Introduction
to Stress:
Stress is the "wear and tear" our bodies
experience as we adjust to our continually changing
environment; it has physical and emotional effects
on us and can create positive or negative feelings.
As a positive influence, stress can help compel
us to action; it can result in a new awareness
and an exciting new perspective. As a negative
influence, it can result in feelings of distrust,
rejection, anger, and depression, which in turn
can lead to health problems such as headaches,
upset stomach, rashes, insomnia, ulcers, high
blood pressure, heart disease, and stroke.
Many times, however, stress can become chronic,
and may last for a week or more. This chronic
condition often results from humans' ability to
project their thoughts into the future, such as
when a person keeps a recurrent and stressful
thought in his or her mind. [1]
With chronic stress, the heart beats at a faster
pace, the arteries' lining contracts and blood
pressure is increased. Thus, with the blood running
at a high speed for long periods of times, the
lining of blood vessels become prone to suffering
injuries. Platelets, whose key goal is to arrest
bleeding, reach the injured site and accelerate
their ability to form blood clots to heal the
area.
And the glucose, triglycerides and cholesterol
-- that run in the blood -- tend to accumulate
in those injuries, in the coronary arteries or
others, paving the way for more serious health
problems to arise. As if all this was not bad
enough, chronic stress often does not let people
think, learn and memorize new things, abilities
that are key in a modern and competitive world.
And since both negative and positive experiences
or emotions produce the secretion of all those
substances (glucose, triglycerides and cholesterol,
etc.) into the bloodstream, they are both as dangerous.
That is why people must learn how to control stress.
"We all have different genetic burdens, different
ways to perceive, interpret, suffer and think
things," said Gutierrez. "So, one same
'stress agent' (emotion or experience) causes
different reactions in people." [2]
Analysis with Reference to Soldiers Under
Stress
In a society where 24 hours in a day is too little
it’s not surprising that we have various
stress related cases. Then combined with factors
like war the stress becomes even more intense.
Consider that during war a reserve is drafted.
As a man, he may be a husband, father, brother
and/or son. When he leaves the family fold to
go for training he is leaving behind members of
his family who have to deal with the fact that
their loved one may well never return. The soldier
has to deal with personal fear, the stress of
training for physical violence and his deployment
to a place far away from his native land. Such
factors can all result in a trauma that would
be hard to face and thus needs, professional intervention.
The armed forces previously did not deal or recognize
forces of stress at work and it was only after
the Vietnam War when a whole generation of soldiers
showed symptoms of stress by which they were unable
to acclimate themselves back into civilian life
that the need for special training for stress
control was realized.
The Vietnam veterans were seen to become dysfunctional
in terms of personality and their inability to
forget the war they had fought. Further combined
with the recriminations they received the post
traumatic stress they underwent was intense. While
many did undergo psychiatric treatment many were
lost in the system as they became victims of their
own inadequacies.
Today, the armed forces and the civilian sector
recognize the need for stress management. This
can be seen from the latest edition to the U.S.
Army field manual (FM) which provides the "tactics,
techniques, and procedures required for small-unit
leaders to effectively prevent, identify, and
manage combat stress when it occurs. This publication
contains essential information about combat and
combat-related stress. It describes, in layman's
terms, techniques to prevent, identify, and treat
harmful combat stress reactions at the lowest
level or until professional medical assistance
is available. It provides a basic understanding
of the causes of stress and describes the preventive
actions that can be taken to avoid or reduce its
harmful effects. It describes how to identify
and manage combat stress symptoms when they appear,
and provides techniques to prepare units to handle
combat stress reactions when they occur. All small-unit
leaders should read this publication." [3]
We see from the past that military operations
are inevitable from the Civil War to the recent
war in Iraq the US has sent its soldiers around
the globe in an effort to control the violence.
Yet, from that time we have seen an increasing
number of soldiers producing combat related stress
symptoms giving rise to the question how best
veterans and their families can be helped to cope
with the reintegration and adjustment problems
once the veteran returns home. Some soldiers may
display post traumatic stress disorders [PTSD]
and other such mental illnesses which have to
be contained as early as possible for full recovery.
As such the non-profit U.S. Medicine Institute
for Health Studies has gone into partnership with
the Veterans Health Administration (VHA) to try
to create the best strategy to cope with the problems
of the veterans.
The army today has Combat Stress Control [CSC]
Units that are equipped with medical personnel
who can help soldiers under extreme stress. Most
CSC units have three prevention teams, a psychiatrist,
social worker, and mental health technicians,
and then there is the restoration team that has
a psychologist, occupational therapist, and clinical
nurse practitioner. According to statistics gathered
from a CSC unit in Iraq the 98th, [4] “…8
percent of soldiers treated by the 98th CSC had
acute stress reactions to combat-related attacks
on them or their convoys. Their symptoms including
nightmares, insomnia, excessive guilt, anxiety,
and an exaggerated startle response. These symptoms
typically remitted in less than one week with
treatment.”
