Fighting PTSD, the inside war

"Stress is a universal component of the human experience. But nowhere is it so predictable, so intense and so persistent as in a war zone, where constant risk of death or injury, frequent loss of comrades and long separations from home are accepted as the norm."

Fighting PTSD, the inside war
By BENJAMIN M. IANZITO
September 11, 2009
It wasn't until 1980 that post-traumatic stress disorder (PTSD) became a recognized psychiatric diagnosis with a disabling symptom profile seen widely in both civilian and military life. Before then, psychiatric problems caused by military action were recognized as serious but transient consequences of combat. "Soldier's heart," "shell shock" or "battle fatigue" were older terms referring to the physical manifestations of combat stress. The symptoms were considered rare, were often covered up or dismissed, and usually stigmatized the victim as either weak or cowardly.

During the Vietnam War, when I served in the Air Force as a psychiatrist, servicemen and -women with psychiatric disorders were deemed either "mad or bad" and were usually discharged during training or when they got into trouble during their one-year tour of duty in Vietnam. Trauma-related symptoms were lumped together in a diagnostic wastebasket called "situational disorders" and viewed as impediments to the mission.


Our contemporary engagements, Operation Iraqi Freedom and Operation Enduring Freedom, have also been taking their toll on the psychological health of our servicemen and -women. But the attitude in the Pentagon and throughout the Department of Veterans Affairs toward psychiatry is much different from what it was during and before Vietnam.

The government is investing heavily in time, money and personnel to provide mental health treatment and benefits to troops returning from Iraq and Afghanistan, as well as to older veterans of prior wars. I have been fortunate to help in a small way by performing psychiatric evaluations on some of our newer veterans and have learned firsthand how much things have changed in the 35 years since Vietnam.

PTSD TALK
"Soldier's Heart - Post-Traumatic Stress Disorder in the Armed Services" will be the topic at the Cape Lyceum at 7 p.m. Sept. 14 at the Cultural Center of Cape Cod, 307 Old Main St., South Yarmouth.
We now know that failure to adequately address combat stress and its consequences probably played a crucial role in the development of disabling, and often lethal, psychiatric illness in a large number of Vietnam veterans.

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Fighting PTSD, the inside war