North Carolina:Teaching doctors to spot PTSD

Local mental health group teaching doctors to spot PTSD in veterans
StarNewsOnline.com - Wilmington,NC,USA
By Vicky Eckenrode
Staff Writer


Published: Sunday, May 25, 2008 at 5:46 p.m.
Last Modified: Sunday, May 25, 2008 at 5:46 p.m.


When Dan Hickman left Iraq, there were stark differences from when he came home from Vietnam decades earlier.

There were no critical debriefings like today. No references for counseling services.

"When you came back from Vietnam, nobody asked you how you were," said Hickman, who in Iraq commanded the 30th Heavy Separate Brigade, North Carolina Army National Guard's largest brigade. "It wasn't a topic of conversation. Nobody even heard of PTSD (post traumatic stress disorder)."

Hickman, whose civilian job is executive vice president of Cape Fear Community College, said the culture was one that sidestepped discussions about mental health and the stress of returning from combat.

"I call it the John Wayne generation, you just sucked it up and moved on," he said. "Your only refuge was your buddies and for some alcohol and things like that."

Despite the changes, Hickman said more can be done to help soldiers who serve in Iraq, particularly for so-called citizen soldiers who aren't returning to careers on military bases, but are instead thrown back into their civilian jobs and communities.

For some, the transition is jolting.
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It isn't just the doctors needing to know what PTSD and how to spot it. It's everyone. I was involved with training some Chaplains to know what to look for as well as what PTSD is at a local hospital. They wanted to know if there were ways to know what to look for. I gave them several ways, but the number one thing I suggested was that they listen to the family. If they hear the words, "suddenly changed" that should be their first clue what they may be dealing with. PTSD is caused by trauma but there are all different kinds of traumatic events. It's very hard to sit and ask people to think about these things when most will not even be aware of the cause.

Vietnam veterans found that while they thought they came home with problems, they were not aware of what it was. For some, they were able to cope with it while it was mild (as with my husband) until another stressor hit and they could not cope on their own any longer. They dealt with the nightmares and flashbacks, the divorces and job loss, the twitches along with everything else but stuffed it into the back of their minds. A secondary stressor sent them over the edge to the point where their lives were in danger. In this case, the family should be asked if the patient was a veteran. This will open up a series of follow up questions. It is not just Vietnam veterans within the older generation. It is also Korean veterans and the remaining WWII veterans. Gulf War veterans also need to be addressed and then there are the new generation veterans.

Within the population of others, there is a long list of traumatic events that can lead to the development of PTSD. If the doctors and providers pay attention to what the family and the patient are saying, they will have clues of what they are looking at. "Suddenly changed" is classic for PTSD.