In order to fully understand the issues with PTSD and the military, one must consider the idea that military service can have a serious impact on soldiers, even when they do not see combat. In the past, the argument has been that PTSD was a combat-related illness, and that only soldiers who were actively engaged in combat in the recent past struggled with the issues related to PTSD. Now, many studies have shown that most soldiers live with the thought of never knowing when their turn to die is next, and that constant agitation and anxiety can cause these soldiers to experience PTSD (Delahanty, 2011; Ehlers, et al., 2010; Feldner, Monson, & Friedman, 2007; van Zuiden, et al., 2009). This is even more pronounced for soldiers who have been on multiple deployments and, by extension, have been in harm's way and under stress more often than other soldiers who have not been deployed at all (or at least not more than once). Not every multi-deployed soldier experiences PTSD, of course, and not all soldiers experience PTSD in the same way. Addressed here will be the military experience with PTSD, along with information related to how PTSD is categorized, the symptoms seen in most cases, and how multiple deployment affects the issue.
Trauma and PTSD
Studies have shown that being prepared for the possibility of a traumatic event can lower the risk that a person will develop PTSD (Cahill & Foa, 2004; Kaplan, Sadock, & Grebb, 1994). Still, that may not always be true, since many soldiers are prepared for the possibility that they could experience trauma - and yet they still experience PTSD in much larger numbers than are seen in the civilian population (Rothschild, 2000; van Zuiden, et al., 2009). It is important to note and consider the idea that a traumatic event may not occur in a first deployment or even in subsequent deployments. It appears to be the possibility of the traumatic event that is the actual cause of PTSD in these individuals - and that is the very thing that some studies have said lowers the PTSD risk. That may be the case with civilians, but it does not appear to be the case with those who are serving in the military. The reasons behind this discrepancy should be explored in future studies.
The lifestyle of people who are in the military - especially if they are frequently deployed to an area where they may see combat - is quite different from the lifestyle of civilians. The level of stress that a person in the military is under is significant, because that person remains under that stress for a prolonged period of time (Kaplan, Sadock, & Grebb, 1994; Kelleher, et al., 2008). Soldiers who are deployed to combat zones, even if they are not actively in combat, are constantly on guard and vigilant. Being required to keep that level of diligence can take a toll on a person, and can make it more difficult each time the person is deployed and asked to return to that hyperaware level (Fullerton & Ursano, 2004). Additionally, even soldiers who are in non-combat deployment situations to "friendly" countries are still required to be very aware of their surroundings and they still know that they could end up in a situation in which they would experience trauma (Cahill & Foa, 2004; Delahanty, 2011; Kaplan, Sadock, & Grebb, 1994; Kelleher, et al., 2008; Rothschild, 2000). No deployed soldier is completely safe, and that is something with which all soldiers (and their families) have to live on a daily basis. It is not surprising that these soldiers become overly sensitive to stress (Kaplan, Sadock, & Grebb, 1994; van Zuiden, et al., 2009).
How PTSD is Diagnosed
There are specific criteria for diagnosis that each person with PTSD (including soldiers) must meet. The first of these is exposure to an event that is traumatic (American, 1994). If there is no trauma, there is, by its very definition, no PTSD. However, what constitutes trauma? That is the real question that has to be answered, and the answer to it can be very subjective depending on who is being asked. The experiences of soldiers who have been studied, however, show that a traumatic event does not have to be combat related. Simply being a soldier can be traumatic, and when a soldier is sent far from home and he or she knows the possibility of dying is very real, that soldier can have a difficult time with the knowledge of that. Some do better than others, of course, but the problem has appeared often enough to be in the literature and be something that needs further study.
The person who is diagnosed with PTSD must have much more than a traumatic experience, however, because most people who experience something very traumatic will not go on to develop PTSD. Re-experiencing of the event must also be seen, and it must be persistent and interfere with at least one aspect of a person's normal life (American, 1994). Because of that, the person starts to avoid certain things that can trigger the feelings and flashbacks, and that person also becomes relatively numb from an emotional standpoint (American, 1994). The increased arousal and anxiety that come with PTSD have to be something that was not seen before the traumatic event took place (American, 1994; Cahill & Foa, 2004). Symptoms of PTSD must last for more than 30 consecutive days, and the impairment to the person's life and functioning must be significant (American, 1994). Only a trained professional can accurately diagnose a person with PTSD.
The Effect of Multiple Deployments
Research has shown that a soldier who has been deployed multiple times can easily develop PTSD even if combat was never an issue (Cahill & Foa, 2004; Delahanty, 2011). A person does not have to fight and/or have his or her life immediately in danger to be traumatized by deployments (Delahanty, 2011). Some of the background behind PTSD in some people is genetic, and this is important to understand because a genetic test may be able to be created that will help show which people are more at risk for PTSD from multiple deployments. While those people could still serve in the military if they chose to, they may be better suited for the kinds of jobs that were less likely to see deployment to other countries. This is something that could be accommodated, and that could have significance for the military both now and in the future. While there is no current test for this kind of genetic issue, science is always developing.
Noticing and diagnosing PTSD as early as possible are very important when treating soldiers who have been through traumatic experiences. If this is done correctly, there will be fewer soldiers with multiple deployments because any PTSD problems will be caught more quickly. A soldier who is already suffering from PTSD should never be deployed because he or she has already experienced trauma and had trouble processing it properly. Another deployment would only make that worse and could harm the soldier and others around him or her. This is something that should be carefully considered with any soldier, but much more so with any soldier diagnosed with PTSD.
While it is clearly not only multiple deployments that can cause PTSD, the soldier who is deployed more than once is at a higher risk of problems related to being deployed frequently. If the military considers that carefully and takes steps to prevent the damage that can be done when soldiers have issues like PTSD and are not treated, the military will operate better and more efficiently as a whole. Taking care of the men and women who are protecting and defending…