VA Steps Up Effort to Educate Families on Stress Disorder

Tri Valley Herald

March 24, 2008 – With roughly one in five soldiers or Marines serving in Iraq and Afghanistan developing post-traumatic stress disorder, and many of them remaining untreated, family members are the target for educational outreach by the Department of Veterans Affairs.
“I think it’s crucial for (military) family members to be aware of the potential mental health problems of their loved ones,” said Dr. Byron J. Wittlin, director of mental health services at the VA’s San Bruno clinic.

As part of an emerging emphasis on training family members to spot signs of the disorder, Wittlin spoke Thursday evening to a group from the Pacifica Military Moms, a chapter of the national organization, The Blue Star Mothers of America.

Debbie Smyser, co-founder of the Pacifica group and a trainer at Genentech in South San Francisco, has a 21-year-old son in Iraq. Some members of the group also have offspring in Iraq or Afghanistan, and Smyser said they wanted to be prepared to help them if they return with mental distress.

“We need to know what to recognize, in case we need to get them help,” she said. “It’s just to make us aware and what signs to lookfor.”

Post-traumatic stress disorder, or PTSD, is nothing new, emphasized Wittlin. It’s a condition plaguing humans for millennia that now has a new name.

“It’s been around for thousands of years,” he told the group. “As long as there’s been war, as long as there’s been trauma.” In World War II, the condition was called “shell shock,” Wittlin added.
Nor is PTSD unique to military personnel who have witnessed or experienced violence from combatants, or other extreme stresses of wartime service, Wittlin explained.

Roughly half of all adults will experience trauma in their lives, ranging from serious vehicle accidents and natural disasters to criminal attacks and sexual abuse. While it’s normal to feel frightened, anxious, angry and depressed after such incidents, if they persist long after the event, that a sign of PTSD.

Of those experiencing trauma during their lives, roughly 8 percent will develop PTSD, according to federal statistics.

But military personnel in Iraq and Afghanistan are coping with, in essence, guerrilla warfare, and must remain constantly on alert, Wittlin said, which also heightens their risks of developing PTSD. They also regularly endure 50-mile-an-hour dust storms, sleep deprivation, long separations from family, and multiple tours of duty.

It takes a trained clinician to accurately diagnose PTSD, and the hallmark symptoms include recurrent and intrusive thoughts about the trauma, avoidance of triggers that are reminders of the event and either a numbing of emotions or the opposite — heightened irritability and excessive vigilance.

For many people, PTSD will fade on its own, he said. But others, it persists, many times for years, disrupting relationships with spouses, children, other family members and friends. Jobs are often hard to keep for those with PTSD, as they become easily irritated and critical of others.

Others begin abusing alcohol or drugs to relieve their symptoms, Wittlin said. At its worst, sufferers can become suicidal, an act easier to carry out since many veterans keep weapons at home.

“A number of veterans come back feeling wary enough that they keep a loaded gun in the house,” said Wittlin. “We discourage that,” he added. “Or we ask them to lock it up.”

It’s not a sign of weakness, experts emphasize, that some develop the condition while others don’t. Researchers are studying risk factors for PTSD, and among them are early childhood trauma, Wittlin said.

Still, many military personnel avoid mental health treatment, often for fear of stigma. Other active-duty personnel are reluctant to report these problems, as they don’t want to abandon their comrades, which “engenders shame,” he added.

As a result, many military personnel remain undiagnosed or untreated, he said.

And the condition is highly treatable, Wittlin emphasized.

“People get better,” he said.

And while nonexperts can’t with certainly conclude if a veteran has PTSD, they can play a crucial role guiding those in need of aid into a health care clinic.

“We encourage family members to be supportive, to mainly listen,” Wittlin said. “And if they feel the vet needs some help, to call the VA and to refer them into us. This is really a complicated problem. And in our system, we have a lot of experience. And this is one of the services we want to offer.”

For more information on Pacifica Military Moms, who accept members from throughout the Bay Area, visit


For more information on PTSD, visit the National Institutes of Health’s Web site on the condition at

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