Psychological trauma and long-term mental health effects in combat veterans

¶ … Psychological aspects of combat

Extreme high-stress incidents can trigger a number of possible experiences and responses including intrusive thoughts slow-motion time, sharper focus, dissociation, visual clarity and temporary paralysis. The occurrence of 'dissociation,' which is a disconnection from emotional and physical reality, might be a sign of danger for the start of post traumatic disorder or PTSD. One of the common and seldom discussed matters is the loss of bowel and bladder control that occurs during intense moments and it's also used as an exemplification by Grossman of the reluctance that people feel in talking about their natural reaction towards the fight against their condition (Grossman and Christensen, 2007).

According to some studies, there were far number of psychiatric calamities as compared to the physical casualties during the Second World War. 98 per cent of the individuals participating in the war would emotionally breakdown after no more than 60 continuous days and suffer long-term-effects as well. It was found out from the evidence of Russian and German Stalingrad's battle that the war participants died almost 30 years young as compared to the males of same age who were not the participants in the war (Grossman and Christensen, 2007).

At the beginning of 1919, a mental condition called 'shell shock' was tracked down by the doctors among the participants of the First World War. The individuals participating in the war had symptoms of anxiety and fatigue, however no effective treatment could be offered by science; and even though a lot of things still have to be learned, there has been a vast improvement in the understanding of the invisible wounds of the war. Currently with the help of modern treatment and screening, we have a lot of different opportunities to react effectively and instantly to the mental health problem of the war participants (Williamson and Mulhall, 2009).

A vast variety of psychological problems might be experienced by the troops that are returning from the war. Those problems might include irritability, feeling of isolation, anxiety, intrusive memories and sleeplessness. Every individual show different symptoms from each other and their severity also changes with time. The symptoms are either diagnosed as major depression or as PTSD, depending upon their severity. Other than the psychological problems, the individuals also suffer from TBI or Traumatic Brain Injury which consists of cognitive and mood changing problems, if he has gone through concussions during the combat. A lot of war participants are suffering from both TBI and psychological crisis which brings forward the impacts of a combination of both injuries (Williamson and Mulhall, 2009).

An act of killing is not an easy thing that someone wants another person to perform a majority of individuals do not take pleasure in performing the killing act; however bringing the feeling of joy from killing is not something impossible to achieve. Different stages are presented by Grossman, which show the reaction of a person after he has killed another during war. 'Survivor euphoria' is the first stage which is felt after one realizes that the opponent is alive. Next comes a feeling of remorse which can result in vomiting because the joy a person feels for being still alive is not easy to disconnect from death of the opponent. This feeling also leads to inquiries about mental health and morality because the person starts questioning his action and what he felt after it. In this case he asks himself about the action of killing someone and feeling good about it. The last stage is 'rationalization' in which the personal belief, that killing is not right, does not match the action, which is killing a person. The failure of this process according to Grossman can result in PTSD because the killers might show various responses depending upon their emotional level and the current circumstance (Grossman and Christensen, 2007).

Animals have the resistance to attack their own specie and Grossman believes that humans kill their own specie with a high frequency as compared to other different creatures. The humans have used complete centuries to develop and improve different means to train humans and come up with better killing skills. Several weapons were made based on the weaknesses of humans to develop mobility, force, protection and distance of the attacker (Grossman and Christensen, 2007).

Killing is enabled by physical mobility and distance, but it also decreases the target's mental impact; so it is difficult to get the consent of the opponent through distanced assaults, for example in artillery or air strikes. Grossman, however, notes that the psychological effectiveness is influenced by the weapon's accuracy; like the weapons used with a crew including canons and machine guns, are enabled as they broadcast the responsibility of the killing to the whole group instead of on an individual (Grossman and Christensen, 2007).

Another element of combat is posturing in which the weapons, war cries and ornamentation serve to compel the opponent to think that conflict is unwise. Guns as compared to the archery weapon are considered to be more effective because of their sound. The main aim of posturing is to weaken the other side in an emotional way and ending the battle before it even starts. However, it can be seen in the past that the killing begins when the opponents are fleeing from their positions. This according to Grossman occurs because first, a human has a deep desire similar to dogs, to attack when the opponent is fleeing; and second, the covered faces and eyes of the victims lessens their humanity (Grossman and Christensen, 2007).

