November 11th, 2008
10:14 AM ET

PTSD: The invisible wounds of war

By Jennifer Pifer
CNN Medical Senior Producer

On Veterans Day, I often think of two men I never knew. Richard Hartman was a pilot during World War II. His plane was shot down over Czechoslovakia in early September, 1944. Around the same time, back in a small southern Illinois town, his wife, Mary, gave birth to their first child, a daughter they named Jane. Mary’s family found out while she was in labor that Dick was MIA. They decided to wait to tell Mary that her husband was missing. A few days later, word arrived that Richard had been killed in action. Mary later said that she knew something was wrong when she stopped receiving daily letters from her husband. This event isn’t written in any book, but its part of my history. Mary is my grandmother. Her little girl Jane is my mother.

One soldier survived the plane crash. My cousin Roberta, who is now on the shady side of 90, recently told me a little bit about what happened to him. He ended up in a VA hospital. Richard’s father and brother visited him once when he returned stateside. The soldier told the family that Richard was a hero and that he did everything he could to save the crew. Imagining the horror of such an event, I asked Roberta if knew if the soldier suffered “shell shock” as it was called back then. Roberta was silent for a moment. “The war changed a lot of people,” was all she said.

When I see battle pictures from Iraq and Afghanistan, I often think about the psychological effects of war. A report by the RAND Corporation this spring found that nearly 20 percent of men and women who have returned from Iraq and Afghanistan report symptoms of post traumatic stress disorder or major depression. Yet – and this is a big deal – only slightly more than half have sought treatment. The reasons vary: Some soldiers are afraid that seeking treatment will ruin their careers. Others don’t have access to care. Some use alcohol and drugs to dull their pain.

There is a bit of good news. Some civilians are helping to fill in the gaps. Give an Hour is non-profit organization that is creating a national network of mental health experts to help soldiers and their families deal with PTSD and other psychological issues related to war. So far, according to the organization, nearly 3,000 experts have agreed to volunteer their services. “It’s a great way to commemorate the service of our military members,” says Dr. Barbara Van Dahlen Romberg, founder and president of Give an Hour.

Now it’s your turn. Have you had personal experience with PTSD either as a soldier or a family member? What happened? Do you think we do enough to help the men and women who defend our country deal with the ‘invisible wounds of war”?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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soundoff (28 Responses)
  1. Kate Liddle

    There is a program called "Vets for Vets" counseling that is free and confidential from an established non-profit organization -Volunteer Counseling Services, Inc. in Rockland County, New York. Contact Dr. Gail Golden at VCS (845) 634-5729.

    They have developed a protocol for vets to counsel other vets and they are ready to accept patients. Again, the service is free to veterans....this is a program that deserves national attention and implementation.

    November 11, 2008 at 10:34 | Report abuse | Reply
  2. Susan Duff

    As a mother, I am writing this not only for my son, but for myself.

    My son served approximately 13 yrs. in the Army.

    About 6 yrs. ago, upon his leave from serving in Afghanistan, his eratic behavior resulted in his being incarcerated in Minnesota.

    At the time of this event, PTSD was NOT brought up since it was apparently not talked about or looked at. The behavior, of my son, was not of him and he was not 'de-programmed' before he was allowed to go on leave.

    It breaks my heart to visit him every week and see him in a 'cattle barn' with no back-up from the 'military' for his time he served his country.

    I have no respect for the 'military' as there was no support when it was needed,

    I do not support anyone going in the 'service' as they (military) will not be there for them.

    My son's father served two tours of Vietnam. In fact, my son was born when his father was in Vietnam. It appears every war, i.e., Vietnam, had 'Agent Orange', the Gulf War had 'Anthrax' shotsand this Middle East war has PTSD issues. The government exposes our men to these poisons, etc. and doesn't admit there's any issues until it's too late.

    Susan Duff

    November 11, 2008 at 17:10 | Report abuse | Reply
  3. M. N. H.

    I am a senior citizen, divorced from a disabled veteran of the Korean and Viet Nam conflicts. My husband suffered from PTSD- now it has a name. The marriage suffered greatly because of this. I tried many times to get help for him, but was promptly told each time that I just needed marriage counseling... I know now that was because the main concern was to protect his career in the military. He suffered many years before he was finally able to get medical help through the military. After the divorce, he started getting into debt. That debt -part credit card debt- has skyrocketed into an amount that he may never be able to take care of. I am writing to you to ask if you know of any programs available to help him manage this debt without exorbitant fees. I would really appreciate any information you can provide. Thank you so much. M. Harmon

    November 11, 2008 at 17:39 | Report abuse | Reply
  4. Lucy

    I had a (now former) boyfriend return home after a year's deployment to Iraq. Due to his job, he wasn't on front lines, but did deal with soldiers and any indescretions or death directly. This was the same job he did while he was at his home post and he anesthetized himself against the stresses of his job with alcohol and a general irresponsibility outside of work.

