Combat Stress and PTSD: My latest column in the North County Times

Here is my latest column in the North County Times.  As a veteran of multiple tours in two wars I have personally experienced and witnessed first hand the the wide spectrum of combat related stress and the effects of Post Traumatic Stress Disorder.  To me it is a truly important subject, and I am writing about the subject as a columnist in our local newspaper.


Stigma still attached to PTSD

Every person who goes to war brings a little bit of it home. For some, they carry memories of their adventures and some stories to tell. Others, however, bring home a burden that weighs upon their psyche and may accompany them for the rest of their lives.

Even though two combat veterans may have been in the same places and experienced the same stresses, joys, horrors and camaraderie that are all factors in the personal experience of warfare, they will return home affected by their participation in very different ways.

There is a wide range of emotional and psychological effects that result from an individual’s involvement in conflict. No veteran returns home without some change within themselves, and in that regard they are no different from any other person who experiences a stress and separation for extended periods of time. Research and common sense both irrefutably show that prolonged exposure to stress, as well as involvement in terrifyingly brief but immensely stressful situations, results in psychological change. Just how much change varies with every person, and the effects of the experience differ for each and every person who goes through such an event.

These effects are not limited to participants in war. Anyone can suffer from long-term exposure to stress or from short-term specific events. Battered women who endure abusive relationships agonize long after they leave the abuser, just as survivors of disasters such as plane crashes or earthquakes endure inner turmoil even though the actual event has come and gone.

Veterans of war share the same inner conflict and anxiety as anyone who has been through the emotional wringer.

Does that mean that we have over a million sufferers of post-traumatic stress disorder? Nope. The majority of veterans return from the combat theater with no psychological damage, but instead with a broader perspective on life that shapes their worldview and subtly alters their thought processes and reasoning as they move on with their lives. They live as they did before they left, except for a greater reservoir of experience to draw from.

That said, a significant number of combat vets experience real difficulty adjusting to life at home when they return from overseas. They suffer from combat operational stress injury, or COSI. Their symptoms range from mild to severe, and from acute to chronic. Some sufferers require little assistance to overcome the challenges they face when they come home, while others are completely incapacitated by the ravages of PTSD.

To the tremendous credit of the Department of Defense and the Veterans Administration those who suffer from COSI are encouraged to participate in treatment that is comprehensive, effective, non-attributional and free. Active-duty personnel can take advantage of Deployment Health Centers that offer a wide range of assistance and treatment options that are designed to help the service member understand and cope with their stress injury while still wearing the uniform. The Veterans Administration likewise offers a wide array of services for veterans who are no longer actively serving; all a veteran needs to do is contact the Veterans Affairs office for assistance.

And therein lies the rub.

There are dozens of programs in the DOD and VA to help people who have fought for their country, but surprisingly few actually seek help even though they really need it. The programs are free, so there is no financial reason to stay away. They are also non-attributional, meaning that there is no official retribution or black mark on a person’s record should they seek help.

Why, then, do so many fail to seek treatment?

The answer is simple. Even though society has come to accept that the mind can suffer injury just as the body can, the same cannot be said for the members of the armed forces. There is a very real stigma attached to those who seek mental help while in uniform, and the perception of the stigma follows closely behind servicemen and servicewomen as they transition back to civilian life.

So why does the stigma still exist in the military when society has largely come to accept it?

The military exists to fight the nation’s wars. Sure, it does a lot of other things, too, like perform humanitarian missions at home and abroad and provide employment —- but the true purpose of the military is to fight.

In order to go to war and win requires that the people in the military be aggressive, fit and mentally inured to hardship in order to do the things required of them in combat. The cultures of the Army, Navy, Air Force and Marine Corps all revolve around things like strength, resilience, aggressiveness and toughness. Any form of weakness is contrary to the warrior culture, and individuals who exhibit weakness are viewed as lesser beings in the eyes of their peers.

Seeking help for stress injuries is viewed as weakness. Even though thousands of people really need help, they won’t pursue it. The official DOD policy states that seeking help is non-attributional and that there will be no detriment to a person’s career, but the truth is different. Warriors don’t want to be seen as mentally frail, so they just suck it up despite all of the opportunities to help overcome their injuries. They fear ostracism, so they just hide their pain and soldier on.

I know, because I have seen it first-hand. I’ll explain in my next column.
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