Wartime Anniversaries Trigger Increased Symptoms in Vets with Post-traumatic Stress Disorder
Summer anniversaries of the First Lebanon War and Operation Protective Edge trigger a worsening of PTSD symptoms in discharged soldiers and veterans. Rambam’s Psychiatric Services Clinic is here to help at times like this. There is a noticeable increase in after hour's calls from discharged soldiers and veterans suffering from post-traumatic stress disorder (PTSD) during the summer, according to the Veterans Outpatient Psychiatric Services Clinic in the Division of Psychiatry & Mental Health at Rambam Health Care Campus. The triggering events, according to clinic experts, are the anniversary of the first Lebanon War (1982-1985) and Operation Protective Edge (2014), both of which occurred during the summer months of June to August, reminding patients of traumatic experiences from previous years. Post-traumatic stress disorder is a mental health problem that develops in some people following a traumatic event, causing them to feel stressed, frightened, and even threatened, although there is no longer any real danger.
About 720 people have been treated at Rambam’s clinic, a 75 percent increase over the past decade. Approximately half were diagnosed with PTSD, mostly combat soldiers from Israel's many wars: the Six-Day War, the War of Attrition, the Yom Kippur War, years of fighting in southern Lebanon, the First and Second Intifadas; and Operations Cast Lead (2008-9), Pillar of Defense (2012), and Protective Edge (2014).
"Among the strongest triggers for worsening post-traumatic symptoms is the anniversary of a traumatic event, Memorial Day of course, and periods when the defense establishment is at a high state of alert," explains Dr. Yael Caspi, Director of Rambam’s Veterans' Outpatient Psychiatric Services and a clinical psychologist responsible for the rehabilitation branch of the Israel Defense Force (IDF) in the Division of Psychiatry & Mental Health. "For example, new patients registered at the clinic after the Second Lebanon War, when the threat to the homes of northern residents recalled traumatic experiences from previous combat events in which they had participated. In tense times, such as during the "Stabbing Intifada" in September 2015, and when Air Force planes are frequently heard at different times of the day, there is a wave of visits to the clinic from long-standing and relatively stable patients due to an exacerbation of their anxieties, difficulties sleeping, and painful memories of past events, impacting their ability to function.”
Recently, in direct correlation with events occurring on the southern and northern borders, there has been an increase in clinic calls outside of daily visiting hours. To address these needs, Rambam maintains a Crisis Clinic (emergency clinic) every day until noon. The clinic is managed by a psychiatric nurse who helps patients without an appointment to cope with their distress until they can meet with a physician.
Post-traumatic Stress Disorder: Affects all Sectors of Israeli SocietyRambam’s medical clinic for IDF patients has been serving members of the IDF, and police and prison services for nearly 30 years. Applications for treatment must be made through the Rehabilitation Branch of the IDF, Northern District. The clinic staff includes psychiatrists, social workers, and psychologists, as well as students and interns. With an average annual growth of 50-60 new patients, ranging in age from their 20's to over 80 years, the clinic's patients represent a cross-section of Israeli society.
"We deal with people in the process of claiming mental health problems who are eligible for medical treatment, or those already recognized to have a disability due to mental impairment," notes Dr. Eyal Fruchter, Director of Rambam’s Division of Mental Health and Psychiatry and former head of the Mental Health Department in the IDF Medical Corps. "The vast majority of our patients are men, with similar representation in the general population of people who serve in the IDF from the Arab sector, especially Druze who are drafted, and Bedouin who volunteer to serve." There are, of course, South Lebanese Army (SLA) members from the Lebanese Christian community who came to Israel after the IDF withdrew from Lebanon in 2000, and a minority of Christian and Muslim Arab volunteers who view recruitment to the IDF as a civic duty. Women have also been treated, some were combatants and others due to events experienced during their service.”
Post-traumatic stress disorder is a very serious condition affecting the brain, body, mind, and spirit, with extensive consequences and injury to all areas of life, including a high probability of accompanying physical diseases. Psychiatric drugs do not usually help. Experience and research indicate that many people in the general population deal with post-traumatic symptoms without being diagnosed and medically recognized.
"Coping with chronic PTSD involves a long process of rehabilitation, including the rebuilding of skills and abilities that were once normal and have since deteriorated," concludes Dr. Caspi. "There is a need to rebuild the person's self-image and ability to maintain close interpersonal relationships. We find that the only way to 'beat' PTSD is to reconstruct, together with the patients, the personal competence that gives them the ability to gain control of their lives.”
Photo: Treating a soldier in the Shock Room at Rambam Photo Credit: Ben Yuster
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