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Surviving Spouses | Mental Health and the Military
Military Challenges: Supporting A Loved One With Bipolar DisorderFor people thinking about joining the military or who are already serving in active duty, trying to keep the home front running can be a huge challenge, especially if there is a loved one at home with Bipolar Disorder. Chances are the person in the military would worry excessively and yet not have the ability to be there first-hand to assist. Being so far away requires the assistance of family and friends to provide care for the person with Bipolar. With the current war, this problem is somewhat common. For the individual with Bipolar, seeing his or her support system gone can only increase the symptoms, causing even greater upset. Okay, so you might ask, "What is the answer?" Unfortunately, for many people in the military trying to handle a loved one with Bipolar, the answer is not easy to come by. If you are in the military and have this situation, then one of the most important things is to have a solid support system made up of good friends, family, and doctors any time you are gone. To make the transition of leaving easier, certain steps must be taken. For example, if you were leaving for a tour of duty, it is crucial that your loved one with Bipolar knows the people that he or she can depend on. That means having met these people and knowing ways to reach them in times of stress. If your loved one is young, then you would need to establish a place where he or she would stay and be cared for but all parties would need to spend adequate time together so the stress level is reduced. In addition, your loved one's doctor should be notified any time you are away, just in case some type of intervention or treatment is required. There could be times when you are gone that the doctor would prescribe different medication, increase therapy, or simply check up on your loved one to ensure things are under control. Your role will be the rock - even from a distance. When on a tour of duty, you would probably have access to email, at least on occasion. To provide the support and reassurance to your loved one with Bipolar, you could establish a day and time when the two of you could meet in cyberspace. The bottom line is that being in the military, whether at home or away and having someone you love with Bipolar in your life can be difficult. However, with good planning, close family and friends, a good doctor, and both determination and dedication, you can make it work. Finally, many good organizations exist for people with Bipolar Disorder. With this, if you were not able to be there in person, your loved one would have ongoing encouragement and support. About the Author David Oliver is the founder of
BipolarCentral.com a one stop source of information on how to cope and deal with bipolar disorder. Sign up for
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Current Bipolar News. Post Traumatic Stress Disorder (PTSD) Post-Traumatic Stress Disorder (PTSD), is a form of anxiety disorder that may develop after a person is exposed to trauma. The patient may, or may not, have experienced physical harm during the event, but the threat of harm is often enough to trigger the symptoms. These events may include violent assault, disasters (either natural or caused by humans), accidents, military combat, and sexual assault, to name a few. When a person is in danger they may be overwhelmed with fear, helplessness and terror. After the trauma, patients may seem normal. Some people feel that they should be able to handle any situation, no matter how horrifying or extreme, and go forward with their daily activities as though nothing had happened. For some, the symptoms of PTSD fade a short time after the event, with or without treatment. Studies show that the more control the patient feels they have during the event, and the more choices they have about how to handle the trauma, the easier it is for them to recover without long term symptoms. But, when the ‘fight of flight’ response is not a choice, when the patient has no options, post-traumatic stress symptoms are typically worse, and last longer. For these people, the memories of the trauma are so stressful and real that many patients are unable to live a normal life if they do not seek treatment. In some patients, the symptoms do not appear immediately after the trauma, but instead the memories are buried, and may be triggered later, perhaps months or years later, by a stressful or similar situation. PTSD patients relive the experience as if it is happening to them again at that moment; they have nightmares and flashbacks, and find it difficult to sleep. Complex (or Chronic) PTSD is a form of PTSD suffered by those who have endured long-term or persistent trauma or abuse. Doctors treat victims of long-term trauma differently (see Complex PTSD for more details) What are the symptoms?There are various primary and secondary symptoms associated with PTSD. Some are physical responses to stress and some are emotional and social responses. - Headache, gastrointestinal symptoms, immune system depression, dizziness, chest pain, thyroid abnormality
- Hyper-arousal of nervous system, hyperactive startle reflex
- Interpersonal and social problems
- Feelings of detachment and estrangement, feeling numb
- Feeling strange and out of place
- Agitation when exposed to sense memories reminding patient of trauma (touch, smell, taste or sound)
- Blanks or gaps in memory of traumatic event
- Avoiding activities, people, discussions or sensations that remind you of trauma
- Difficulty in experiencing strong feelings of love or attachment
- Heart pounding, difficulty breathing
- Self blame or feelings of guilt about the trauma
- Alcohol and drug abuse
- Reliving traumatic episode, realistic flashbacks (minutes or hours, occasionally for days), nightmares, frightening images and thoughts
