Page 42 - Beaufort County Military and Veterans Resource Guide

The Unrecognized Invisible
Wound from Military Service

Post-Traumatic Stress Disorder (PTSD), traumatic causes functional disability: hyper-arousal/irritability,
brain injury (TBI) and major depression have all been avoidance, emotional negativity/numbing, and intru-
identified as invisible wounds of the Iraq and Afghan- sive nightmares/flashbacks. Moral injury is accom-
istan Wars. Despite the im- panied by feelings of guilt,
provements in treatment shame, self-condemnation,
interventions for PTSD over loss of trust, loss of mean-
the last decade, many veter- ing, and spiritual struggles.
ans are not responding to the Its impact can change the
latest pharmacological and trajectory of relationships
psychological approaches. and of one’s behavior, work,
There is also concern over and adjustment into civilian
the rise in suicide rates both life. It can also lead to ques-
in active duty and Veteran tioning of one’s character
populations. An additional and worth. Until resolved,
factor that remains unrec- these internal conflicts can
ognized and unaddressed is in turn exacerbate social
Moral Injury. Moral Injury problems (e.g., isolation,
is not a new term as it was aggression, legal issues) and
first identified by Jonathan mental health symptoms
Shay in his 1994 book, “Achilles in Vietnam”. (e.g., anxiety, depression, PTSD, substance abuse,
suicide risk).
Researchers describe moral injury as a breach of a
person’s ethical code that inflicts lasting behavioral, An estimated 11% to 20% of the 2.7 million men and
emotional, and psychological damage. This “wound women who deployed to Iraq and Afghanistan have
to the soul” most often occurs when individuals com-
mit, fail to prevent, or witness an act that cuts against
their moral beliefs (Kutz, 2019). This can happen
either through an act (perpetrator) or failure to act
(silent witness) in war or garrison incidents, and/or
can result from abuse, threats, or betrayal (victimiza-
tion, e.g., by peers or chain of command) while serv-
ing in the military. Other examples include decisions
that result in catastrophic loss, such as survivor’s guilt
or torturing/killing the enemy, civilians, or children;
being a survivor when others have died can leave life-
long scars.

According to the VA, PTSD is a “mental disorder that
requires a diagnosis” while moral injury is considered received a PTSD diagnosis linked to their military
a “dimensional problem” with no definable threshold service. A study last year showed that 9 in 10 veterans
for its presence. PTSD is a fear- based disorder that diagnosed with PTSD also exhibited at least on symp-

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