May 21, 2007- More local veterans are seeking help for post-traumatic stress disorder, and the numbers are expected to rise as more troops return home from Iraq and Afghanistan.
But, while the military is getting better at addressing mental illness, some doctors say that not enough veterans are seeking help. Psychologists say the stigma attached to mental health is one reason more veterans are not coming in for help, but the sooner they are treated for post-traumatic stress disorder, the better chance they have of overcoming it.
“Of course, there’s no cure for memories, there’s no cure for difficult experiences, but there are many things that can help,” said Bruce Purvis, a psychologist at the VA Medical Center in Asheville.
Post-traumatic stress disorder, or PTSD, is an anxiety disorder that can occur following the experience of a traumatic event. While anyone who witnesses a traumatic event can suffer from PTSD, people who have been in combat are extremely susceptible to developing the disorder.
Andrew Clark, 24, began experiencing symptoms of the disorder about one month after he left the Air Force in 2005, following two deployments to Iraq.
Clark started to have nightmares. He would wake up soaked in sweat and his heart would be racing. He found himself searching the side of the road for trash as if he was looking for roadside bombs. He couldn’t wait in line and would explode if the person behind the counter couldn’t ring him up fast enough. After his unit was deployed back to Iraq and Clark was unable to go, he plunged into depression.
“Adapting back to civilian life is the hardest part of it,” he said.
Clark said when he was in Iraq, it was necessary to put his emotions aside so that he could do his job.
“It took me awhile to understand that I’m not in that environment anymore,” he said.
PTSD numbers increase
The National Center for PTSD estimates that about 30 percent of men and women who served in Vietnam experience PTSD and an additional 20 percent to 25 percent have had partial PTSD at some point in their lives. The center also estimates that between 6 percent and 11 percent of veterans from the war in Afghanistan and about 12 percent to 20 percent of military personnel who served in Iraq have been diagnosed with PTSD.
At the Asheville VA Medical Center, the number of patients being treated for PTSD has increased over the past 10 years.
Like most VA Medical Centers across the country, most of the PTSD claims at the Asheville VA are from Vietnam War veterans, but the number of veterans from recent wars who are being treated for the disorder in Asheville has more than doubled to 170 patients from October through April of this year from 58 patients during the 2006 fiscal year. This number does not reflect veterans who are also getting help at the Veterans Center and other mental health facilities.
“Until we send our robots out to fight their robots, we’ll always have PTSD,” Purvis said.
Soldiers returning from World War I experienced shell shock, and veterans from World War II were said to suffer from combat fatigue. But a formal diagnosis for PTSD did not exist until the early 1980s.
According to the National Center for PTSD, people with the disorder have four major types of symptoms: They re-experience the event either while awake or asleep; they stay away from people, places and things that remind them of the trauma; they experience a loss of emotions; and they feel on guard, have trouble sleeping and are irritable.
To receive a formal diagnosis of PTSD, these symptoms must last for more than one month, cause significant distress and affect the person’s ability to function normally.
The combat behaviors veterans learn in the military and the return to civilian life after being in a life and death situation can exacerbate some of these symptoms.
But, Purvis said these are normal responses to an abnormal situation.
“It’s the way we’re put together,” Purvis said. “It’s the way we’re wired.”
Dr. Alan Krueger, a former psychiatrist at the Asheville VA Medical Center, said even if military personnel don’t develop PTSD or other mental health issues, war has some effect on everyone who is involved in it.
“I don’t think anybody who goes into combat comes out unscathed,” Krueger said.
The lessons of Vietnam
But doctors say newer veterans like Clark may have a better chance at recovery than some of the older veterans who fought in Vietnam.
“The symptoms are very much the same but the package is different,” Purvis said.
Lonnie Darr, 60, was in Vietnam for three years. After he left the military in 1980, he couldn’t hold down a job, his wife and kids left him, and he withdrew from the world.
One morning, he woke up in his car under a freeway in Los Angeles, homeless and alone, and decided to seek help.