"Another study in the New England Journal
of Medicine of U.S. combat infantry troops returning
from operations in Iraq and Afghanistan found
that 15.6-17.1 per cent screen positive for major
depression, generalized anxiety disorder, or PTSD
after deployment. However, for those who screened
positive, only 23 to 40 per cent actually sought
care. The study’s military authors conclude
that while returning troops are at significant
risk of stress-related mental health problems,
“subjects reported important barriers to
receiving mental health services.” [5]
The Army is now training its leaders to ensure
they can provide the leadership necessary to help
soldier’s combat stress which is one of
the main problems or stressors. There are of course
interpersonal problems that are dealt with but
as leaders of the armed forces are now being given
training to treat the stress of the soldiers the
soldiers well being is easier to forecast. [refer
to appendix]
The purpose of this training is to ensure that
problems are tackled within the environment of
the stressor for better results. That way the
soldier does not have to go back to the States
for treatment. The marines have their own program
referred to as the Operational Stress Control
and Readiness (OSCAR) program. It ensures that
there is a psychologist with the Regimental Combat
Team. This ensures that the Marines are effective
during combat and any problems that occur after
deployment are tackled immediately. [6]
To ensure that the family is not affected and
prepared for the soldier’s deployment the
army has started separation preparedness programs
that help the family cope with the soldiers leave.
The Support Unit and Family Readiness through
The Army Family Team Building (AFTB) Program provisions
for the soldier and family and ensures they are
both ready for the separation.
Health Services are a recognized requirement for
combat soldiers. Yet, while the onsite programs
help soldiers deal with stress to a large extent
these same soldiers require some help once they
come back to civilian life.
Soldiers may be disabled; scarred, unable to acclimate
back to civilian life and deal with changes in
their personal life from divorces to deaths. This
civilian change then requires the intervention
of social and health services other than those
of military scope.
The Salvation Army is one such group that helps
through various programs in helping the disabled
and displaced veterans find a place for themselves
in the civilian world.
According to the Veterans Administration [VA],
"About a third of the adult homeless population
has served their country in the armed services.
On any given night, as many as 250,000 veterans
are living on the streets or in shelters and perhaps
twice as many experience homelessness over the
course of a year ." The VA provides homes
and shelters and psychiatric evaluations for veterans
helping them cope with PTSD. The VA ensures that
the veterans that come to them for help are provided
shelter and programs within the administration
help the veterans make sense of their disorientation.
Then there is the Health Care for Homeless Veterans
and Veterans Benefits Administration which both
aid the VA in its work.
Today, psychiatrists and other mental health
professionals have good success in treating the
very real and painful effects of PTSD. These professionals
use a variety of treatment methods to help people
with PTSD to work through their trauma and pain.
Behavior therapy focuses on correcting the painful
and intrusive patterns of behavior and thought
by teaching people with PTSD relaxation techniques
and examining (and challenging) the mental processes
that are causing the problem. Psychodynamic psychotherapy
focuses on helping the individual examine personal
values and how behavior and experience during
the traumatic event affected them.
Family therapy may also be recommended because
the behavior of spouse and children may result
from and affect the individual with PTSD. Discussion
groups or peer-counseling groups encourage survivors
of similar traumatic events to share their experiences
and reactions to them. Group members help one
another realize that many people would have done
the same thing and felt the same emotions. Medication
can help to control the symptoms of PTSD. The
symptom relief that medication provides allows
most patients to participate more effectively
in psychotherapy when their condition may otherwise
prohibit it. Antidepressant medications may be
particularly helpful in treating the core symptoms
of PTSD—especially intrusive symptoms. [7]
Conclusion
The evaluation and recognition of the various
stressors of a combat soldier has allowed the
soldier to be viewed in a more sympathetic light.
It can not be easy leaving ones family and loved
ones within a secure environment to go to an area
that is not only alien but hostile as well. Physical
factors may aggravate the stress and fear and
personal problems from home would further cause
agitation. The depression, anxiety and stress
of being deployed in a hostile land has to be
taken care of within the hostile environment for
better facilitation which is what the army is
trying to do. The leaders no longer view stressors
of combat as weaknesses rather, they help the
soldiers cope and reassess the situation in a
healthy way. The problems of acclimating oneself
back to civilian life is still a problem for while
the soldiers have been living in a status quo
as far as personal life goes, their family and
social life back home continues as usual. To come
back from a hostile situation after being in a
potentially violent situation and having to be
aggressive oneself may not be easy. In order to
control the aggressiveness requires therapy not
only for the soldier but family as well so that
the family can deal with the soldiers problems.
The various steps taken by the armed forces are
commendable and go a long way in aiding the mental
and behavioral health of veterans.
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