Dd Literature Review

Literature Review:
The term Post Traumatic Stress Disorder, has only recently been officially recognized by the United States. The Diagnostic and Statistical Manual of Mental Disorders (DSM) officially added PTSD in 1980. Prior to 1980 PTSD was known as “Nostalgia”, a name coined by Swiss military physicians in 1678 (“PTSD”). Around that time, French, German, and Spanish doctors were also studying and discovering its effects and symptoms as well. The symptoms found can across the same all around the world, they found that the patient exhibited a type of melancholy that gripped its host causing a loss of appetite, lack of sleep, anxiety, stupor, fever, and incessant thoughts of home (Hoge, Charles W. 2004).
During the Civil War, in the mid

1800’s, physicians noticed the same anxiety and fear. At that time, it was known as “soldiers heart” or “irritable heart”, by Jacob Mendez Da Costa. Da Costa also found that the soldiers had higher blood pressure and heart rates. Perceived as a disease of cowards, soldiers afflicted with it were treated in hospitals typically used to treat the mentally insane (Hoge, Charles W. 2004). During World War I, symptoms of PTSD appeared again, and this time, it was coined as “shell shock” in reference to soldiers suffering from PTSD being near bomb droppings. However, not all soldiers who developed the symptoms had been near bomb droppings. At the time, scholars were studying PTSD more extensively and several people, including Sigmund Freud, to interest in the symptoms. However, it was not until World War II that a large number of soldiers developed the symptoms and it became a clear phenomenon that needed to be observed and treated. Now known as “battle fatigue”, psychiatrist found that around half of the soldiers engaged in longer more intense hours of combat were more likely to develop the symptoms of PTSD, regardless of their previous mental health (U.S. Department of Veterans Affairs, 2007). In 1947, the U.S. Army released a documentary, Shades of Gray, detailing the effect of PTSD. It also explained the different treatment methods and preventative solutions. During the Vietnam War, PTSD came to be known as “Gross Stress reaction” and was officially included in the Diagnostic and Statistical Manual I (DSM).
The symptoms of PTSD often appear in a multitude of ways, some of which can affect a person’s quality of live more than others. In a recent article published by Medical News Today, Jason Doctor proposed that “of [the] four major symptoms associated with PTSD, not all were associated with a patient’s immediate quality of life” (Medical News Today). Instead is seemed that the majority of debilitating symptoms were those related to heightened arousal, trouble sleeping, irritability, and vigilance. Depression and anxiety also impaired a person’s quality of life. Although it troubles professionals that avoidance is one of the most common coping strategies, they found that avoidance was positive in that improved immediate welfare, therefore is was found to be less capable of harming the quality of life in the present moment (“PTSD”).
Treating PTSD is a time-consuming and expensive process that typically involves psychotherapy, of Cognitive-Behavioral Therapy (CBT).

Treatments can vary depending on which proves to be most effective for the patient. The most common treatments are, exposure therapy, cognitive restructuring, stress inoculation training, and virtual reality treatment. Currently, certain drugs are being tested and researched to determine if they can help prevent symptoms of PTSD. Researchers are also trying to determine if transcendental medication, computer vaccines, and other less conventional methods of medication might help to mitigate of even prevent PTSD. In order to better understand PTSD, scientists are also looking into certain genetic markers, childhood events, prior diseases, or any other factors that may play a part in getting PTSD later. Finally, the long term effects of PTSD could potential lead to increased risk for hear disease in women, Alzheimer’s and dementia in veterans, and a decrease in drug effectiveness for those with HIV (Ramchand, Rajeev,

