Treatment available to troops suffering from combat stress Published July 17, 2004 By Army Sgt. 1st Class Doug Sample American Forces Press Service WASHINGTON (AFPN) -- The servicemember who goes to combat and the one who comes back are never the same person, the Defense Department's director of mental-health policy said July 14."No one comes back unchanged," said Army Col. (Dr.) Tom Burke.Dr. Burke and other DOD health officials try to reach out to those returning from Iraq and Afghanistan who may be suffering from combat-related mental-health problems or post-traumatic stress disorder, he said.Recently, the Army released a first-of-its-kind medical report that showed frontline action had adversely affected the mental health of some servicemembers. Dr. Burke, who advises DOD leaders on mental-health issues, said combat veterans and their families should watch for changes in behavior that can range from mild depressive and anxiety symptoms to trouble sleeping and nightmares."In the majority of the cases, these symptoms are transient; they are common and diminish with time," he said. Servicemembers may have the occasional sleepless night or memories that come back out of nowhere for years, "and that's normal."Other symptoms to look for, he said, are sad and withdrawn moods, tearfulness, problems sleeping -- too much or too little -- and problems with appetite, memory loss and concentration. Drug and alcohol abuse also are symptoms of a problem.But the problems are not always mild, and the symptoms are not always subtle. "If (people start) talking about hurting themselves [or] killing themselves, it's important to not panic but to take that kind of talk very seriously and get them to help," Dr. Burke said, "even if it involves calling 911."The doctor said that mental problems can go on for years if not treated, and that symptoms of combat-related mental illness do not always happen right away. "They develop over time," he said.An Army study published in the July edition of the New England Journal of Medicine showed that 6 percent of soldiers and Marines returning from combat duty experienced mental health problems. Dr. Burke said the low number did not amaze him, based on what the Army has learned from studying prisoners of war suffering from post-traumatic stress disorder."The number of 6 to 12 percent is not surprising," he said. "The experience in the past among POWs," he said, "is (that) about 50 percent have PSD; among Vietnam veterans, over the years, about 30 percent; (Operation Desert Storm), 10 to 15 percent."He said that declining percentage of combat-related mental-health concerns might be attributed to the military's approach to getting better mental-health services to servicemembers before, during and after deployment."I would like to believe that part of that is because of the proactive care on the battlefield and the full range of services by the military health-care system," he said, "and the proactive preventive services that are provided (to) combat units."Also, he said, screening now takes place before deployments, preventive service is provided during deployments, followed by more screening during redeployments and follow-up care at treatment facilities.Dr. Burke said the low percentage also indicates that the majority of servicemembers surveyed are faring well under combat conditions. That may be because of realistic training and having the "best equipment in the world," he said.He said that tougher training and better equipment, along with a more stable rotation schedule "has contributed to the resilience of (servicemembers) and their ability to handle the stresses of combat."Dr. Burke said that Defense Department does not "want to see the Soldiers of today live through years of suffering when there’s help available now.” The military has a number of resources to help those seeking assistance, he said, starting with the servicemember's chain of command. He also encourages them to talk with comrades or their chaplains.He said that DOD "really cares" about its servicemembers and their families, and he encouraged them to take advantage of the various programs that are available."The help doesn't work if you don't come in to use it," he said. "Mental-health problems are problems that have solutions."Servicemembers can get confidential counseling through the military’s "One Source" program. The 24-hour-a-day service is for servicemembers and their families, and provides quick, professional assistance with problems.