Filed under: Mental health
Pain can be unpredictable, uncontrollable, and unrelenting, so even the most resilient Warfighters can be vulnerable to it. Because of pain, you may experience symptoms of anxiety or depression; your mind may even exaggerate the intensity and awfulness of pain. Socially, you might experience criticism, rejection, and negative interactions with family, spouse, or peers. Even if interactions are generally positive, you may want to withdraw from people or difficult situations
Chronic pain, which lasts longer than three months and is unresponsive to treatment, can affect quality of life for many. At least 100 million adults in the U.S. suffer from chronic pain. Unfortunately, combat and other situations make Warfighters especially susceptible to experiencing injury and pain. One study of an infantry brigade found that three months after return from Afghanistan, 44% of the soldiers reported chronic pain.
The American Psychological Association has shared evidence that relief from pain is more likely when mind and body are both treated. The National Center for Complimentary and Alternative Medicine has also indicated that continued study of non-drug approaches to pain management is a priority.
The latest trend in treating pain is the “biopsychosocial model,” which focuses on exercise and sleep (not just meds and surgery) as important biological influences. Important psychological factors include thoughts, emotions, behaviors, and attention. And impactful social factors involve healthcare, family, and work. All of these factors can contribute to understanding and mitigating the impacts of pain.
The American Psychological Association shares concrete advice to manage pain, including these tips:
- Distract yourself.
- Stay active and exercise.
- Know your limits.
- Follow prescriptions carefully.
- Make social connections.
- Don’t lose hope.
Having good social support is beneficial in many ways and can come in a furry package! Pets are wonderful companions, and you benefit by having one (or more) in so many ways: They get you out exercising, increase your self-esteem, decrease a sense of isolation, and help you through tough times. If that’s not enough, there’s a growing amount of research on the use of dogs providing therapeutic benefits to individuals coping with post-traumatic stress disorder and traumatic brain injury. Dog owners are also more likely than those who don’t have dogs to meet physical activity guidelines. So if you have a furry creature at home, remember to give them a big pat for enhancing your life. Indeed, one researcher described these relationships as truly “friends with benefits.”
For Warfighters about to be deployed, pets also can come with the added stress of needing to find a temporary home. To get some tips about what to do with your pet while you’re on deployment, check out this article from HPRC and/or this Department of Defense blog.
The term “mental toughness” is often tossed about, but what is it really? And do you have it? Mental toughness is important to the success of Warfighters, athletes, business people, and others who have to overcome adversity to be successful.
Sport psychologists and others interested in optimal performance talk a lot about mental toughness, but it’s a bit complex, so it’s often misunderstood. Mental toughness is not just one trait; it’s a mixture of them.
Boiling it down, mental toughness is a strong belief in yourself and an unshakable faith that you control your own destiny. If you’re mentally tough, you can remain undaunted by adversity.
If you have these 4 Cs, you’re mentally tough:
1) Control: You feel in control of your emotions and influential with the people in your life.
2) Commitment: You embrace difficulty rather than running from it.
3) Challenge: You believe that life is full of opportunities, not threats.
4) Confidence: You know you have what it takes to be successful.
Mental toughness is a psychological edge that some are born with and others develop. It allows you to consistently cope with training and lifestyle demands better than those who don’t have it.
You can develop mental toughness through a long-term process of developing mental skills. Leaders can promote mental toughness by creating a learning environment centered on the mastery of those skills (listed above) and by being generally supportive, encouraging Warfighters to maintain positive relationships. Over the long haul, to maintain your mental toughness, you need to continue honing mental skills, and you need a self-driven, insatiable desire to succeed.
Stress isn’t an isolated event. It can infiltrate your life in many ways. A survey of more than 12,000 military personnel across the services revealed the impact of stress levels on Warfighter performance. Compared with those with low stress, Warfighters with high stress were much more likely to be late for work, leave work early, get hurt on the job, or miss work altogether because of illness or injury. These trends were especially strong among a smaller subset of personnel who had recently needed a mental health evaluation. Other research suggests that stress can combine with a person’s (often unknown) predispositions, sometimes triggering mental health issues.
Depending on the severity of mental health concerns, focus on performance can take a back seat. So stress, mental health, and performance often go hand in hand. Stress-management techniques and proactive approaches to mental health can help stressed Warfighters perform their best.
When you have to focus continuously for long periods of time, your brain does, in fact, become tired. Take a break: The symptoms of being mentally burned out can include irritability, lashing out at others, inability to plan, problems with decision-making, lack of drive, and performance errors. Mental fatigue can set in before you’re even aware you need a break, leading to the types of attention problems that ultimately lead to poor performance.
Mental fatigue can also include:
- Lack of clarity in your own head
- Conflict between what you’re thinking and what you are actually doing
- Feeling like you are in over your head
Mental fatigue can also make you feel tired physically, which is why it can be a greater risk for those who must sustain both focus and physical alertness. A brain busy with non-relevant matters also can be tied to feeling “spent.” You not only lose your mental edge and feel more exhausted, but you probably won’t push yourself physically as hard as you need to.
Fortunately, there are ways to combat mental fatigue. The best way is take a break and escape to a place you find relaxing or inspiring. However, if you’re in an office or on a mission, there are various mind-body strategies you can try. Mindfulness techniques are “mental push-ups” that strengthen as well as refresh your brain, so give them a try and give your brain a break.
HPRC’s Performance Strategies “For single Warfighters coming home” gives you helpful tips for returning home after deployment if you are single. It highlights suggestions that manage your expectations (as well as those of your family and friends), as well as ideas for easing back into “normal” life, establishing an at-home schedule, increasing your support system, and other important aspects to consider.
