1. Explain at least four specific warning signs of severe depression (not necessarily suicide). a. Sleeping habits change– When a person suffers from severe depression you may notice a change in their normal sleeping pattern. Some people will sleep too much and others will sleep very little b. Loss of concentration – A person can lose their concentration in all aspects of their life. This means that they are no longer interested in participating whether it be at work, school or home. c. Eating habits change – Often you will find that people who suffer from severe depression have had a loss of appetite or a sudden weight loss may be noticeable. On the opposite spectrum of that you may find a person who overeats to compensate their depression. d. Arrangements – A person suffering from severe depression may choose to make arrangements if they are considering suicide. These arrangements can include care for their family and pets in their absence.

2. Research a disorder associated with stress or mental health. - PTSD
A military deployment can take a toll on any given person. The toll can be seen in many different forms such as emotional and mental disorders. These types of disorders can destroy an individual from the inside, out. Now multiply those symptoms by the number of deployments some soldiers have endured and the chance for mental disorders like post- traumatic stress disorder (PTSD) increase drastically. There have been many studies done to determine the correlation between the number of deployments and PTSD. One particular study was conducted with the help of the US Navy Bureau of Medicine and Surgery under the Wounded, III, and Injured/Psychological Health/Traumatic Brain Injury Program to determine if the amount of dwell time a soldier has between deployments decreases PTSD.
It has been shown by this study and several others that dwell time can affect whether or not you suffer from PTSD or the severity in which you suffer. Dwell time is the amount of time that a soldier is home between deployments. Dwell time is family time not just not deployed training time. The study was conducted on both male and female soldiers of the United States Marine Corp from the ages of 17-57. Subjects had either 1 or 2 deployments but no more than 2. There were 49,328 Marines in this study that were deployed only once and 16, 376 of those deployed a second time to Operation Iraqi Freedom. The study duration was calculated using the length of the deployment plus an additional year. This additional year was needed to view the study subject post deployment and dwell time.
The results of this particular study stated that the Marines with the longer periods of dwell time were less likely to suffer from mental disorders such as PTSD. It made no difference it they were male or female. The same was the case in other studies. It has been shown consistently that it affects both male and female soldiers across different Branches of the United States military. The lengths of the studies differed being that the deployment lengths ranged from 4 to 18 months. However, it was concluded that the soldiers with the longest dwell times available to them were less susceptible to PTSD and other mental health disorders. “Lack of an adequate dwell time may prevent the service member from fully recovering from the first deployment which suggests that a mental “reset” period is needed before subsequent deployment.” (VI, M.H. 2008) It would be easy to say that we should just give all of these soldiers additional dwell time in between deployments but that is not always realistic or possible during a time of war. Although you can see that based on the studies conducted we can substantially drop the number of soldiers being affected my emotion and mental disorders if we could at least give them adequate dwell time between deployments. The longer the deployments the longer the soldiers should have from dwell time with they return.
It has been shown in studies over and over again that soldiers are increasingly more susceptible to PTSD with each deployment they complete. As multiple deployments continue to take their toll on America’s soldiers, we have to wonder if their readiness ability, mentally and physically are being affected. A self-administered survey was collected from 2,665 National Guard soldiers, 2,543 of those surveys were analyzed for this study. These soldiers all had previously served a deployment in Iraq at some point in 2008.
Mental health risks were accessed in this study to help determine the New Jersey National Guards readiness. “National Guard and Reserve troops are more vulnerable than active-duty troops, with 35.5% of Guard and Reserve troops at mental health risks 6 months after deployment compared with 27.1% of active duty soldiers.” (Miliken, 2007) The resources and training available to active-duty military on a daily basis does not compare to what is available to the National Guard and Reserves as they cannot as easily access and have at their disposal all the resources available on a daily basis to a soldier that is active-duty and stationed on a military base. The do not train as often and do not have the personal to train them daily even if they personally could train as often as an active-duty soldier.
