thedrifter
09-15-07, 06:02 AM
Stress creating casualties of war
JENNIFER HLAD
September 15, 2007 - 1:11AM
DAILY NEWS STAFF
EDITOR’S NOTE: This is the first of a three-part series about combat-related post-traumatic stress disorder. The other two parts of the series will introduce you to veterans from the Vietnam War and wars in Iraq who have been diagnosed with the disorder.
Shell shock. Combat fatigue. The symptoms of post-trau-matic stress disorder have been around likely since men began fighting wars, said Lt. Cmdr. Chad Bradford, head of the Camp Lejeune Naval Hospital’s psychiatry department.And the anxiety disorder — known as PTSD — has been a recognized clinical disorder for decades. But the recent war in Iraq has brought with it earlier detection of the disorder and more aggressive intervention, said Capt. Mark Olesen, the Naval Hospital’s commanding officer.
It also has created new patients. Veterans Affairs clinics and Vet Centers treated more than 367,000 veterans with post-trau-matic stress disorder in fiscal year 2005. Experts estimate about 30 percent of Vietnam veterans, 10 percent of Gulf War veterans, 6 percent to 11 percent of Af-ghanistan veterans and 12 to 20 percent of Iraq veterans expe-rience PTSD, according to the National Center for PTSD. At Camp Lejeune, the Naval Hospital’s mental health depart-ment diagnosed 378 patients with post-traumatic stress dis-order last year alone — mainly with moderate to severe symp-toms — while patients with milder symptoms were diag-nosed at the base’s post-deploy-ment health clinic.
But unlike after the Vietnam War, when the majority of veter-ans had not even heard of PTSD, Olesen said service members now are screened before, during and after deployment for physi-cal or mental health conditions. “I think we are more attuned to it,” Olesen said. PTSD is an anxiety disor-der characterized by three symptoms that result after a trauma, Bradford said: hyperarousal, avoidance and intru-sive thoughts.Hyperarousal symptoms in-clude not being able to fall asleep, hypervigilance and “feeling like your nervous sys-tem is always on edge,” Brad-ford said.Avoidance includes avoiding situations that remind the pa-tient of the trauma, emotional numbing, and decreased inter-est in activities, he said.Intrusive thoughts include nightmares, flashbacks and recurring thoughts about the trauma that the patient cannot shake, Bradford said. Still, the symptoms must cause problems in the patient’s life to be considered PTSD, Bradford said. And the trauma does not have to be combat-related. Vic-tims of personal assaults or nat-ural disasters are among those who also may experience PTSD symptoms, he said.Often, PTSD patients are more angry and irritable, easily star-tled, depressed and may drink more alcohol than before the trauma, Bradford said, but they may not know what’s going on.“We do our best to get out there and educate people about PTSD,” he said.At Camp Lejeune, education about PTSD starts before de-ployment, Bradford said, with briefs for service members, spouses and children. During the deployment, spouses and children can attend workshops for dealing with stress at home, he said.Once the service members return, they are screened for health problems, and though it is possible that a service member could minimize their symptoms or purposely answer untruthfully, Bradford said in those cases, the symptoms of-ten become obvious to others.“Commands may detect symptoms well,” he said. “Spouses notice something dif-ferent that isn’t being talked about in the open.” The data suggests Marines “will, in fact, report health is-sues,” Olesen said. “The Marines have done a very, very good job of destigma-tizing within the unit,” he said. “They’re very committed to taking care of their Marines.”Veterans Affairs also has taken steps to improve mental health services, including those for PTSD. The VA has partnered with the Department of Defense to create a user-friendly guide to effective, evidence-based diag-nosis and treatment of PTSD, said Fayetteville VA Medical Center spokeswoman Norma Byrd. The VA Medical Center in Fayetteville has an outpatient PTSD clinical team providing care specific to combat veter-ans, as well as other services for PTSD patients who suffered oth-er types of trauma, Byrd said.
The Fayetteville center also has two clinicians on duty spe-cifically for Iraq veterans, and is recruiting another clinician for the Jacksonville clinic, she said. The VA also has enhanced access to substance abuse ser-vices and hired a suicide pre-vention coordinator, as well as other changes, Byrd said.Still, Bradford said, challeng-es remain.Military officials are still working to break down possible barriers, he said, and continue to destigmatize the disorder.And in the military environ-ment, people are expected to potentially redeploy, which may or may not be a good idea for the patient, Bradford said. Because active-duty service members generally move of-ten, continuity of care is a chal-lenge, he said. There aren’t al-ways as many people available to provide treatment as some would like. And mental health officials must rely on the patient to re-port his or her symptoms, Bradford said.
But, he said, the stigma sur-rounding PTSD has greatly di-minished from what it was. “We see a lot of Marines and sailors every day, and PTSD makes up more than a quar-ter of the diagnoses,” Bradford said. “That would lead me to believe that people are not hes-itant to come in.” Visit www.ncptsd.va.gov for more information about the symptoms of PTSD and other facts.
Contact military reporter Jen-nifer Hlad at jhlad@freedomenc.com or 353-1171, ext. 8449. To comment on this story, visit www.jdnews.com.
