iraq that are well trained and prepared for various traumatic scenarios."
Obviously, prevention [of combat stress] would be to avoid the trauma altogether," she said. "But in [service members"] line of profession, that's not going to happen. The hope is that with early intervention, the incidents of PTSD will be minimized.
Theoretically, the earlier you intervene, the better the outcome.
"Like any disease, Alfonso said there is a spectrum in PTSD, from a short term to a long-term disorder. Symptoms may range between acute stress disorder and chronic PTSD."
The main difference between acute stress disorder and chronic PTSD is time limit," said Alfonso. "Acute stress disorder has a minimum of two days and a maximum of four weeks. In about a month, the patient is essentially symptom-free."Individuals suffering from acute stress disorder may exude a number of symptoms.
"These may range from feelings of detachment and decrease in awareness to feelings of derealization [loss of sense of reality], depersonalization, or dissociative amnesia [incapacity to remember significant part of trauma]," she said.Chronic PTSD, on the other hand, occurs if the duration of symptoms lasts three months or longer.
A deferred onset of symptoms may also transpire at least six months following the traumatic event."Chronic PTSD is marked by recurrent and disturbing thoughts and feelings about the event," said Alfonso. "This may include a sense of reliving the experience, as well as having illusions, hallucinations or flashbacks."Such constant feelings and thoughts may also lead to an individual's persistent need to avoid anything that reminds him or her of that traumatic event, whether it be a person, place or even type of activity."
Service members need to be reminded that there are services available for them in their time of need," said Spc. Kimberlee Campbell-Tripp, a mental health specialist with the 602nd Area Support Medical Company. "Although [mental health professionals] can't solve problems for people, they help them sort those problems out."Campbell-Tripp, who has been deployed to Kuwait since January, said the Arifjan TMC holds a number of options for servicemember's dealing with depression, anxiety, or combat stress.
Services range from moderate one-on-one counseling sessions, which may be walk-in or scheduled by appointment, to more intensive outpatient programs and inpatient hospitalization.
"Being away from home and being in a combat situation is highly stressful, so it really helps to have someone to talk to," she said.