Like many studies this one concluded that soldiers with multiple deployments are most affected by mental health disorders like PTSD. In this study the National Guard was found to lack readiness due to the mental health conditions affecting their working abilities. Besides the mental health disorders affecting the soldiers, substance abuse and physical pain were also attributes to the National Guards lack of readiness. The effects of each form of attribute mentioned increasing with the number of deployments. Once again, the number of deployments plays a role in the soldiers’ mental health and stability. An individual with PTSD does not solely carry the burden of their disorder. “Beyond the mental distress experienced by trauma survivors, studies have consistently shown the detrimental effects of trauma on the survivor’s family.” (e.g., O’Donnell, Cook, Thompson, Riley, & Neria, 2006) Many studies have been performed over the years and they have come to show that many survivors of traumatic events struggle with family reintegration upon the return of a deployment. Minimal dwell time is a factor as well, in the success of the reintegration.

The marriage of a soldier suffering from PTSD suffers in myriad ways. Multiple studies have indicated that trauma survivors often experience difficulties in intimacy and marital communication (Cook, Thompson, Riggs, Coyne, & Sheikh, 2004). This is a combination of PTSD and learning to reintegrate into the marriage after being deployed for several months. It is a difficult situation for both the soldier and the spouse. It doesn’t make it any easier if the soldier is the husband or the wife. They have both been doing things as they please and not necessarily having to consult with one another. This change the soldier arrives can bring on a lot stress even when one should be rejoicing that their soldier arrived home safely. PTSD has many symptoms. If experiencing outbursts of rage and aggression, which is common, it will make it even more difficult to communicate with one another. Limiting the line of communication between spouses heads their marriage in the wrong direction. This lack of communication can also cause a reduction in sexual desire and difficulties with sexual functions. Lack of performance can make both partners feel inadequate especially after being separated for such long periods of time. With a lack of intimacy and communication marriages have very little stability. Add the outburst of rage and aggression and you have the formula for a divorce if left untreated. Divorce rates are significantly higher in marriages where there is a spouse suffering from PTSD. It is also been noted that there are higher divorce rates in general with soldiers that have multiple back to back deployments.

A marriage is not the only part of the family affected by the symptoms of PTSD. Take the outburst of rage and aggression. If these are directed towards a child, regardless of the age, it can have a detrimental effect on the child because the parental skills have been compromised. Although you may not want it to affect the child or you think the child is not being affected studies show that even if not directed at them the child suffers as well. This type of reaction often leads to feelings of fear and guilt. “It was also found that the relationship between the traumatized veteran and his child is often characterized by entanglement, control, excessive closeness, and overprotectiveness. This, in turn, might lead to various psychopathologic symptoms among victims’ offspring, a phenomenon known as “secondary traumatization” (Jordan, Marmar, Fairbank, & Schlenger, 1992) The soldiers come back with what they feel Is little control. They try hard to regain some of the control the spouse has had while they were gone. The children also have a hard time because they have grown accustomed to only going to one parent and not the other. The soldier can sometimes feel like they are being left out and even have resentment towards their own children.

