The Forgotten Military Spouse
Military Mental Health: The Forgotten Military Spouse
Military spouses are living in a state of distress with the prolonged wars around the world. They endure the heavy burden of keeping their household running smoothly, dealing with deployments, and moving every 2-3 years, all while also facing everyday stressors that begin to weigh heavy on their shoulders. They do all of this with little access to resources to help them, thus leaving them looking for alternative methods of lowering their stress. According to the article Deployment and the Use of Mental Health Services among US Army Wives, where military spouses had a significant other that was deployed for 1-11 months, “there were more diagnoses of depressive disorders, sleep disorders, anxiety, and acute stress reaction and adjustment disorders,” when looking at the statistics for longer than 11 months there was a dramatic increase in each disorder (Mansfield et. al, 2010). With most resources being allocated to the service member, military spouses are now seeking out more holistic ways to reduce their high allostatic loads. There is an extreme focus on mental health and stress reduction for soldiers and less on their spouses. Most behavioral health clinics on military installations are for the soldier because the service member comes first. Leaving the spouse to look outside of the installations for providers where they run into long wait lists and many providers do not take their insurance. Military spouses are also misunderstood by their surrounding civilian communities leaving them to feel like outsiders in both worlds. These are a few of the obstacles the military spouse must face within their own community and outside of their immediate military communities to get help. It is argued by many that the service member has the more stressful job, but I believe that this may not always be the case.
While it is known that military spouses need mental health care, they lack accessibility and childcare support to truly get the help that they need. This leaves them either, not searching for help and suffering in silence or paying out of pocket to get help through alternative methods. Many spouses use at least one of these methods to help improve their mental health: nutritional therapy, chiropractic care, massage, exercise, or therapy to help improve their mental health outcomes. One of the unique situations that military spouses find on top of everyday stressors is added stress from the service member’s deployment cycles, “It is important to understand factors that contribute to reintegration stress since reintegration stress can affect their own and their family’s emotional health and well-being for months if not years into the future” (Marek, L. I., & D’Aniello, 2014). Military spouses are also at risk of the fact that combat stress may lead to “secondary traumatization of spouses and children and interfere with effective parenting” (Lester et. al, 2011). Secondary post-traumatic stress is not often taken into consideration when it comes to the military spouse which needs to be considered more often if this community is going to heal from the wounds of war. It has been found that PTSD symptoms in Vietnam War veterans have many negative impacts on relationships with spouses and family members. “Thus, research on PTSD appears to indicate that military children may be at greater risk relative to civilian children due to negative parent-child interactions, which appear to be related in some degree to how parenting skills, attachment, and hostility and violence are impacted by PTSD symptoms and impairment” (A, & Palmer, October 5, 2022). This creates an environment that adds loneliness to their stress buckets and eventually their buckets begin to overflow with unwanted symptoms that are then creating a vicious cycle with little resources to get help. The circumstances that they live in are enough to create trauma let alone the effects of war on their soldier. The military knows that this is an issue within the community and there are still not enough resources to truly help the spouses and families. In Special Operations, the soldier is generally deploys for 4-6 months a year. Additionally, training can take them away from the home anywhere from 1 week to 4 weeks each month that they are home. When stress is considered as either short or long-term. “Short-term activation of these neurohormonal pathways is normal; however, long-term activation, such as being in a state of chronic stress, can have deleterious effects on the cardiovascular, metabolic, and immunologic systems. Long-term, harmful activation of the body’s stress response can be described as allostatic load,” (Christina Joseph, 2017).
It is often thought that the soldier is the one who experiences the high allostatic load and not the spouse. Is this true? Or is it true that both the service member and the family unit suffer from this lifestyle? The journal article News from the front: A monthly study on stress and social support during a military deployment to a war zone stated, “This monthly diary study found that consistent with resource theories of occupational stress, the previous month’s combat stressors had a detrimental effect on many outcomes, and the resource of social support from work and home during the previous month improved physical health and depression, respectively” (Ragsdale et. al., 2021). This shows that when the soldier is supported, mental health issues such as depression can be positively improved. Service members have access to behavioral health and outside programs to aid in traumatic brain injuries (TBI) and PTSD. The behavioral health clinics that are located on installations have a multitude of resources to help the soldier which includes multiple different healing modalities. Soldiers have specific command-sponsored inpatient clinics that they can go to get help. Spouses do not have access to these resources, and it often leads to alcohol consumption as a coping mechanism.
Alcohol consumption is a contributing factor to increased negative mental health outcomes and the journal article Mental Health Outcomes and Alcohol Consumption among UK Military Spouses/Partners: A Comparison with Women in the General Population found that military spouses were more likely to suffer from depression than their civilian counterparts and they were more likely to suffer from hazardous alcohol consumption and binge drinking (Gribble et. al., 2019). It is common for the military spouses’ community to offer a bottle of wine or to have an alcoholic beverage when they are feeling stressed. It has been normalized within the community to associate high stress with alcohol consumption as the means to lower stress levels. While drinking is a coping mechanism for many military spouses it has deleterious effects on their mental health outcomes. Military spouses are not alone when it comes to the negative effects of alcohol consumption and their mental health in the journal article Prevalence and Correlates of Alcohol Misuse among Returning Afghanistan and Iraq Veterans, it was found that, “Thirty-six percent of the service members met criteria for alcohol misuse,” (Burnett-Zeigler, Inger, et al, 2011). When a service member suffers from abusing alcohol it is found that, “among those misusing alcohol who had received services, spouses were most commonly endorsed as facilitating the pursuit of care,” (Burnett-Zeigler, Inger, et al, 2011).
