PTSD and other psychological issues in Pakistan army

[FaujHistorian]

Hi All,
@extinct brought up a good topic in another thread. This is about the occurrence of PTSD (Post traumatic Stress Syndrome) in Pakistani army at a lower level compared to say US army soldiers. This is in no way an effort to put down all those millions of fine soldiers of US military, but a humble effort to perform some rational analysis.

Because in the end of the day, I firmly believe that US and Pakistan army soldiers are brothers in arms. Their destinies tied in everywhich way.

I have several family members and friends who were or are in PA and served in different theaters of war but have never heard of any case of PTSD in PA... I believe that being immensely sad at the moment is nothing but human but having nightmares for months or years is a whole different matter... it is the latter that is the signature of PTSD which miraculously is absent in PA...

Extinct bhai,

I too have relatives in army in the past and in present.

PTSD is not absent in PA, it is of lower intensity than one would expect. So why it is lower in intensity compared to the expected situation? There are many many reasons both professional and social.

1. Average age of fresh recruit in PA is higher compared to Western armies. This allows a bit more mature men to participate in the war and then be able to deal with after effects.

2. Martial traditions - Pakistani army is recruited from a distinct group of regions / tribes. While Western armies have much bigger and wider recruitment base.

3. Retirement age is much much higher in PA compared to Western armies. For example in US army, you do certain numbers of tours of duty, and you are let go into civilian life. In PA (or Indian army), The concept is very very limited and few army men leave army after 3-4 years of service.

4. Family structure. this is linked to #2 above. As most of the soliders come from martial tribes, certain outcomes like death and injury is accepted as "natural outcome", and everyone around the injured /handicapped soldier is willing to lend a helping hand.

5. Lack of alcoholism. While Alcohol in small quantities is great for ones health, the same think can't be said about someone becoming alcohol say finishing 1 or 2 bottles of liquor a day. I suspect a lot of PTSD issues become much worse when you add drug/alcohol abuse.

6. Wars are typically close to home. Pakistani army soldiers can usually come home on a short notice. The last big wars for soldiers from our region, that were long way from home happened to be WWI and WWII. Back then, even US army soldiers suffered much less PTSD. These days US soldiers serve through out the world and thus in many cases loose direct and immediate contact to the families back home. Suppose if we deploy 100,000 troops in Iraq to face off IS, then perhaps PTSD incidents could go up.


Please make sure you look at all of these as a holistic picture and not as individual factors. Some people may try to drag "Islam" into this, but Islam is not a valid reason for lack of PTSD severity. Sikh and Hindu from martial tribes in our region do as well if not better than Muslims soldiers from martial tribes.

So there you have it.

Please feel free to add more if you like.


Thank you.

@Slav Defence, @Luftwaffe, @WebMaster, @Jungibaaz, @jaibi, @notsuperstitious, @Azlan Haider, @ajpirzada, @DESERT FIGHTER, @AgNoStiC MuSliM, @Jazzbot, @Jf Thunder, @Hyperion, @JonAsad, @Nihonjin1051, @cirr, @Cherokee @Donatello, @Genesis, @Bamxa, @SarthakGanguly, @Cat Shannon, @Butchcassidy, @Norwegian, @Mr.UTurn, @GreenFalcon, @Syed.Ali.Haider, @CENTCOM,@Joe Shearer, @scorpionx, @Irfan Baloch, @orangzaib, @jhungary,@Xeric @Icarus

 

[Sliver]

On what basis have you concluded that PTSD is lower in PA than the US Army?
It could also be that PTSD symptoms are pooh poohed away in your "martial" race leaving the victims to suffer.

But really, please enlighten as to how or what is the basis of your statement PTSD being "lower" in PA

 

[FaujHistorian]

@Joe Shearer, @scorpionx, @Irfan Baloch, @orangzaib, @jhungary,

 

[Not Sure]

I seriously doubt the Pakistani Army is fully equipped to assess the prevalence of PTSD among the soldiers returning from the battlefield.

Even in instances where they do not get injured in battlefield, but are traumatized by what's happening to their fellow soldiers (such as in Siachen Avalanche) might adversely affect their psychological conditions.

Add to that the anger, frustration, and confusion that comes from fighting with those who too claim to fight in the name of Allah.

The rate of PTSD among Pakistani soldiers must actually be higher but the soldiers are not as frequently diagnosed and they make do with it somehow.

 

[Armstrong]

I don't know of any instance of PTSD or any other psychological problems in the PA !

Unless I'm mistaken we don't even have the problem of soldiers committing suicide 'cause of psychological issues.

What say you @Xeric @Icarus ?

 

[Icewolf]

PTSD may just be less reported in Pakistan or the soldier may just not understand what he is going through.
There is a big scientific study going on about psychological implications on knowing that you have a disease...

