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Sunday 21 October 2012

PTSD a very real — but mysterious — problem for soldiers (by Peter Worthington)

The Harper Conservatives are all about fighting, dominance, etc.  They don't seem to care about the individual or social psychological consequences of their aggressive approach to politics.  Our democracy is suffering.  Our soldiers are suffering.  It's not too late, though - they can turn the ship around.  If they won't, then perhaps it's time for a new captain.

PTSD a very real — but mysterious — problem for soldiers

TORONTO - In recent years, it’s become generally accepted that post-traumatic stress disorder (PTSD) is a genuine affliction that can affect those in high-tension, physically and emotionally charged jobs: Military, police, fire-fighters, emergency medical people.
Soldiers, especially, are prone to PTSD. In fact, the greatest threat to Canadian soldiers on dangerous missions (like Afghanistan) is not roadside bombs, ambushes or enemy fire, but PTSD.
It’s estimated that up to 25% of soldiers in danger zones come down with some degree of PTSD. And symptoms can occur years after the experience, and/or be manifested in alcoholism, severe depression, aberrant behaviour, even suicide.
PTSD is an invisible war wound that can be as devastating as a missing limb. Or more so. Often unrecognized, there is also stigma attached — though not as much as in the past when PTSD was variously labeled as shell shock, lack of moral fibre (LMF), battle fatigue, even cowardice.
These days PTSD is accepted for what it is. Soldiers basically feel relieved if they don’t come down with it – or don’t think they are afflicted. Often they just don’t know. Research is never-ending about the causes and incidents of PTSD.
In the U.S., it’s estimated that PTSD afflicted up to 20% of those who served in the second Iraq war; 10% who were in the brief Desert Storm campaign; 30% who served in the Vietnam war.
When undiagnosed and untreated, PTSD sometimes leads to suicide.
A recent news item that caused concern was 38 U.S. Army soldiers committing suicide last July — a grisly record, considering that in a volunteer army, all applicants are supposedly screened for emotional and physiological stability and such.
Since the beginning of the war in Afghanistan, over 2,600 American soldiers have committed suicide — compared to 2,000 who died fighting. That’s a horrendous statistic.
Of 187 U.S. military personnel who committed suicide up to August this year, 116 were on active service, 71 in reserves. It’s probable they all suffered from PTSD.
In the Canadian military, 20 soldiers committed suicide in 2011—up from 12 in 2010. While not on the scale of the U.S. military, it’s still a concern because volunteers in our military are also screened for emotional stability.
While there is research to determine types who might be susceptible to PTSD — and even more research on how best to treat the ailment — there is virtually no research underway on personalities unlikely to succumb to PTSD.
And there are such types who seem immune to stress disorder.
The Bellwood Health Clinic in Toronto specializes in treating those afflicted with PTSD. And it’s not just soldiers. Police, firefighters, individuals in hazardous jobs are all susceptible courtesy of their occupations, though for obvious reasons they get far less attention than the military.
(As an aside, it has always puzzled me that a young nurse in an emergency ward can be exposed to horrendous injuries yet not come down with PTSD, while a soldier who is trained to expect the worst, may find it traumatizing).
At Toronto’s Bellwood Health Clinic, Michael Hartmann, clinical manager of the PTSD/trauma program, and Dr. Simone Arbour, research coordinator, suggest that what may tip the balance with a soldier, say, in Afghanistan, is not what he endures but the horrors he sees others subjected to. This seems a valid observation, since being in the eye of a hurricane is often easier than being on the fringes.
One of the problems of soldiers returning home with undiagnosed PTSD, is that they often have no outlet for their feelings. Family members and friends can’t fully understand what they’ve been through, thus they turn inward and emotionally further isolate themselves.
Bellwood staff find families can be vital for helping veterans readjust. The longer PTSD is dormant and untreated, the more rigid and obsessive it can get.
Some soldiers have done several missions in Afghanistan while being afflicted throughout with varying degrees of PTSD, that steadily intensify.
What makes Afghanistan so prone to cause PTSD is that every time a soldier left the base for any reason, he/she was constantly aware that a they could run into a roadside bomb could at any time. In some cases, a soldier in Afghanistan might never have been shot at, never engaged the Taliban in a fire-fight, yet came down with PTSD from simply driving in streets or the countryside.
Every soldier was always aware that someday the law of averages was likely to catch up with him. Every trip outside the wire increased the odds for an incident.
In that sense, Afghanistan was more nerve-wracking than a conventional shooting war like WWII or Korea, or even Vietnam.
When asked if there’s any way to detect those likely to be susceptible to PTSD, the answer from Michael Hartmann was a blunt: “That’s the million-dollar question.”
It’s an answer the army would like to know. Training, morale, discipline, understanding, all help to prepare an individual, but there are no guarantees. Lt.-Gen. Romeo Dallaire coming down with PTSD after commanding UN Forces in Rwanda during the time of genocidal slaughter, brought acceptance and respectability to the ailment, but did little to lessen its prevalence.
U.S. and Canadian statistics alone indicate need for research into personality types resistant to PTSD. As far as one can determine, those who have the ability to put events behind them and move on without looking back, seem less prone to come down with PTSD. But the human psyche can take only so much.
In World War II, Field Marshal William Slim remarked of the Burma campaign that “the British soldier is not braver than other soldiers, he is just braver longer.”
That assessment could apply to those who don’t come down with PTSD. It just takes longer to get them. No normal person can endure horrors indefinitely without cracking.
Now that Afghanistan is kaput for Canadians, the task of dealing with PTSD “victims” (if that’s the right word) is the responsibility of Veterans Affairs, which these days has to deal with a different sort of wounded soldier than in past wars.
Not all PTSD is the same, but all types can be crippling and all deserve the support that is given to those who have visible, life-altering wounds.
In many case, PTSD is a war wound — and soldiers who are wounded for their country have earned and deserve everything the country can do to repair the damage.
Most would agree with this, but words and deeds don’t always coincide.
Too many of Canada’s wounded feel now that the shooting is over, they are being abandoned. Sometimes, their only protector is media publicity, because that’s what grabs the attention of politicians who make the decisions.

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