"Is Uncle Sam Brushing this Under the Carpet?" [Archive]

hawk71049

05-10-2008, 04:19 PM

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The purpose of this thread is not to bash any one of our fine services, but to unite all of our interests and concerns, by bringing out the facts, so we are all on the same page as to where we are, what needs to be done, and possibly how we go about getting there…
I would expect that many soldiers will not respond to this thread as I understand the stigma (so unfairly) attached to this topic, so Wife’s, Girlfriends, Fiancés, Mothers, Daughters, and all relatives and friends of soldiers, please add anything you wish to in regards to this topic.

We have read many articles, threads and posts here on the forum; we read about this in the newspaper, we hear about it on the news, and our local radio stations talk about it, there are truck loads of books and articles written on this subject, yes sensationalism of this sells, that topic being… Posttraumatic Stress Disorder… PTSD

Ladies & Gentlemen, my questions are this: In Your Opinion…

1) What is your branch of the service doing in a proactive attempt to prevent/treat soldiers and or assist veterans and their families in their dealing with PTSD?
2) Are we/society doing enough?
3) Should Active Duty members be required to complete only 2 deployments unless they voluntarily decide to embark on another tour?

I have listed below 2 articles and or threads relating to this disorder from both here on the forum and articles found on the world wide web, if you find articles that provide additional information please include this in your post.

In addition, each time I find or have found something pertinent to this topic I will post links for all to see. I am hoping that as a community we will be able to discuss this sensitive topic professionally and maybe even use our voices to make a change because we have that power. This topic is one that is both felt personally and globally.

God Speed…hawk

1) Denial in the Corps (http://www.truthout.org/docs_2006/020208Z.shtml)

“Unlike the Army and the Air Force, almost every Marine and Navy base has a brig on board, and that makes it easy to use the brig as storage for a troubled marine. "We think pretrial detention is overly prescribed," Faraj says. "More often than not it's used as a tool, because the command doesn't want to deal with someone." Consequently, marines with mental health problems are not only locked up in a brig without adequate mental healthcare but are asked to make serious legal decisions while actively suffering from mental disorders. "I think doing a court-martial at that time is a setup," Judith Litzenberger, the civilian defense lawyer, says. "It's totally devoid of due process.

You don't have a client there that you can talk to. We need some long-term psych hospitals that can treat these guys." The hospital at Pendleton lost its psych treatment certification a few years ago and never worked to get it back, so the camp no longer has an inpatient psychiatric facility. Marines who attempt suicide in the brig are sent to the Naval Medical Center in San Diego, but the naval hospital offers only acute care to marines, so once the suicidal marine is stabilized, he is sent back to jail. Though commanders do not purposely use pretrial detention to break a marine, that is often the effect on a marine suffering from PTSD - as it was in the case of Sgt. Patrick Uloth."

2) Multiple deployments, war tours and PTSD (http://www.militarytimes.com/forum/showthread.php?t=1561779&highlight=PTSD)

“I was hoping to meet any wives that are currently in a similar situation to us. My husband is combat arms and has been deployed to Iraq twice each for a year and just a little over the second time. It’s our fourth deployment in 6 years. Deployments 1-3 we were fine but upon his homecoming for #4 we've been having some difficulty adjusting to each other. He has seen mental health here for PTSD, all they did was give him meds and send him on his way, I think what he really needs is to talk to someone about everything he saw there and went through. He wont talk to me because "I don’t understand" which is fine, he has his friends but they are all pretty much following the same token of not talking and being angry. I'm just having a hard time with the man that used to be my husband that came back. I know it can take a few months for everyone to get back into their groove but I fear that 2 years in Iraq was too many.”

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I'm His Lucky Charm....

05-10-2008, 05:22 PM

Okay... so I am not the person that likes to make myself the center of attention... but this situation truly hits home for me. I felt compelled to say something using the power of the written word, or in this case the keyboard.

My marine and I are engaged and we recently lost our child due to complications with the pregnancy. Aside from trying to deal with our loss almost 3,000 miles away from each other, he is deploying for the third time to Iraq. He is truly my hero, my inspiration, and my everything. As a result, I am taking this deployment extremely hard, but he knows that he has my full support as I still stand by his side..(metaphorically speaking...)

He is already been diagnosed with PTSD and at times he feels like he is going to snap. He has tried (when we were still pregnant) putting in for PTAD and humanitarian requests; he has been to the Chaplain and the marriage counselor. Somewhere along the line, between all of the paperwork he filled out (believe me...it was mountains full) and the people he was directed to talk to, nothing ever came of it. He was granted emergency leave (that was taken from his leave on the books, so now he is in the hole for 3 days) to come home and be by my side for the termination our baby.

Regardless, I feel that this 3rd deployment is one that frightens me. He already has nightmares, at times he experiences feelings of rage, and he is the first person to wake up swinging if you are not careful with how you wake him up; but this is all I have left....him. I don't want him to have to go the Sandbox and come back home more emotionally distraught than ever before.

Maybe "Uncle Sam is brushing this under the carpet.....," as mentioned above. I understand many are diagnosed with PTSD, but what precautions and measures are being taken for people like my fiance who maybe should not be going back into combat....not because they don't want to, but because as a society, it is the humane thing to do?

Below you will find a link to a T.V. show entitled "Intervention." It is graphic and shows what some of our honorable active service men and women as well as veterans are experiencing.

http://youtube.com/results?search_query=brad+intervention&search_type=

You will have to click to the various parts in order to view entire episode (sorry thought the link I posted was a full episode; this is all I could find)

Thanks for your time.

Hoping for a miracle,
~His Lucky Charm...........

caliny

05-10-2008, 05:42 PM

I don't really have anything to offer in terms of the topic, Hawk. However, Charm, thank you so much for sharing your story. It's incredibly powerful and I'm sure not an easy one to share with those you don't know (us :)). I'm so sorry about your loss of you and your fiance's child. Though words seem inadequate, you have my heartfelt condolences, warmest hugs and many prayers.

~cali

Feel free to come join us down in the girlfriends section if you need shoulders to lean/cry on, ears to listen or a place just to relax, be yourself and laugh. We'll help you through this as best we can.

uconn

05-11-2008, 01:20 AM

Lucky Charm,
Thank you so much for having the courage to share your story. I am so sorry for your loss, and I am so sorry that your fiance's upcoming deployment is making things even harder. Please know that you two are in my thoughts.
I have some experience with PTSD, on my own personal level, and related to deployments. (Charm, is you want to/need to feel free to PM me)

Hawk,
Thank you for starting this topic. I know it is a very sensitive one. However I do think that we can all do our part to remove the stigma, even if it is just by talking. Sometimes just knowing that someone is, or has gone thru the same situations as you can make a world of difference.

kenny10

05-11-2008, 07:04 AM

Let me tell you all something, they honestly don't care. As sad as it sounds, they don't.
I have done 3 back to back to back deployments to Iraq. I haven't even hit my four year mark in the military yet. Just after returning from my 3rd freaking tour in Iraq, i got orders to go to freaking Okinawa for a year. It wasn't Iraq but it was still away from my family, once again. I am engaged by the way and waiting until I get back to get married. I have spent 10 months out of the last 3 years with my significant other. I was looking forward to being able to spend a summer in California and sometime with my family and friends but nooooooooooo. I was going to refuse the orders but I was threatened. I was told that if i did not take the orders to Okinawa that I would be NJP'd, knocked down in rank, lose some pay, maybe brig time and sent back to Iraq for a 4th time! oh and I only had 5 months of dwell time between each deployment
I have spent 23 months in Iraq and by the time I am done with my year in okinawa I would have spent 33 months overseas to 15 months back home. I am getting out in May 0f 2009 and nothing in the whole entire world could get me to reenlist. I don;t know if i will get ptsd sometime down the road but after three deployments i am sure i am crazy somehow.

1000hearts

05-11-2008, 11:20 AM

I don't have a lot to offer by way of this topic. However, after reading your post Kenny I wanted to thank you for the service that you have done and continue to do for our country. You, your family, and fiance have made great sacrifices...thank you all!

kenny10

05-12-2008, 12:21 AM

hawk71049

05-12-2008, 12:54 AM

Thank you for thanking me I guess. I used to think thank you's were pretty good and they also felt good, but now I could careless about a thank you, its a sad thing to say
I am not knocking you I am sure your thank you is geniune but thank yous to me have become nothing

Kenny,

we care, we do… words can be so cheap sometimes, as though they were mostly meaningless, they can never reach that feeling deep inside that is tearing us apart about what injustices have occurred in our lives, i am so proud of you that you could come on here and tell us your story… like you i am not happy that you have yet to do another tour away from your fiancé, and family & friends, this is most difficult, i very much respect your discipline in not choosing the easy way out… it shows that you are a man of character, one thinking of the future, your plans, and desires to start a relationship on a sound foundation.

i think you for all the your effort, your time spent away from those that love you, all that you have gone through and yet you are doing yet another tour…

the good news here is that you are on the downhill side, less than a year to go, and you will be able to pursue all your dreams, and desires… as I am sure you are planning ahead save as much of your earning as possible so you can start your new life off financially stable, should the job market still be on the down-swing…

be safe while on the rock, and keep us posted on all your doings…

take care and God bless….

Sempher Fi… hawk

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1000hearts

05-12-2008, 12:59 AM

Kenny,
No hard feelings at all! While I certainly don't understand how you feel, or pretend to, I had a cousin who completed 2 back to back tours in Iraq last year. By the end of it, he was tired, changed, ready to go home, and ready to get out of the Army. I really can't imagine. However, I really just wanted you to know that your sacrifice and the sacrifice of your loved ones has not gone unnoticed. So for whatever it is worth, thank you.

hawk71049

05-14-2008, 03:36 AM

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what happens at Camp Pendleton when a Marine checks in for health care, and he tells them he is having trouble sleeping at night, and is jumpy and irritable…

this is what happens he is given a list of questions to answer (a check list for PTSD, if you will) and is told he can get medication, and visit Miramar (some 50 miles away) for this condition…. what is going on… Camp Pendleton…:confused:

Denial in the Corps ( http://www.truthout.org/docs_2006/020208Z.shtml)
Clips from the article (below)…

Unlike the Army and the Air Force, almost every Marine and Navy base has a brig on board, and that makes it easy to use the brig as storage for a troubled marine. "We think pretrial detention is overly prescribed," Faraj says. "More often than not it's used as a tool, because the command doesn't want to deal with someone." Consequently, marines with mental health problems are not only locked up in a brig without adequate mental healthcare but are asked to make serious legal decisions while actively suffering from mental disorders. "I think doing a court-martial at that time is a setup," Judith Litzenberger, the civilian defense lawyer, says. "It's totally devoid of due process.

You don't have a client there that you can talk to. We need some long-term psych hospitals that can treat these guys." The hospital at Pendleton lost its psych treatment certification a few years ago and never worked to get it back, so the camp no longer has an inpatient psychiatric facility. Marines who attempt suicide in the brig are sent to the Naval Medical Center in San Diego, but the naval hospital offers only acute care to marines, so once the suicidal marine is stabilized, he is sent back to jail. Though commanders do not purposely use pretrial detention to break a marine, that is often the effect on a marine suffering from PTSD - as it was in the case of Sgt. Patrick Uloth."

Effort Build to Help ‘Forgotten” Troops with PTSD (http://www.npr.org/templates/story/story.php?storyId=17362654)
Clips from the article (below)… you may also click on the red box above the picture to listen to the NPR report…

But veterans advocates say that even if the military and the Department of Veterans Affairs became models for helping troops with mental health problems, it wouldn't help a large category of vets who are already wounded and forgotten. These soldiers and Marines came back from combat, couldn't get adequate help, "flipped out" and misbehaved in some way — and as a result, were kicked out of the military without all the financial and medical benefits that veterans usually receive.

"I think it's an outrage that we have not taken proper care of them," said Sen. Christopher "Kit" Bond (R-MO), one of the most influential voices on veterans' affairs. "Too many of these people have been kicked out because of the results of the stress they've been under."
Push for Change
NPR tracked down dozens of vets like Uloth, including Marcus Johnson in Oregon; Nicholas Jackson in Georgia; Matt McLauchlen in California; and Jason Harvey in Florida. Their stories are variations on the same script: They fought in Iraq, got PTSD, couldn't get much help, got in trouble — and got kicked out without all their benefits.
NPR asked Pentagon officials to disclose how many vets with mental health problems have been discharged without all their benefits since the U.S. invaded Afghanistan and Iraq.
Pentagon spokesmen told NPR they don't know.
The Army said that since the U.S. went to war in Iraq, the Army alone has discharged about 28,000 soldiers for bad behavior, from taking drugs to going AWOL to assault. An Army spokesman said they can't tell how many of those soldiers were diagnosed with mental health problems, but medical specialists say troops who have PTSD or traumatic brain injury commonly misbehave in exactly those kinds of ways.
So advocates like Gary Myers, a former Army lawyer now in private practice, call on the nation's leaders to declare an amnesty. They say lawmakers should restore full benefits to all troops who were discharged for misconduct or other behavior after they returned from combat if they were also diagnosed with mental health problems such as PTSD.
"Congress needs to change the law," Myers says. Myers says commanders have to discipline troops who misbehave or it would destroy military discipline. But Myers adds, "We can no longer treat this as business as usual."
But Bond and almost a dozen other senators have asked President Bush to form a special commission to review the files of all vets who were diagnosed with mental health problems and discharged without all their benefits — and then restore those benefits, where commissioners believe that PTSD or other combat-related mental health problems played a major role.
"We need to take care of the soldiers and Marines who have been kicked out without benefits," Bond told NPR, "and may have done so because of undiagnosed, unrecognized mental health problems they may have. It's simple justice."
Officials at the Pentagon did not respond to NPR's repeated requests for comment.

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The Universal Curmudgeon_guest

05-14-2008, 04:07 AM

Okay... so I am not the person that likes to make myself the center of attention... but this situation truly hits home for me. I felt compelled to say something using the power of the written word, or in this case the keyboard.You may feel "lost and abandoned" as well as emeshed in an "uncaring system" and, given your history, that isn't unexpected.

