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2009

Originally published in Wired, August 18, 2009 .

Military’s Plan for PTSD: Early Diagnosis Good, Prevention Better

The military is struggling to address a surge in mental health problems being reported among returning soldiers. As the New York Times recently reported, suicides are at their highest level on record, with 129 reported between January and mid-July — more than the number of troops killed in active combat during the same period.

090417-F-2907C-064The military is struggling to address a surge in mental health problems being reported among returning soldiers. As the New York Times recently reported, suicides are at their highest level on record, with 129 reported between January and mid-July — more than the number of troops killed in active combat during the same period.

A boost for existing programs is step one of the Pentagon’s plan to help vets. They’re hiring more staff for mental health services, and they’ve commissioned a five-year study on soldier suicide. But the military also wants new and better ways to handle PTSD and related illnesses: they’re requesting proposals for projects to improve diagnosis and treatment, and maybe even prevent post-war trauma entirely.

First up is diagnosis: earlier and for every returning soldier. Sleep disorders are a common symptom of PTSD, but diagnosis requires expensive tests in dedicated sleep clinics. Now the military is after proposals for a portable sleep monitoring system that would be cheap enough for widespread at-home use. The tool would measure physiological markers like respiration and pulse, and transmit the data via wireless signal.

But two other projects would allow for diagnosis even earlier: while soldiers are still in combat. The military wants a non-invasive, portable system that can diagnose traumatic brain injury using speech pattern analysis. According to the military’s solicitation, PTSD and depression create “speech and language processing deficits” that show up in basic conversation — and could be detected long before more serious symptoms.

The military’s also after a portable gadget to detect subtle brain wave changes in soldiers immediately after combat. Acute head injury, which often leads to PTSD, creates subtle changes to brain waves and oxygenation levels. The changes can’t be picked up by EEG or MRI alone, but new research shows that combining both tests yields better results. By creating a combo-system for in-combat testing, the military hopes to pick up on the first signs that a soldier suffers from brain damage.

Earlier diagnosis could improve treatment outcome, and might even prevent soldiers with undetected problems from being redeployed. But even better would be stopping wartime stress at the source.

And that’s where Darpa, the Pentagon’s far-out research arm, enters the fray. In June, they hosted a one-day information session on “Enabling Stress Resistance” using pharmacology to short-circuit the brain’s stress response. Now, they want specific proposals to “inoculate Warfighters against the complex stressors of combat operations.” And save the military some serious cash: Darpa reports that psychological treatment for soldiers returning from Iraq and Afghanistan could cost up to $6 billion dollars.

But until the military’s armed with anti-stress vaccines, war vets will still be popping pills. Sometimes in lethal combination, which led to a rash of overdoses last year. The Pentagon’s taking note of the risks, and wants to revamp their electronic monitoring system to incorporate patient information with a more detailed profile of medications and their potential side effects.

[PHOTO: U.S. Department of Defense]

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