    I attributed a lot of this to the stress of deployment. Unfortunately, that was part of his personality and I believe made him more susceptible to PTSD (yes, I think some are better able to cope with certain situations than other). After his return (both during R&R and when his tour ended), he was markedly different in attitude, though not in his choice of self-medication and escape.

    Due to my job at the time, I knew what it was and urged him to seek treatment; I even set up a confidential appointment for him outside of military channels. He refused, citing that someone in his job who went for treatment was soon out of a job. I discounted that, but he was adamant. I doubt seriously that he has yet to seek treatment (he returned 2 years ago). It was one of (though by no means the only reason) the factors in my decision to leave. I knew I couldn't solve his problems without his help.

    I think a great deal of the mindset regarding mental health still needs to be addressed, and stigmas removed. There is no shame in a mental issue anymore than there is for having a cold or strep throat. The public needs to be educated that it's not weak to seek treatment of a mental health issue and get better anymore than it is strong to ignore it and transform into a completely different, emptier person.

    November 11, 2008 at 20:18 | Report abuse | Reply
  5. HHinson

    Everyone should know that it isn't just soldiers who have PTSD. It can happen to anyone, from abuse survivors or even accident victims.

    These people, however, are chided by others and told "not to live in the past" and "just move on and quit feeling sorry for yourself. It's over."

    When you have nightmares, flashbacks. and panic attacks, it's not over.

    November 12, 2008 at 09:12 | Report abuse | Reply
  6. Rebecca

    There is an incredible non profit program for both the veteran and there spouse that works on PTSD and other issues the couple faces. The organization operates under that when the soldier goes to war the family goes to war, and when the soldier is wounded the family is wounded. My husband and I have been to one of the retreats the organization puts on after his second tour and right after I got out of the Army. Everything, including plane tickets, food, lodging, snacks, etc is paid for. They have "fun" such as horseback riding, fishing, dancing, games, as well as individual, couple, and group counseling. It really is an awesome experience. The website link to the organization is: http://www.uswelcomehome.org/

    November 12, 2008 at 18:54 | Report abuse | Reply
  7. Kate

    I suffered from PTSD from early childhood sexual abuse. This disorder is responsible for higher rates of autoimmune diseases and heart disease among other physiological problems. Unfortunately I was left with Ankylosing Spondylitis and Fibromyalgia. Fortunately I was able to get help. My psychologist used Eye Movement Desensitization and Reprocessing (EMDR) a form of cognitive remapping . It was very helpful for me. I heard that this methodology is also being used at the VA, and is having some success. I hope all those suffering from this horrible disorder are able to find the help they need. The Armed Forces need to quit penalizing people who are trying to get help for a disorder that their service in the Armed Forces has caused. These folks are heroes, and deserve the best this country can offer.

    November 12, 2008 at 23:12 | Report abuse | Reply
  8. Michael J Allison Jr

    I am a 100% Service Connected Disabled Vietnam Veteran who in 1994 was diagnosed with PTSD. I tried for 22 years to drink and drug away the nightmares, afraid to go out in public, going off for no apparent reason, fights and a very bad feelings about myself. Neither could I hold a job. I actually applied for a disability shortly after returning from Vietnam and was denied, however I had no idea that this was due to what we today call PTSD. I can well understand why Veterans don't seek treatment. Most that I have talked with are just "Downright Scared" of the government. Then there are those like me that know that the VA just doesn't fix anything. They give you all of these drugs then treat you like a criminal for taking them. I think I was a much happier person before the disability. Today after several years of treatment by the VA, I have become more and more afraid of what the VA is doing to me. I know for a fact that they still do experiments on our Veterans. My friend was one of them and was left nearly dead and will never live any kind of normal life. They performed a Whipple Procedure on him so other doctors could observe. They told him that they were going to only do exploratory surgery, but they had already prepared for many doctors to observe. After 3 years near death a doctor let it slip and told him the truth. He has received no disability of assistance from the VA. They have me on so many drugs, past and present that I am losing my memory and at only 56 years of age, I am totally wore out. The only way to keep young men from dealing with PTSD is don't send them to a war in the first place.

    November 13, 2008 at 20:02 | Report abuse | Reply
  9. Dr. Michael Cox

    “Give an Hour” is an outstanding organization but it is a shame the nation’s military healthcare system is incapable or unwilling to care for it’s combat veterans and must rely on the kindness of strangers.

