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Misunderstandings about military psych care

Posted by mattdds on August 16, 2006, at 9:59:09

In reply to Re: 5 percent of combat troops in Iraq are on ADs, posted by cecilia on August 14, 2006, at 4:00:56

Hello,

I'm an officer in the US Army. I'm not deployed, but likely will be sooner or later (my next duty station will be one where I'll be associated with a highly deployable unit). I'm not an infantry officer, I'm in healthcare. But with today's battlefield being 360 degrees, all of us that wear the uniform need to be prepared for it.

My experience with military p-docs has been very pleasant (I take a benzo long term for anxiety / panic disorder). I do have a medical profile, but more for the nature of the medication I'm taking, not my mental status (e.g. what if I got stuck in combat and I couldn't get access to my meds - benzos are not drugs to discontinue abruptly, and could make me a liability to those around me).

The docs certainly are not forcing AD's, but they are available when soldiers need them. The military has taken a big initiative to take the stigma away from psychiatric problems. I know in the past this was not the case, but it's getting better.

Personally, I think AD's are at best a placebo, and can very possibly worsen anxiety (obviously the biggest problem in combat). That is coming from someone who suffered years of anxiety and depression. 5% AD use sounds too high to me, but simply because I think AD's are ineffective. I'm a big believer in old meds, such as benzodiazepines and stims for some. I also believe CBT techniques would be extremely helpful.

I have never been forced to take any meds or vaccines. Example - I was given the opportunity to take the anthrax vaccine, and I opted in. It's optional. Nobody is forcing AD's either, it just happens to be (sadly, IMO) that AD's are the "standard of care" for depression.

I believe Air Force pilots are still taking stims to ward off fatigue during long runs. Like I said, I'm in the Army so this may have changed. I know Army aviators are grounded if they take psychiatric medications - a tricky problem. It may deter some from choosing that career path (which may be good - we're not all cut out to be aviators), but it also discourages them from getting care when they may need it. There is no easy solution. A Blackhawk pilot may be impaired if taking a benzo, but may also be impaired if suffering from crippling anxiety.

But my impression is not at all that we are being "doped". Incidents in the past, where soldiers were ordered to take meds are usually misunderstood. Take the example of the Gulf War, where pyridostigmine bromide was given before expected nerve agent attacks. This is sometimes perceived as forced medication. But it could have been life saving if the attacks had taken place. Commanders decided the risk was worth it. In a similar situation, with similar intel, I would probably do the same in the spirit of protecting our troops.

These are tough times. I consider the daily stress of fighting an extremely unpopular war compounded with mental illness - it's piling horror on top of horror for very young people. My heart goes out to our soldiers.


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