By Griffin Swartell | CSMNG Staff Writer
The military demands its service members maintain a culture of physical fitness, and walking around any base, it’s easy to see the results. But good mental health lacks that same visibility. Mirrors can show toned muscles, but they’re not as good at reflecting finding inner peace and purpose. However, psychologists have published a wealth of information on mental health, including specialized research on those in the military.
Mental health issues aren’t uncommon in the military — according to the American Psychological Association-published book “Deployment Psychology: Evidence-Based Strategies to Promote Mental Health in the Military,” a 2004 report showed that between 16% and 29% of Soldiers and Marines showed symptoms of PTSD, depression or generalized anxiety when interviewed three to four months of a deployment. The book further notes barriers to seeking care, including major social stigma around asking for help.
“Less than half of service members with serious mental health problems reported receiving professional help,” the book says. “[Discussions on this] contributed to the development of population-wide postdeployment training to reduce stigma and encourage service members to seek care.”
But since mental health has no physical refelction, it’s not always easy to know how bad things are and how serious a response is needed. Another APA-published book, “Building Psychological Resilience in Military Personnel,” says that service members who address minor problems and anticipate challenges before they can turn into bigger problems tend to be more resilient.
“Seeking help when people are first noticing their distress [helps],” said Maj. Judy Cole, mental health flight commander for the 21st Medical Group at Peterson Air Force Base. “If someone hasn’t been sleeping or has been feeling down for a few months, that is the time to come in for help.”
She clarifies, however, that members should come in anytime for assistance, even if they have been struggling with mental health concerns for an extended period. With the variety of helping agencies the military offers, no one need to try to handle their concerns alone. Rather, she says that less healthy coping mechanisms have consequences, and if someone has been officially reprimanded or is facing legal consequences, asking for help won’t make the legal issues go away, but we can help individuals cope better with these situations.
It’s crucial, then, for service members to be paying attention to any warning signs of declining mental health. Cole suggests using an app or a journal to keep track of what’s going on, since writing things down can make trends or worrying behaviors pop out more clearly.
Another potentially useful tool from the APA perspective, “Building Psychological Resilience,” discusses the Soldier Adaptation Model (SAM) for looking at a service member’s mental health. It models mental health in three stages: potential stressors, strains and outcomes.
Potential stressors, as defined by the book, are pretty straightforward. It lists extended work hours, isolation from family, boredom and potential danger. That model focuses on deployed service members, so it’s important to reflect on other stressors, such as deadlines, paperwork and physical fitness tests. That reflection should extend beyond work, too, and encompass private life stressors like illness.
Strains, in the SAM, are negative responses to those potential stressors. They can be emotional responses like irritability or emotional exhaustion, but they can also be behavioral. Be aware of withdrawal from social groups or activities, as well as of increased drinking or substance use that may suggest substance abuse. The Center for Disease Control defines moderate drinking as no more than one drink a day for women and no more than two for men, with a “drink” being a standard 1.5-ounce shot of 80-proof spirits or the equivalent amount of alcohol in beer or wine. Be aware also of cognitive strains — things like unusual distractibility or forgetfulness. Other warning signs include reckless driving and unusual aggression.
Outcomes are the consequences of those strains, which includes things like chemical dependence, on-the-job accidents, anger management issues and more.
Generally speaking, Cole said that behavioral changes are tells when someone’s mental health is declining. Overeating or unhealthy eating can be a mental health red flag, for example, as can lingering headaches and starting or increasing a smoking habit.
As for the solutions, preventative or responsive, they’re simple and straightforward, and they involve taking basic care of oneself.
“There are a group of people that are more resilient, and from what we’ve seen, that group … they’re taking care of themselves,” Cole said. “They’re staying active. They’re putting good food into their bodies, engaging in enjoyable activities, and making sleep a priority … it’s the simple things that we do that have the most impact.”
The Department of Veterans Affairs offers a variety of apps to help maintain these healthy habits, as well as to ward off bad coping habits. Cole makes particular note of the Mindfulness Coach app, which, according to the VA website, is designed to help veterans, service members and others develop the habit of paying attention to a moment and understanding it without passing judgement. Practicing mindfulness can also include journaling, yoga, tai chi or other meditative practices, depending on the interests of the individuals in question.
The VA website also offers a variety of more specific use apps, from a Mood Coach that helps schedule and track positive, mood-affirming activities, to Stay Quit Coach and VetChange, which are designed to help users quit smoking and develop healthier drinking habits, respectively.
Of course, the military is fundamentally a workplace, so looking at strategies for coping with stress at work apply. In addition to mindfulness and developing healthy responses like diet, exercise, sleep and a sense of connection to friends and family, the APA talks about establishing and communicating boundaries. Having a clear line between working and not working can help keep work stress from bleeding over into relaxation and recreation time. It’s especially easy to neglect or be expected to breach that boundary in the internet age, but that makes said boundaries all the more important.
“There are very few of us who actually need to be attached to our phones 24/7,” says Cole.
Having that clear boundary makes it easier to plan relaxing and recharging time, too. Cole notes that service members get 30 days of leave time per year. She said it’s important to make use of that time, rather than letting it build up, and that it’s good to plan out longer blocks of time in order to be able to disconnect and recharge.