More combat veterans seek help as counselors try to redefine post-traumatic stress disorder.
Take people 6,000 miles from home. Shoot at them. Blow stuff up. Hide the bad guys among the good.
Even normal men and women – brave and strong American soldiers – feel their emotions fray when they return home.
It seems easy to understand, until doctors put it in a medical book, label it “post-traumatic stress disorder” and try treating folks.
After years of clinical study of the way the brain changes under stress, doctors and psychologists have built a vocabulary around the issue. Symptoms are classified. Levels of anxiety are measured. Signs of “disassociation” are determined. Healing is marked by phases.
The lingo can make any soldier diagnosed with the problem feel abnormal. Or worse: weak.
So the military is trying to change the message.
Counselors who work with soldiers have scrapped a lot of the clinical talk, reassuring everyone they see that their emotional changes are normal.
And leaders are making sure that more soldiers than ever receive help.
They know it’s a growing problem.
An estimated 19 percent of the roughly 222,000 U.S. soldiers who have served in Iraq have shown signs of mental health problems, according to a February report published in the Journal of the American Medical Association.
Maj. Gen. Bill Libby, Maine’s adjutant general, issued orders this year for every National Guard member who returns from Iraq or Afghanistan to talk one on one with a counselor.
“We are all Type A’s,” Libby said. “Lots of us don’t like talking about our feelings. We’d rather do something.”
However, Libby knows the emotional healing needs to happen.
“These men and women have been forever changed by their experiences,” said Libby, a veteran of the Vietnam War. “Thirty-eight years later, I am still struggling with my experiences.”
The state has welcomed about 1,600 Guard men and women home from Iraq.
Many have sought help, said counselors who attended a day-long symposium on post-traumatic stress disorder on March 25.
They talked about the clinical causes and treatments. And veterans, particularly from Vietnam, pleaded with Maine’s newest vets to seek help.
“Don’t wait for 30 years, please,” one said.
Counselors hope Libby’s order – forcing soldiers to meet for at least one short session – will bring forward people who need their help.
People were not built to handle a war’s stress. To be injured by it is only normal.
“It’s the one anxiety disorder that happens to normal people,” said Glenn Schiraldi, a psychologist from the University of Maryland who literally wrote the book on PTSD.
The clinical side
The disorder, as the clinicians describe it, is not limited to soldiers who have experienced combat.
Police officers and firefighters are sometimes diagnosed with the problem after witnessing such events as the 9/11 tragedy. Other traumas include rape and sexual assault.
According to the National Institute of Mental Health, the disorder affects an estimated 5.4 million people every year.
“It’s a normal response by normal people to abnormal conditions,” said Schiraldi, who authored an inch-thick textbook on the issue, “The Post-Traumatic Stress Disorder Source Book: A Guide to Healing, Recovery and Growth.”
When someone is exposed to trauma, the brain changes. Memories of an overwhelming event are treated differently than most. Rather than being filed away, like a document in a computer, the memory stays close and accessible, activated by the slightest trigger, Schiraldi said.
A solider might re-experience the event again and again, be hyper-vigilant and on edge but yet emotionally numb, shutting down feelings to turn off the pain.
The remaining jumble of memory and emotions can lead soldiers to pull away from their families, abuse drugs, become violent or suicidal. Many have problems sleeping. If religious, they may lose their faith in God.
Many feel guilty when they deserve no blame. Some feel they have done things that even God cannot forgive.
“I call it â€˜a shattering of the soul,'” Schiraldi said. “The therapeutic goal is to put the pieces back together.”
Souls can get better.
Treatment may include simple breathing exercises, medications, hypnosis or intensive trauma-therapy retreats.
Bruce Letsch, a counselor who has met with veterans in Maine for more than 20 years, said he begins by just talking and listening.
Over time, soldiers learn they can trust him.
“Once somebody knows you are genuinely interested and care, they confide,” Letsch said. “It’s one of the most important kinds of therapy.”
His discussions with people are typically aimed at breaking down the isolation that so many veterans feel.
“My goal is trying to help people reconnect with humanity,” he said.
Many soldiers who have experienced symptoms of post-traumatic stress do not have the full-blown disorder. Often it’s one or two problems, such as nightmares or trouble relaxing.
Such symptoms may not surface until a soldier is home from combat for two or three months.
Quick work is critical. Early treatment for anxiety helps people recover four to 10 times faster than waiting a year, Schiraldi said.
Not that there is a time limit.
The recent talk about post-traumatic stress disorder has led many Vietnam veterans in Maine to seek help. Some have never asked for help before.
“It’s never too late to restore or recapture your humanity,” Letsch said.