Invisible Scars : National PTSD Awareness Month Shines Spotlight on Devastating Psychological Disorder

PTSD and Veterans

Every Monday evening in Nampa, Idaho, a group of twenty veterans gather to share stories and support. The men range in age from grizzled Vietnam warriors to young soldiers who have just returned from Afghanistan. On the night they invited me to visit, their leader and Warrior Pointe founder, Reed Pacheco, entered the room with a cell phone to his ear, brainstorming intervention strategies for a veteran who had threatened suicide.

Pacheco, a U.S. Army veteran of Desert Storm and Somalia pre 9/11, envisioned Warrior Pointe as a “safe zone” where former soldiers could come together to talk about the issues that continue to haunt them, including Post-traumatic Stress Disorder (PTSD). “The VA (Veterans Administration) just isn’t there for us,” he said, as heads around the table nodded emphatically.

Tom Bosch, a Carrington College Massage Therapist Program graduate who served two tours with the U.S. Army in Iraq and suffered a traumatic brain injury in an IED attack, noted that “we have a small pharmacy around this table. The VA can give you lots of things for physical pain. But they can’t cure the mental pain.”

 “The first thing people ask when you get back is ‘Did you kill somebody? How many people did you kill?’” one Vietnam veteran told me. “They just don’t understand how inappropriate that question is. We did what we had to do. You want to know what PTSD is like? You can’t know what it means to sit, 40 years later, in front of a television set reliving the same 40 seconds, over and over and over. You can’t know. You don’t want to know. We don’t look any different on the outside. But on the inside…”

PTSD is a serious psychological disorder that develops in some men, women, and children who have survived a traumatic or frightening ordeal. Sometimes the condition resolves after a few months. But sometimes it lasts a lifetime. Nearly 260 million people around the globe suffered from PTSD in 2013; in any given year, the 3.5 percent of adults in the U.S. have the condition, with a median onset age of 23. Quick response and early intervention can dramatically reduce the risk of developing PTSD after a traumatic event, which is why it’s so important for survivors to seek medical care as soon as possible.

Not everyone who experiences trauma develops PTSD, but 60 percent of women and 50 percent of men will experience at least one traumatic event in their lifetimes. More women than men develop PTSD; as I wrote in a previous article, sexual assault and domestic abuse are serious risk factors, with as many as 49 percent of women developing PTSD after rape. According to one 2009 study, as many as 60 percent of children also experience traumatic events, including physical assault, violence, and sexual assault. Children in foster care are especially at risk of developing the disorder: 21 percent of young adults who were raised in foster care have a PTSD diagnosis.

But nowhere is this largely invisible disorder more spotlighted than in the military. For active duty combat soldiers and veterans, as many as 26 percent of those who served in the post 9/11 Overseas Contingency Operations (aka the War on Terror) including tours in Iraq and Afghanistan, have been diagnosed with PTSD; 30 percent of Vietnam War veterans have it.

“The seventy-seven day siege of Khe Sanh hammered, pierced and drilled fear into the innards of our brains, the spot where fear resides beside the animal will to survive. We are forever alert, on guard, ready to laager, then attack. This is my PTSD,” said my friend Ken Rodgers, Marine, author, and documentary filmmaker when we were discussing the harrowing Vietnam War experiences that led him to write and produce Bravo: Common Men, Uncommon Valor. While Rodgers has been able to manage his condition, it’s something that he lives with every day.

Robert Feliciano is the Veterans Representative for the Idaho Department of Labor. He spent four years in the Army overseas, including one tour in Afghanistan, so he understands firsthand the issues that veterans with PTSD face as they try to return to civilian life. “The first three months over there, I was very jittery,” he told me. “After three months, I became complacent because you always heard the alarms.”

Now Feliciano works with veterans like Tom Bosch to help them transition to civilian life. But Feliciano says he struggles to help employers understand what PTSD is and how it affects veterans.  “Most employers see PTSD as if it’s a disease. That’s a misconception we need to correct,” he said. “The fact that a veteran was in a war environment makes the employers nervous. They have a pre-assumption that the veteran is a liability, not asset. That’s just not true at all.”

Feliciano now presents PTSD orientations to employers, noting that it helps to focus on positive stories of former veterans who are now model employees. For example, one call center in Boise has a veteran focus group that helps them to share experiences and be more focused and productive by allowing them to sit together. That same employer is actively creating ways to celebrate its veterans within the company, including bringing in on-site service providers.

All of the veterans I talked to noted that veterans are more at ease talking to other veterans than to others who have not shared their experiences. “I didn’t have social problems because I never socialized with anybody,” one of the Warrior Pointe veterans told me. “For me, PTSD wasn’t about the blood and guts. It was the survivor guilt. When your buddy goes down, you have to move on. You’re not crazy. You just keep it to yourself until you’re with someone who can understand your experience.”

The good news is that there are a wide variety of treatments for PTSD, with new therapies on the horizon. Promising new trials with medications like MDMA (also called Ecstasy) have shown improvements in PTSD symptoms.1 Some veterans and other trauma survivors are reporting positive impact with service dogs, though studies of their effectiveness are still preliminary.2 And the Defense Advanced Research Projects Agency (DARPA) recently announced that it will begin a project to create implantable devices designed to stimulate the brain to treat PTSD and other mental illness.3 Trauma survivors from veterans to sexual assault victims to children raised in foster care can find hope and healing. Robert Feliciano said, “I take medications on a daily basis, but PTSD is treatable. Even just working with a therapist can help. Medications can help. And satisfying employment plays a critical role in reestablishing self-concept and building self-esteem.”

1 http://psychcentral.com/news/2014/01/18/brain-scans-hint-at-therapy-uses-of-ecstasy-for-anxiety-ptsd/64700.html

2 http://www.ptsd.va.gov/public/treatment/cope/dogs_and_ptsd.asp

3 http://www.usatoday.com/story/news/nation-now/2014/05/28/military-brain-mental-illness-chip/9663083/

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