Many Soldiers experience PTSD. Studies have continually allowed for PTSD to be acknowledged as a mental disorder. In the past before many studies were conducted ti was neither acknowledged or treated. What is is often not discussed is how the spouses of these soldiers develop PTSD-like symptoms. Women as caretakers take the brunt of their spouse’s symptoms. We try to make excuses for them and overcompensate for their behavior. As symptoms and severity of symptoms vary from one individual to another the same goes for the spouse’s of the soldier’s suffering with PTSD. “They come to recognize and manage all the cues that precede disruptions associated with the PTSD, such as alcohol and drug abuse, triggers of flashbacks, and increasing tension, that are part of a cycle of violence.” (Maloney, 1988; Walker 1979) Male soldiers play a stereotypical role in that they do not show emotion, they are perceived as aggressive and strong, where women are expected to play the opposite role. Being in these particular roles makes it difficult to deal with and process all of the changes someone with PTSD is going through. This study again shows how both men and women are affected. This study however, unlike the others accounts for the differences between the men and women being affected. Women have a very difficult time because they are fearful of the symptoms exhibited by their partner. They fear their safety and mental stability, the safety and mental stability of their children and of their spouses’. Due to the degree of stress associated with PTSD, it is very difficult for women to be effective or consistent with how the cope. With PTSD symptoms you can really never anticipate what will set someone with this disorder off and to what severity it will set them off to. Women find themselves overloaded with the demands of managing a family. Managing a family is a full-time job but having to do it with such high levels of anxiety can be overwhelming. Having to be over responsible, caring for the family and managing their partner’s symptoms women often find themselves at a loss. “When their needs go unmet, physical and psychological problems may be a consequence. For example, they may neglect their health, gain excessive weight, or become depressed when others do not respond to their efforts to help.” Unmet needs contribute to the extreme sense of loneliness and isolation for both spouses.
Ultimately the spouse begins to have similar symptoms to those suffered by their partner. Women try to identify with their spouse and can even have flashbacks based on how their mind perceives and processes the thought. Studies show that the women can have symptoms with the same severity as their spouse without having ever left the country. It is important that the soldier and their spouse seek professional help. “Effective treatment should involve family psycho education, support groups for partners and veterans, concurrent individual treatment, and couple or family therapy.” (Nelson and Wright, 1996) This is the key to healing and healing as a whole. It is not affected if only one party receives the necessary treatment. The treatment is also not limited to the spouses but to the families of both spouses as well. Just because a person doesn’t physically see it does not mean they are not affected by it emotionally.
Studies have consistently found that soldiers serving multiple deployments to Afghanistan and Iraq are over three times at risk acute depression and post-traumatic stress disorder (PTSD) than soldiers who have not previously been deployed. So we see that the pattern exists that the more deployments a soldier has completed the higher the risks emotionally and mentally. Geographic and social isolation is a major challenge for the military members. This brings on a whole other wave of emotions and stressors. Being displaced form ones family causing feelings of isolation and desertion. There is the guilt of leaving your family behind. Along with the constant concern that they are ok because you are unable to protect them yourself.
We also have to be empathetic to their needs. As many refuse to speak about their experiences for one reason or another. Unless we’ve been there ourselves we can only begin to imagine what they have seen and experienced. The disturbing images that they must have seen and often replay in their minds are horrific in nature. Multiple exposures to such a hostile environment are traumatic all in itself but then to have the constant mental reminder is a whole other traumatic experience in itself. It is difficult enough for a soldier to express themselves as they are often trained not to. However, when they also feel isolated because no one at home can relate to what they have just been through makes it additionally painful and difficult.
Soldiers can also suffer from other mental disorders such as survivor’s guilt. This is the guilt that they should have been the ones that were hurt and the unanswered question of, why them and not me? This guilt increases with the number of losses. These are losses of people who you cared for and would have died protecting. It is an internal battle for the surviving soldier. This can bring on the same symptoms as PTSD. You can anticipate for this person to be anxious, aggressive and for them to feel isolated even when surrounded by family and friends. They can also in turn be extremely controlling. They want to control the people who are around them in order to protect them, sometimes further isolating themselves. I speak of this not only as statistical knowledge based on several studies. I speak of this from personal experience, but from the experiences of many of our military friends. My husband, a soldier is currently battling with PTSD and survivors guilt. These disorders have consumed my family. After 6 deployments the damage has been done. This last one being the worst, with the highest number of losses he has ever seen. 8 of those loses coming upon his return home. These 8 tragedies have brought on the Survivors Guilt. He has been a soldier for 13 years and has seen many things but the loss of these 8 men has put him over the edge. The fear, anxiety and aggressiveness that he exhibits is nothing that I could have ever imagined. The only thing that has helped has been the therapist he sees. It amazes me the difference a little help can make.
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