2010).
Today, PTSD is recognized, researched and given more credibility than it did a century ago. The treatment of PTST relies on mental repair though a number of costly session of psychotherapy, thus, a large number of veterans who are diagnosed with PTSD often do not receive the medical treatment that they require. In addition to not getting the necessary treatment, those who are able to receive the medical treatment often require years of treatment. A conservative estimate, by the Census Bureau, estimates that around 20% of U.S. veterans suffer from with PTSD or TBI. These health care costs cannot be sustained by health care policies of the CBO or VHA (Rosenheck, R.A., 2007).
The cure for PTSD or a TBI is not an instantaneous remedy. It can take several years for a patient to overcome their symptoms and even then, there is no guarantee that all symptoms will dissipate. The uncertainty and length of the process serves as a deterrent for both budgets and the patients. The incentive for curing a veteran suffering from PTSD is very low considering that the treatment will take a considerable length of time and is not guaranteed. Therefore, it is in the program’s best interest to either limit the number of veterans or to come up with a “cure” more quickly (Veterans Day, 2014). This is both unfair to the patient as well as detrimental to society as a whole. Considering that veterans are at an increased risk to commit or participate in violence after they return home, it in necessary to measure the cost to society . Veterans who suffer from PTSD and are “cured” are encouraged to participate in civilian life again, however there is no guarantee that they will not act out in some way. Should a patient involuntarily act out, the results are not ideal. Veterans can be sent to prison or in some cases even receive the death penalty all because they were unable to get the help that they needed in the first place (Veteran’s Health, 2012).
Patients are unlikely to seek treatment due to the debilitating nature on both their personal and professional life. For instance, taking time off of work hinders both their income and their professional development. An employer is less likely to reward an employee who constantly takes time off for health reasons. Being aware of this, veterans are wary of accepting help for the VHA. Another deterrent is cultural perceptions themselves. PTSD is seen as an illness of the weak of as an inability to handle situations of extreme duress (“PTSD”). This sense of weakness is particularly hard for males, as cultural perceptions have it unacceptable for them to be weak. These soldiers have been trained to ignore and deny their own vulnerabilities, such as accepting that they suffer from PTSD or a TBI. Outreach programs are attempting to eradicate this stigma, though it continues to persist and often prevents veterans from seeking the help they need.
Some research, consistent of drug trials, is being done to see if improved psychotherapy will be helpful for PTSD patients. If there are medications that can improve the effectiveness, then psychotherapy session will not necessarily have to take up as much time, nor would the be as costly. If drug treatments can influence the efficiency of psychotherapy, then the competition between therapists will increase. If drugs are able to improve psychotherapy sessions, then the similarities in how those sessions are run will increase. If deviations amongst therapists drop, the result will be increased competition and thus, the supply of therapy will increase resulting in a drop in prices. Additionally, if screening methods can better predict where some patients might succumb to PTSD, then improvements in deployments will reduce the number of veterans developing symptoms. This will cause the demand for medical care to decrease which would further decrease prices for psychotherapy. In some local communities, techniques such as yoga and meditation have been implemented with varied results. Meditation helped the veterans sleep more peacefully and reduced their feelings of depression. If these techniques can help improve the symptoms of PTSD, then the subsequent decrease in demand will also lower the prices. If the cost of medical care were to drop for these veterans, then both the VHA and CBO would be able to focus their efforts on helping new patients as well as provide more support to those most affected by PTSD.
The presence of veteran suicides speaks to the inefficient way that veteran’s mental states are handled. While everyone is at risk of committing suicide, the truth is that more veterans commit suicide, this is due to stress that combat causes. Suicide in the United States actually is quite expensive. This is because it reduces the workforce participation as well as wage loss. When a family’s disposable income is threatened due to a loss in income, their disadvantages increase. They are unable to consume as much which adds to the loss in consumption, and they are also forced to seek income elsewhere. Families may turn to the government programs for their medical and sustainability needs. Therefore, the government spending is allocated to assisting those in need, rather than contributing to other sectors such as infrastructure or capital assets. Although it is important that the government provides additional income, part of the issue could be solved by preventing PTSD symptoms from overtaking a veteran’s life. If there were more programs in place that helped screen for mental instability in veterans, or programs that could lower stress and anxiety in veterans, it is possible that suicide rates would drop. Ultimately, mental repair is necessary in order to prevent suicide, this being said, policymakers should take this information into consideration when making decisions regarding PTSD and it’s effects on society.
The U.S. Department of Veterans Affairs make options available to veterans who suffer from PTSD. Though the department does not offer clinical services or therapy, it does provide information that connects veterans to medical services that help veterans deal with their PTSD. Essentially, the Department of Veterans Affairs is a huge resource for veterans and their families who are seeking help in finding the necessary sources for recovery (Department of Veterans Affairs).
The nature of PTSD is enigmatic and quite difficult to treat. Soldiers who experience PTSD and receive treatment must put their careers, relationships, and life on stand by in order to cope with the many symptoms caused by the disorder. Programs that offer therapy and treatment to veterans are taxed but the weight of having to cure something that is complex in the fact that it is neither seen nor is it heard. The very idea of mental disorder is that it exists only in a persons psyche. It is not an illness comprised of infections or even a disease at all. With this being said, the treatment rests in the amount of effort the person is willing to put into overcoming their fears and trauma that they experienced. The programs and therapists that help these patients can take several years in order to cure them (“PTSD”).
Some of the problems that arise with mental health issues is the fact that very few soldiers who suffer from PTSD wand to be seen.