But you should also remember that things don't happen overnight. Having an O-5 working on the problems of an E-3 is rather unusual - but it does happen. However even O-5s can't perform miracles and it is going to take time for the Base Chaplain's Office to budge a rather inert system.

And that is, most likely, what you are dealing with - inertia - and not "uncaring".

On a more general note, I agree that the problem with PTSD is most worrying and is also one that the military is going to HAVE TO find a way of dealing with. It could well transpire that the more "civilized" a people become the less able they are to engage in war - which would raise an entirely different set of problems.

All I can really advise is that you "Hang in there.". Since you and your Corporal have already shown the guts to make it through a really tough situation, I have every confidence that you are going to make it through this one as well, and that the shared experience is going to deepen and strengthen your bonds.

hawk71049

05-14-2008, 11:05 AM

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Army Medicine ( http://www.armymedicine.army.mil/news/releases/20080501MHMonth.cfm) Raises Mental Health Awareness with Programs to 'Get Connected' ( http://www.armymedicine.army.mil/)

The Army is joining in promoting mental health during May, which is celebrated as Mental Health Month under the sponsorship of Mental Health America, formerly known as the National Mental Health Association. The theme for 2008 is "Get Connected," emphasizing the valuable support people gain by connections with family, friends, community and mental health professionals.

PTSD: What You Need to know ( http://www.military.com/opinion/0,15202,79791_1,00.html) As the wars in Iraq and Afghanistan wear on, hundreds of thousands of veterans are at significant risk for a particularly distressing and impairing mental health syndrome: Posttraumatic Stress Disorder. First documented in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders in 1980, PTSD (http://www.military.com/PTSD) becomes a serious risk when a service member experiences, witnesses, or is confronted with an event involving actual or threatened death or serious injury, or a threat to the physical integrity of self or others -- welcome to any day in the Global War of Terror.

Part I: Stacking the Deck ( http://epluribusmedia.net/archives/archives/features/2006/20060206PTSD_pt1.html) War is hell. Unlike the Hollywood soldiers whose stoicism and stiff upper lip signal heroism; real men and women are not uniformed machines that can perform under great stress with little consequence. Trained to be part of the superior fighting machinery of the military, they are still human, mortal and unique. The gruesome terrors of war not only damage the body but can also shatter self-image, ability to trust, and belief systems, leaving the individual disillusioned and bitter. The returning combat veteran’s nervous system overloads from the assault by the stealth enemy: Post Traumatic Stress Disorder (PTSD).

Part II: Ration & Redefine ( http://epluribusmedia.net/archives/archives/features/2006/20060206PTSD_pt2.html)" Our pain from seeing these slanderous attacks stems from something much more fundamental, that if one veteran's record is called into question, the service of all American veterans is questioned... there is nothing complicated about supporting our troops, and the leaders of this nation should make it clear that the members of our military will not only be supported when they wear the uniform, but also when they return home to the land they fought to defend. Their valor and their wounds, both physical and psychological, make them heroes for as long as they live..."

Part III: Malign & Slime (http://epluribusmedia.net/archives/archives/features/2006/20060206PTSD_pt3.html) It will certainly cut costs to blame the veteran for the psychological damage experienced in war through locating the source of that damage in morals, sin, and pre-existing pathology. But it is one thing to cut costs by using a cheaper grade of toilet tissue; it is entirely of another magnitude to cut costs by using disposable soldiers.

The U.S. Department of Veterans (http://www.tampabay.com/news/military/veterans/article439790.ece ) Affairs agreed this week to reinstate group therapy for 11 battle-scarred Vietnam veterans coping with post-traumatic stress disorder.
The decision came after U.S. Rep. Ginny Brown-Waite, R-Brooksville, intervened on behalf of the Tampa Bay area veterans and after a March 11 St. Petersburg Times story detailed their plight.

The U.S. House of Representatives and the U.S. Senate recently passed budgets that boost funding for veterans’ (http://ptsdcombat.blogspot.com/2008/04/editorial-veterans-funding-or-permanent.html) health care and other veterans’ needs at amounts higher than the Bush Administration’s proposal. The Bush budget boosts total VA funding by about 1.6 percent, or $1.7 billion.

The House bill adds about $600 million to the Bush proposal, which would bolster overall spending to about 2.6 percent. The Senate adds $3 billion, making the overall spending increase about 5 percent.

Many veterans groups have favored the congressional proposals saying the number of veterans entering the VA health system from wars in Iraq and Afghanistan warrants the extra funding. In fact, Congress and the president in the most recent fiscal year boosted VA funding by an “emergency” $3.7 billion appropriation midway through the budget year after seeing tremendous increases in health care costs for veterans returning from Iraq and Afghanistan. That figure is close to the increase being proposed by Bush.

Coverage & Access | U.S. Soldiers Experience Increased Rates of Depression, PTSD on Third, Fourth Tours in Iraq, Study Finds [Mar 07, 2008]

About 15% to 20% of U.S. soldiers in Iraq have signs of depression or post-traumatic stress disorder, and about 30% of soldiers on their third or fourth tours have experienced emotional illnesses, according to a study released on Thursday by the Army, USA Today’ ( http://www.usatoday.com/news/world/iraq/2008-03-06-soldier-stress_N.htm) reports (Zoroya, USA Today, 3/7). The survey included anonymous responses collected from 2,295 soldiers in Iraq in October and November 2007 (Spiegel, Los Angeles Times, 3/7). Mental health teams from the Army Surgeon General's Office (Army Medicine Raises Mental Health Awareness with Programs to 'Get Connected') conducted the survey (USA Today, 3/7).

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hawk71049

05-15-2008, 05:34 PM

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Posttraumatic Stress Disorder DSM-IV™ Diagnosis & Criteria (http://www.mental-health-today.com/ptsd/dsm.htm)

Diagnostic Features The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion B), persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (Criterion C), and persistent symptoms of increased arousal (Criterion D). The full symptom picture must be present for more than 1 month (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Medical officer links misconduct and PTSD ( http://www.marinecorpstimes.com/news/2007/06/marine_mental_health_070623/)

Marines involved in misconduct following their deployment to a combat zone — whether in the midst of battle or even after returning home — “should be aggressively screened” for stress injuries such as post-traumatic stress disorder because there is a possible correlation between the two, according to a senior Navy medical officer.

The Ballard of Travis Twiggs ( http://www.healingcombattrauma.com/ptsd/index.html)

I'm personally still reeling from the apparent murder-suicide of USMC SSgt. Travis N. Twiggs and his brother, Will Twiggs, as the cops closed in on them in Arizona yesterday. (See umpteen shallow news reports for the same basic information, but no explanatory context or any insights as to why.) Our previous blog entries about Travis Twiggs are here here and here.
While I make my feeble attempt to sort through what is known and what is not, and blog about it later, I'm struck by one comment Twiggs made in the essay he published about his own significant struggles with PTSD. The comment is specifically about PTSD:

"I pray that no Marine or sailor, or any service member for that matter, ever has to go through what I went through." -- Travis N. Twiggs, RIP, 5/14/2008.

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I'm His Lucky Charm....

05-16-2008, 05:46 AM

Post Traumatic Stress Disorders-Part 1:
http://www.youtube.com/watch?v=Uof9aNH4w8U

Post Traumatic Stress Disorders-Parts 2:
http://www.youtube.com/watch?v=jikWw3tTtLk&feature=related

Post Traumatic Stress Disorders-Parts 3:
http://www.youtube.com/watch?v=91rxDnl4gu4

I am not sure what to say for the simple fact that this IS a PROBLEM and it needs to be addressed. Watch the above report and think about all the service men and women that have already given so much to our country. How is our government helping these fine young men and women? Maybe it is just not enough. How can this problem that will only continue to grow be prevented? How can we help? Is our country failing our service men and women?

hawk71049

05-16-2008, 11:01 AM

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Posttraumatic Stress Disorder in Veterans (http://www.psychiatrictimes.com/display/article/10168/1147456?pageNumber=1)...

In the current war, military hospitals and Department of Veterans Affairs (VA) hospitals have seen many patients for the treatment of mental illness. The VA hospital system alone has seen thousands of veterans for treatment of mental illnesses related to the conflicts in Afghanistan and Iraq, and patients continue to present for treatment.

Troops serving in Iraq and Afghanistan may be more vulnerable to mental disorders for several reasons:

• Because of the lack of a formal battlefront, soldiers deal with constant threat and combat uncertainty.
• Many of the troops are from National Guard units; as such, these soldiers frequently receive much less training than active-duty units.
• Tours of duty are long and they frequently include direct combat exposure.
• Many military service members face redeployment.

A recent editorial in the Journal of General Internal Medicine noted "Iraq has become a more effective incubator for posttraumatic stress disorder (PTSD) in the American service members than any mad scientist could conceivably design."2

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Their psychiatric problems go beyond posttraumatic stress because of unique combat in Iraq and Afghanistan.
Timothy W. Lineberry, MD

U.S. troops returning home: Are you prepared?

New wars, new names for psychiatric combat reactions (http://www.jfponline.com/Pages.asp?AID=3781)...

1. During the Civil War, it was called............................… “irritable heart” or “soldier’s heart”
2. World War I... they were said to have.......................... “shell shock”
3. World War II and the Korean War…… they had........... “combat fatigue”
4. Vietnam…it was posttraumatic stress disorder.............. (PTSD)

Along with evolving psychiatric nomenclature and diagnostic schema, each war—including those in Iraq and Afghanistan—has had unique symptom constellations.11 These differences relate to the contemporary state of scientific and medical knowledge, sociocultural factors, and popular press concerns. Some differences stem from actual or perceived weapon effects (such as chemical warfare or depleted uranium).

For example, World War I physicians at first considered “shell shock” to result from traumatic effects of high-explosive shells on the brain. This explanation proved inadequate when soldiers without direct concussive exposure expressed trauma-related symptoms.12

National Guard and Army Reserve troops constitute an estimated 30% to 40% of the 1 million-plus U.S. military personnel deployed in Iraq and Afghanistan.1-3 Many of these civilian soldiers—once considered “weekend warriors”—are serving a first combat tour, returning home, and being redeployed for additional tours of duty.

Because of these unprecedented deployment policies, civilian psychiatrists will likely play a greater role in treating combat-related mental health problems than in any previous U.S. war. You may need to provide initial and long-term psychiatric care for reservists and Guard members returning to your community during 2006 and beyond.

To help you prepare, we discuss the combat situations these soldiers are experiencing, types of psychiatric problems they are reporting in anonymous surveys, and their attitudes about seeking psychiatric care. We also offer practical resources on combat-related posttraumatic stress disorder (PTSD) for nonmilitary or Veterans Administration clinicians.

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I'm His Lucky Charm....

05-16-2008, 05:37 PM

http://www.youtube.com/watch?v=bMdjZ7R8-wo

"100,000 Iraq Vets has been diagnosed PTSD and the number increases by the hundreds every single week. 1000+ (and steadily increasing) Iraq vets attempt suicide each month many are successful. Most of the PTSD diagnosed troops are either suicidal, addicted to illicit drugs or addicted to prescription drugs. Many are a combination of the three. Support the troops. Bring them home."

I'm His Lucky Charm....

05-16-2008, 05:50 PM

"The Ground Truth-When The Killing Ends..."

"The Ground Truth stunned filmgoers at the 2006 Sundance and Nantucket Film Festivals. Hailed as "powerful" and "quietly unflinching," Patricia Foulkrod's searing documentary feature includes exclusive footage that will stir audiences. The filmmaker's subjects are patriotic young Americans - ordinary men and women who heeded the call for military service in Iraq - as they experience recruitment and training, combat, homecoming, and the struggle to reintegrate with families and communities. The terrible conflict in Iraq, depicted with ferocious honesty in the film, is a prelude for the even more challenging battles fought by the soldiers returning home - with personal demons, an uncomprehending public, and an indifferent government. As these battles take shape, each soldier becomes a new kind of hero, bearing witness and giving support to other veterans, and learning to fearlessly wield the most powerful weapon of all - the truth." -imdb.com

Click on the link to view this documentary.

http://www.moviesfoundonline.com/ground_truth.php

So...Uncle Sam, are you ignoring a growing problem? How many men and women will suffer? How many spouse, fiances, girlfriends, boyfriends, mothers, fathers, brothers, sisters, etc. will lose someone they deeply care about and support because the issue of PTSD is "brushed under the carpet..."

Proud Mom

05-17-2008, 08:43 PM

This article appeared online today. It is a tragic story of a Marine diagnosed with PTSD. May he rest in Peace

Marine Who Died in Cross-State Chase Wrote of War Stress (http://www.foxnews.com/story/0,2933,356501,00.html)

hawk71049

05-19-2008, 06:49 AM

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Washington, DC - Today Washington, DC -

Today, Citizens for Responsibility and Ethics in Washington (CREW) and VoteVets.org released an e-mail (http://www.citizensforethics.org/files/VA%20E-Mail.pdf ) obtained from a Veterans Affairs (VA) employee directing VA staff to refrain from diagnosing soldiers and veterans with Post Traumatic Stress Disorder (PTSD).
On March 20, 2008 a VA hospital's PTSD program coordinator sent an e-mail to a number of VA employees, including psychologists, social workers, and a psychiatrist, stating that due to an increased number of "compensation seeking veterans," the staff should "refrain from giving a diagnosis of PTSD straight out" and they should "R/O [rule out] PTSD" and consider a diagnosis of "Adjustment Disorder" instead.

Read the full story. (http://www.votevets.org/news/?id=0132)

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Army Times
VA e-mail: Save money, do not diagnose PTSD

By Kelly Kennedy - Staff writer
Posted : Friday May 16, 2008 10:24:47 EDT

Two veterans advocacy groups have asked for copies of all documents relating to the Veterans Affairs Department’s post-traumatic stress disorder policies after an e-mail surfaced asking VA doctors to keep costs down by giving diagnoses of adjustment disorder instead.
Veterans diagnosed with PTSD are eligible for health benefits and, in some cases, disability retirement pay. Adjustment disorder, on the other hand, is considered a short-term diagnosis, and does not qualify veterans for benefits, said Brandon Friedman, vice chair of VoteVets.org, one of the advocacy groups.