September is Suicide Prevention Month — a good time to review how you can possibly help someone in need. Rule number one: Trust your instincts. If you’re worried about someone in particular, don’t ignore it—talk to that person about the concern you feel for him or her. Don’t know how? Be an ACE: “Ask, Care, Escort.”
Ask. If you’re concerned, ask directly and without judgment, “Are you thinking of killing yourself?” If he or she responds “yes,” determine if he or she has a plan by asking, “Have you thought about ways that you might hurt yourself?” (Note: The more specific the plan, the greater the risk).
Care. Next, care for your friend by staying with him or her, actively listening, staying calm, and removing anything he or she could use to hurt him/herself. Don’t leave your friend alone.
Escort. Tell someone immediately. Take your friend to someone who is trained to help, such as a primary care provider, chaplain, or health professional, and call the National Suicide Prevention Lifeline or 911 for additional support.
The Department of Defense has dedicated September to building awareness around suicide prevention. DoD has kicked off the campaign with a new Crisis Support Guide for Military Families—“Supporting Military Families in Crisis: A Guide to Help You Prevent Suicide”—that addresses suicide prevention, including warning signs, risk factors, and what to do in an emergency. Although the focus is on what families can do to help Warfighters at risk, there is advice for individuals too. Highlights include things you can do to take action: offering support, promoting a healthy lifestyle (caring for yourself, too!), and different treatment approaches that could help.
For more resources, go to HPRC’s section on suicide prevention.
The purpose of the 2011 Department of Defense Health Related Behaviors Survey of Active Duty Military Personnel (HRB) is to assess the health practices of active-duty service members. Substance abuse, mental and physical health, and lifestyle choices are important matters, especially when you need to be at your best for the demands of military life. Certain areas of this study directly affect human performance, and results (as reported in the Executive Summary) show that health behaviors vary between services.
Physical Activity/Body composition
Here are some figures from the Physical Activity/Body Composition portion:
- Overall, service members have lower rates of obesity (as defined by BMI) compared to the general public.
- More than one-third of active-duty service members age 20 and older were considered to be at a healthy weight, which exceeds the Healthy People goal as well as civilian population estimates.
- 75% of active-duty members practiced moderate to vigorous physical activity in the 30 days prior to the survey, with Army and Navy personnel having the highest rates.
- Almost half of service members do strength training three or more days a week.
Physical health and fitness are key components to optimal fitness. While these numbers are encouraging, there is no doubt that a larger portion of the military should be at a healthy weight and fit enough to fight. Make fitness and weight management your priority for performance.
- Only 40% of all active-duty personnel surveyed get the recommended seven to eight hours of sleep per night.
Sleep is an important factor in recovery. Poor sleep habits can take a physical and mental toll on your health, your relationships, and your performance.
Tobacco and alcohol
One area where the military could improve is in the use of tobacco products and alcohol:
- Almost one-quarter of service members reported smoking a cigarette in the 30 days prior to taking the survey, which is higher than the civilian population and the Healthy People objective.
- Smokeless tobacco use is also prevalent in the military with 12.8% of all service members using smokeless tobacco in the month leading up to the survey.
- Rates of binge drinking were higher in the military than in the civilian population and more prevalent in the Marine Corps than in any other branch.
Tobacco in any form is detrimental to your health. If you’re thinking about quitting smoking or would like to talk to someone about your alcohol use, there are lots of resources and professionals that can help you achieve your goal.
Stress and mental health
After more than a decade of ongoing war, troops have—and will continue to experience—significant mental stress as a result of their service. In general, 5-20% of service members reported high rates of anxiety, depression, PTSD, and/or other mental health concerns.
- The most common military-related sources of stress were being away from family and friends and changes in workload but included financial problems and family members’ health problems.
- Women reported experiencing personal sources of stress more often than men did.
- Those who drank heavily were more likely to report problems with money and relationships.
Drinking, smoking, overeating, and even attempted suicide are all negative coping factors when dealing with stress. The survey found that the most effective methods of coping were planning to solve problems and talking with friends or family members. Find out how to use productive and effective methods for coping with stress and mental health.
Nutrition and dietary supplements
Being fueled to fight is an important component for anyone in the military. Proper nutrition requires consuming healthy—and avoiding bad and potentially harmful—foods and beverages.
- According to the survey, active-duty personnel eat too many unhealthy foods such as snacks, sweets, and sugary drinks and not enough of the recommended servings of fruits and vegetables.
- More than one-third of personnel reported daily dietary supplement use.
What you decide to put in your body now may affect your performance and your career later. For more information on nutrition for combat effectiveness, read Chapter 15 of the Warfighter Nutrition Guide. And make sure you know what you’re putting into your body. Dietary supplements are not subject to pre-market approval by the FDA, and there are many ingredients that may do more harm than help. You can learn more about dietary supplements at Operation Supplement Safety. And for more information about the Health Related Behavior Survey, visit TRICARE’s webpage.
You know the positive effects of exercise on your health: how it can benefit every part of the body and dramatically extend your lifespan. But did you know that—in addition to reducing risk factors for cardiovascular disease, diabetes, and hypertension—exercise also can play a role in helping some mental health issues? Physical fitness and regular exercise appear to buffer against depression and anxiety, promote calmness, enhance mood, and help protect against the negative effects of stress.
Exercise also can benefit your brain in other ways. Exercise benefits learning and memory, protects the brain from degeneration, and increases the brain’s ability to adapt after new experiences. Physical fitness and regular exercise promote both physical and mental resilience—something that is important for all to think about.