Filed under: Mental health
Since 2000, around 350,000 service members have been affected by traumatic brain injuries. TBI often impacts memory, especially short-term memory. Think of long-term memory and short-term memory as “holding bins” for information. Your long-term memory can hold information from several days to decades, while your short-term memory retains information for just a few seconds. And short-term memory is closely associated with working memory (your ability to manipulate information in your head) and sustained attention (your ability to maintain focus).
When memory problems strike, short-term memory, working memory, and sustained attention tend to suffer before long-term memory does. Regardless of cause, memory of a remote event stands out more than newer events because your mind has “rehearsed” the older event repeatedly, essentially embedding it in your brain through repetition. By comparison, your mind hasn’t yet “learned” the newer event. For example, you might recall every detail of combat stories but have difficulty remembering what you ate for lunch. In this case, brain connections that rehearsed the combat story have become solidified, while connections responsible for learning this new information haven’t formed yet.
Depending on the location and nature of the injury, your brain might work differently than it did in the past. This could happen because brain cells that used to “communicate” with each other easily are now being rerouted.
Short-term memory, working memory, and sustained attention also can be affected by other factors such as stress, distraction, poor sleep, depression, anxiety, and/or body toxins. The cause isn’t always obvious. Your doctor can help sort it out, answer questions about your condition, treatment, and prognosis, and refer you to a neuropsychologist for further evaluation. In the meantime, you might find HPRC’s TBI resources useful too.
Sometimes just understanding what’s going on can help the process of recovery. If you’re experiencing post-traumatic stress disorder (PTSD), it might help to have a better idea of how your brain functions and how the various parts are supposed to work. This also can help you understand the treatments used to help “rewire” your brain, so it can work properly again.
PTSD is a mental health condition stemming from traumas—experienced during combat, disasters, or violence—that impact brain functioning. The alarm system in your brain, that normally helps ensure your survival, malfunctions; it becomes triggered too easily. In turn, parts of your brain responsible for thinking and memory stop functioning properly. When this happens, you have difficulty comparing what’s happening now with safe events from the past. Read more...
You probably know how good it feels to tap your foot to the beat of a familiar song. But did you know that moving your body in sync with a beat could help improve thinking and learning abilities? It might possibly repair brain injuries too.
Recent hi-tech breakthroughs show that lining up precise, repeated movements (such as hand clapping) with a certain beat could boost brainpower. Similar to how biofeedback helps you use your mind to ease stress and manage pain, this synchronized metronome training (SMT) approach helps to master the timing of these movements.
SMT is linked to improved concentration, academic performance, behavior, and muscular coordination in children diagnosed with Attention-deficit/hyperactivity disorder (ADHD). It’s also a promising treatment for those diagnosed with brain-based movement disorders such as cerebral palsy, Huntington’s and Parkinson’s diseases, and stroke-related injuries. SMT offers mind-body benefits for active-duty soldiers coping with blast-related traumatic brain injuries (e.g., inattention and short-term memory loss). It’s even helped healthy golfers step up their game.
SMT helps improve fluid movements for those experiencing excess muscle tension. It also enables better concentration for those feeling distracted or anxious. People can learn to complete a task without trying too hard. Through SMT, you can train your brain by “letting” movements happen—key to its success.
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 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.
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.