- Insomnia or interrupted sleep cycles, trouble falling asleep or staying asleep
- Shaking, trembling, sweating
- Abnormal neuro-hormonal levels (cortisol, epinephrine, norepinephrine, natural opiates)
- Feelings of danger or fear
- Physical numbness or strange physical sensations that can’t be otherwise explained
- Anger, aggression, need to defend self
- Memory and cognitive difficulties, inability to focus or concentrate
- Depression, loss of interest in activities that used to be pleasurable, loss of religious beliefs or hope
- Inability to feel pain or sensation
- Physical health symptoms that do not have any other cause
- Self Esteem and Identity problems
How is it diagnosed and treated?Not everyone who endures a trauma will experience a full array of PTSD symptoms. PTSD is only diagnosed if symptoms last more than a month. For those who do develop symptoms, the symptoms will typically start within three months of the trauma, but they can also start months or years later. Doctors will usually perform a thorough medical and psychiatric evaluation before diagnosing and treating PTSD to be sure there are no other causes for the symptoms. A PTSD diagnosis is typically made if the person exhibits numerous symptoms from the list of symptoms noted above, and if those symptoms persist for more than one month. Treatment(s) can include: - Psychodynamic Therapy
- Psychotherapy
- Eye Movement Desensitization and Reprocessing (EMDR)
- Cognitive Behavioral Therapy
- Group and Family Therapy
- Medication (Sertraline, psychotropic medications, lorazepam, neuroleptics, haldol, anticholinergic, antiadrenergic agents (clonidine, guanfacine, propranolol) Seratonin Reuptake Inhibitors (SSRIs), Antidepressants
- Coping Skills for Survivor and Family
StatisticsPTSD affects about 5% of the adult population in the U.S. 50% of patients with PTSD experience remission of symptoms within 6 mos. The other 50% will experience symptoms for years. For example, 30% of combat veterans will suffer from PTSD, and of those, 15% will still have symptoms of PTSD 19 years after combat. About 3.6% of PTSD sufferers experience at least one year of symptoms, though women are more prone to long-term effects than men (1 in 10 women are at risk). This statistic is typically attributed to the fact that women are more often the victims of domestic violence, rape or abuse. Research shows that 60.7% of men and 51.2% of women have had at least one traumatic event in their lives. For men it is typically a trauma related to rape, combat, childhood neglect, or physical abuse during childhood. For women it is most commonly due to rape, sexual assault, physical abuse or attack, threat or attack with a weapon, or physical abuse during childhood.
Service Members and Their Families Get Online Counseling Referral Military members and families coping with the stress of overseas deployments and other potential health-threatening issues can log onto the Internet to get help. Service members from all components and their families can obtain a mental health self-assessment or screening through a Web site co-sponsored by Department of Defense (DoD) and Screening for Mental Health Inc., a nonprofit organization. The Web site, brought online in January, augments other DoD mental health assistance resources. People who log onto the site are asked to answer a series of questions. The program "grades" the completed survey, and gives people an evaluation of their current mental health, providing assistance resources, if deemed necessary. Other DoD-endorsed health sites tell customers how to access mental health counseling services, but do not provide an online mental health screening program. National Guard and Reserve members returning from overseas deployments also are authorized to use the Web site. Returning Reserve Component members have two years of health benefits provided by the Department of Veterans Affairs. Such services are especially important today, because of the potential stressful effects deployments can have on both military and family members. As Soldiers re-integrate with their families there may be conflict in the family that is not easily resolved. The mental health screening Web site and other related programs available to service members and their families provide a level of benefits and a level of service to help them understand what services are available to them for mental health issues. For more information, visit: https://www.militarymentalhealth.org/welcome.asp. What Services Require Prior Authorization?TRICARE requires prior authorization for the following behavioral health care services: - Substance abuse treatment (inpatient or outpatient)
- Inpatient levels of care, including care rendered by residential treatment centers
- Partial hospitalization levels of care
- Psychological testing (including neuropsychological testing)
- Psychoanalysis
- Electroconvulsive therapy
Under the behavioral health care benefit, all TRICARE Prime beneficiaries except active duty service members are entitled to eight unmanaged psychotherapy visits per fiscal year (Oct. 1-Sept. 30)—meaning you can seek your first eight outpatient visits without a referral from your primary care manager (PCM) or prior authorization from ValueOptions, Humana Military’s behavioral health contractor. Active duty service members require a PCM referral and prior authorization for all outpatient behavioral health care. Any psychotherapy sessions beyond the initial eight visits require authorization from ValueOptions. Your behavioral health provider is responsible for obtaining that prior authorization. Be sure you notify your provider if you have seen another provider for behavioral health services, as the eight visits are per beneficiary, not per provider. | Press ReleaseTRICARE Beneficiaries May Seek Mental Health Care If They Need It |