Read the full story. (http://www.armytimes.com/news/2008/05/military_va_adjustmentdisorder_051508w/)
Read the full story. (http://www.militarytimes.com/forum/showthread.php?t=1564666)

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Closing Arguments in Suit on Veterans’ Mental Care
By NEIL MacFARQUHAR Published: May 1, 2008

SAN FRANCISCO — The issue of whether veterans with mental health problems are neglected or whether their sheer numbers are overwhelming the system divided closing arguments on Wednesday in a class-action lawsuit in federal court here.
Arturo J. Gonzalez, the lawyer arguing on behalf of the Veterans for Common Sense and the Veterans United for Truth, the two groups who brought the lawsuit against the Department of Veterans Affairs, said that the agency had failed to fully put into effect an action plan it developed four years ago.
The fact that it takes more than 180 days to process a veteran’s claim for benefits represents a “pattern of neglect,” Mr. Gonzalez said, adding that anyone who enters an appeal has to wait four and a half years for a resolution.
“I don’t know how any veteran can stand it and stick with it and get to the end of this process,” Mr. Gonzalez said.

Read the full story. ( http://www.nytimes.com/2008/05/01/us/01vets.html?fta=y)

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Courier-Journal.com Louisville, Kentucky * Southern Indiana
Veterans' issues need more attention
April 23, 2008

In response to your article in the Sunday paper titled, "Killin' is Just What I Do," we feel that The Courier-Journal has given short shrift to the most important aspect of this tragic case.

While Pvt. Kenneth Eastridge's offenses need to be understood and accounted for, the greater question of what is to be done with the large proportion of our returning veterans suffering from Post Traumatic Stress Disorder (PTSD) and similar combat injuries is raised only briefly. While a handful of our combat veterans running amok makes for great headlines, this treatment of the greater issue does little to address the real problems facing our servicemen and women whose issues are more benign but still tragic.

VoteVets.Org as well as the military mental health establishment understand that mental injuries such as PTSD are just as much combat injuries as a gunshot wound. More than that, the military understands that given sufficient exposure to combat stress, every service member will eventually experience similar symptoms. What we call for is accountability when the Department of Defense (DOD) and Department of Veterans Affairs (VA) shirk their duty to these injured troops.

The Commonwealth of Kentucky is blessed with a tremendous number of men and women who are dutiful and brave enough to put on the uniform in defense of our liberties. We are the men and women who have risked our physical and mental health, and we are not to be feared or pitied. Rather, we ask that those charged with providing that aid, the DOD and VA, be held accountable when that service is refused, delayed or insufficient.

We invite the reporters and editors at The Courier-Journal to explore the issues facing returning veterans in a meaningful manner. We must remember that this current war of choice in Iraq has lasted longer than World War II and that the active duty components of the Army have been deployed to several 12- and 15-month tours in Iraq. These men are under stresses that are quite literally unprecedented in their duration and frequency. Our dedication to their care and readjustment must be equally great.

GEORGE ZUBATY
VoteVets.Org
Kentucky State Captain
Louisville, 40217
The writer served in Afghanistan and Iraq with the 101st Airborne. -- Editor

Read the story. (http://www.courier-journal.com/apps/pbcs.dll/article?AID=/20080423/OPINION02/804230811)

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I'm His Lucky Charm....

05-19-2008, 08:46 PM

http://youtube.com/watch?v=Cm28SxYBmn8
"Interview of Jessica Rich at Camp Casey/Colorado Springs.
She was preparing to enter a treatment facility for PTSD before she died."

http://youtube.com/watch?v=ZBWwcrFmPhQ
"Numerous reports indicate that a large percentage of soldiers returning from Iraq and Afghanistan are suffering from mental health problems such as post-traumatic stress disorder. The Oversight Committee holds a hearing with afflicted soldiers and their families, and examine the ability of the DOD and the VA to screen, treat, and track returning soldiers who are at risk, and assess the impact that these illnesses are having on military readiness and military families. Richard Coons, father of Sgt. James Coons whose suicide after suffering from PTSD and neglect remains mysterious, gives testimony."

http://youtube.com/watch?v=LZJayI_InMY
"A new study found that 1 in 5 U.S. troops suffer from depression or post traumatic stress disorder from service in Iraq and Afghanistan. Randall Pinkston comments."

http://youtube.com/watch?v=rXCxPrXSx9k&feature=related

Michele

05-20-2008, 12:21 AM

you people dont deserve my knowledge

uconn

05-20-2008, 01:27 AM

Hawk,
I just want to thank you again for having the courage to take on this issue. I know not many people have posted here but you can see that many of read it. If even one person walks away with a better understanding of what PTSD is then your efforts have been well worth it.

hawk71049

05-20-2008, 01:09 PM

.

the world is watching

The National Center for PTSD (NCPTSD) is the Federal research and education agency within the Department of Veterans Affairs. This is the best place to find scientific information about PTSD.

The Dart Center for Journalism and Trauma educates the media about PTSD, but also provides a short "cyber-course" on the subject that would help anyone learn more.

Gift From Within exists to inform and support survivors of trauma and abuse. It includes an e-mail pen-pal service, an art gallery and many useful essays, articles and links to other resources.

The National Center for Victims of Crime serves victims of any kind of crime, including those whose victimization results in PTSD. They have a Helpline, 1-800-FYI-CALL, and welcome your call.

Welcome to this new site - the first of its kind, receiving responses from viewers of the Dart Foundation's national PTSD awareness campaign.

And please if you'd like to view the public-service announcements on PTSD that aired in 15,000,000 homes.
The National Center for PTSD (http://www.ptsdinfo.org/) read more…
Wikipedia Posttraumatic stress disorder (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder) a great source for reference materials….
United States Department of Veterans Affairs National Center for PTSD (http://www.ncptsd.va.gov/ncmain/index.jsp)

Michele,

first... thank you for expressing an interest in this topic… as your view point is very much welcomed… please feel free to continue to contribute to this topic… or make suggestion as you have done so in the past… i am open to any and all ideas… with all respect please understand…i cannot and will not accept... there is nothing that can be done short term... or long term…

actually the first step in solving a problem is to recognize that one exists…
i am not sure that we as a nation are fully aware of the complexity of this topic, and how it effects the service member, their families, our community… our NATION…

most generally speaking one would start with the top (our law makers and military leaders) and work down… since that’s not working… i decided to work both angles… (the Shot Gun effect)
you get a hand full of military wives, girl friends or individuals such as yourself united… start breading a few toes n fingers…. and the sky is the limit…

THE ISSUES AS I SEE THEM1. make it a criminal offense (under the UCMJ) to discriminate against those that are affected, especially those Commanding Officers, and Staff NCO’s…
2. get the word out to those affected… their loved one… their families…
3. ensure those that are affected help is on the horizon…
4. get those agencies that are responsible for the care involved in the solution…
5. immediately… separate deployments with enough time to allow those soldier to recover…
6. determine how many soldiers are effected in mental illnesses including… a) PTSD b) Brain Injuries…
7. determine the treatment…
8. set up a budget…
9. monitor patient care…
10. establish Short Term & Long Term Goals…

having somewhat of a financial background and working within the GAO system…
i have copied the President’s Budget for the Department of Defense DoD…FY 2007, 2008 & 2009 and pasted it to a Micro Soft Spread Sheet… i am manually typing in the numeric data into columns of reference… and have been working on this for over two weeks now… what a freaking night mayor… what’s really scary is that it’s starting to make sense… i am finding some very interesting facts, when one compares individual military strengths (man power) to line item budgets as compared to the other services, and their line item budgets… i will presented these concerns here on the FORUM…

ok you may ask what the hell does the DoD Budget have to do with PTSD… i will address that question in my summary… in the mean time there is much work to be done… this is very tedious and time consuming... hawk

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hawk71049

05-21-2008, 04:17 PM

Page 1

Invisible Wounds of War ( http://www.rand.org/pubs/monographs/2008/RAND_MG720.pdf)

This work was funded by a grant from the Iraq Afghanistan Deployment
Impact Fund, which is administered by the California Community
Foundation. The study was conducted jointly under the auspices of the
Center for Military Health Policy Research, a RAND Health center,
and the Forces and Resources Policy Center of the National Security
Research Division (NSRD).

This product is part of the RAND Corporation monograph series. RAND
monographs present major research findings that address the challenges facing
the public and private sectors. All RAND monographs undergo rigorous peer
review to ensure high standards for research quality and objectivity.

Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments—many involving prolonged exposure to combat-related stress over multiple rotations—may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a President’s Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. Many recent reports have referred to these as the signature wounds of the Afghanistan and Iraq conflicts. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it.RAND conducted a comprehensive study of the post-deployment health-related needs associated with post-traumatic stress disorder, major depression, and traumatic brain injury among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of that study. These results should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation’s veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org.

Data collection for this study began in April 2007 and concluded in January 2008. Specific activities included a critical review of the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of servicemembers and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well as utilization of and barriers to care; a review of existing programs to treat servicemembers and veterans with post-traumatic stress disorder, major depression, and traumatic brain injury; focus groups with military servicemembers and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions over time.

Interviews with senior Office of the Secretary of Defense (OSD) and Service (Army, Navy, Air Force, Marine Corps) staff within the Department of Defense and within the Veterans Health Administration informed our efforts to document the treatment and support programs available to this population. Note, however, that the views expressed in this monograph do not reflect official policy or the position of the U.S. government or any of the institutions we included in our interviews. This work was funded by a grant from the Iraq Afghanistan Deployment Impact Fund, which is administered by the California Community Foundation. The fund had no role in the design and conduct of this study; collection, management, analysis, or interpretation of data; or in the preparation of this document. The study was conducted jointly under the auspices of the Center for Military Health Policy Research, a RAND Health center, and the Forces and Resources Policy Center of the National Security Research Division (NSRD). The principal investigators are Terri Tanielian

continued.... Page 2
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hawk71049

05-21-2008, 04:49 PM

Page 2

Invisible Wounds of War ( http://www.rand.org/pubs/monographs/2008/RAND_MG720.pdf)

Key Findings
Prevalence of Mental Health Conditions and TBI What is the scope of mental health and cognitive issues faced by OEF/OIF troops returning from deployment? Most of the 1.64 million military servicemembers who have deployed in support of OIF or OEF will return home from war without problems and readjust successfully, but many have already returned or will return with significant mental health conditions. Among OEF/OIF veterans, rates of PTSD, major depression, and probable TBI are relatively high, particularly when compared with the general U.S. civilian population. A telephone study of 1,965 previously deployed individuals sampled from 24 geographic areas found substantial rates of mental health problems in the past 30 days, with 14 percent screening positive for PTSD and 14 percent for major depression. A similar number, 19 percent, reported a probable TBI during deployment. Major depression is often not considered a combat-related injury; however, our analyses suggest that it is highly associated with combat exposure and should be considered as being along the spectrum of post-deployment mental health consequences. Although a substantial proportion of respondents had reported experiencing a TBI, it is not possible to know from the survey the severity of the injury or whether the injury caused functional impairment.

Assuming that the prevalence found in this study is representative of the 1.64 million servicemembers who had been deployed for OEF/OIF as of October 2007, we estimate that approximately 300,000 individuals currently suffer from PTSD or major depression and that 320,000 individuals experienced a probable TBI during deployment. About one-third of those previously deployed have at least one of these three conditions, and about 5 percent report symptoms of all three. Some specific groups, previously understudied—including the Reserve Components and those who have left military service—may be at higher risk of suffering from these conditions. Seeking and Receiving Treatment. Of those reporting a probable TBI, 57 percent had not been evaluated by a physician for brain injury. Military servicemembers with probable PTSD or major depression seek care at about the same rate as the civilian population, and, just as in the civilian population, many of the afflicted individuals were not receiving treatment. About half (53 percent) of those who met the criteria for current PTSD or major depression had sought help from a physician or mental health provider for a mental health problem in the past year.

xxii Invisible Wounds of War
Getting Quality Care. Even when individuals receive care, too few receive quality care. Of those who have a mental disorder and also sought medical care for that problem, just over half received a minimally adequate treatment. The number who received quality care (i.e., a treatment that has been demonstrated to be effective) would be expected to be even smaller. Focused efforts are needed to significantly improve both accessibility to care and quality of care for these groups. The prevalence of PTSD and major depression will likely remain high unless greater efforts are made to enhance systems of care for these individuals. Survey respondents identified many barriers that inhibit getting treatment for their mental health problems. In general, respondents were concerned that treatment would not be kept confidential and would constrain future job assignments and military-career advancement. About 45 percent were concerned that drug therapies for mental health problems may have unpleasant side effects, and about one-quarter thought that even good mental health care was not very effective. These barriers suggest the need for increased access to confidential, vidence-based psychotherapy, to maintain high levels of readiness and functioning among previously deployed servicemembers and veterans.

Costs
What are the costs of these mental health and cognitive conditions to the individual and to society? Unless treated, each of these conditions has wide-ranging and negative implications for those afflicted. We considered a wide array of consequences that affect work, family, and social functioning, and we considered co-occurring problems, such as substance abuse, homelessness, and suicide.

The presence of any one of these conditions can impair future health, work productivity, and family and social relationships. Individuals afflicted with any of these conditions are more likely to have other psychiatric diagnoses (e.g., substance use) and are at increased risk for attempting suicide. They have higher rates of unhealthy behaviors (e.g., smoking, overeating, unsafe sex) and higher rates of physical health problems and mortality. Individuals with any of these conditions also tend to miss more days of work or report being less productive. There is also a possible connection between having one of these conditions and being homeless.

