Refers to a variety of psychological disorders, usually temporary but sometimes permanent, resulting from exhaustion, the stress of combat, or the cumulative emotions and psychological strain of warfare or other traumatic situations. It is characterized by anxiety, depression, irritability, memory and sleep disorders, and various related symptoms. Also called combat neurosis; war neurosis. See also posttraumatic stress disorder, shell shock.
“When you were in Baghdad you were going all the time, all day and half the night, the fatigue catches up with you. There are times when I’ve had problems concentrating, I’ll have the 1000-mile stare,”
– Joseph Sharpe, a reservist who recently returned from a year-long deployment to Baghdad.
The lack of sleep, high levels of stress, long deployments, are very stressful on a soldier, even those not in regular fire fights. Some even relied on Red Bull to get through the day. The mental strain of living in a combat environment, referred to as combat stress, doesn’t immediately subside when a soldier returns home. Instead, it is often compounded with the realization that an entire year has gone by and a lot has changed while the soldier was deployed.
More than 15 percent of service members returning from Iraq and 11 percent of service members returning from Afghanistan have met the screening criteria for major depression, generalized anxiety, or post-traumatic stress disorder (PTSD), according to a study by Col. Charles W. Hoge, a medical doctor at the Department of Psychiatry and Behavioral Sciences at Walter Reed Army Institute of Research.
Modern day antidepressants primarily are theorized to improve neurotransmitter post-synaptic transmission utilizing different mechanisms. Ensuring adequate neurotransmitter synthesis of dopamine, serotonin and norepinephrine alleviates symptoms of PTSD and depression is of paramount importance. Not surprisingly in combat stress and fatigue these are commonly problematic.
Stress is a major factor that depletes neurotransmitters. When we are stressed our catecholamines (epinephrine, norepinephrine and dopamine) rise leading to a release of serotonin and GABA to counteract it. If we are constantly under stress and releasing serotonin and GABA we will desensitize to them and they will become depleted. This leaves the catecholamines to run rampant. Excess amounts of catecholamines in our system lead to depression, anxiety, and insomnia. Poor sleep, illness, and excessive heat (all experienced in combat downrange zones) will also deplete serotonin as does cortisol. Cortisol actually damages serotonin receptor sites.
The importance of proper nutrition is often forgotten or underemphasized in modern day Westernized medical care. There is much research that supports the benefits in particular of the essential B vitamins 6, 9 and 12 in neurotransmitter synthesis and thus being helpful in battling depressive symptoms, including fatigue. Vitamin B9 (Folic acid) and Vitamin B12 work closely together in many bodily functions including brain and nerve function, turning food into fuel, and using fats and protein. Therefore it’s often recommended that they be taken together.
The mental changes caused by deficiency of Vitamin B12 can rise from difficulty in concentrating or remembering, mental fatigue and low moods, to a severe depression, intense agitation etc. These symptoms are often experienced in combat fatigue. Left untreated these can easily lead to depression. Vitamin B6 has a major role in regulating mood disorders and is the most implicated of all the vitamins in the cause and treatment of depression. Low folic acid (Vitamin B9) levels are somewhat common and a deficiency can lead to mental sluggishness, forgetfulness, and irritability.
Ultimately to achieve optimal mental and physical wellness, we need to eat better balanced diets, manage stress and exercise routinely. As the average American diet fails to meet the necessary daily requirements Advyndra® offers a synergistic blend of important amino acids and B vitamins that support neurotransmitter synthesis. Replenish first—strengthen your foundation is the approach. A dietary and nutritional approach that is not addressed via modern day anti-depressants.
Germaine Hawkins, D.O.
Director, Mental Health Division