“I never heard of PTSD until I went to the Vet Center,” he said. “I knew something was horribly wrong, but I couldn’t put my finger on it.”
Although Darr is now getting help, he still struggles with many of the symptoms of PTSD on a daily basis. He is married for the third time, but he hasn’t been able to work for the past three years because of severe anxiety and intrusive thoughts about Vietnam.
Most days, Darr stays in his home office, which his wife has nicknamed “the bunker.” Even a trip to Sam’s Club causes him severe anxiety.
While the number of times he thinks about Vietnam has decreased, a few times a week, Darr will be back in a bunker staring into the face of a teenage North Vietnamese soldier or running through a firefight in Khe Sanh.
“In my day-to-day life, I see Vietnam all the time,” Darr said. “This doesn’t leave you.”
Because PTSD was not formally diagnosed until the 1980s, many Vietnam veterans like Darr went without help for a long time, which made their symptoms worse and harder to overcome.
“When the Vietnam veterans came out we seemed to be pretty unaware of the psychological consequences of combat,” Purvis said.
Krueger said because they are getting treatment at a younger age, veterans of Iraq and Afghanistan might have a better chance of overcoming PTSD than the veterans of previous wars.
Younger veterans have fewer additional health problems, and because they are being treated earlier for PTSD, fewer structural changes take place in the brain that compound the problems, Krueger said.
“The sooner we can intervene, the better,” he said.
The military now also acknowledges the need for mental health services. Families and soldiers are educated about PTSD, and there are more support services both before and after soldiers go to war. The military screens soldiers for mental health problems during combat, and they have critical stress units on the ground in Iraq.
Krueger said doctors and the military today also realize that the methods of individual deployment and lack of time for adjustment back to civilian society during the Vietnam era affected soldiers’ mental health. Veterans of the Vietnam War also came home to an unwelcoming society and felt isolated and rejected, something that contributed to the development of PTSD.
Purvis said he thinks these differences may mean that younger veterans will have an easier time overcoming PTSD.
“I think we’re trying to do a number of things to help the younger veterans because of the lessons learned from Vietnam,” he said.
Problems still exist
But, there is still a stigma associated with mental illness, both in the military and in civilian society, that prevents some veterans from getting help for mental health issues.
Both Clark and Darr said they tried to deny that they had a problem in the first place, a common response in veterans with PTSD, and both men said many of their friends claim there is nothing wrong with them even though they suffer from many of the symptoms of PTSD.
“They often think they’re the only ones who are affected that way,” Krueger said.
Clark said he realizes now that he isn’t alone and the help he has received at the VA has helped him with his symptoms.
He is less irritable with other people and realizes he doesn’t have to constantly be on alert, but Clark said he still suffers from occasional nightmares and anxiety.
“I don’t know if it goes away or not,” he said.
But, Purvis said that if veterans get help soon enough and they receive the proper care, they can overcome PTSD.
“I think you can put a great deal of it behind you,” he said.
What PTSD sufferers can do
How to get help:
People who suffer from PTSD should see a therapist to help them deal with their symptoms. Veterans can call the VA Health Benefits Service Center at (877) 222-VETS to find the closest VA Hospital or Veterans Center.
Help in WNC:
Veterans who want help at the VA Medical Center need to get into the VA system. They can do that by visiting admissions at the VA hospital. For emergencies, veterans should go to the emergency room. Veterans need to prove their eligibility for services by bringing a copy of their DD214. The Asheville VA Medical Center is at 1100 Tunnel Road. Veterans can also call the hospital at 298-7911.
Veterans also can visit the Veterans Center in Greenville, S.C. The Veterans Center does not require any paperwork and accepts walk-ins. For more information, call David Hollingsworth at (864) 271-2711. The Vet Center is at 14 Lavinia Ave., Greenville.
On Wednesdays, Hollingsworth comes to the Pardee Health Center in the Blue Ridge Mall in Hendersonville.
For more information, call 692-4600. There are group sessions at noon and 6 p.m. Individual counseling is available by appointment. There is also a spousal support group that meets once a month.