Suffering from these conditions can also impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat experiences across generations. Associated Costs. In dollar terms, the costs associated with mental health and cognitive conditions stemming from the conflicts in Afghanistan and Iraq are substantial. We estimated costs using two separate methodologies. For PTSD and major depression, we used a microsimulation model to project two-year costs—costs incurred within the first two years after servicemembers return home. Because there were insufficient data to simulate two-year-cost projections for TBI, we estimated one-year costs for TBI using a standard, cost-of-illness approach. On a per-case basis, two-year costs associated with PTSD are approximately $5,904 to $10,298, depending on whether we include the cost of lives lost to suicide. Two-year costs associated with major depression are approximately $15,461 to $25,757, and costs associated with co-morbid PTSD and major depression are approximately $12,427 to $16,884. One-year costs for servicemembers who have accessed the health care system and received a diagnosis of traumatic brain injury are even higher, ranging from $25,572 to $30,730 in 2005 for mild cases ($27,259 to $32,759 in 2007 dollars), and from $252,251 to $383,221 for moderate or severe cases ($268,902 to $408,519 in 2007 dollars).

However, our cost figures omit current as well as potential later costs stemming from substance abuse, domestic violence, homelessness, family strain, and several other factors, thus understating the true costs associated with deployment-related cognitive and mental health conditions.

Translating these cost estimates into a total-dollar figure is confounded by uncertainty about the total number of cases in a given year, by the little information that is available about the severity of these cases, and by the extent to which the three conditions co-occur. Given these caveats, we used our microsimulation model to predict two-year costs for the approximately 1.6 million troops who have deployed since 2001. We estimate that PTSD-related and major depression–related costs could range from $4.0 to $6.2 billion over two years (in 2007 dollars). Applying the costs per case for TBI to the total number of diagnosed TBI cases identified as of June 2007 (2,726), we estimate that total costs incurred within the first year after diagnosis could range from $591 million to $910 million (in 2007 dollars)..

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The Universal Curmudgeon_guest

05-22-2008, 02:27 PM

You have hit the nail on the head TUC.

We know that many mental illnesses are caused by a physical dysfunction of the brain (a pre disposition to it if you like). PTSD is triggered by a multitude of scenarios, not just military. Who takes care of those people?

The problem is unfixable in the short term IMHO.I also suspect that there is a direct relationship between the difference between "previously perceived experience of exposure to violence" and "current actually experienced effect of exposure to violence".

In other words, someone who has spent 10 years "blowing people away" in video games is likely to be more prone to PTSD than someone who spent 10 years working on a family farm where they slaughtered their own animals for food (to give just one example).

Thus, someone who comes from a more "civilized" (read as "rejects violence as a means of dispute resolution") society and who has never actually experienced the effects of violent death/injury on anyone is going to be more susceptible to PTSD than someone who comes from a less "civilized" (see previous definition) society and who has seen people beaten and killed (or simply allowed to die of starvation) for most of their life.

On the other hand, actually researching that question would be difficult because it implies certain "value judgements" on the life styles of other people - and that would make it almost impossible to obtain any research grants - and no research is done without research grants because researchers have to make a living too.

Michele

05-22-2008, 10:33 PM

you people dont deserve my knowledge

hawk71049

05-23-2008, 12:30 PM

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GROUP OFFERS FREE PSYCHIATRIC CARE TO WAR VETS
Stars and Stripes May 20, 2008 (http://www.stripes.com/article.asp?section=104&article=62283&archive=true)
By Leo Shane III, Stars and Stripes
Mideast edition, Tuesday, May 20, 2008

WASHINGTON — A coalition of mental health groups announced plans Monday to establish a nationwide network of psychiatrists, psychologists and other experts to provide free counseling to combat veterans and their families.

"Citizen soldiers have had extended, long deployments, and that has created a difficult situation for them and for their families," said Dr. Richard Harding, president of the American Psychiatric Foundation. "Those people need help … and we have a duty to take care of them."

The groups’ goal is to enlist about 40,000 mental health professionals — about 10 percent of the nationwide force — to donate time and services to individual veterans, their families, or veterans groups.

The resources would be in addition to services already provided by the Defense Department and Veterans Affairs agencies, especially in areas with long wait times or long travel distances for servicemembers to easily take advantage of those official medical treatment options.

Dr. Barbara Romberg, president of the Give an Hour Foundation, said more than 1.6 million servicemembers have deployed to Iraq and Afghanistan over the last seven years, and studies show at least 20 percent have battled with anxiety, depression and serious stress disorders since their return.

Those figures don’t include family members, who can also suffer mental health issues when their loved ones are sent to war.

"But there is reason for hope and optimism," she said. "We know so much more today about mental health in general and about conditions like PTSD. We know that post-traumatic stress disorder doesn’t need to turn into a chronic illness."

Her group currently has about 1,200 licensed professionals donating an hour a week to counsel servicemembers and their families.

The Eli Lilly foundation donated $1 million to the effort at the event. Project officials said the funds will be used for public awareness and servicemember outreach programs, as well as recruiting more counselors throughout the country.

To find a counselor in your area, or to volunteer services to the mental health counseling project, visit www.giveanhour.org.

Leo Shane III / S&S
Dr. Barbara Romberg, founder of the Give an Hour Foundation, speaks to reporters in Washington, DC Monday about her group’s new joint work with the American Psychiatric Foundation to provide more free mental health counseling for combat troops and their families.

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Pacific edition
Dealing with PTSD ( http://www.stripes.com/article.asp?section=125&article=54936)

Sunday, May 18, 2008
Stars and Stripes

Letters to the Editor

The post-traumatic stress disorder subject, a topic of discussion in your Opinion section, is disturbing, to say the least. Many have opinions on the why’s and who’s of PTSD. I have yet to see anyone — doctors, senior leaders or otherwise — knowledgeable on this subject make a comment.

As a retiree of 22 years in the Army and spouse to a military member who suffers PTSD, I find it disheartening that no one has said that this is enough. I know many great improvements are being made in the area of PTSD, but the great lack of knowledge throughout the services among personnel is a problem.

When the doctor at Fort Bliss, Texas, called it a stigma to those diagnosed with PTSD, why is that? To me, that is the question many leaders should ask themselves. As a witness, I can tell you my perspective is that many think of it as a simple weakness. This is far from the truth. Having seen how those with PTSD are treated, I can assure you that most are treated as such due to lack of knowledge.

If a soldier is to rid himself of this stigma, I believe awards isn’t the route. But a very big step in the right direction would be for all enlisted leaders and officers who know or suspect that a soldier may suffer from PTSD to help make him see he is a functioning, contributing team member, instead of useless.

Discover the issues and ensure as leaders that anyone treating someone suffering from PTSD in an other than proper military manner is dealt with and educated, as that seems to be the biggest problem.

Mark R.C. Baker
Camp Victory South, Iraq

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Pacific edition
PTSD causes real pain (http://www.stripes.com/article.asp?section=125&article=54915)

Monday, May 19, 2008
Stars and Stripes

Letters to the Editor

The May 8 letter "Medal for PTSD a bad idea" opposed awarding a Purple Heart medal because someone has post-traumatic stress disorder.

People with mental challenges have always been viewed as second-class citizens. In the past, the military told the soldier to suck it up and be a man. My father is a proud Vietnam War veteran and, to this day, he is exceedingly jumpy when surprised. He has carried the burden of always being afraid when someone unexpectedly comes up behind him. I would characterize these symptoms as PTSD. People who suffer with this have real ailments that cannot be seen but cause real pain.

I think the letter writer disregarded PTSD as a real medical condition. People always like to say: "It’s in your head." Yet isn’t the brain what controls our pain sensors? Are we supposed to let these soldiers come home and be completely incapable of dealing with everyday life? They may not be missing a limb, but they are missing something.

Let us not discount their conditions. They can get help but will carry the scars forever.

Carol Wainz
Yokosuka Naval Base, Japan

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The Universal Curmudgeon_guest

05-23-2008, 02:07 PM

Well I agree to a point but I don’t think it’s a case of, we know absolutely nothing either.It's not so much a matter of "not knowing" as it is of applying what we do know to the situation - and I don't think that there is enough "moral rectitude" in higher echelons to do that.

We know that people become “desensitized” to certain things if they expose themselves to it for long enough. We also know the reverse is true. That we can overcome phobia’s like fear of heights etc if we expose ourselves to those fears for long enough. True. However, if the "desensitization" isn't done properly the net result is highly likely to be an intensification rather than a decrease of the undesired result.

Of course, there are many variables involved here but as I said, it’s not like we know absolutely nothingQuite right, and thank you for the useful references.

I'm His Lucky Charm....

05-25-2008, 06:44 PM

http://blogrevolution.com/archives/2008/05/18/3729409.html

dgeezy

05-25-2008, 08:00 PM

Cajun's Girl

05-26-2008, 02:17 AM

I don't know, I guess all people are different. To me, PTSD is a load of BS. It's just another excuse to get benefits, and it is being abused terribly. PTSD is on the same level as RLS (restless leg syndrome) to me, a crock.

Dude you need to LAY OFF the POT. PSTD has to be diagnosed, often times it isn't diagnosed soon enough. There's a lot of literature on PSTD, it would do you well to research it. Perhaps you could spend your leave learning about something that is an issue to maybe you someday..or your comrades....rather than smoking weed.

My mother HAS RLS....don't try to tell me it's not real.

dgeezy

05-26-2008, 12:59 PM

Dude you need to LAY OFF the POT. PSTD has to be diagnosed, often times it isn't diagnosed soon enough. There's a lot of literature on PSTD, it would do you well to research it. Perhaps you could spend your leave learning about something that is an issue to maybe you someday..or your comrades....rather than smoking weed.

My mother HAS RLS....don't try to tell me it's not real.

HAHAHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHHA!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
That is the biggest crock of S#!T i have ever heard in my life. "I need a pill cause my legs wont quit shakin"
just like "Oh i've been to Iraq, and sat on the FOB for 7 months, I HAVE PTSD" Get a life and quit trying to live off the system you welfarite scum.

caliny

05-26-2008, 02:51 PM

dgeezy

05-26-2008, 03:39 PM

dgeezy~

Originally, you made a somewhat valid point. While I firmly believe that PTSD is real, I also believe that it has been misdiagnosed in some and that others may abuse such a diagnosis (though not the majority). Some are quick to diagnose as PTSD a servicemember's temporary difficulty readjusting to non-combat life.

However, your argument lost whatever credibility it had by the above comment. We've managed to have a perfectly civil conversation so far, though we may disagree with one another's viewpoints. No one brought up living off or taking advantage of the system. No one mentioned anything about welfare. The fact that you brought it up in such a manner brings to light more about your character and whatever valid point you made fades into the background. Just something to consider for future posts.

caliny~

If you read my post above you would know that it was a response to Cajun Girl's post about me. I was simply defending myself, it was not directed at anyone else except "her". What I meant by living off of or taking atvantage of the system is the continuing actions of Marines lying about having PTSD just so they can claim disability, to me, this is a form of welfare, and anyone who participates in this deserves no respect. Do I think PTSD is real? Yeah, i guess. I have never had a personal experience with it, so I can not say for certain. I believe life is what you make of it, and that theres nothing in life, no matter how traumatic you cannot overcome with a positive attitude. Thats all.

Cajun's Girl

05-26-2008, 03:47 PM

Apparently you've changed your tune from believing PSTD is bullshit to "I guess" it's real. Anyways, I would love to see evidence about how many people in fact milk the PSTD "welfare" system. PSTD is hard for people to accept having in the first place, there is still a great amount of perceived stigma throughout the military and it is not something soldiers RUSH to claim to have. I suppose there are a few guys out there who have tried to get these benefits, but alas the hassle for them, and MEDICATION they often get would likely weed out small amount of fakers.(AKA More of a hassle than it's worth for non PSTD individuals) You have a lot to learn about psychological disorders. GO read up on some of these things before you try to claim that it is a bullshit phenomenon.

As for you making fun of my mother's one of many problems that's pretty childish. Again, do some research, there is a science behind it..like many other diseases/disorders.

caliny~

If you read my post above you would know that it was a response to Cajun Girl's post about me. I was simply defending myself, it was not directed at anyone else except "her". What I meant by living off of or taking atvantage of the system is the continuing actions of Marines lying about having PTSD just so they can claim disability, to me, this is a form of welfare, and anyone who participates in this deserves no respect. Do I think PTSD is real? Yeah, i guess. I have never had a personal experience with it, so I can not say for certain. I believe life is what you make of it, and that theres nothing in life, no matter how traumatic you cannot overcome with a positive attitude. Thats all.

caliny

05-26-2008, 03:48 PM

I did realize that your post was a response to CG's. I only meant to point out that "unrelated" posts still affect the apparent credibility of arguments. That's all. :)

What I meant by living off of or taking atvantage of the system is the continuing actions of Marines lying about having PTSD just so they can claim disability, to me, this is a form of welfare, and anyone who participates in this deserves no respect.

Fair enough. Absolutely, agreed.

dgeezy

05-26-2008, 04:00 PM

Apparently you've changed your tune from believing PSTD is bullshit to "I guess" it's real. Anyways, I would love to see evidence about how many people in fact milk the PSTD "welfare" system. PSTD is hard for people to accept having in the first place, there is still a great amount of perceived stigma throughout the military and it is not something soldiers RUSH to claim to have. I suppose there are a few guys out there who have tried to get these benefits, but alas the hassle for them, and MEDICATION they often get would likely weed out small amount of fakers.(AKA More of a hassle than it's worth for non PSTD individuals) You have a lot to learn about psychological disorders. GO read up on some of these things before you try to claim that it is a bullshit phenomenon.

As for you making fun of my mother's one of many problems that's pretty childish. Again, do some research, there is a science behind it..like many other diseases/disorders.

There are PLENTY of people who try to milk the system. Go to any TAPS or SEPS brief, and wait until they ask if anyone in the room has anything they want to claim for disability, SEE if 3/4 of the room doesnt stand up or raise their hand. Its disgusting.

And as for RLS, please.... It's a BS "disease" made up a drug manufacturer so they could make a pill to treat it.

Cajun's Girl

05-26-2008, 04:37 PM

There are PLENTY of people who try to milk the system. Go to any TAPS or SEPS brief, and wait until they ask if anyone in the room has anything they want to claim for disability, SEE if 3/4 of the room doesnt stand up or raise their hand. Its disgusting.