If a doctors tells you that you have cancer then you might experience cancer symptoms, even if you really don't.

 

[VCheng]

.......
PTSD is not absent in PA, it is of lower intensity compared to US army. So why it is lower in intensity compared to let's say US soldiers?
...............

Before we talk about anything else, please present the basis for claiming that "PTSD is of a lower incidence and/or intensity in PA" other than anecdotal stories and impressions.

Data about the US forces looks at the issue in detail and is available openly:

How Common is PTSD? - PTSD: National Center for PTSD

 

[extinct]

I don't know of any instance of PTSD or any other psychological problems in the PA !

Unless I'm mistaken we don't even have the problem of soldiers committing suicide 'cause of psychological issues.

What say you @Xeric @Icarus ?

I am sorry but all I can say is that what @Armstrong is saying is precisely what my experience is... I am an Army Brat and have NEVER heard of anyone doing anything to his fellow soldiers or family or anyone else or a nervous breakdown for that matter after a tour of duty... I could be an exception but I can only say what I saw and experienced... I studied in Army run schools/college in several cantonments and 70% of my friends were also Army Brats (the rest were sons of Government Public Servants etc)... There is no hush-hush within the fraternity of PA, stories and rumors float but I never even heard of anything like that... It is an enigma indeed, I only heard of this phenomenon after the US gulf wars... Very stereotypical to mention here but it is definitely ingrained in the "martial" tribe/caste/race or whatever you wanna call it... for good or bad, right or wrong reasons there is a strong belief in afterlife, "the will of the divine" and ofcourse the "nature of the job"... My mother always told us how uncertain/tough it was for her when my father went to wars but she always said that this is "what was to be done" and my father never ever mentioned any horrors or anything about any of them... there is a reason my avatar is what it is and if Pathankot rings a bell to anyone here then trust me my father must have been pushed real hard to have PTSD... The OP has some very good points and they should be considered and not just brushed aside as pure patriotic rhetoric... Militaries of ideological countries like (early) Israel and (to date) Pakistan with their back against the wall run on different batteries...

 

[Jungibaaz]

It's probably around, undiagnosed. I'm sure it's there, just not recognized for what it is and called PTSD.

 

[ghoul]

Most soldiers of Pakistan army are not from "martial races" anymore. From my own experience, most members of "martial races" prefer to join as officers rather. When they get rejected, they prefer other jobs rather than working as soldiers. Martial race theory was more or less abandoned as far back as world war 2 by Britishers themselves.

 

[extinct]

Most soldiers of Pakistan army are not from "martial races" anymore. From my own experience, most members of "martial races" prefer to join as officers rather. When they get rejected, they prefer other jobs rather than working as soldiers. Martial race theory was more or less abandoned as far back as world war 2 by Britishers themselves.

What you mentioned is correct, Army Brats will only join officer ranks for that is a tradition... then again an NCO's son can become a COAS as well... And you will not find a Lance Naik or Sepoy that is BA/BSc degree holder... but those are also from the same "martial race" from the same villages or towns... "martial race" here does not mean rich/educated/elite it only means the "type of blood" that runs through your veins...

 

[Viper0011.]

I seriously doubt the Pakistani Army is fully equipped to assess the prevalence of PTSD among the soldiers returning from the battlefield.

Even in instances where they do not get injured in battlefield, but are traumatized by what's happening to their fellow soldiers (such as in Siachen Avalanche) might adversely affect their psychological conditions.

Add to that the anger, frustration, and confusion that comes from fighting with those who too claim to fight in the name of Allah.

The rate of PTSD among Pakistani soldiers must actually be higher but the soldiers are not as frequently diagnosed and they make do with it somehow.

There are a couple of real scenarios and then there are 'assumptions' made here. Mental health isn't this easy or black and white.

In countries like Pakistan, India, etc, the mental health related issues aren't talked about a lot and it's a cultural norm. In fact, someone hallucinating (schizophrenia or paranoid bi polar disorder) is usually taken to some Imaam or Pandit or some other 'dude' to get rid of the 'evil spirit' or 'magic'.

A man shouting all the time is respected and others remain silent due to his older age. But in the West, people will tell him that his behavior is strange so he should go see a doctor. Also, someone coming from a divorced background with a destroyed family and displaying 'I can rule the world and everyone is after me', is really showing classic symptoms of the BI Polar disorder. But many people would see this kind of individual with respect thinking he is right and he can really do big things ONLY because of his or her status in a society.

Similarly, in the military, people with trauma have PSTD (its natural as we are all humans). There may be some reality to the fact that the numbers may be lowered in Pakistan / India or Israel's case as your militaries have a huge element of religion dictating wars vs. the West where a lot if time, people who are patriots but also want to progress in life, get in due to perks and money the military service offers. Another element is family support. Let's drill into this some more.