Ellie
JENNIFER HLAD
September 15, 2007 - 1:11AM
DAILY NEWS STAFF
EDITOR’S NOTE: This is the first of a three-part series about combat-related post-traumatic stress disorder. The other two parts of the series will introduce you to veterans from the Vietnam War and wars in Iraq who have been diagnosed with the disorder.
Shell shock. Combat fatigue. The symptoms of post-trau-matic stress disorder have been around likely since men began fighting wars, said Lt. Cmdr. Chad Bradford, head of the Camp Lejeune Naval Hospital’s psychiatry department.And the anxiety disorder — known as PTSD — has been a recognized clinical disorder for decades. But the recent war in Iraq has brought with it earlier detection of the disorder and more aggressive intervention, said Capt. Mark Olesen, the Naval Hospital’s commanding officer.
It also has created new patients. Veterans Affairs clinics and Vet Centers treated more than 367,000 veterans with post-trau-matic stress disorder in fiscal year 2005. Experts estimate about 30 percent of Vietnam veterans, 10 percent of Gulf War veterans, 6 percent to 11 percent of Af-ghanistan veterans and 12 to 20 percent of Iraq veterans expe-rience PTSD, according to the National Center for PTSD. At Camp Lejeune, the Naval Hospital’s mental health depart-ment diagnosed 378 patients with post-traumatic stress dis-order last year alone — mainly with moderate to severe symp-toms — while patients with milder symptoms were diag-nosed at the base’s post-deploy-ment health clinic.
But unlike after the Vietnam War, when the majority of veter-ans had not even heard of PTSD, Olesen said service members now are screened before, during and after deployment for physi-cal or mental health conditions. “I think we are more attuned to it,” Olesen said. PTSD is an anxiety disor-der characterized by three symptoms that result after a trauma, Bradford said: hyperarousal, avoidance and intru-sive thoughts.Hyperarousal symptoms in-clude not being able to fall asleep, hypervigilance and “feeling like your nervous sys-tem is always on edge,” Brad-ford said.Avoidance includes avoiding situations that remind the pa-tient of the trauma, emotional numbing, and decreased inter-est in activities, he said.Intrusive thoughts include nightmares, flashbacks and recurring thoughts about the trauma that the patient cannot shake, Bradford said. Still, the symptoms must cause problems in the patient’s life to be considered PTSD, Bradford said. And the trauma does not have to be combat-related. Vic-tims of personal assaults or nat-ural disasters are among those who also may experience PTSD symptoms, he said.Often, PTSD patients are more angry and irritable, easily star-tled, depressed and may drink more alcohol than before the trauma, Bradford said, but they may not know what’s going on.“We do our best to get out there and educate people about PTSD,” he said.At Camp Lejeune, education about PTSD starts before de-ployment, Bradford said, with briefs for service members, spouses and children. During the deployment, spouses and children can attend workshops for dealing with stress at home, he said.Once the service members return, they are screened for health problems, and though it is possible that a service member could minimize their symptoms or purposely answer untruthfully, Bradford said in those cases, the symptoms of-ten become obvious to others.“Commands may detect symptoms well,” he said. “Spouses notice something dif-ferent that isn’t being talked about in the open.” The data suggests Marines “will, in fact, report health is-sues,” Olesen said. “The Marines have done a very, very good job of destigma-tizing within the unit,” he said. “They’re very committed to taking care of their Marines.”Veterans Affairs also has taken steps to improve mental health services, including those for PTSD. The VA has partnered with the Department of Defense to create a user-friendly guide to effective, evidence-based diag-nosis and treatment of PTSD, said Fayetteville VA Medical Center spokeswoman Norma Byrd. The VA Medical Center in Fayetteville has an outpatient PTSD clinical team providing care specific to combat veter-ans, as well as other services for PTSD patients who suffered oth-er types of trauma, Byrd said.
The Fayetteville center also has two clinicians on duty spe-cifically for Iraq veterans, and is recruiting another clinician for the Jacksonville clinic, she said. The VA also has enhanced access to substance abuse ser-vices and hired a suicide pre-vention coordinator, as well as other changes, Byrd said.Still, Bradford said, challeng-es remain.Military officials are still working to break down possible barriers, he said, and continue to destigmatize the disorder.And in the military environ-ment, people are expected to potentially redeploy, which may or may not be a good idea for the patient, Bradford said. Because active-duty service members generally move of-ten, continuity of care is a chal-lenge, he said. There aren’t al-ways as many people available to provide treatment as some would like. And mental health officials must rely on the patient to re-port his or her symptoms, Bradford said.
But, he said, the stigma sur-rounding PTSD has greatly di-minished from what it was. “We see a lot of Marines and sailors every day, and PTSD makes up more than a quar-ter of the diagnoses,” Bradford said. “That would lead me to believe that people are not hes-itant to come in.” Visit www.ncptsd.va.gov for more information about the symptoms of PTSD and other facts.
Contact military reporter Jen-nifer Hlad at jhlad@freedomenc.com or 353-1171, ext. 8449. To comment on this story, visit www.jdnews.com.
Ellie