And as for RLS, please.... It's a BS "disease" made up a drug manufacturer so they could make a pill to treat it.

3/4 of the room, of people you don't know personally..that you have no authority to diagnose them...how would you know if they don't have a problem? How do you know if they don't have a true disability that they actually GET the funding? You still don't know, you have no proof to your claims. I think there are a handful of people who try to milk the system, but again you really don't understand the depth of accepting and recognizing that you may have a disorder.

Again your ignorance for RLS..it is a neurobiological disorder..here READ THIS (http://www.neuro.jhmi.edu/rls/causes.htm)...educate yourself rather than saying it doesn't exist because you or nobody you know has it...So is cancer made up too for the pharmaceutical companies??? Parkinson's? Don't be so quick to put your foot in your mouth when you have absolutely nothing to back up you claims. Just because you think it sounds impossible or stupid...or have a grudge against the greedy pharmaceutical companies doesn't mean that RLS doesn't exist.

dgeezy

05-26-2008, 04:45 PM

3/4 of the room, of people you don't know personally..that you have no authority to diagnose them...how would you know if they don't have a problem? How do you know if they don't have a true disability that they actually GET the funding? You still don't know, you have no proof to your claims. I think there are a handful of people who try to milk the system, but again you really don't understand the depth of accepting and recognizing that you may have a disorder.

Again your ignorance for RLS..it is a neurobiological disorder..here READ THIS (http://www.neuro.jhmi.edu/rls/causes.htm)...educate yourself rather than saying it doesn't exist because you or nobody you know has it...So is cancer made up too for the pharmaceutical companies??? Parkinson's? Don't be so quick to put your foot in your mouth when you have absolutely nothing to back up you claims. Just because you think it sounds impossible or stupid...or have a grudge against the greedy pharmaceutical companies doesn't mean that RLS doesn't exist.

Oh god, here we go with the "YOU DONT KNOW, I DO.... I REEEEEEEEEEEEAAAAD!!!" You sound like Tom Cruise on the Today Show " You dont know about the history of psychiatry (sp) I Do!!"
You say its a handful of people, I say its more. There we can agree to disagree.
You say RLS is a "disease". I say, if you cant stop your legs from shaking go take a stroll around the block or do some areobic exercise. STFU, all you're going to keep doing is saying "I KNOW, YOU DONT" Im not in 3rd grade anymore so I refuse to argue like that. Peace

Cajun's Girl

05-26-2008, 04:53 PM

I am not the one arguing like a 3rd grader. You consistently make claims that are not supported by any academic resources. If you would like I can provide you with many articles on both ends of the spectrum. I still have access to the university's e-journals. What is your background in psychiatry? I realize that there is a skeptical side of psychiatry, especially with certain disorders..but when you have neurobiological evidence of abnormal brain functioning in conjunction with symptoms I would say its quite reasonable to believe that in fact a disorder is there. Yes pharmaceutical companies love to make money on tons of drugs, but in that case it benefits people in the capitalist race to MAKE drugs to help people, however it is a rip off when it comes to buying some of these meds. You have to have damn good insurance these days.

Anyways, you obviously know nothing about RLS...come on, you think that since my mother, who HAS RLS...makes me completely ignorant on the subject? Do you think that if she would walk around the block it would help? Well I got news for you, it don't. And what do you read? Opinions of other people who have NO clue what they are talking about or do you read articles from REAL doctors? Again I can get some of those for you...after I mow the lawn anyways. Come on kid open your eyes...do the research, present it..then maybe I will take you seriously.

Oh god, here we go with the "YOU DONT KNOW, I DO.... I REEEEEEEEEEEEAAAAD!!!" You sound like Tom Cruise on the Today Show " You dont know about the history of psychiatry (sp) I Do!!"
You say its a handful of people, I say its more. There we can agree to disagree.
You say RLS is a "disease". I say, if you cant stop your legs from shaking go take a stroll around the block or do some areobic exercise. STFU, all you're going to keep doing is saying "I KNOW, YOU DONT" Im not in 3rd grade anymore so I refuse to argue like that. Peace

dgeezy

05-26-2008, 04:58 PM

I am not the one arguing like a 3rd grader. You consistently make claims that are not supported by any academic resources. If you would like I can provide you with many articles on both ends of the spectrum. I still have access to the university's e-journals. What is your background in psychiatry? I realize that there is a skeptical side of psychiatry, especially with certain disorders..but when you have neurobiological evidence of abnormal brain functioning in conjunction with symptoms I would say its quite reasonable to believe that in fact a disorder is there. Yes pharmaceutical companies love to make money on tons of drugs, but in that case it benefits people in the capitalist race to MAKE drugs to help people, however it is a rip off when it comes to buying some of these meds. You have to have damn good insurance these days.

Anyways, you obviously know nothing about RLS...come on, you think that since my mother, who HAS RLS...makes me completely ignorant on the subject? Do you think that if she would walk around the block it would help? Well I got news for you, it don't. And what do you read? Opinions of other people who have NO clue what they are talking about or do you read articles from REAL doctors? Again I can get some of those for you...after I mow the lawn anyways. Come on kid open your eyes...do the research, present it..then maybe I will take you seriously.

If youre not taking me seriously then why are you arguing with me?

You Lost.

Get over it.

Cajun's Girl

05-26-2008, 06:56 PM

I'm not arguing with you because I think you have a valid point..if that were the case I wouldn't have much to say. I am pointing out your flawed concepts and reasoning. Rather then let the world run around with uneducated people, or those who make assumptions without proof I would like to provoke better thought processes. Besides, you like to run your mouth off a lot without any proof...I take you seriously as to you believe in what you say..but I don't take your statements/claims seriously as to them being the truth without you presenting any research as backup to your radical statements..does that make more sense to you, or do I need to draw a picture?

If youre not taking me seriously then why are you arguing with me?

You Lost.

Get over it.

I'm His Lucky Charm....

05-26-2008, 09:09 PM

http://woundedtimes.blogspot.com/

This site is a blog, but I felt it worth sharing...has some interesting pieces of information...

Michele

05-26-2008, 09:41 PM

you people dont deserve my knowledge

hawk71049

05-27-2008, 01:36 AM

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If youre not taking me seriously then why are you arguing with me?
dgeezy,

im not sure anyone is truly arguing with you… just an attempt to rectify your ignorance… if that is even possible… please understand… not all are equipped to read research with understanding and comprehension… or even the headlines that plague our newspapers about this disorder… forget about what is going on around them… hawk

now back to this figment of our imagination…

One In Five Iraq And Afghanistan Veterans Suffer From PTSD Or Major Depression ( http://www.sciencedaily.com/releases/2008/04/080417112102.htm)

Numerous news stories in the popular print and electronic media have
documented suicides among servicemembers and veterans returning from Operation
Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). In the United States,
there are more than 30,000 suicides annually. Suicides among veterans are included
in this number, but it is not known in what proportion. There is no nationwide
system for surveillance of suicide specifically among veterans. Recent data show that
about 20% of suicide deaths nationwide could be among veterans. It is not known
what proportion of these deaths are among OIF/OEF veterans.

Threads here on the forum that discuss PTSD…..

Reed official touts new medical care units ( http://www.militarytimes.com/forum/showthread.php?t=1560656&highlight=PTSD)

Many soldiers are returning from deployment from Iraq and Afghanistan with mental, as well as physical, medical problems. But the Army was slow to realize the impact of traumatic brain injury and post-traumatic stress disorder, Tucker said.

“We had an awareness problem,” he said. “We had to train our leaders into knowing what their responsibilities were and to get the soldier the proper care.”

Tucker said the military cannot leave another generation of war veterans unprepared to take care of themselves after their military service.

“We’ve got to give them the skills to be successful, to be providers for their families,” he said, adding that the Army is reviewing personality disorder discharges to see if the soldiers were actually suffering from PTSD or TBI.

Every discharge now has to go through a screening for those disorders, he said.

“We’re going back to account for that,” Tucker said. “The Army isn’t going to look the other way.”

Suicide hotline working well, VA chief says (http://www.militarytimes.com/forum/showthread.php?t=1560087&highlight=PTSD)

Operation Iraqi Freedom, Operation Enduring Freedom and other terrorist-related missions have produced about 750,000 new veterans, he said. About one-third have sought VA medical care, he said, noting that screening for stress and for mental health disorders such as traumatic brain injury and post-traumatic stress disorder are now part of the VA system.

“The stress of the type of warfare our service members are experiencing, coupled with the fact that they are redeploying with their units multiple times, can sometimes give rise to one or more mental health diagnoses such as PTSD, substance abuse, depression or anxiety,” he said.

Military kids bear their own scars (http://www.militarytimes.com/forum/showthread.php?t=1559998&highlight=PTSD)

Patients with PTSD tend to be “hyper-vigilant, irritable and always looking for danger,” Ordway says. She says initial studies of their children show that many “model” their behavior after their parent’s and become more anxious, more depressed and less able to sleep. That can lead to shorter attention spans and behavior problems.

Post-deployment suicide: A closer look ( http://www.militarytimes.com/forum/showthread.php?t=1559241&highlight=PTSD)

Is the military doing all it could and should? Do we need to enlist assistance from the private sector? How do we let our troops returning home know that there's no stigma attached to needing help adjusting? Or is there? Where do we go from here?

Thurman says deployed with head injury (http://www.militarytimes.com/forum/showthread.php?t=1558993&highlight=PTSD)

Meanwhile, a former Fort Carson officer has come forward to denounce the treatment of a soldier diagnosed with pre-existing personality disorder, rather than PTSD and traumatic brain injury, after reading about the case of Spc. Jon Town in Military Times.

Army lawyer slams disability retirement system (http://www.militarytimes.com/forum/showthread.php?t=1558921&highlight=PTSD)

Where do we begin to bring this to resolution? Can Engle's efforts make a difference? This thread is for the discussion of the disability system and related topics.

Anti gun traitors trying to disarm vets (http://www.militarytimes.com/forum/showthread.php?t=1560122&highlight=PTSD)

Can anyone see what's happening here? Vets, hide your guns.
Hundreds of thousands of veterans -- from Vietnam through Operation Iraqi Freedom -- are at risk of being banned from buying firearms if legislation that is pending in Congress gets enacted.

How? The Veterans Disarmament Act -- which has already passed the House -- would place any veteran who has ever been diagnosed with Post Traumatic Stress Disorder (PTSD) on the federal gun ban list.

This is exactly what President Bill Clinton did over seven years ago when his administration illegitimately added some 83,000 veterans into the National Criminal Information System (NICS system) -- prohibiting them from purchasing firearms, simply because of afflictions like PTSD.

The proposed ban is actually broader. Anyone who is diagnosed as being a tiny danger to himself or others would have his gun rights taken away ... forever. It is section 102(b)(1)(C)(iv) in HR 2640 that provides for dumping raw medical records into the system. Those names -- like the 83,000 records mentioned above -- will then, by law, serve as the basis for gun banning.

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hawk71049

05-27-2008, 02:17 PM

.

Threads here on the forum that discuss PTSD…..

Study: 300,000 vets have depression or PTSD (http://www.militarytimes.com/forum/showthread.php?p=93518)

WASHINGTON — Three hundred thousand U.S. troops are suffering from major depression or post-traumatic stress disorder as a result of serving in the wars in Iraq and Afghanistan, and 320,000 received brain injuries, a new study estimates.

Only about half have sought treatment, said the study released Thursday by the RAND Corp.

“There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan,” said Terri Tanielian, the project’s co-leader and a researcher at the nonprofit RAND.

Movie: Stop-Loss (http://www.militarytimes.com/forum/showthread.php?p=89859)

Reality or all Hollywood? Is it truly the "first movie of the year that touches greatness"?

VA adds $2 million for PTSD center (http://www.militarytimes.com/forum/showthread.php?t=1564393&highlight=PTSD)
After a series of congressional hearings showed that gaps remain in mental health care for veterans, the Veterans Affairs Department announced Friday it is allocating an additional $2 million to the National Center for Post Traumatic Stress Disorder.

A recent Rand Corp. study found that more than 300,000 combat veterans suffer from PTSD or major depression — a number that mirrors the Defense Department’s own studies.

But Rand found that only 50 percent of them receive care — and of those, only half received “minimally adequate” care — or care proven to be effective in treating PTSD.

Bill would expand PTSD benefits (http://www.militarytimes.com/forum/showthread.php?t=1564182&highlight=PTSD)
“There are cases of people coming home from Iraq with all the classic symptoms and being denied care,” said John Hall, D-N.Y., chairman of the House Veterans’ Affairs disability assistance subcommittee.

As more cases of suicide, divorce and bankruptcy appear, ensuring veterans receive the care they need becomes more important, Hall said April 24.

17 vets a month commit suicide under VA care (http://www.militarytimes.com/forum/showthread.php?t=1564090&highlight=PTSD)

After learning that more than 17 veterans per month commit suicide while under the care of the Veterans Affairs Department, senators accused VA of withholding information about suicide rates and demanded the removal of its mental health chief.

Tricare duped of more than $100 million (http://www.militarytimes.com/forum/showthread.php?t=1564092&highlight=PTSD )

MADISON, Wis. — The U.S. military’s health insurance program has been swindled out of more than $100 million over the past decade in the Philippines, where doctors, hospitals and clinics have conspired with American veterans to submit bogus claims, according to prosecutors and court records.

Group home for PTSD troops opposed (http://www.militarytimes.com/forum/showthread.php?t=1563277&highlight=PTSD)

GUERNEVILLE, Calif. — Merry Lane, a cul-de-sac shaded by redwoods in Sonoma County wine country, would seem a pleasant place to recover from the psychic wounds of war. Nadia McCaffrey’s dream is to set up a group home there for veterans plagued by post-traumatic stress disorder.

Overdose raises questions at Walter Reed (http://www.militarytimes.com/forum/showthread.php?t=1563224&highlight=PTSD)

The night before he was to enter a drug and alcohol rehabilitation program, Army Pfc. Chris Eckert swallowed a pill prescribed to help him sleep without the nightmares that have tormented him since he left Iraq.

