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Keeping our troops psychiatrically medicated long-term is not going to work.
(Bear in mind: the author is a psychology student with three years of study, not a trained psychologist. This is an attempt to raise awareness and offer suggestions, but I hope that more qualified speakers can pick this up.) Battles and wars lead to tremendous psychological strain. Soldiers are responsible for defending their lives and the lives of their fellow soldiers, but they also have to kill their fellow man. We're all trained that killing is something we should never do, and for the soldiers who have to go out and do it, it's not an easy burden. According to Time, antidepressants are being used wide-scale to counter the effects. On the surface, this may seem like a good idea. . . but there are numerous factors that quickly make it into a band-aid when our soldiers need better care. For one, some antidepressants seem to accelerate the likelihood of suicide in some individuals (2.) This is a minor problem already among the civilian population, who don't all have access to guns. A soldier who's dealing with severe mental stress, placed on watch, carrying a gun, and who's just been hit by crushing side effects is probably more likely to kill himself than a thirteen-year-old in his bedroom who's dealing with the same side effect. If we're going to be giving our troops antidepressants for the first time, we need to also have some sort of system in place to help soldiers considering suicide be pulled out of combat to where they can be watched and helped if they get worse. (There might be some who would abuse this, but pretending one is insane has always been an option. Soldiers don't take it because they don't want to desert their units.) Then there's the problem of side effects. Antidepressants adjust brain chemistry. One chemical, seratonin, controls mood but also is used by the digestive system. A medication that affects seratonin can literally make someone sick. Soldiers who are already under stress, are going to be impatient with meds that are giving them side effects. They can't afford to be asleep on their feet to awake for two days straight. Antidepressants can have severe side effects on mind and body, and there's no real way to tell how someone will react to a med besides seeing how they do on it. Soldiers can't afford to have memory or attention problems or be too sick to stay out of bed. If a soldier's having bad side effects, he or she may do what a lot of civilians do: stop taking meds or try to create their own doses. The "Time" article also describes soldiers who need to travel some distance, endangering their unit on the trip with them, when they need a refill. If they suddenly stop their meds and then suddenly get back on, they're hit with side effects both ways. If their depression is bad enough that they're suicidal when not on medication, it might surprise them when they've run out or missed a dose. Perhaps most troubling is the military's idea of using medication against "combat fatigue." Post-traumatic stress disorder has also been dubbed combat fatigue. Using drugs to treat PTSD is like putting a band-aid on a broken bone. Post-traumatic stress disorder is accompanied by a physical change in the brain: the hippocampus shrinks, (3) and the way the person's brain functions changes permanently. Post-traumatic stress disorder is marked by reliving what happened through flashbacks, by sleep problems, and emotional problems. There may be personality changes, too. Medication may make the person less depressed about having PTSD, but it's not a cure. The best remedy is counseling so that the soldier can better deal and live with PTSD (and not being in a place where the affected soldier is being shot at.) (There's still some question about how PTSD and the smaller hippocampus works. Do people with smaller hippocampuses get PTSD more easily, or does PTSD shrink the hippocampus that much? The only way to tell is through MRIs, and few people have before and after MRIs to compare. Enough has been done that we believe the hippocampus actually shrinks, but still, nobody's sure what's happening. Medication may prevent it, but it's possible a soldier would need to start meds before they ever got into a bad situation. This would basically mean medicating everyone.) A soldier who's been overmedicated through his stint might come home and find his problems are huger than he knew. This is not the sort of discovery you want to make while you're putting your civilian life together! Medication also simply isn't as good a treatment of depression as counseling and medication together. Are soldiers told this? (What if they can't afford it?) Meds seem like a good idea on paper. But they aren't magical. Right now, it sounds like we're trying to treat an hugely stressed population with an understaffed and overworked psychiatric branch, little to no available counseling, and difficulty providing for and following each soldier's case. This is not going to give our soldiers the help they deserve. While professional psychologists and the military are going to think of better solutions and ways around the problems I raised, the first fix I would like to suggest is more training, and more thorough training. It's psychological practice for the battlefield. It helps soldiers to mentally brace themselves for the time ahead. The second I can think of is screening more often for suicidal soldiers or soldiers suffering PTSD. While other soldiers may benefit from medication that buffers them from stress, this population is the one that's already hurting. A band-aid won't cut it. Keeping them out in combat is only going to hurt them more. My thanks to everyone out there who's trying to help our soldiers, and thanks to our soldiers themselves. 1- Time's article: http://www.time.com/time/nation/article/0,8599,1811858,00.html 2- Antidepressants and the chance they'll increase suicide: http://www.mcmanweb.com/FDA_suicide.htm 3- the hippocampus and PTSD http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=43615
- TAGS:
- military,
- medication,
- psychiatric,
- war
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