An Cosantóir

| 27 www.military.ie THE DEFENCE FORCES MAGAZINE regularly witnessing death. Whilst many personnel are resilient and possess the mechanisms to cope with such life-threatening stressors, an overwhelming 29% develop PTSD in the first years after deployment. The following first-choice interventions are recommended in many clinical practice guidelines: eye movement desensitisation and reprocessing, exposure therapy, cognitive therapy, cognitive restructuring therapy, cognitive processing therapy, and trauma-focused cognitive behavioural therapy. It is evidenced that many military personnel do responded well to these recommended therapies. That being said, the majority of veterans (in excess of 75%) continue to receive therapy four years after their initial treatment. Furthermore, military personnel diagnosed with PTSD tend to benefit less from psychotherapy than their civilian counterparts. The postulated reason for this is due to the complex nature of combat-related traumatic events. That being said, exposure therapy and cognitive processing therapy prove very effective in targeting combat-related PTSD. From a social standpoint, military personnel tend to perform worse in treatment if they are socially isolated, have a dysfunctional family, or experience martial distress. The trauma experienced by these individuals during various conflicts while on deployment has the potential to negatively impinge on their psychological wellbeing and in turn may have a negative impact on the mission's success. Therefore, the importance of psychological support cannot be overstated, during deployment in the building of mental health resilience and improving overall wellbeing, and also post-deployment, to aid the individual in the transition back to civilian life. This combined with the stresses associated with evolving war tactics, for example the development of nuclear weaponry, has proved that psychological support is of the utmost importance to military personnel - further highlighting that peacekeeping operations have evolved to more complex politico-military- humanitarian efforts. Social support is also important when personnel return from deployment or on retirement from the Defence Forces as an aid in transitioning back into civilian life. This social support may in some way compensate for the lost comradery and 'brotherhood' these individuals may experience on leaving the military. Conclusion United Nations Peacekeeping Operations in general have been the subject of much worldwide attention over many decades. However, the mental health of personnel deployed on such missions has not received the same attention. With adequate preparation and training there is potential to equip serving personnel with the means to boost their mental resilience during service which is of the utmost importance as it can encourage those who are suffering to come forward, without fear of stigma, at an earlier stage in their illness. Should the significance of peacekeepers mental health and psychological wellbeing receive more attention, the efficacy of peacekeeping operations could also benefit as a consequence. Now that we have more advanced methods of measuring someone's psychological wellbeing it is easy to question why PTSD was not diagnosed earlier and treated as a severe illness. But as in today's society, there was a stigma around mental health during the First World War period. Perhaps the origin of PTSD was actually a result of the anxiety experienced by soldiers, returning from war, in reacting to the stigma of 'madmen' and the perception of the population thinking the individual to be 'gone mad'? Maybe they felt the intense pressure to be seen as courageous when all they had witnessed was death and suffering. During the First World War the number of patients in mental asylums increased dramatically, perhaps this was a factor which pushed for the diagnosis and care of those suffering from PTSD. While PTSD is widely studied, there are still a number of questions surrounding it: why do some people experience PTSD while others do not? Why does it affect some people more than others? Can we predict its onset before the event? Are there structural or chemical differences in the brains of those who suffer? However, one thing is for sure – many more veterans and civilians will continue to suffer until these questions are answered. References Alexander, C. (2010). World War 1 100 Years Later: The Shock of War. Carter, S. et al (2011). Relationships between soldiers' PTSD Symptoms and spousal communications during deployment. Chen, Y. and Huang, W. (2011). Non-impact, blast-induced mild TBI and PTSD: Concepts and caveats. Haagen, J.F.G, et al. (2015). The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis. History of PTSD. (n.d.). Timeline. Global.unc.edu. (2018). King's College London Researcher Sharon Stevelink Delivers Talk on Mental Health of Armed Forces ~ UNC Global. Jones, E. and Wessely, S. (2005). Shell Shock to PTSD. Joseph, PhD, S. (2011). Is Shell Shock the same as PTSD? nhs.uk. (2018). Causes. Raju, M. (2014). Psychological aspects of peacekeeping operations. Shigemura, J. and Nomura, S. (2002). Mental health issues of peacekeeping workers. Staggs, S. (2018). Posttraumatic Stress Disorder (PTSD) Symptoms. Zagata, D. (2010). History of PTSD: How Post Traumatic Stress Disorder was Slowly Recognized as a Disorder. www.military.ie THE DEFENCE FORCES MAGAZINE | 27 Lady Clementine with her daughter The Vietnam War Soldiers experiencing trauma in war

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