PTSD? NOT QUITE:SUBTHRESHOLD SYMPTOMS IN SOLDIERS
A significant factor that sets humans apart from animals, is the notion of a civilised society. A society wherein the fundamental rights of an individual have been put across in a legally binding document. The most basic of which is the right to life, not just as an individual who lives and breathes, walks and talks, but as someone who doesn’t live in constant fear of death. The peace we exist in sources from our belief that these rights will be protected and safeguarded by the systems of which we are a part. These systems are made of complex webs and within this tapestry, which is frequently marred with red-tapism and corruption, lies the embodiment of our freedom- the soldiers of the nation, with their unwavering spirit and determination and their bravery to give their lives for the safety of the nation. However, this only depicts a more attractive and alluring side of their post. Being a soldier almost necessarily means having to face the possibility of death everyday, having to constantly miss major milestones in family life due to deployment. It also means living in constant fear of letting down one's comrades, of making one small error in judgement and subsequently costing the freedom of a nation. Making a mistake does not simply amount to a personal failure; it extends to the failure of dangering the community they hold more important than life itself. This deep-seated fear of failure paired with the responsibility of upholding the values of the country adds to their pre-existing dread.
Situations like war create an intense state of uncertainty, one which causes civilians to feel constant anxiety. The effects it has on frontline workers is something completely unfathomable. Waking up and reliving the nightmarish dread of letting down your comrades and country, and going through the day being grappled by constant fear and anxiety has long term implications on them. Their job demands them to be hyper vigilant at all times. A momentary mistake or slip can cost a life. The responsibility that the post carries with it, is itself enough to create a severely unstable and anxious state. The impact a war has on soldiers extends far beyond their physical wounds.
The military is often portrayed as the face of resilience. However, one look into their daily life brings to light countless problems they struggle with; problems, the magnitude of which that they are not equipped to manage. The atmosphere of their deployment creates an environment of persistent danger; the ever present risk of injury or of death along with the need for hyper-vigilance adds on to their mental toll. Apart from war, there are a multitude of internal battles they have to fight. Loneliness, isolation, separation from loved ones and the general unpredictability of life. These emotional, physical and psychological stressors manifest into trauma symptoms in the aftermath of the deployment. A post-war world brings new problems of adjustment, PTSD, mental scars, strained relationships and sometimes substance abuse. Due to such risk factors, mental well-being is evaluated in this post-deployment timeframe. This is primarily to promote early identification of any mental health problems. It is assessed in various ways such as screening positive for posttraumatic stress disorder (PTSD), post deployment health assessments (PDHA), clinical interviews, and other forms of behaviour assessments. These tests are mainly to find the presence of PTSD, major depressive disorder and substance abuse. It helps identify early warning signs. Once identified, the individual is referred to a treatment suitable to the diagnosis.
Post traumatic stress disorder develops after witnessing or experiencing a traumatic event or a series of events like natural disasters, murder, sexual assault, accidents, terror attacks and such. People with PTSD can have recurring flashbacks and disturbing images. They may experience anger and sadness and may detach themselves from people and situations. It often leads to extreme emotional distress and individuals suffering from PTSD can have a violent physical reaction to anything that reminds them of the traumatic event. On the other hand individuals suffering from subthreshold PTSD experience some symptoms that cause a clinically significant impairment to their life. However, often,these symptoms do not meet the full diagnostic criteria of PTSD. They cause distress in important areas of functioning such as social and occupational. A study conducted on this found out that many individuals who are exposed to trauma fail to meet the full diagnostic criteria for PTSD but nevertheless they develop subthreshold symptoms that are often psychologically significant and that require therapeutic intervention.
Popular Research findings:
Clinicians often completely overlook these symptoms, only because they can not be diagnosed as PTSD. Since the initial stage of identification isn’t done accurately, neither is the following stage of treatment. Rather they are let go without any referral or help. It was found that out of all the individuals who face trauma, only 15 percent develop PTSD while others experience other symptoms of trauma that cannot be diagnosed. This leaves behind a large group of people not getting the treatment they need. Research shows that subthreshold symptoms of PTSD make an individual more prone to developing major depressive disorder. They also have higher rates of suicidal ideations along with increased aggression and agitation. These moderations make them more susceptible to various other mental disorders. Since subthreshold PTSD isn’t often recognised, it acts as an overlooked trigger for major disorders.
All that you see isn’t always all that is present. Unrecognised symptoms are left underestimated, without proper care and treatment. This creates an acute need for more meticulous assessment of mental health patterns. This is where we need to step back and re-evaluate the treatment of soldiers who return from deployment. They come facing various emotional, physical and mental scars, all for the sake of the people of their country. The strangers they hold so close to heart, taking the burden and responsibility of people they will never meet in life. Therefore, should it not be considered the moral duty of all civilians alike to ensure that the military get the same amount of protection that they provide? Should our concern be so fickle that it vanishes the moment we know we are out of danger? If their job is upholding and protecting our rights, shouldn't we too contribute to protecting theirs? Do human rights not apply to them in the same way that they apply to us? Soldiers might not serve the nation for their entire lives; nevertheless, the mark their spirit and service leaves on the soul of the country is enough to last decades after their sacrifice. This kind of impact deserves more than just momentary praise and recognition; the least that can be done is ensuring that they are not left to deal with their agony alone.
References:
https://pubmed.ncbi.nlm.nih.gov/35048836/
https://news.yale.edu/2016/06/01/not-quite-ptsd-still-quite-mental-health-problem
About the author:
Namrata Oak,
First Year, Member, PsyCreative Column
Namrata is a 17 year old student pursuing psychology in NMIMS. She will willingly give up her beauty sleep to read thriller novels. She adores dogs and stops after every 50 meters to pet one. She is all about travelling to places and trying to accommodate and understand their culture so if you ever have an extra ticket she should be the first person you call.
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