Perhaps more than any other war, post-traumatic stress disorder (PTSD) is a prime affliction from the wars in Iraq and Afghanistan, thanks primarily to tensions caused by the constant threat of roadside bombs and explosive devices.
Studies in the U.S. indicate up to 30% of those who serve are susceptible. One study of three U.S. army and one Marine unit showed up to 17% who served in Iraq suffered traits of PTSD, while 11% in Afghanistan did.
In the Canadian army, it is estimated that 13% to 20% of soldiers show signs of PTSD, depending on how many tours of Afghanistan they’ve undergone. In Canada, by the very nature of their trade, soldiers and police are especially susceptible to PTSD.
While very real, with both physical and emotional overtones, PTSD does not affect everyone who is exposed to war, violence, atrocities and tragedies. It strikes me it is worth studying why some individuals seem immune to the disorder, as well as studying those who are its victims.
It’s a complicated issue, made more so by a certain respectability, even popularity, that PTSD has acquired. The poster boy, so to speak, of PTSD is Lt.Gen. Romeo Dallaire whose emotional breakdown after commanding UN forces in Rwanda at the time of the genocidal massacres, is attributed to the horrors he witnessed.
That doesn’t begin to explain why some people are more prone than others to PTSD – which has a long history of being misunderstood and unappreciated.
In WWI, what would be called PTSD today was termed “shell shock,” and was vaguely embarrassing to those suffering from it, and often it was denied or disguised for fear it would be interpreted as “weakness.”
At the beginning of WWII, “shell shock” was defined as “lack of moral fibre” – a cruel indictment, utterly unfair and just plain wrong. By the end of the war, lack of moral fibre was changed to “battle fatigue,” which also had a certain respectability, and at least was recognition that some individuals crack, or break emotionally, more than others might.
Towards the end of the Pacific war, when it was clear the Japanese were beaten, an Australian commander in one of the islands was having trouble with a huge number of soldiers – maybe 25% – claiming “battle fatigue” rather than going on mopping up patrols.
The commandeer issued orders that henceforth “battle fatigue” would not go on medical records, but would be called “cowardice.” The percentage of claimants dropped instantly to 4%, — and was recorded as battle fatigue, since the lead-swingers were now back on duty.
When WWII ended, it was fashionable to warn families at home, not to interrogate or ask returning veterans too many questions because of the trauma of remembering horrors they’d seen. Max Shulman wrote a humorous novel, Rally Round The Flag Boys, of a returning veteran who wanted to tell of his adventures but no one in his family would listen out of deference to his emotional health. This presumed lack of interest caused an emotional breakdown in the guy. Funny, but also pertinent.
While police and soldiers are the ones most prone to PTSD from what they are exposed to, training can alleviate much of the trauma such unpleasantries might cause. Usually that works, but on occasion, training films soldiers are subjected to have caused PTSD.
On the other hand, few consider what young nurses who work in, say, hospital emergency wards are exposed to, yet manage to do their job without breaking down. Maybe that’s because no one expects nurses to be anything but professional – so that’s what they are.
Again, none of this explains why some are more prone to PTSD than others. Has it something to do with individual empathy, sensitivity, too much imagination, propensity to brood or worry? Dunno.
I do know that no soldier dismisses PTSD, or thinks poorly of those afflicted, and those who aren’t susceptible thank their luck at being immune.
golftilyoodrop // Apr 13, 2010 at 4:33 pm
Many nurses who served in Viet Nam suffered PTSD.
golftilyoodrop // Apr 13, 2010 at 4:37 pm
Man, just Google “PTSD and nurses” and see what you get.
TheRightsWriter // Apr 13, 2010 at 8:39 pm
A nice overview. It seems to demand reference to George Carlin’s bit on renaming Shell-Shock “Post-Traumatic Stress Disorder.”
Sunny // Apr 14, 2010 at 9:36 am
I’m not sure it’s a matter of immunity. I suspect it’s more a tolerance level. What concerns me as well is that it’s kind of like ADHD, based on a number of *behaviors*. And I believe psychiatrists understand that once you identify a thing based on behaviors, you exponentially increase the number of people who will conform to that diagnosis. They’re not faking it. They’re conforming to expectations. That concerns me, too.
I did a lot of reading on PTSD just in preparation when my son deployed, so I could anticipate and short-circuit any problems he might have (because it turns out PTSD actually benefits from early detection and attention). I’m glad I did. He had a lousy first deployment in Anbar. It felt like that weekly the little online group of battalion moms and wives (and dads) we were getting emails that began, “The moderators are saddened to announce”.
So he came home, and after his 10 day decompression period on base (whatever they call it — I’ve forgotten now) he came home and met us at the boat dock as we were just heading out. He hopped on the boat, pulled me to the side, and with a stricken look on his face announced that he had PTSD, based on some generalized post-deployment briefing they’d all gotten on the signs and symptoms.
I was able to tell him that 1) he might indeed have PTSD, but he wouldn’t know for another six months or so, if his problems persisted. 2) That I had already investigated the best courses of treatment, talked to other battalion mothers about what sorts of attention had helped their sons and what hadn’t. 3) That I was fully prepared to utterly skip the lag time of the VA and fund whatever he needed, IF he needed, and 4) That he needed to realize that what he was going through right at that time was a _normal_ response to abnormal circumstances.
Those young men were in high alert all the time. They lost people close to them, in terrible ways. They narrowly avoided the same thing themselves. They lived in MREs and the cans of ravioli and jerkey I sent. And when tragedy struck, they didn’t have the luxury the rest of us do of the normal mourning period. They had, at best, a few hours stolen from sleep time to talk and cry and commiserate — and they they had to return their focus to the task at hand, trying not to get blown up themselves.
Which has to mean that when they come home, they’ve got all that unresolved stuff yet to go through. Mourning isn’t ever comfortable or easy, and when it’s months removed from the event(s) you’re mourning, it has to feel really strange. But anger, nightmares, trouble sleeping — all those are normal when you’ve lost someone close to you.
My own belief, at least at present, is that the instances which leave the real, lasting problems are those which trigger that intense fear/fight/flight instinct. Given human empathy, I believe that can be simply a sight of something horrible, even if there’s no immediate threat — if people faint at the sight of blood because their own physiology sees someone else’s blood and forces them go get prone to protect blood flow to the brain, it certainly seems possible that the sight of someone else’s death has the potential to invoke some preservation instincts in someone else as well. Anyhow, what seems to happen, at least in some cases, is that that traumatic event isn’t ever mentally processed the way most traumatic events are. Somehow, it gets stuck in a feedback loop, where even subconscious cues reminding of the event are enough to suddenly invoke those horrible feelings of panic. There’s an interesting — and apparently really effective — treatment involving flashing lights and revisiting whatever event in a counselor setting. Somehow, following the lights changes the mental patterns, and starts helping that event move out of a feedback loop and start being processed normally. Remembering the experience eventually becomes less intense over time, until it becomes what traumatic events usually are for all of us — an experience remembered with sadness, perhaps, but not something that drives us to our knees for the rest of our lives.
rookie // May 4, 2010 at 1:24 pm
Posttraumatic stress disorder is a very nasty, silent killer:
http://surftofind.com/cops
It sounds like a terrible, mental illness.