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Mental Matters, Part 1

PacMed doctor tackles mental health issues in the military

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The mind is a complex and cavernous place, and its health fuels emotional stability and clarity. Unfortunately, mental health is sometimes overlooked, pushed into the shadows by its physical counterpart. Often, mental health issues and post-traumatic stress disorder (PTSD) are stigmatized within the military, much to the detriment of soldiers and civilians alike. Here, Pacific Medical Centers' Family Medicine Physician Zaal H. Paymaster, M.D., delves into the complicated realm of mental health, discussing warning signs, coping techniques, and perhaps most importantly: how to ask for help.

PTSD and other mental illnesses oftentimes have a negative stigma associated with them - especially in the military. What advice can you give to soldiers to lessen the burden of asking for help?

Throughout all the branches of the military there is the perception by individual servicemembers that seeking mental health assistance will have dire consequences on their military careers. Those fears have fueled a mental health crisis, where countless servicemembers are returning home from various theaters of operations with symptoms of post-traumatic stress disorder or major depression, but very few seek treatment. This disturbing reality has not been lost on military leaders, who worry that these invisible war injuries decimate an already stretched thin fighting force. So, independently and in a coordinated effort, every branch of the military is now fighting the stigma of seeking mental health services. These campaigns have brought mental health to the forefront and make mental fitness as important as physical fitness for the soldier, sailor, Marine and airman. There has been a dramatic change in the entire military culture, where seeking mental healthcare doesn't harm your career; however, not being able to do your job because of a mental illness can harm your career. These resources are available for the servicemember, they simply need to seek them out or voice their need for help. This focus on helping to identify and treat mental illness has become so important in the military that the behavioral health resources have been pushed as far forward on the battlefield as possible; with servicemembers having access to these resources well before they leave theaters of operation.

What are some behavioral red flags of mental illness people should be aware of within themselves, someone in their unit, or other loved ones?

Like many things within the military, mental health should be approached as a buddy system. At times, the individual suffering from the mental illness may be completely oblivious to the changes in their mood and affect, and it is up to fellow soldiers to be vigilant about their brothers and sisters in arms. Symptoms can either be observed or mentioned by the patient, and include but are not limited to:

Withdrawal - Recent social withdrawal and loss of interest in interacting with others

Drop in functioning - An unusual drop in functioning, at work, in school, or social activities, such as quitting sports, or difficulty performing familiar tasks or routine duties

Problems thinking - Problems with concentration, memory or logical thought and speech that are hard to explain

Increased sensitivity - Heightened sensitivity to physical stimuli (sights, sounds, smells or touch; avoidance of over-stimulating situations) or decreased emotional resiliency

Apathy - Loss of initiative or desire to participate in activities that were previously enjoyable

Feeling disconnected - A vague feeling of being disconnected from oneself or one's surroundings; a sense of unreality

Illogical thinking - Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or "magical" thinking typical of childhood in an adult

  • Nervousness - Fear or suspiciousness of others or a strong nervous feeling
  • Unusual behavior - Odd, uncharacteristic, peculiar behavior
  • Sleep or appetite changes - Dramatic sleep and appetite changes or decline in personal care
  • Mood changes - Rapid or dramatic shifts in feelings

One or two of these symptoms alone can't predict a mental illness. But if a person is experiencing or exhibiting several at one time and the symptoms are causing serious problems in the ability to work, perform basic activities of daily living, or relate to others, he or she should be seen by a mental health professional. People who express suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

See next week's issue for Part 2 with Zaal H. Paymaster, M.D.

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