Then, sitting in his barracks at Walter Reed Army Medical Center on Jan. 17, he counted out seven methadone tablets and popped them into his mouth.

Obama addresses vets on drinking age, PTSD (http://www.militarytimes.com/forum/showthread.php?t=1563131&highlight=PTSD)

Seven of the eight veterans raised their hands when Obama asked who had suffered emotional or mental problems as a result of their service.

Christina Correa, 23, of California, said she believed she might have post-traumatic stress disorder but that it was especially hard for women to find treatment.

Testing breakthrough for mild TBI (http://www.militarytimes.com/forum/showthread.php?t=1562488&highlight=PTSD)

After months of military officials and medical personnel lamenting the lack of an immediate, unequivocal, physical proof of mild traumatic brain injury, an anesthesiologist thinks he has found a solution.

And it may be as simple as two sensors and a BlackBerry.

PTSD victims no longer need to prove trauma (http://www.militarytimes.com/forum/showthread.php?t=1562389&highlight=PTSD)

“This change provides a fairer process for veterans with service-connected PTSD,” Sen. Daniel Akaka, D-Hawaii, said in a written statement. It “leaves claim adjudicators more time to devote to reducing the staggering backlog of veterans’ claims.”

VA simplifies PTSD claims for some veterans (http://www.militarytimes.com/forum/showthread.php?t=1562387&highlight=PTSD)

The Department of Veterans Affairs has scrapped a policy requiring combat veterans to verify in writing that they have witnessed or experienced a traumatic event before they can file a claim for post-traumatic stress disorder — but only if the military has already diagnosed them with PTSD.

Vets pan treatment of jailed GI with PTSD (http://www.militarytimes.com/forum/showthread.php?t=1562288&highlight=PTSD)

AMI — A soldier with post-traumatic stress disorder is being jailed on a desertion charge and has not seen a judge since his arrest earlier this month, leading a veterans group to criticize the Army for not acting fast enough to transfer the man.

Free Counseling in S CA for mil, families (http://www.militarytimes.com/forum/showthread.php?t=1561875&highlight=PTSD)

www.TheSoldiersProject.org offers free psychological counseling for all Service Members/Vets who have served in OIF/OEF, as well as for their loved ones - girlfriends, boyfriends, spouses, partners, kids, parents, grandparents.

More must be done for PTSD vets, panel says (http://www.militarytimes.com/forum/showthread.php?t=1561801&highlight=PTSD)
The head of a commission that spent 2½ years studying veterans’ disability benefits says the government needs to do more for those suffering post-traumatic stress disorder.

How your disability is rated (http://www.militarytimes.com/forum/showthread.php?t=1560939&highlight=PTSD)

Q: I have been injured and am waiting for my military service to give me a rating. What is the significance of the military rating? Is it the same as I will receive from the Department of Veterans Affairs?

Recovery centers cater to female vets (http://www.militarytimes.com/forum/showthread.php?t=1561537&highlight=PTSD)

More than 182,000 women have served in Iraq, Afghanistan and the surrounding region — about 11 percent of all U.S. troops deployed, the Pentagon says. That dwarfs the 7,500 who served mostly as nurses in Vietnam and the nearly 41,000 women deployed during the 1991 Persian Gulf War. Although some of those women suffered PTSD, few saw actual fighting or were subjected to the stress of multiple deployments.

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hawk71049

05-28-2008, 07:27 AM

.

Threads started by guest here on the Forum…

Courage After Fire (http://www.militarytimes.com/forum/showthread.php?t=1563265&highlight=ptsd)

Authors: Keith Armstrong, L.C.S.W. / Suzanne Best, Ph. D. / Paula Domenici, Ph. D.
The book is set up in 7 chapters. Each chapter deals with a different aspect of the veteran's experience while serving in OEF or OIF.

1. Reactions to War
2. Strengthening Your Mind and Body
3. Coping Strategies
4. Grief and Loss
5. Changed Views of Self, Others, and the World
6. Returning to Civilian Life
7. Restoring Family Roles and Relationships

Military Operational Medicine Research Program (http://www.militarytimes.com/forum/showthread.php?p=90641)
I started this as a new thread only because I found the sight interesting and possibly a good resource place for those who have their loved ones deployed.

Understanding deployment (http://www.militarytimes.com/forums/forumdisplay.php?s=&daysprune=&f=125http://www.youtube.com/watch?v=tPrm6luPmME)

Information found on the World Wide Web

Finding a therapist: (http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_finding_a_therapist.html )

When selecting a therapist there are several things to consider. A professional who works well with one individual may not be a good choice for another person.

Self care disaster & PTSD ( http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_self_care_disaster.html)

The impact of the terroristic violence on September 11, 2001 will affect people at all levels of involvement: victims, bereaved family members, friends, rescue workers, emergency medical and mental-health care providers, witnesses to the event, volunteers, members of the media, and citizens of the community, the country, and the world. Terroristic events can cause people to feel angry, frustrated, helpless, and afraid. Terrorism can also make people want to seek revenge. Studies have shown that acting on this anger and desire for revenge can increase feelings of anger, guilt, and distress rather than decreasing them.

Eye Movement Desensitization and Reprocessing (http://www.emdr.com/)
• " EMDR has been listed as an effective treatment by the American Psychiatric Association, Departments of Defense and Veterans Affairs, International Society for Traumatic Stress Studies, and numerous international agencies. See list below.
• More than a dozen controlled clinical trials support the use of EMDR for trauma such as that resulting from natural disaster, and EMDR has been used successfully to treat war- and terrorism-related trauma.

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hawk71049

05-28-2008, 09:45 AM

Are we moving forward or backward...

THE WHITE HOUSE, STATE of THE UNION ( http://www.whitehouse.gov/stateoftheunion/2008/initiatives/veterans.html)
January 28, 2008

• The President will call on Congress to approve legislation that allows service members to transfer their unused Montgomery GI education benefits to their spouses or children. The GI bill provides up to 36 months of education benefits to eligible veterans for college, technical or vocational courses, and other job training. Today, the Army is the only branch of the military to allow benefits to be transferred to service members' children. The President believes benefits should be transferable to spouses and children of those who have served America in the Armed Forces.

• The President will ask Congress to pass a bill creating new hiring preferences across the Federal government for military spouses. Under current law, veterans of America's Armed Forces are entitled to preferences over others in competitive hiring for positions in the Federal government. The President proposes extending this preference to the spouses of our Nation's veterans.

President Bush will also call on Congress to enact the reforms recommended by the Dole-Shalala Commission so that our returning wounded warriors receive the services they need. President Bush created the President's Commission on Care for America's Returning Warriors (http://www.pccww.gov/) in March 2007 to conduct a comprehensive review of the services America is providing our returning wounded warriors. The Commission, co-chaired by Senator Bob Dole and former Health and Human Services Secretary Donna Shalala, released its findings in July and the Administration has already moved forward to implement the recommendations that can be achieved administratively. Some recommendations of the Dole-Shalala Commission require legislative action, however, and Congress should act promptly to pass legislation the President has called for.

President Bush remains committed to the well-being of the brave men and women who have served in America's Armed Forces. Over the past seven years, the Administration has increased funding for veterans by more than 95 percent.

The Administration Is Taking Steps To Keep America's Promise To Those Who Have Defended Our Freedom

The Administration is successfully implementing the six recommendations of the President's Commission on Care for America's Returning Wounded Warriors that can be achieved administratively. Our military doctors and nurses are among the best in the world. Unfortunately, some of our wounded warriors encountered unacceptable bureaucratic delays and administrative failures. The Administration took immediate action to fix those problems and ensure that America's injured service members are receiving the care and attention they deserve. The President has called (http://www.pccww.gov/docs/Kit/Main_Book_CC%5BJULY26%5D.pdf) upon the Department of Defense (DoD) and Department of Veterans Affairs (VA) to implement the Dole-Shalala Commission recommendations: (http://www.pccww.gov/docs/TOC%20Subcommittee%20Reports.pdf)

1. The first Federal Recovery Coordinators, who will help guide seriously wounded service members through their recuperation, have been hired, trained and are working with patients.

2. A pilot program establishing a single comprehensive disability exam – replacing the two separate exams normally given in the Department of Defense (DoD) and Department of Veterans Affairs (VA) – is underway in the National Capital Area. ( http://www.veterans.senate.gov/public/index.cfm?pageid=16&release_id=11582&sub_release_id=11643&view=all)

3. A new National Center of Excellence for Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury has been established in the D.C. area. ( http://www.defenselink.mil/transcripts/transcript.aspx?transcriptid=4211)

4. DoD and VA are creating a single Web portal that will enable wounded service members and veterans to track their medical and recovery records, access information regarding Federal, State, and local services and benefits, and apply for benefits and services through available self service options. ( http://www.fcw.com/online/news/150780-1.html)

5. Proposed regulations to update the disability schedule for Traumatic Brain Injury and burns were published in the Federal Register on January 3, 2008 for a 30-day public comment period ( http://edocket.access.gpo.gov/2008/pdf/E7-25525.pdf)

6. DoD is using special authorities to retain the best health professionals working at Walter Reed right up to its scheduled closure.

VA has also initiated two important technical studies that will allow a thorough modernization of the VA's disability system. These studies are part of the Dole-Shalala Commission's recommendations. One study will examine compensation payments for service connected disabilities. The second study will determine the appropriate level and duration of transition payments for veterans participating in a rehabilitation program. ( http://www.gao.gov/new.items/d071246t.pdf)

The President Is Keeping His Commitment To Provide For Our Nation's Veterans
Since 2001, VA has provided medical treatment to nearly 1.4 million additional veterans, including hundreds of thousands of men and women returning from Afghanistan and Iraq. Nearly 5.3 million veterans will receive care at the VA in 2009.

VA has significantly expanded its counseling and other medical care services for recently discharged veterans suffering from mental health disorders, including post-traumatic stress disorder. VA has created dozens of new mental health teams based in VA medical facilities that focus on early identification and management of stress-related disorders. It has also recruited about 100 combat veterans to help former service members transition successfully from military to civilian life.

VA has expanded resources for patients with multiple complex injuries. To further meet the specialized medical care needs of returning combat veterans, VA has expanded its four polytrauma rehabilitation centers in Minneapolis, Palo Alto, Richmond, and Tampa to encompass additional specialties to treat patients for multiple complex injuries. A fifth polytrauma center has been approved in San Antonio, and is currently under design for construction. This polytrauma system of care has been expanded to 21 polytrauma network sites and clinic support teams around the country that can provide state-of-the-art treatment to injured veterans at facilities closer to their homes.

VA is leading the way in the use of electronic health records to enhance patient safety and prevent medical errors. All VA medical records are stored and tracked electronically, rather than on paper. This system allows physicians to review a patient's medical history, diagnoses, medications, charts, and X-rays at any of VA's 1,400 sites. It also substantially cuts down on errors in drug prescription, curbs repetitive and unnecessary tests, and helps identify patients who need vaccinations and other services.
DoD and VA have made great progress in sharing the electronic data necessary to streamline eligibility and benefits determinations for separated service members. At more than 140 military installations, VA benefits counselors reach out to separating service members in the "Benefits Delivery at Discharge" program – ensuring that each can seamlessly transition to civilian life.

The President remains committed to reducing processing time for veteran disability benefit claims by continually improving methods and technology. Since the President took office, average waiting time has dropped from 230 days to an estimated 145 days in 2009.

New VA facilities are being located in communities where many veterans live, so that more veterans can access top-quality health care closer to their homes.

VA is expanding access to non-institutional long-term care, enabling veterans to live and be cared for near, or in the comfort of their homes, surrounded by family.

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populancefirst

05-28-2008, 03:14 PM

I am a Marine and I can tell you the general response has been mixed. After returning from both Iraq and Afghanistan the opinion held by many senior officers and enlisted persons was one of denial and disdain. Of course they never related their disbelief of the effects of PTSD to their lack of acctual combat even when deployed.

2) Society in general Im not to sure we can determine what they can do. Congress has been very supportive in my view but only after they are made aware of the treatment of miliitary members with health concerns. I recall the Walter Reed incident, and how the ripples of the Congressional outrage caused many critics of mental health in the chain of command to go silent. To have a greater role Congress should allow advocacy groups like votevets to make regular inquiries and report back to them. The Veterans admin. recently said the PTSD and traumatic brain injury claims are overrated and akin to "football" injuries. The chain of command is unlikely to be a true advocate for military members un able to be on deployment rosters, and so advocacy groups are the best representatives for the To - date unrepresented (military members).

3) To your final question....That would be superb, it would be a morale booster and would force the so called hawkish civilian and senior officer/enlisted to reconsider policy strategy and tactical planing. However they would oppose this with everything they have. First, civilian supporters of this would be called ill informed, liberals, even traitors. Second, military supporters would be called ill disciplined, sand baggers, and even cowards. Of course the bulk of this criticisim would come from chicken hawks, the so called hawks who chapion war and aggression but would never involve themselves in acctual fighting. Of course the old gaurd of senior officers/enlisted would oppose it, despite the relatively relaxed time they have in combat zones. But for the military fighters of the Republic...this idea would be the best thing.

armyforlife

05-29-2008, 12:23 AM

Hawk_ I came across this useful website so I posted the link in the MGF sections but Proud Mom suggested i post here as well

iraqwarveterans.org/readjustment_deployment

hawk71049

05-29-2008, 02:58 AM

.

Hawk_ I came across this useful website so I posted the link in the MGF sections but Proud Mom suggested i post here as well

iraqwarveterans.org/readjustment_deployment

army,

thank you for the web site… http://iraqwarveterans.org/readjustment_deployment.htm

i noticed this link is no longer functional…A Guide for SPOUSES of Service Members Returning from Deployment –

i noticed there is no data referencing the latest research data such as the… Rand Research Report…. Ref..Post #26… you will see extracts from this report in a lot of journals and news articles… data on this web site needs to be updated… IMO

this however is a great web site for there are links to great organizations…. thank you very much…..hawk

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I'm His Lucky Charm....