When a soldier fights with God in mind with a believe system behind it, then it becomes a 'cause'. That alone pushes an ordinary person beyond his brain's normal ability to tolerate trauma. Second, when a soldier does go through trauma, and comes back, early PSTD symptoms are really due to depression that becomes chronic and long term. However, in the West, everyone works. You don't have the luxury of having your wife, kids and parents around you all the time and people live individual lives vs. a joint family system like its in Pakistan, India, etc. The joint family system ensures that at any given time, you'll have company and they know you are upset so they'll sit down and provide that mental and emotional support a human needs. Money isn't the greatest factor in those countries so it makes a difference as people are more accessible to 'talk' and share life experiences with. If the West, you have to go see a shrink or a therapist once a week or so. Which I don't think is enough time but it does work and helps millions.

In the West, anyone getting out of the military service has to find work or continue with the service, the bills keep coming, the mortgage is due every month, student loans, etc. All these added responsibilities and associated stress adds more on top of an already suffering PSTD soldier / patient. So it further complicates the case. Many soldiers unfortunately face divorces or other family related issues too, so those have added impact and contribute to chronic depression and anxiety, in an already disturbed individual.

Plus, medications for Depression, Anxiety and other mental health issues don't kick in like Tylenol or Aspirin (in 45 minutes). These medications usually take 3 plus weeks to start showing results and often require trying a few meds before something suits a certain individual as we are all different. Someone mentioned Alcohol, yes, it's a super depressant. Many with depression and PSTD try drinking Alcohol thinking it will help fix their issues, but many become aggressive, manic and commit acts of aggression due to being on the wrong meds or drinking too much Alcohol.

All in all, having family to support you does have a huge role in relieving symptoms of depression, PSTD and other mental disorders. Religious believes with peaceful meditation and yoga type of activities help a lot in bringing back a normal life. But mental health is probably the most complicated top. and it is still being researched at a much larger scale today.

 

[extinct]

@orangzaib I mostly agree with what you mentioned...

Do consider that we have documented cases of PTSD or other discontent causing extremely distructive behavior and even suicide in IA (especially in demanding theaters like in Kashmir) but there has been no such report (that I have ever heard of or reported in public) stating as such for PA... Please note that chance of reports circulating within the fraternity of PA is much much higher than anything leaking in the public... There is some dynamic at play which keeps mass scale PTSD cases at bay in PA and this dynamic needs to be studied... I respectfully disagree that it is just "under reporting" or "under diagnosing"...

I agree with your rationale about the "sense of cause" and a family support system... lets just say in PA (or IDF in years past but not in IA in select conflict theaters) there is a sense of pride and honor in what they do and that shapes their outlook on the whole thing differently... PA thinks of itself as a savior of the "republic" and just like the courage of people who drown while saving others they take everything that comes their way as "cost of doing business"...

 

[Cinder]

Because in the end of the day, I firmly believe that US and Pakistan army soldiers are brothers in arms. Their destinies tied in everywhich way.

Easy there homie Lol

 

[Joe Shearer]

At a very superficial level, the more the Indian Army expands beyond the so-called martial races, the more the cases recorded of stress in serving soldiers, expressed not in classic terms as described as the symptoms of PTSD, but clearly seen in instances of nervous breakdowns, of fragging and of suicide.

Why?

I am not aware of the formal work done in this respect; our very professional medical services and military medical practitioners must have studied these phenomena but this discussion catches me off balance. Continuing at a superficial and even speculative level, it might be useful to mention that there may be a link to social norms of those who join as soldiers. Some parts of the country have far higher levels of acceptance of violence in day-to-day civilian life, some have less. This is to be taken as a sweeping generalisation, made only for the purpose of maintaining the momentum of the discussion.

Most of the country has far lower levels of endemic violence and readiness to take to violence than the bits that earlier were used to recruit soldiers: examples, the Punjab, Haryana (!!), Rajasthan, parts of UP and MP, proximate to the Punjab and to Rajasthan. Some new recruitment locations are also violence-prone: Nagaland, for instance, where the Nagas stand out over the surrounding tribes for their aggression and pugnacity. This might provide for tension and stress when an individual from other, less violent areas is recruited and taught to be violent.

Weakening of support from families is another reason. India's stress points are on the northern borders; most active duty is spent in the mountains. The bulk of recruits is from the plains, and far from the hills. Another set of stress points is in the border territory in the west; as the recruitment pattern shifts away from the traditional soldier mines, leave and relief issues become important. It is depressingly familiar to read about fragging due to disputes between NCOs and enlisted men on leave-related issues, or on disciplinary issues.

These might be two issues which generate actions not perhaps counted as PTSD, but which might substitute for it.

PS: Read posts 12 and 13 after writing this above.