Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.
Scientists are finding that trauma affects how the brain functions and, especially in children, can create long-term debilitating problems, including anti-social behavior, dissociation, emotional numbness and trouble forming social relationships.
Fortunately, scientists also are finding there are therapeutic tools that can help.
The science around chronic trauma is evolving quickly and in exciting new ways. Even as scientists discover new evidence about what is happening in the brains of chronically traumatized people, intriguing new techniques are emerging for coping with the effects.
Johnson, the Oakland Tribune‘s Violence Reporting Fellow, is blogging at OaklandEffect.com, where he has written about his own experiences and about attending the recent “Healing Moments in Trauma Treatment” conference. Johnson’s position is funded by the California Endowment and he will be with the Tribune for a year, reporting on a wide range of issues, including those related to the impacts of violence on the mental health of Oakland residents.
Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006” and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”
The increase comes despite the military’s increased focus on combating mental health problems among American soldiers. The largest number of evacuated soldiers are still those diagnosed with “noncombat-related injuries, such as muscle and joint problems that come from carrying equipment,” but psychiatric evacuations are a growing and complex problem.
… those suffering from mental health issues had a remarkably low rate of returning to full duty. “Psychiatric conditions have the lowest return to duty rates among any diagnostic group aside from combat injuries,” (study leader Steven P. Cohen, an associate professor of anesthesiology at the Johns Hopkins School of Medicine and a colonel in the U.S. Army Reserve) wrote. “But the effects are much worse, because psychiatric conditions worsen the prognosis for all other conditions.”
“Patients with PTSD — as a rule — have multiple other complaints,” he continued. “Studies have shown that most people with persistent PTSD have ongoing musculoskeletal, neurological and constitutional complaints that are unlikely to respond to treatment.”
Writing for the Dart Center for Journalism and Trauma, Judith Matloff and Robert Nickelsberg look at the effects of decades of strife upon the disputed South Asian province of Kashmir. A third of Kashmir’s residents suffer from psychological distress (in the United States, that number is around 6 percent to 8 percent) and the region’s few psychiatrists are so overwhelmed – one small clinic saw over 100,000 visitors last year – that they can do little more than rush through minutes-long consultations and hand out prescription medication as if it were “Tootsie Rolls at Halloween.”
Clouds gather over Kashmiri peaks, photo by Brian Guest via Flickr
Practically everything that can cause PTSD has coalesced in Kashmir — loss, fear, distrust, random violence, a sense of powerlessness. The unrelenting Indian occupation fuels despair. Stress affects nearly everyone: the men routinely frisked on the street, the women forced to beg when their husbands vanish and the children given up to orphanages. Kashmir illustrates what researchers have long suspected: that prolonged exposure to direct confrontation results in still greater anguish. People don’t get used to violence; they grow more vulnerable.
Suicides are up in the region – despite strong taboos among the Muslim populace – and the community’s psychological state deteriorates further with every passing year. “‘The accumulation of events results in higher levels of distress,’ (Kaz de Jong, a mental health advisor with MSF-Amsterdam) explains. ‘What you see in chronic conflict is that self-support mechanisms and resilience go down.’ Instead of getting stronger, the afflicted just get more desperate.”