[Military spouse strategizing how to do everything alone while her spouse is gone, again. ]
Military spouses are known to initiate their own problem-solving by finding creative solutions to a problem. Many of the ways that they find help for mental health is by paying out of pocket for alternative ways to lower their stress. The article, Randomized controlled evaluation of the psychophysiological effects of social support stress management in healthy women states, “While the focus group showed improvement in psychosocial perceived stress during the group at follow-up appointments showed the success to be transient (Heimgartner, Nadja, et al, 2021),”showing that women need consistent group support for it to be effective in lowering perceived stress. It is also important to recognize that, “A person can establish healthy eating, exercise, and sleep habits. Well-rounded diets are associated with lower rates of depression, anxiety, and stress (Gale, 2022). ” While this might seem like these are well-known ways to reduce the stress that these women are under, they are not often given as resources. Spouses tend to use chiropractic care and massage therapy to reduce physical symptoms, not understanding that what they are experiencing is directly related to the stress that they are under.
In the end, there is a significant amount of evidence showing that the military spouse lives with high-stress loads, and yet, there are significantly more resources for those that serve. The research article Deployment and the use of mental health services among U.S. Army Wives states that “Overall, our data suggest that the mental health effects of current operations are extending beyond soldiers and into their immediate families (Mansfield et. al., 2010),” making it imperative that more resources become available to help reduce the amount of distress military spouses are facing. Repeatedly, it is the military spouse that holds things together, gets their soldier help when needed, is traumatized by this lifestyle, and can often be dealing with their own secondary post-traumatic stress. There are non-profit organizations that are taking note of the negative effect the military is having on the entire family unit. The Green Beret Foundation offers health and wellness support for the entire family, especially to spouses who need help. Operation Healing Forces, a non-profit, will provide all expenses paid marriage retreats for families within Special Operations that have dealt with illness or injuries. They are now offering caregiver retreats to the Special Operations spouses to give wives time to build community, heal, and to be able to relax. These are examples of organizations that are listening to the community and are filling in the gaps to help the military spouse where the military as an organization is falling short. Educating spouses about the negative health implications of not lowering their stress levels should be a focus along with providing multi-faceted healing modalities. Change begins when we first acknowledge what spouses are dealing with, second by providing education, and then by producing viable solutions for them to choose from.
Works Cited:
Mansfield, A. J., Al., E., Author AffiliationsFrom the Departments of Epidemiology (A.J.M., Friedman, M. J., Others, S. C. and, Others, P. F. and, Others, R. A. and, Others, S. C. and, Others, L. T. and, & Fass, R. (2010, January 14). Deployment and the use of mental health services among U.S. Army Wives: Nejm. New England Journal of Medicine. Retrieved October 5, 2022, from https://www.nejm.org/doi/full/10.1056/NEJMoa0900177
Marek, L. I., & D’Aniello, C. (2014, November 12). Reintegration stress and family mental health: Implications for therapists working with reintegrating military families - contemporary family therapy. SpringerLink. Retrieved October 5, 2022, from https://link.springer.com/article/10.1007/s10591-014-9316-4
Patricia Lester, MD, Catherine Mogil, PsyD, William Saltzman, PhD, Kirsten Woodward, LCSW, William Nash, MD, Gregory Leskin, PhD, Brenda Bursch, Ph.D., Sara Green, MA, Robert Pynoos, MD, William Beardslee, MD
Military Medicine, Volume 176, Issue 1, January 2011, Pages 19–25, https://doi.org/10.7205/MILMED-D-10-00122
Ragsdale, J. M., Kochert, J. F., & Beehr, T. A. (2021). News from the front: A monthly study on stress and social support during a military deployment to a war zone. Journal of Occupational Health Psychology, 26(4), 326–338. https://doi.org/10.1037/ocp0000278
A., & Palmer, C. (n.d.). A theory of risk and resilience factors in military families. Taylor & Francis. Retrieved October 5, 2022, from https://www.tandfonline.com/doi/full/10.1080/08995600802118858
Gribble, et al. “Mental Health Outcomes and Alcohol Consumption among UK Military Spouses/Partners: A Comparison with Women in the General Population.” Taylor & Francis, https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1654781.
Joseph, Cristina L. “Examining Chronic Stress in Spouses of Active Duty Military Members.” 2017 Digital Commons @ RIC, https://digitalcommons.ric.edu/etd/240/.
Heimgartner, Nadja, et al. "Randomized controlled evaluation of the psychophysiological effects of social support stress management in healthy women." PLoS ONE, vol. 16, no. 6, 4 June 2021, p. e0252568. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/A664135392/OVIC?u=tel_a_apsu&sid=bookmark-OVIC&xid=c0e97822. Accessed 29 Sept. 2022.
Burnett-Zeigler, Inger, et al. “Prevalence and Correlates of Alcohol Misuse among Returning Afghanistan and Iraq Veterans.” Addictive Behaviors, Pergamon, 13 Jan. 2011, https://www.sciencedirect.com/science/article/abs/pii/S0306460311000074.
"Anxiety and Stress Management." Gale Opposing Viewpoints Online Collection, Gale, 2022. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/OKAGSB857583876/OVIC?u=tel_a_apsu&sid=bookmark-OVIC&xid=2ccb49b5. Accessed 13 Oct. 2022.