What Is Post-Deployment Syndrome?
Post-Deployment Syndrome best describes probably the five key diagnoses or combination of concussion, which is also called a mild traumatic brain injury; post-traumatic stress disorder, which is also called post-combat stress disorder; major depression; chronic pain; and generalized anxiety disorder, GAD. Those are the five most common diagnoses that we're seeing as a result of the conflicts, and having two or more of those that are non-proving is typically put into Post-Deployment Syndrome. We typically wait a minimum of 3 months, usually 6 months, before using that label, because in those separate diagnoses, you don't have general anxiety disorder unless you've had it for at least 6 months. Post-traumatic stress disorder is at least 3 months. Post-concussive syndrome from a brain injury is at least 3 months. So we don't label someone--you know--at the get-go. It's inappropriate. It's a minimum of 3 months to see. If you're diagnosed with Post-Deployment Syndrome and the typical symptoms that go with that, usually by the time that occurs, you're a minimum of 3 months after injury or after deployment, sometimes 6 months, 2 years. The further out you are and the more subdiagnoses that are in that pot, the more stressors you had in theater and you've had since that time, are going to all weigh in to determine how well you're going to get and how long it's going to take. So if you're 3 months out and you've got four symptoms and two subdiagnoses and you haven't gotten well with the right type of care, you've got a wonderful chance of near-total recovery in the next 3 to 6 months. However, most people aren't seen until they're hardened in terms of their symptoms, they're a year out and they've got several other things going on their life. They've now lost their job, their benefits haven't come through yet, they've got other stressors. Now, in that case, it's going to take significantly longer, and it's feasible--it's possible that not all of these symptoms will go away. That's another key point. Just as in the management of brain injury, the management of pain, the management of a lot of behavioral conditions, there can be some recurrence of those symptoms, or sometimes you always have some pain in your back, or you always have some thinking problems from a brain injury. The key is to focus on the 95 percent recovery you've made, or 87 percent, and let's see how we can adapt your life and adapt the environment so that you can go back to activity--you can go back to your family life, your social life. You can go back to work. You can go back to sleeping pretty well. It's important to keep--to give them a realistic perspective--you know--say, like, "We're absolutely hoping for the best. But we're also going to plan this so that if you don't get fully well, you're still going to be active." Because there are lots of folks who aren't physically 100 percent who are working, who are having a great time in their life, who are playing with their kids, who are in the military. And that's a real important point as well.
Post-deployment syndrome can include concussion, PTSD, major depression, chronic pain, and general anxiety disorder.
Posted on BrainLine November 12, 2010.
David Cifu, MD is chairman of the Department of Physical Medicine and Rehabilitation at the Virginia Commonwealth University (VCU) School of Medicine in Richmond, Virginia, and national director of the PM&R program office for the Veterans Health Administration.
Produced by Victoria Tilney McDonough and Brian King, BrainLine.