Healing Invisible Wounds: Psychological Rehabilitation for War Veterans

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When you think of wars, what do you picture? Grenades, destruction, injuries, and gore are some of the elements one imagines when it comes to war. However, war leaves more than merely physical scars. For most veterans, the true battle commences after returning home. They fight a concealed enemy—y- Post Traumatic Stress Disorder. The battle for them does not cease with the uniform coming off. PTSD affects the mental health of millions of veterans while they try to amalgamate into their routines. Ranging from sleepless nights, to war flashbacks, to extreme devastation, these veterans fight an unseen battle too. PTSD transforms once-acquainted warzones and conventional sounds into daunting reminders even in their day-to-day lives.


Through innovative psychological rehabilitation techniques, these veterans are provided with the means to rediscover their strength, reclaim their routines, build healthy relationships, and integrate into their lives seamlessly. This blog delves into the hardships, avenues of treatment, and recovery journeys of these veterans.


PTSD is a grave anxiety disorder that arises due to trauma—for instance, being exposed to life-threatening incidences, being surrounded by death and extreme conditions. The most occurring symptoms include hypervigilance, flashbacks of the warzone, feelings of emptiness, and nightmares. 


According to the U.S. Department of Veterans Affairs, approximately 11-20% of veterans from the Iraq and Afghanistan wars (Operations Iraqi Freedom and Enduring Freedom) are victims of PTSD annually. Furthermore, an average of 17 veterans die by suicide each day, most of who have experienced PTSD of some sort in their life, according to the U.S. Department of Veterans Affairs. These alarming statistics show the immediate need for preventive measures to be taken to avoid this drastic step taken by the veterans. 


Psychological rehabilitation concerning war encompasses various interventions that not only focus on instant relief, but also long-term recovery. This is a several-pronged approach and multiple therapies can help achieve these objectives.


The most prevalent and widely used is Cognitive Behavioural Therapy. In accordance with the Journal of Traumatic Stress - Monson, C. M., et al. (2012), veterans who underwent CBT had a success rate of around 60-70% and experienced substantial reductions in PTSD symptoms. It is extremely effective and it helps the veterans address their emotions and confront their traumas in a controlled environment. It helps in reducing negative thoughts and preventing symptoms that can lead to destructive thinking patterns.


Exposure therapy is another widely used method that helps veterans relive their traumatic experiences in a safe therapeutic space thereby reducing their anxiety related to those events. 65% of the individuals undergoing this therapy have shown significant reduction in their visible symptoms, as stated by a study conducted by JAMA Psychiatry.


In selective cases, certain medicated help is imperative, this is when pharmacological interventions are employed. Medicine like Selective Serotonin Reuptake Inhibitors (SSRIs), especially sertraline and paroxetine, are prescribed to these individuals. These medications are approved by the FDA and are effective with around 50-60% of the veterans.


Eye Movement Desensitization and Reprocessing (EMDR) is an extremely effective intervention. The research paper published by Shapiro, F. (2014), evaluates the effectiveness of exposure therapy for veterans with combat-related PTSD and suggests it had a 77-90% success rate in diminishing symptoms related to PTSD in veterans. 


A study conducted by Morland, L. A., et al. (2010) depicts the efficiency of group therapy is not as much as the other ones, however, it can be beneficial to certain veterans who find it easier to talk about their shared experiences and can experience a sense of belonging in these group settings. Research shows that 50% of the veterans who underwent this particular therapy had reduced symptoms. It can aid in creating a sense of belonging and acceptance by fostering a community of people who have shared experiences that society in general cannot fathom. 


Apart from the professional interventions listed above, the support of family, friends, and community is extremely imperative in helping veterans integrate into their daily routines. However, more often than not, families and friends are required to be educated on PTSD and what the rehabilitation process entails to help support and empathise with the veterans better. This is the most vital step to ensure preventative measures are taken optimally. Peer support programs catering to veterans can be implemented that help the veterans feel included and reduce the sense of isolation. Veteran peer support programs can range from awareness campaigns to local organisations to support groups.


Research conducted by Military Medicine in 2016 demonstrates how veterans who were a part of peer support programs were two times as likely to seek professional help for not only PTSD, but also other underlying mental health issues.


All in all, by providing veterans with the correct means, we can help them rebuild their lives and go back to their routines seamlessly. Coming home from war should be a relief, a chance to embrace loved ones and rediscover peace. By providing them with community support, medication, and access to professional help, we can make sure the sacrifices they made are honoured. While the scars of wars may be invisible, their path to recovery does not have to be.


About the Author 


Anusha is a first year psychology student at NMIMS. She recently acquired the title of Miss Teen India and is soon to represent India in Miss Teenager Universe. Apart from pageantry and modelling , she adores nature and you can always find her with a flower clip in her hair. She enjoys dancing and has been trained in jazz and contemporary since she was 5 years old. Music is an integral part of her life- she plays the piano, guitar and ukulele amongst other instruments. She aspires to be a voice for the youth and uses her platform to inspire young girls to be themselves unapologetically whilst benefiting society.


References


Foa, E. B., et al. (2013). Effectiveness of Exposure Therapy for Combat-Related PTSD. JAMA Psychiatry, 70(4), 413-420. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1658179


Monson, C. M., et al. (2012). Cognitive Processing Therapy for Veterans with Military-Related Posttraumatic Stress Disorder. Journal of Consulting and Clinical Psychology, 80(6), 968–981.

https://psycnet.apa.org/doi/10.1037/a0029961


Schnurr, P. P., et al. (2007). Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Veterans: Randomised Trial and Clinical Outcome Measures. Archives of General Psychiatry, 64(5), 513-520. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482248


Shapiro, F. (2014). The Role of EMDR Therapy in the Treatment of Combat Trauma

https://onlinelibrary.wiley.com/doi/10.1002/jclp.22189


Morland, L. A., et al. (2010). Telehealth Group Therapy for Veterans with PTSD: A Controlled Study

https://www.nejm.org/doi/full/10.1056/NEJMoa040603


Seal, K. H., et al. (2011). Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans

https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2010.300097


Sayer, N. A., et al. (2014). Reintegration Challenges and PTSD in Returning Iraq and Afghanistan Veterans

https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2013.301763

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