Tuesday, May 26, 2009

Depression - as linked to Post Combat or PTSD

Many combat veterans have to deal with various forms of depression, when they return from a combat zone, especially those that get medevac'd out earlier from being wounded or injured, and leaving their comrades behind. Again I will start by using the Wikipedia definitions for various depression states, I did not find any relating to Post-Combat or PTSD, maybe in the future their will be when the Military Psychiatric Doctors & Medical Evaluation Boards start doing the right thing by our Combat Veterans. Also this Post-Combat or PTSD Depression is one of the major causes of so many suicides in our return War Veterans.

These are the various types of psychological depression, as defined in Wikipedia:

Major Depressive Disorder: (also known as clinical depression or major depression), a specific diagnosis from the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association.

1) Major Depressive Episode

2) Atypical Depression, a cyclical sub-type of major depression where sleep, feeding and perception of pleasure are normal but there is a feeling of lethargy.

3) Melancholic Depression, a sub-type of major depression characterized by an inability to feel pleasure combined with physical agitation, insomnia, or decreased appetite.

4) Psychotic Depression, a sub-type of major depression combined with psychotic or delusional perceptions.

Depression (mood).

Postpartum depression, a depressive episode occurring within a year of childbirth.

Dysthymia, a long-term low-grade depressive condition.

Adjustment disorder with depressed mood, previously known as "reactive depression"

Seasonal Affective Disorder (SAD), a depressed mood related to the seasons.

Depression is the fourth stage of the Kubler-Ross Model (commonly known as the "stages of grief").

That was the Wikipedia definition & breakdown of varios forms of depression, like I said above, I believe eventually there will be another diagnosis, dealing with Post-Combat or PTSD(Post Traumatic Stress Disorder/TBI Traumatic Brain Injury. I myself have dealt with and still is fighting depression, and it has been over 4 years since I have been back from Iraq. When I was first medevac'd out of Iraq to Landstuhl Army Medical Center in Germany, I fought and argued with the doctors to go back to rejoin my unit, I had a deep feeling of guilt and felt ashamed because I was safe in Germany and they were still in harms way. I have talked to many other wounded and injured veterans at Landstuhl and at Walter Reed Army Medical Center, where I was sent after Germany, they all had felt the same way guilty and ashamed to leave their comrades behind. It is some that the Army Medical Centers do not deal with properly, which is why their are so many suicides in wounded and injured soldiers. When I first got to Walter Reed, there were two to three suicides a week, we kept hearing the ambulance in middle of night pulling up to the Molonge House where many of the outpatients were housed. It got better, but there are still a lot of suicides nationwide at Army hospitals. A member of my unit that got medevac'd out of Afghanistan, gunshot wounded to arm, was recovering well, committed suicide at Fort Bragg, while recovering. The Army needs to take a serious look at the Psychiatric Doctors & Practices, many of Army Psychiatrists are fresh out of school and inexperienced. Coupled with the Army thinking that most returning Veterans, are "faking it" especially National Guard and Reservists.

The Army Medical Evaluation Board(MEB)/Physical Examination Board(PEB), does everything possible to avoid documenting & compensation soldiers suffering from depression, PTSD & TBI, the evaluating psychiatrists will blame it on pre-existing conditions, like pi-polar disorder, anxiety & mood disorders, or just claim the soldier is just faking it or exagerating his or her condition. It is really a humiliating process for a combat veteran to go through. It is hard enough in the first place(with all the stigmatism attach to these conditions), to come forward and admit you have a problem, but to then go through this process and be treated like a dirtbag or someone who is faking it, is too hard for some soldiers to bear. This is part of the reason for so many suicides in returning combat veterans.

I feel that the entire Medical Evaluation Board (MEB)/ Physical Evaluation Board (PEB) system must be revamped, get rid of all the people currently on there, and get qualified, caring and profeessional people on the boards. The Army has to stop trying to save money by the blood of it's combat veterans, and take responsibility for doing the right thing. Fairly compensate these soldiers for there wounds, injuries and mental problems. Get them the proffessional help they need. And follow up on these soldiers, even when they are out of the system and make sure the Veterans Administration is taking proper care of them.