    Veterans and their loved ones should be aware the Veterans Administration was ordered to hire Mental Health counselors in 2006 – The VA has drug their heels in bold defiance of this law (PL109-461).

    Before 2006 the VA utilized Social Workers to augment psychologists in mental health counseling – a role social workers are not routinely trained for, a fact patients and families are unaware of. When utilizing a team approach to the treatment of PTSD Social Workers and Mental Health Counselors worker better together than either does alone.

    Last month a a bipartisan group of House and Senate members wrote a letter to VA Secretary James Peake. They chastised the VA for blatantly ignoring the law. Unfortunately the VA will probably simply ignore them as well, after all it’s only a letter.

    Veterans and their families should demand the VA employ mental health counselors immediate to augment their understaffed PTSD treatment services!

    Michael Cox, PhD, RN, EMT-P, CEN, CCRN, NCC, BCECR, BCETS
    Diplomat, American Academy of Experts in Traumatic Stress
    Diplomat, National Center for Crisis Management
    Board Certified Expert in Traumatic Stress Management
    Board Certified Expert in Emergency Crisis Response
    National Certified Counselor
    Major, US Air Force Retired

    November 13, 2008 at 23:50 | Report abuse | Reply
  10. DVJ

    I was NOT in the armed forces, however suffered from it due to an event that I witnessed some 14 years ago. It's dramatically changed me. Although I do function in society, it's had some devastating effects. I cannot even begin to imagine what our military face once they return???? Something has to be done to recognize this issue & help them.

    November 14, 2008 at 12:40 | Report abuse | Reply
  11. M

    From my own personal experience with PTSD, a lot of military members will not or feel they can not seek help because it will damage or end their military career. For a lot of security clearances this appears true.
    I am not sure to what end giving a high security clearance to someone who could suck-up and hide their growing problems for a time is a good idea, but that is what is encouraged.
    Unfortunately my spouse claims marriage counseling also falls in this category....I would think then, that divorce should also affect clearance negatively by making your problems more obvious.
    I suspect higher ranking military are even less likely to seek help.

    November 14, 2008 at 14:32 | Report abuse | Reply
  12. Phil

    I was diagnosed with PTST, from combat in Vietnam, by the VA. It took them four and one-half years to approve my claim for disability. That is pretty standard and does little to help the vets with the disorder. Many give-up and the suffering of the vet and any family members continues.

    The medical people at the VA are anxous to help PTSD sufferers while the disability claims people will do their best to turn vets away from any treatment.

    November 15, 2008 at 16:16 | Report abuse | Reply
  13. Jonnie Potts

    My precious son joined the Army and within a matter of months was sent to Bosnia, he also was in Afganistan. He came home a very different man. There was times of violent anger and other times he would be like his old self. Five years ago after doubts of severe depression violent outbursts he was diagnosed with PTSD. His wife left him and took their 3 children, their home everything and he was basically homeless. He lost his job, and all the while trying to hold on to what sanity he had left. The VA put him on one drug and then another and then a multiple of medications that did nothing but either put him in a coma, make him have blackouts or on several occasions made him suicidal. He has been in and out of jail for one thing or another the past 2 years. The last time was all over the news in Colorado. He was released from jail in Greeley where he had been for 7 months for having an accident he doesnt even remember , and upon his release they give him all his meds. Not even 12 hours later he is in an accident, the officer takes him to the hospital, my daughter asks them to please keep him there until we can come and get him because he has no where to no money no nothing. After a few hours of back and forth conversation with the nurse and doctor, we are asured they will not release him until we can get there. Well of course they did release him said he did not fit the criterea to hold him..This was the very hospital he had been taken too on several suicide attempts and they were fully aware of his PTSD. What happened not even 3 hours later was all over the news, he had an altercation with a police officer while trying to drive to his family in Utah...The picture of him on the internet, is not my son, I would have never recognised him. If you could see what he looked like even a year ago you would know what I mean. The war has taken my son from me, it has taken a brother, a father, a loving caring human being that would go out of his way to help anyone in need, and did and look how he is repaid. This country should be ashamed of what they are allowing to happen to the young men and women who are diagnosed with this horribly ignored illness. My son and others like him put their very lives on the line for this country and this country has turned their back on them and has continued to do so for decades.

