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.