05-31-2008, 09:26 AM

Inspired???

http://video.google.com/videoplay?docid=8664881687327330813&hl=en

I'm His Lucky Charm....

05-31-2008, 09:31 AM

http://video.google.com/videosearch?client=safari&rls=en&q=ptsd%202008&ie=UTF-8&oe=UTF-8&um=1&sa=N&tab=wv#client=safari&rls=en&q=ptsd%202008&ie=UTF-8&oe=UTF-8&um=1&sa=N&tab=wv&start=40

Hero

06-02-2008, 11:38 AM

The U.S. Air Force is now undergoing a manpower draw-down to save money to buy airplanes (F-22). As a result, some AFSC or MOS are now deploying every six months especially those assigned to support Army missions (also called In Lieu Of or ILO taskings). With frequent deployments comes the propensity for deployment-related stress (PTSD, marital problems, etc.)

From what I have seen in one command (MAJCOM), witch-hunting for mental health problems (war-stress and marital problems) was used to justify the removal of one member's security clearance. Same service member was forced into "voluntary" retirement without providing sufficient time for recovery.

The member was subjected to a Command-Directed (mental health) Evaluation to justify the termination of the security clearance. And this happened after the member had already volunteered to seek help from the Chaplain and the Marital Counselor. This witch-hunting is contrary to what the SECDEF said about not punishing people for seeking help, but it happened anyway. Every service seems to have its own selfish agenda when it comes to treating people coming back from deployment with stress-related problems.

Interestingly enough, the same command signed and endorsed the member's "voluntary" retirement papers on the same day the person was told to see mental health.

How many cases like this happen that we never hear about? People tend to keep quiet because of the stigma associated with the label "mental health". It is like being raped, but the stigma deters the victim from coming forward to file a complaint.

Nobody will listen anyway, because during a Reduction-In-Force (RIF) everyone is expendable. We have seen this in the early 1990s after Desert Storm.

I'm His Lucky Charm....

06-02-2008, 12:05 PM

thank you for your post...how very true...I think unless you are directly involved...people really do not know "what happens.."

be well....

The U.S. Air Force is now undergoing a manpower draw-down to save money to buy airplanes (F-22). As a result, some AFSC or MOS are now deploying every six months especially those assigned to support Army missions (also called In Lieu Of or ILO taskings). With frequent deployments comes the propensity for deployment-related stress (PTSD, marital problems, etc.)

From what I have seen in one command (MAJCOM), witch-hunting for mental health problems (war-stress and marital problems) was used to justify the removal of one member's security clearance. Same service member was forced into "voluntary" retirement without providing sufficient time for recovery.

The member was subjected to a Command-Directed (mental health) Evaluation to justify the termination of the security clearance. And this happened after the member had already volunteered to seek help from the Chaplain and the Marital Counselor. This witch-hunting is contrary to what the SECDEF said about not punishing people for seeking help, but it happened anyway. Every service seems to have its own selfish agenda when it comes to treating people coming back from deployment with stress-related problems.

Interestingly enough, the same command signed and endorsed the member's "voluntary" retirement papers on the same day the person was told to see mental health.

How many cases like this happen that we never hear about? People tend to keep quiet because of the stigma associated with the label "mental health". It is like being raped, but the stigma deters the victim from coming forward to file a complaint.

Nobody will listen anyway, because during a Reduction-In-Force (RIF) everyone is expendable. We have seen this in the early 1990s after Desert Storm.

hawk71049

06-02-2008, 02:05 PM

Reactions split on awarding medal for PTSD (http://www.stripes.com/search.asp?searchnow=Y)

Some say Purple Heart would no longer be special
By Jeff Schogol, Stars and Stripes
European edition, Sunday, June 01, 2008

ARLINGTON, Va. — The question of whether troops with post-traumatic stress disorder should be eligible for the Purple Heart is not an easy one.

Currently, PTSD is one of the injuries that does not merit the Purple Heart, along with trench foot, heatstroke and self-inflicted wounds.

But when a reporter recently asked Defense Secretary Robert Gates about a military psychologist’s suggestion that troops with PTSD be eligible for the award, Gates said: "It’s an interesting idea. I think it’s clearly something that needs to be looked at."

Awards experts and other officials will review the matter at a meeting in June, but they are not expected to make a recommendation on the matter, said Lt. Col. Jonathan Withington.

"The department’s long-standing policy is not to create a new award or modification that would dilute the recognition provided by our existing awards and thereby lessen their prestige," Withington said in an e-mail on Friday.

Stars and Stripes asked readers for their input on whether troops with PTSD should be eligible for the Purple Heart. Over two weeks, Stripes got 68 responses through e-mail, most of which opposed such a move.

Some readers said it would be too easy for troops to be awarded the Purple Heart by faking PTSD symptoms.

"Some people WILL lie just to get the medal and other benefits," said Army Sgt. 1st Class Christopher Russell, based at Forward Operating Base Warhorse, Iraq. "The good of the few definitely doesn’t outweigh the good of the many or the good of the institution in this case. Give them their own medal but it will be clear what it’s for."

Other readers said awarding the Purple Heart to troops with PTSD would cheapen the award.
"The Purple Heart would no longer be special; it would be like the freaking AAM (Army Achievement Medal)," said Army Spc. Ebony Martin, at Camp Virginia, Kuwait.

Vietnam veteran Dewey E. Du Bose said the Purple Heart is only for troops killed or wounded in combat.
"PTSD is not an injury to the physical body, it could be called a mental injury, but so could my jumping whenever I hear a loud noise. Are we going to call PTSD a mental illness?" said Du Bose, a retired Army sergeant major.

"If that’s the case then we will have to ‘award the [Purple Heart]’ for everyone who has ever been discharged from the military because on mental stress and other mental problems. Why award the medal to one group of mental patients and not the rest of them?"

But fellow Vietnam veteran Edward Stump said that troops suffering from PTSD that came as a result of enemy action should be awarded the Purple Heart.

"Not all wounds are on the outside of the body," Stump said. "Those can be treated and are more likely to heal. The wounds from PTSD are different. They affect the hardest place in the body to treat: your mind."
Stump said he served in Vietnam with the Marines from 1966 to 1967.

"My wounds do not bleed but they have as many scars as a lot of other wounds," he said. "These wounds will never heal anymore than the scars, from any that are from combat-related fighting, will disappear."

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hawk71049

06-06-2008, 03:23 PM

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VA officials answer criticisms in Congress (http://www.stripes.com/article.asp?section=104&article=55337)
By Leo Shane III, Stars and Stripes
Pacific edition, Friday, June 06, 2008

WASHINGTON — For the second time in a month, Department of Veterans Affairs leaders testified before Congress about an embarrassing e-mail which implied a cover-up of serious health problems among servicemembers.

This time, Democratic senators and veterans advocates called for an independent investigation of the department, saying they believe leaders have created a toxic culture for veterans seeking care.

"There is a sense, whether it’s perception or reality, that [VA officials] make decisions based on money and not on whether veterans are getting the best health care they need," said Sen. Patty Murray, D-Wash. "It’s disconcerting when we see things like this."

Jon Soltz, chairman of VoteVets.org, said a VA bonus program to reward clinics that process the most cases has only exacerbated the problem, unintentionally encouraging managers to cut corners and opt for less-costly treatments.

But VA officials denied those charges. Dr. Michael Kussman, undersecretary for health at the department, said recent controversy surrounding the department is the result of poor publicity from a few missteps, but not a lack of effort by employees treating veterans.
"Any suggestion that we would not diagnose a condition, any condition, is unacceptable," he said. "Not only was there no systemic effort to deny diagnoses, there was not an individual effort to that end."

Last month Dr. Norma Perez, a psychologist and coordinator at a department’s clinic in Central Texas, circulated an e-mail warning colleagues not to diagnose post-traumatic stress disorder in new patients too quickly, noting the growing number of "compensation seeking veterans" coming in.

Instead she suggested diagnosing adjustment disorder — a condition which carries no disability rating — and following up with further PTSD tests.

On Wednesday she appeared before the Senate Veterans Affairs Committee to clarify her memo, insisting it was more about providing accurate and timely treatment options for patients than about costs for the department. The clinic does not perform any disability ratings or compensation work.

But senators on the committee said were skeptical of that explanation, pointing to lingering concerns with e-mails written by department Mental Health Director Ira Katz that were made public in April.

Those notes concerned higher-than-expected suicide rates among veterans. Last month Katz told a House committee that those memos — one note’s subject line reads "Shh!" and asks "Is this something we should carefully address … before someone stumbles on it?" — were poorly worded but not an effort at a cover-up.

"I’m very frustrated by the fact that whether I’m asking about veterans’ suicides or construction of a new clinic, the answer from the players at the VA bureaucracy seems to be the same: ‘It’s no big deal,’ " said Sen. Jon Tester, D-Mont. "It’s a big deal to me."

After the hearing, a pair of combat veterans spoke out about their problems navigating the system. Retired Army Pfc. Kenneth Gumm, who served in Iraq in 2005, said since then he has received several conflicting diagnoses from Perez’s clinic. The last one was for PTSD, which could mean a higher disability rating down the road.

"Money is nice," he said, "but I’d rather not have my problems."

Kussman said the department has made tremendous strides in treating mental health disorders in recent years, including hiring nearly 4,000 new psychologists and counselors since 2005. But he acknowledged the department still has more work ahead.

See the complete Perez e-mail here ( http://www.stripes.com/08/jun08/va_email.html)...

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hawk71049

06-06-2008, 04:25 PM

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Military sees spike in number of PTSD cases (http://www.stripes.com/article.asp?section=104&article=62451&archive=true)
Army, Marine Corps see tenfold increase in diagnoses since 2003
By Lisa Burgess, Stars and Stripes
Mideast edition, Wednesday, May 28, 2008

ARLINGTON, Va. — The number of soldiers and Marines diagnosed with post-traumatic stress disorder jumped tenfold from 2003 to 2007, according to statistics released by the Army’s surgeon general Tuesday.

Lt. Gen. Eric B. Schoomaker, who also heads U.S. Army Medical Command, attributed the rise in the Army numbers in part to the increase in the overall number of soldiers exposed to combat and better record-keeping by the service. But he also said that clinicians today "have a higher sensitivity to diagnosing" the condition than they did back in 2003, and researchers still have much to learn about why some people develop PTSD.

"I think we’re still in our infancy of fully knowing how to track it," Schoomaker said.

According to Army data, 10,049 soldiers who had been deployed to in combat zones were diagnosed with PTSD in 2007. In 2003, the number of cases was 1,020. The number of Army PTSD cases has risen each year since the start of combat operations in Iraq.

The PTSD diagnoses came from troops using the military health care system and deployed in deployed in support of Operation Iraqi Freedom or Enduring Freedom, Schoomaker said.

Cases of PTSD also rose significantly among deployed Marines, according to the data. In 2003 officials diagnosed 206 Marines with PTSD; in 2007, there were 2,114 cases.

Army surveys have found that the more often a soldier is deployed, the more likely he or she is to experience signs or symptoms of PTSD, Schoomaker said.

"We know that human beings exposed to that environment are susceptible to developing symptoms [of PTSD]," he said. "Soldiers are human beings, and they are subject to extreme stress [in Iraq and Afghanistan]."

Schoomaker cautioned that the data he provided does not necessarily paint a complete picture of PTSD among soldiers.

The Army, like the other services, has no way to collect information on members who go outside the military health care system and use private mental health care providers, and that information is kept confidential in most cases, he said.

This doctor-patient confidentiality is important as the Army continues to battle the stigma associated with mental health issues, whether it is inside the military system or outside, Schoomaker said.

"We want to minimize soldiers’ perceptions that they are being watched," he said.

The Air Force recorded 190 cases of PTSD in 2003, and the Navy recorded 216. In 2007, there were 871 airmen diagnosed with the condition, and 947 sailors. The Army has made up the bulk of personnel deployed to Iraq and Afghanistan zones since 2003.

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Hero

06-06-2008, 04:37 PM

"And the peace of God, which passeth all understanding, shall keep your hearts and minds through Christ Jesus" (Philippians 4:7)

This helped many of us through our pain and sorrow. Through prayers and supplications, God purged all the hurtful things in our hearts and minds.

And you can also find this peace through our Lord, Christ Jesus!

He is the perfect Counselor and Comforter!

hawk71049

06-06-2008, 05:01 PM

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Wartime PTSD Cases Jumped Roughly 50 Pct. in 2007
Number of troops diagnosed with post-traumatic stress disorder jumped roughly 50 percent in 2007
By PAULINE JELINEK Associated Press Writer

WASHINGTON May 27, 2008 (AP) ( http://abcnews.go.com/Politics/wireStory?id=4939300)...

The number of troops with new cases of post-traumatic stress disorder jumped by roughly 50 percent in 2007 amid the military buildup in Iraq and increased violence there and in Afghanistan.

Records show roughly 40,000 troops have been diagnosed with the illness, also known as PTSD, since 2003. Officials believe that many more are likely keeping their illness a secret.

"I don't think right now we ... have good numbers," Army Surgeon General Eric Schoomaker said Tuesday.
Defense officials had not previously disclosed the number of PTSD cases from Iraq and Afghanistan.

Army statistics showed there were nearly 14,000 newly diagnosed cases across the services in 2007 compared with more than 9,500 new cases the previous year and 1,632 in 2003.

Schoomaker attributed the big rise over the years partly to the fact that officials started an electronic record system in 2004 that captures more information, and to the fact that as time goes on the people keeping records are more knowledgeable about the illness.

He also blamed increased exposure of troops to combat.

Factors increasing troop exposure to combat in 2007 included President Bush's troop buildup and the fact that 2007 was the most violent year in both conflicts.

More troops also were serving their second, third or fourth tours of duty — a factor mental health experts say dramatically increases stress. And in order to supply enough forces for the buildup, officials also extended tour lengths to 15 months from 12, another factor that caused extra emotional strain.

