Myth Busters

We often hear that people struggle to understand mental health and trauma because the injuries that Veterans come to Combat Stress with cannot be seen.

We have developed this quick Myth Buster guide to answer some questions we hear regularly. We want people to know more about Veterans' mental health and the symptoms of trauma so that they can have the conversations that tackle stigma and make it easier for people to seek help.
If you think someone you know should take a look, or would like to help tackle the stigma of Veteran mental health, please share this page using one of the options on the top right or on Twitter using #CSMythBuster.

• Post Traumatic Stress Disorder (PTSD) is the only mental illness caused by military service.
• Mental illnesses only occur amongst junior ranks, senior ranks don't get them.
• You can only get mental illness if you have seen combat.
• PTSD is the biggest mental health problem facing the UK Veteran community.
• You cannot cure PTSD.
• Most UK Armed Forces personnel who have served in Iraq and Afghanistan return with psychological injuries.
• The suicide rate amongst Veterans is higher than the general population.
• There is a bow wave of Veterans' mental health problems building up.

Post Traumatic Stress Disorder (PTSD) is the only mental illness caused by military service.
PTSD is one of the mental illnesses most associated with military service but there are a range of other more common mental illnesses which might affect Service and ex-Service personnel.  These include depression, feelings of anxiety, panic attacks and substance misuse, most commonly alcohol misuse.

Mental illnesses only occur amongst junior ranks, senior ranks don't get them.
This is incorrect. Mental illness as a result of the traumatic experiences witnessed during Armed Forces service can affect any member of the Armed Forces regardless of rank. We have treated Veterans of various ranks suffering from PTSD and other mental ill-health - from Privates up to Brigadiers.

You can only get mental illness if you have seen combat.
Far from it, there are many traumatic experiences that sailors, soldiers and airmen could witness during their military careers which take place outside of live combat situations. Whether it is training incidents, administering medical treatment, or other activities in war zones, these traumatic experiences can stay with personnel and lead to mental ill-health in later life.

PTSD is the biggest mental health problem facing the UK Veteran community.
PTSD is a problem for a minority of Veterans. Around 1 in 25 Veterans of the Iraq and Afghanistan wars are likely to develop PTSD, similar to that in the general public. However, while the rate of occurrence is similar, the complexity of the disorder tends to be much greater in Veterans. Furthermore, it often occurs alongside other medical problems such as pain, disability and substance misuse, particularly alcohol misuse.
You cannot cure PTSD.
PTSD has been left untreated for a number of years or decades will require more intensive treatment. There are still positive health outcomes for sufferers, and the potential for a life beyond symptoms, but seeking suitable, timely treatment is key to maximising the chances of recovery.If PTSD is diagnosed early and the sufferer receives the right treatment in the right environment, rates of recovery are very positive. Veterans can live normal fulfilling lives, able to work with the condition and generally become symptom free for long periods.
There is a risk of delayed-onset of PTSD, where symptoms do not occur for years or decades after the traumatic event. Veterans who present with delayed-onset PTSD have often been exposed to the effects of multiple traumas over a longer period of time. This suggests that those who serve multiple tours are more at risk of developing PTSD several years after leaving the Military.

Most UK Armed Forces personnel who have served in Iraq and Afghanistan return with psychological injuries.
The majority of Armed Forces personnel deployed do not experience lasting mental wounds as a result of their service. However, around 1 in 25 Regulars and 1 in 20 Reservists will report symptoms of PTSD following deployment in Iraq or Afghanistan. This is very similar to the rate in the general population.
Furthermore, 1 in 5 Veterans are likely to suffer from a common mental illness - such as depression, anxiety or substance (generally alcohol) misuse - which has been caused or aggravated by their Armed Forces experiences.

The suicide rate amongst Veterans is higher than the general population.
Suicide remains a rare occurrence in both UK Regulars and Veterans. In fact, the suicide rate is not significantly different to the rate amongst the UK general population, and for most age groups is actually lower. Seeking help for suicidal thoughts remains crucial and there is extensive mental health support available to both serving and ex-Service personnel.

There is a bow wave of Veterans' mental health problems building up.

Source: https://www.blogger.com/blogger.g?blogID=4592506238738253894#editor/target=post;postID=319661997249822347

Depression

Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Over 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
Although there are known, effective treatments for depression, fewer than half of those affected in the world (in many countries, fewer than 10%) receive such treatments. Barriers to effective care include a lack of resources, lack of trained health care providers, and social stigma associated with mental disorders. Another barrier to effective care is inaccurate assessment. In countries of all income levels, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.
The burden of depression and other mental health conditions is on the rise globally. A World Health Assembly resolution passed in May 2013 has called for a comprehensive, coordinated response to mental disorders at country level.

Types and symptoms

Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe.
A key distinction is also made between depression in people who have or do not have a history of manic episodes. Both types of depression can be chronic (i.e. over an extended period of time) with relapses, especially if they go untreated.
Recurrent depressive disorder: this disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment, and reduced energy leading to diminished activity for at least two weeks. Many people with depression also suffer from anxiety symptoms, disturbed sleep and appetite and may have feelings of guilt or low self-worth, poor concentration and even medically unexplained symptoms.
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent.
Bipolar affective disorder: this type of depression typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.

Contributing factors and prevention

Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.
There are interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.
Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention.

Diagnosis and treatment

There are effective treatments for moderate and severe depression. Health care providers may offer psychological treatments (such as behavioural activation, cognitive behavioural therapy [CBT], and interpersonal psychotherapy [IPT]) or antidepressant medication (such as selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]). Health care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists.
Psychosocial treatments are also effective for mild depression. Antidepressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with caution.

WHO response

Depression is one of the priority conditions covered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders, through care provided by health workers who are not specialists in mental health. The Programme asserts that with proper care, psychosocial assistance and medication, tens of millions of people with mental disorders, including depression, could begin to lead normal lives – even where resources are scarce.
Source:  http://www.who.int/mediacentre/factsheets/fs369/en/