    November 16, 2008 at 11:08 | Report abuse | Reply
  14. Terry

    My son spent a year and a half in Iraq as an infantry soldier, his experiences there have changed him profoundly. I noticed the signs of PTSD the first time he came home on leave from the war zone. He did not sleep well if at all, he paced back and forth, could not keep still, he had problems with frequent urination, and he was very irritable. I chalked alot of it up to his inability to seperate himself from his comrades that were still in Iraq, he watched the news constantly and was very agitated when there were reports of soldiers deaths, one of them was a buddy of his and he cried like a baby. Upon his return he witnessed a buddy killed by an I.E.D. and had to assist in the transport of dead civilians and insurgents. Not experiences that you would think your 21 yr old child would have to deal with on almost a day to day basis. He has been discharged now for about a year and a half, the first 6 months were awful, he was just a shell of the young man that left his home to serve in the Army, many of the same symptoms of PTSD were obvious this time and were accompanied by fits of rage over the littlest things. He has gotten better over this time, but he's still not the child that I remember before he enlisted and I don't think he ever will be.

    November 16, 2008 at 18:42 | Report abuse | Reply
  15. Alyssa

    Being very close to someone who is currently overseas in the Middle East, I can tell you first hand that the military is NOT doing enough to help these vets. Instead of noticing that my friend is suffering from PTSD, the military insists that he is just a raging alcoholic and continues to send him to alcohol abuse classes. Not only is he an alcoholic, but he clearly has issues with depression. Instead of observing him and taking note of his actions, they just sweep it under the rug as if its not an issue. This has caused both families extreme pain because of the military's refusal to see the true problem.

    November 17, 2008 at 13:25 | Report abuse | Reply
  16. tamara

    This is a sensitive, but real topic for me. My ex' fiance' returned from Afghanistan this past January. This was his second deployment. I noticed a dramatic change in his behavior. He was not the loving and understanding guy that i knew. His behavior was erratic. He would call me all kinds of names and was extremely verbally abusive. He would throw items in the home. His anger was undescribable. He did not want to leave the home. When he did, he was always looking around as if someone was going to attack him. If he heard noises that were loud, he would tell me to drop to the ground. He had sleep terrors and would shake in his sleep uncontrollably. He would lash out on me for no apparent reason. He would walk around the home with his gun during the middle of the night. When he saw me cry from his actions, he had no emotion. He was not like this previously. He began to drink and use substances. I told him to seek help but he refused and stated that there is nothing wrong with him. The relationship ended. Its sad because I feel as though something bad is going to happen to him. I tried notifying his unit, but they did not do anything. I believe that he is suicidal. PTSD needs to be addressed in the army. Its sad that at 26, he is damaged mentally.

    November 19, 2008 at 00:26 | Report abuse | Reply
  17. ruth

    Hi to all the Parents of children battling PTSD.
    While my son was not a War Vet, he too suffers from PTSD as a result of being shot 3 times, in DC as an Officer with MPDC.

    As a result of being shot On-Duty he must constantly undergo mental evals. He is a wonderful young man, who has managed to co-raise 2 [he is divorced] my oldest to grandchildren. There are times when he MUST be alone. He can't stand for anyone to touch his head, He can't ride in convertible cars. There are things that people can't begin to fathom that people who have PTSD, go through – every day. Blessings on all!!

    November 26, 2008 at 14:51 | Report abuse | Reply
  18. Dr. Don Dorrell PhD

    Dear Dr Gupta You may not be familiar with a medical procedure that was used for cancer treatment before chemotherapy and radiation called chealation . I have personal experience that the procedure also works miracles on lead poisoning and a great number of other blood disorders.It is somewhat costly,tho effective but it is immensely less physically invasive and in addition approaches 100.0 percent health improvement as verified thru blood tests .Somewhat newer applications use oral treatment ,maybe not quite as effective but still a very amazing medical treatment.You may be interested in looking into this . Thanks for your great medical contributions . Sincerely ,Don

    December 2, 2008 at 17:28 | Report abuse | Reply
  19. Margery Day

    My husband is an Iraq war veteran who was diagnosed with PTSD as a service connected disability 6 months after getting out of the military. His symptoms were not severe and he sought treatment, meeting with a VA psychiatrist every few months for a year. His symptoms almost immediately resolved as soon as he knew what he was dealing with. He made the effort to talk about what he saw and experienced. He turned to faith, friends, and family. 3 years later he has no symptoms, and is now facing the "stigma" associated with PTSD by our state when seeking employment with the Highway Patrol. This is his dream, and the "stigma" of PTSD is keeping him from achieving it. We always wondered why none of his friends would get treatment for their symptoms...I suppose this is why.

    December 3, 2008 at 14:51 | Report abuse | Reply
  20. stuart bellant

    Just saw your response to the lady who asked about her extreme anxitey affecting her chance of heart problems. I'm a high school drop out and don't what to pretend to know more about health issues than the medical community but I've known for years that mental and physical health issues have to affect each other because they are wrapped in the same package and connected by thousands (millions?) of nerves and inter-related systems. Spirit is in there too. repair one system help them all, neglect one, harm the whole.

    December 4, 2008 at 09:15 | Report abuse | Reply
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