The military does not force any veterans to undergo a psychiatric evaluation. For those who do seek treatment, dropping out of treatment is a troubling issue. It shows the lack of importance being placed on mental health. There is also a lack of effort being put into supplementing soldier’s time. The time it takes to deal with PTSD is considerable and they simply need time to devote themselves to alternative areas of self-improvement such as education or advancing their careers. Taking the time to handle the stress and overcome anxiety is neither rewarding in the short run, not an opportunity cost worth pursuing, from the soldier’s

perspective.
Finally, there is the issue of homeless veterans. After returning from war, many veterans are unable to re-immerse themselves into society and thus, they join the homeless population. Homelessness is generally understood to be the condition in which a person is unable maintain a stable residence (Lee, Barrett A. 2010). Many people see homeless as sloppy, unkempt, and filthy people who reside in the street. However, there are many different reasons that someone could be homeless. Many people assume that homeless people are drug addicts or alcoholics. However there are many veterans in the homeless population. Veterans who are unable to get the medical help that they require often have a difficult time holding down a job or even getting on in the first place. With no steady means of income, they are forced onto the streets. These soldiers, who put their lives on the line to serve the United States are treated like garbage when they return. They give so much only to receive almost nothing in return. If they were able to receive the medical assistance and social re-integration that they needed, they would be better off.

Conclusion:
In the military, many soldiers make a career out of serving their country. Those who believe that admitting to suffering from PTSD is a weakness risk of missing promotions or even being fired. This stigma is partially true within the private sector as many soldiers are often overlooked when hiring due to the belief that they will be a liability in the future. The avoid this issue, it is important that soldiers are treated just as any other citizen and that employers are educated on PTSD and the symptoms. Soldiers must also feel welcomed in their business environment regardless of their mental health status.
Overall, the issues surrounding PTSD revolve around not knowing the benefits of treatment. Soldiers who fear that they will not be hired, or fired are unable to participate in activities that the actually enjoy. Eradicating these misconceptions falls to the employers and the military, through education and ensuring that all soldiers are treated fairly. For soldiers who do receive treatment should focus on the long term benefits of eventually not suffering from the disorder. They should feel as though their treatment is positive, not as a burden to their time. Giving them the same opportunities as other civilians promotes the fact idea that they are an important part of society in both the workplace and in their social lives.
Employers who do offer fair treatment of veterans must be backed by the military. Their help in hiring veterans should be shown off and encouraged. Their work should be recognized as a socially responsible business model.
Ultimately curing PTSD, and TBI’s will be a long process where soldiers, employers, and the military must educate themselves on the long term effects. If war and combat is allowed to continue, then soldiers who come from abroad must be cured appropriately and given the same chances to live their lives as fully as those who do not go into combat. The Unites States should recognize their contribution to the national defense, and work to promote their wellbeing.