War in Iraq and Afghanistan: Psychological-health effects

Since the War of Vietnam, the most sustained wars are in Iraq and Afghanistan which are most likely to bring forward a different generation of war fighters consisting of never-ending mental problems related to the war. Stress is one of the most common challenges faced by the veterans in Iraq and Afghanistan which has also been studied in the individuals of previous combats. The stress might include the fear of taking part in the killings and fear for their own life.

The psychological effects of the combats in Iraq and Afghanistan have yet only been studied comprehensively once and it evaluates the reports of the soldiers consisting of their experiences in war (Hoge et al., 2004). The study also includes the mental distress symptoms reports. The study estimated the risk for PTSD to be 18 per cent and 11% in Iraq and Afghanistan war respectively.

A lot of different studies show that a more intense and frequent involvement in the war raises long-lasting psychological problems and PTSD. Evidences of the Iraq war shows that the involvement of the soldiers is very intense and there is a high risk of them being wounded or killed, to have seen others' suffering and to have taken part in wounding or killing the opponent during the war. The growth of PTSD is associated with these activities. Hoge et al.'s (2004) studies indicated that 51 per cent of the participants in war reported uncovering or handling remains of humans, 68% had reported highly injured or dead Americans, 86 per cent of the soldiers had reported someone killed or injured that they knew personally, and 94% had reported being shot at with small fire. Furthermore, 28 per cent of the soldiers reported as being a participant and responsible for killing a non-combatant, 48 per cent reported their responsibility of killing an opponent in war and 77 per cent reported directing or shooting fire at the opponent. Another reason for stress that has stemmed out is from the reality that these conflicts have put forward more terrorist actions and guerilla clashes from unknown and ambiguous non-military threats. This means that the soldiers have to stay vigilant and cautiously respond to threats as no place is safe. This also puts forwards more concern because the soldiers might think the non-combatants to be their enemy as well as they have to stay alert of not causing any secondary damage to the civilians.

Stress does not only happen due to participation in the war activities. Some evidence shows that stress is also associated with the growth of performing sexual harassment and sexual assault as both the female and male combatants are at risk of becoming a victim of this action. Furthermore, the different factors of environment might also play their part in the psychological crises in the war participants like deficient adaption, harsh weather, and poor diet will create the responses of the soldier to the deployment in war zone. For the reserve troops and the national guards, problems like interruption in career goals, and staying away from the family for a long time might also contribute in stress. Opposite to that, a lot of soldiers might find gratification and meaning in the roles of the helpers in Afghanistan and Iraq, that can safeguard the effect of some stressors of war zone.

Long-Term Effects

Comprehensive research has indicated that long-term prediction cannot be done by initial symptoms and distress of Post-Traumatic Stress Disorder. According to a report of Hoge et al., around 18 per cent of the soldiers who were re-deployed have a high rate of PTSD which is likely to decrease with time. On one hand, the studies show that the a lot of male and female do extremely well towards serious demands of military service; but if the stress and demands of deployment are increased, if the new combats are not given the right support and services and their expectations are not being fulfilled, if the troops are deployed more than they were expected to, and if the war mission does not succeed, then the psychological injuries of the Iraq and Afghanistan wars might rise up more with time.

The long-term course of PTSD which is military related is the most challenging aspect for the veterans who do not recover from the injuries of the war. Evidence suggests that the soldiers who have developed combat-related Post Traumatic Stress Disorder are likely to suffer from lifelong symptoms and the treatment will not have a lasting effect on them as compared to other different forms of life long PTSD. So, it is very essential to provide the veterans with early treatments in order to decrease the chance of long-term impairment in the combat soldiers. Problems can also come from the participants of military combat who have voluntarily taken part in the battle. They might hesitate from seeking help of the professionals or help might also not be quickly provided to them. Hoge et al. (2004) reported that 80 per cent of the Afghanistan and Iraq veterans who suffered from high psychological disorder accepted that they suffered from a problem; among them, 40 per cent of the soldiers said they were eager to receive any kind of help and 26 per cent of the soldiers stated to have received any professional psychological health treatment. It can be seen that the current soldiers are concerned more about the embarrassment that is associated with psychological health issues and how it would negatively affect their goals and careers in the future.

A lot of things still have yet to be known that exist among the war zones and how the demands of the veterans can be met in those cases. It is highly important to acknowledge the traumas and stress that these war veterans go through which would help to increase the awareness among the civilians. This would also help the civilians to arrange for the help that these soldiers would need once they return back home.