David Earl Johnson, LICSW

3 minute read

AlterNet has the best article I’ve seen in the media about PTSD and the Iraqi veterans. Unfortunately, the news is not good. The proportion of vets with PTSD is higher in this conflict than in any other previously monitored war. Suicide accounted for over 25 percent of all noncombat Army deaths in Iraq in 2006, that’s double what it was in peace time and much higher than rates from Iraq War I and Vietnam. With the [VA reporting inadequate resources][2] to treat returning veterans, slow response to those most at risk for PTSD: the National Guard and Reserve troops, and the continuing stigma of mental illness are greatly exacerbating the problem.

Female vets are returning home with [PTSD due to sexual trauma][3], too often allegedly perpetrated by fellow American soldiers. There is some good news in all this. There is evidence that treatment is helpful to improving the quality of life of vets. Brief Cognitive Behavior Therapy can mitigate initial symptoms, but [doesn’t impact long-term prognosis][5]. However, there is a promising new treatment called “prolonged exposure” that has demonstrated efficacy in a few studies.

“Post-traumatic Stress Disorder is the result of subtle biological changes in the brain chemistry as a response to severe stress, which alters the way the brain stores memories. During a particularly intense episode, the body releases massive amounts of adrenaline, and the physiological alterations associated with the intense emotional reaction create memories that disrupt normal life.

The markers of post-traumatic stress include nightmares; avoiding reminders of the traumatic event; hyperarousal, a physiological response to stress that can lead to irritability and restlessness; and drug use and alcohol abuse. “Veterans screening positive for PTSD reported significantly more physical health symptoms and medical conditions than did veterans without PTSD. They were also more likely to rate their health status as fair or poor and to report lower levels of health-related quality of life.”

Among soldiers who develop PTSD, “there was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants.”

More than any previous war, the Iraq war is likely to produce the highest number of soldiers suffering from PTSD. There is considerable psychological distress associated with going into a country under the auspices of liberating a people, only to have them rise up against you, and it lingers long after the war has ended. Adding to the pressure is that many mental health officials believe that the nature of urban street fighting and insurgent warfare, coupled with heavy reliance on National Guard and Army Reserve troops, will result in higher rates of PTSD among this group of veterans than those in previous conflicts.

Another reason for the escalating mental health challenges is that while soldiers typically spent one tour of duty in Vietnam, troops are serving two, three and occasionally four rotations in Iraq. An additional challenge is the moral ambiguity of fighting a war without front lines, where the combatants are, or are dressed as, civilians. Many veterans are finding it difficult, if not impossible, to reconcile experiences such as shooting at civilians because they had failed to stop at a checkpoint.

“At least 30 percent of Iraq or Afghanistan [veterans] are diagnosed with PTSD, up from 16 percent to 18 percent in 2004,” said Charlie Kennedy, PTSD program director and lead psychologist at the Stratton VA Medical Center. The number of Iraq and Afghanistan veterans getting treatment for PTSD at VA hospitals and counseling centers increased 87 percent from September 2005 to June 2006, and they have a backlog of 400,000 cases, including veterans from previous wars. The most conservative estimates project that roughly 250,000 Iraq war veterans will struggle with PTSD. [MORE][7]“

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