Officials have been encouraging troops to get help even if it means they go to civilian therapists and don't report it to the military.
"We're trying very hard to encourage soldiers and families to seek care and to not have them feel in any way, shape or form that we're looking over their shoulder or that we're invading their privacy," Schoomaker told a group of defense writers.

Noting that stigma is a problem in American civilian society, not just the military, he said, "I think that's the preferred way to do it."

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Hero

06-08-2008, 11:21 AM

.

Noting that stigma is a problem in American civilian society, not just the military, he said, "I think that's the preferred way to do it."

.

PTSD, even marital problems, carries a BIG stigma in the civilian society. Even with the SECDEF statement about not punishing service members by taking away their security clearance, does not work when you apply for a job in the civilian law-enforcement and intelligence agencies.

Defense contractors seem to be more lenient with PTSD as long as you get your clearance back. One service member who went for in-residence treatment for PTSD was hired by a defense contractor after he retired from the military.

Another retired service member had his clearance eligibility reinstated. This person was offered a job as the primary candidate for an Intelligence Analyst position. However, after learning about his PTSD and marital problems, the same agency said that he is no longer the primary candidate even though they stated that "we are not denying your security clearance."

There is no set standards as far as the civilian sector is concerned. DoD may be working to remove the stigma, but society in general has a different attitude.

I'm His Lucky Charm....

06-10-2008, 09:34 PM

PTSD: The War Within

http://riograndevalleyvamc.com/Agenda.aspx

Reprinted courtesy of the Marine Corps Gazette.
Copyright retained by the Marine Corps Gazette.

PTSD: The War Within

A Marine writes about his PTSD experience

By SSgt Travis N. Twiggs

All in all I made four trips over to the “sandbox.” It was upon returning from my second trip that I began to notice “changes” in myself. By changes I mean I was more irritable, paranoid for no reason, unable to sleep, and had trouble focusing when around other people. At the time my wife and I agreed that I would not deploy again for a while. Well, after about 1 month at home, I began yearning to go back. The Marines and sailors in my charge were asking me daily to go back with them. So late one night I approached my wife with my idea of returning to Iraq. She began to cry and said that I should go, bring the boys home safely, and get this out of my system. From that day forward, my symptoms went away. After all, I was going back to the fight, back to shared adversity, where the tempo is high and our adrenaline pulses through our veins like hot blood. It is in this place that there is no time for posttraumatic stress disorder (PTSD).

*Please Click Above Link to Continue Reading..... Article was too long to post....

dgeezy

06-11-2008, 12:50 AM

I guess some people can just suck it up, and others can't. No fault of their own, it's probably just the way their built

Hero

06-11-2008, 10:02 AM

Every person is different. The same also applies to the services (Air Force, Marine Corps, Army and Navy).

In the Air Force, you want to "suck it up" and keep your problems to yourself. But your command will try to witch-hunt or dig your secret problem to force you out of the service. The USAF is undergoing a military draw-down or reduction-in-force.

In the Marines and the Army, it does not matter. They will deploy you as long as you can pull the trigger, PTSD or not.

I do not know about the Navy.

Bottomline: Our military and society have a moral responsibility to care for those with PTSD and mental health problems as a result of these wars.

hawk71049

06-11-2008, 03:22 PM

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The Charleston Gazette
Wednesday June 11, 2008 ( http://wvgazette.com/News/200805230640)...
May 24, 2008
Vets taking PTSD drugs die in sleep
Hurricane man's death the 4th in West Virginia
By Julie Robinson
Staff writer

A Putnam County veteran who was taking medication prescribed for post-traumatic stress disorder died in his sleep earlier this month, in circumstances similar to the deaths of three other area veterans earlier this year.

Derek Johnson, 22, of Hurricane, served in the infantry in the Middle East in 2005, where he was wounded in combat and diagnosed with post-traumatic stress disorder while hospitalized.

Military doctors prescribed Paxil, Klonopin and Seroquel for Johnson, the same combination taken by veterans Andrew White, 23, of Cross Lanes; Eric Layne, 29, of Kanawha City; and Nicholas Endicott of Logan County. All were in apparently good physical health when they died in their sleep.
Johnson was taking Klonopin and Seroquel, as prescribed, at the time of his death, said his grandmother, Georgeann Underwood of Hurricane. Both drugs are frequently used in combination to treat post-traumatic stress disorder. Klonopin causes excessive drowsiness in some patients.

He also was taking a painkiller for a back injury he sustained in a car accident about a week before his death, but was no longer taking Paxil.

On May 1, the night before he died, Johnson called his grandfather, Duck Underwood, and asked if he could pick up his 5-year-old son and take him to school the next day. Johnson and his wife, Stacie, have three children, all under 6 years old. Their car had been totaled in the accident the previous week.

When Underwood arrived to pick up the boy the next morning, his knocks were not answered at first. He heard Stacie Johnson screaming. She opened the door and told him she couldn't wake her husband. They called paramedics, who could not revive him. Doctors did not declare an immediate cause of death.

Toxicology and autopsy results could take as long as 60 days, authorities told the family.

"I want to know the cause of death," said Ray Johnson, Derek's father. "Stacie said he was fine that night. Everything was normal. He kissed her goodnight and went to sleep."

Stan White, father of soldier Andrew White, has become an advocate for families of returning veterans with post-traumatic stress disorder. During his son's struggle with the disorder and since his death, White has tracked similar cases. He knows of about eight in the tri-state area of Kentucky, Ohio and West Virginia.

He and his wife, Shirley, introduced themselves to the Johnsons and Underwoods at Derek's funeral and offered their help. He is in contact with the office of Sen. Jay Rockefeller, D-W.Va., who is a member of the Veterans' Affairs Committee. Rockefeller requested an investigation into these deaths, which is ongoing, said Steven Broderick, the senator's press secretary.

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hawk71049

06-11-2008, 03:56 PM

Page..4... continued...

Saturday, June 07, 2008
Are PTSD-Medicated Veterans Dying in Sleep -- or Committing Suicide? ( "http://ptsdcombat.blogspot.com/2008/06/are-ptsd-medicated-veterans-dying-in.html")…

--Buspirone (Buspar)

This anti-anxiety drug works differently from the benzodiazepines (like Valium). Like anti-depressants it takes a few weeks to kick in. It takes effect gradually, like the tide coming in. It usually has few side-effects and may help some people with intrusive thoughts and nightmares. Buspirone has no street value and is almost useless as a suicide pill. I am not aware of other drugs in this family coming along, but I hope there will be. I have recently read the report of a colleague who works with combat veterans that the best results with buspirone come at doses above 60mg/day. I do not yet have enough personal experience with patients who have tried this, to confirm or deny this report.

--Beta-blockers: propranolol (Inderal), nadolol (Corgard), atenolol (Tenormin), etc.

This family of drugs breaks the mind-body-mind vicious cycle in rage reactions, by blocking the body effects of adrenalin. For example, if someone at work says something offensive about Vietnam vets, the words start the mind working into rage. The rage starts in the mind—but within a second the body responds with adrenalin, which makes the gut burn, the heart pound, the muscles tense. These body changes send loud messages back up to the mind. For some veterans, the roar of the body drowns out all thought and shuts out everything else coming in. When adrenalin is roaring, it’s impossible for most people to think clearly and to take in non-combat possibilities in the situation. This is the mind-body-mind vicious cycle that beta-blockers break up. By blocking the adrenalin effect on the body they prevent the roar of the body from drowning out all thought and choice about what you really want. “Is it really in my interests to rip this guy’s lungs out? Is it really what I want to do?” When adrenalin is roaring these questions sometimes cannot be heard.

Some vets feel that these medications weaken them, because they associate being pumped up with adrenalin with their personal strength. When someone is over-medicated on these drugs (which started life as blood pressure meds) he is weaker because his blood pressure is too unstable, but this is usually not a problem with a correct dose. Tolerance does not develop to the anti-adrenalin effects of these drugs. Massive overdoses of a beta-blocker can be fatal, by dropping the blood pressure and slowing the heart to the point that the brain is not getting enough blood flow.

--Low-dose lithium

Some respected practitioners of PTSD pharmacotherapy speak highly of lithium to help veterans maintain their self-control when they are angry. This means doses of about 600mg/day, far less than is usually needed to treat bipolar affective disorder (manic-depressive disorder), and does not imply that the doctor recommending this thinks that the veteran is manic-depressive.

I agree that this can help some veterans, but I have found fluoxetine to be more reliable. It is also safer, in that lithium is readily fatal in a large overdose. For a veteran who cannot tolerate fluoxetine and whose life has been blighted by explosive violence, low-dose lithium may be a good thing to try. [no blood tests because of low dose]

Other drugs for special circumstances

--Trazodone (Desyrel) for sleep

Trazodone is a non-toxic anti-depressant that has a useful side-effect: It causes drowsiness, and people don’t get tolerant to this effect. Because fluoxetine slows the rate that the liver breaks down trazodone, much lower doses are needed for sleep by patients on fluoxetine than people who are not on fluoxetine.

--Quinine for nocturnal myoclonus

This is the “sleep jerks.” If quinine works, the veteran himself may not notice much but his wife has much better sleep.

--Low-dose antipsychotics for violent urges: thioridazine (Mellaril), mesoridazine (Serentil), etc.

The key here is brief treatment on an as-needed basis, controlled by the veteran himself [for a limited time, when hospitalization is not possible]. The doses needed have been low, and I prefer the sedating anti-psychotics like thioridizine and mesoridizine, which appear to carry the least risk of dangerous (neuroleptic malignant syndrome) or possibly irreversible (tardive dyskinesia) complications. An unexpected additional use for these drugs also involves brief, low-dose treatment: to help someone who wants to get off marijuana get through the withdrawal syndrome.

Future drugs

Many combat veterans with PTSD feel dead inside. It is possible that this psychic numbing comes from the brain making its own opium-like substances, and that opiate blockers can give people back their feelings. It is not yet clear whether this works.
I hope the future will bring a drug like clonidine (trade name: Catapres) that people do not develop a tolerance to. In my experience, about one out of five combat veterans with PTSD experience major improvement of almost all of their PTSD symptoms on clonidine—but the heartbreak has been that they grew tolerant to it in about a week. Any future drug in this family that does not induce tolerance to this effect will relieve much suffering. A new drug in this family, guanfacine (tradename, Tenex) has recently appeared, but I have no experience with it and have not heard any reports of usefulness to combat veterans with PTSD.

The most helpful drugs are likely to be ones that don’t yet exist.

hawk71049

06-11-2008, 03:59 PM

Page 3... continued...

Saturday, June 07, 2008
Are PTSD-Medicated Veterans Dying in Sleep -- or Committing Suicide? ( "http://ptsdcombat.blogspot.com/2008/06/are-ptsd-medicated-veterans-dying-in.html")…

Therapeutic effects (benefits) and side-effects

Drugs are dumb chemicals—they don’t know what they are. They aren’t born in a laboratory with a word spelled out across their foreheads “Anti-depressant!” or something like that. Most have been discovered by accident. Almost every drug known has multiple effects on the body. Which effect is a therapeutic (beneficial or main) effect and which is an unwanted side-effect is a human decision, not a chemical decision.

Illustrations: Think of the well-known drug Elavil (generic name: amitriptylene). What is it? An anti-depressant you say? Why is it used in the Intensive Care Unit to stabilize the heart beat of certain patients? Not because depression causes their irregular heart beat. Why is it used by neurologists to treat migraine? Not because depression causes migraine—and the doses that work for migraine are usually too small to touch a depression. The point is, of course that a drug doesn’t know what it is. Its successful human uses make it an anti-depressant, a migraine drug, an anti-arrhythmic.

What about side-effects? Again, this is a matter of the human purposes involved. Think of the anti-depressant trazodone (most common trade name: Desyrel). Its most prominent side-effect is drowsiness. I prescribe trazodone fairly often as a sleep medication to veterans who are on fluoxetine. It has the advantage that it doesn’t lose its effect with repeated use (which also means there’s little withdrawal syndrome when the veteran stops it), and it’s almost useless as a pill to kill yourself with. So here the side-effect is the main effect and the anti-depressant effect is a side-effect—Is anybody confused yet?

Important to remember: When a drug has several different effects, each effect has its own way of unfolding in time. How long a drug takes to produce its different effects, is often different for each effect. The side-effects may hit immediately and the main effect only develop after several weeks! With another drug it’s the opposite, with the main effect coming on immediately and the side effects happening later. An analogy: Think of a plant on your window sill. You’ve been away for the weekend and it’s gotten dry and droopy. You give it water and the leaves begin to respond almost as soon as the water goes on—the plant responds as soon as the water reaches the roots. If the roots dry out, again the plant wilts again. This is like a pharmacokinetic effect. If you put some fertilizer in the water, on the other hand, this reaches the roots as fast as the water reaches them, but you may not see any result for days or weeks. This is because the plant has to build new parts in its own cells. This is like a pharmaco-dynamic effect.

Example: Most anti-depressants reach the brain quickly, but take several weeks to have an anti-depressant effect. This is probably because the changes that have to take place in the cells take that long to happen. However, some side-effects like a dry mouth or drowsiness happen quickly because they do not require cells to make anything new, but only to do what they’re already doing faster or slower. ...

Characteristics of good drugs for combat PTSD

Makes something better for the veteran
Does not lead to tolerance
Does not lead to abuse
Cannot be used to commit suicide
Does not require blood tests
Does not cut a person off from the world or from himself
Causes few, bearable side-effects

Some good drugs for combat PTSD

--Serotonin reuptake inhibitors: fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), etc.

The main effect of fluoxetine on combat vets with PTSD whom I’ve worked with is to allow them more time to think before they act, particularly in anger. It does this without sedation or cutting a man off from himself or the world. The duration of anger, once aroused, is also shorter. Greater self-mastery of anger leads to an increase in self-respect and relief from a sense of humiliation. Most men feel humiliated after they go off on people in situations they really would not have, if they had had the freedom to choose. In addition to this, fluoxetine may have a direct anti-depressant effect in combat PTSD. Fluoxetine effects on self-control and rage may take many weeks to kick in, although I’ve seen it as soon as a week.

Fluoxetine is practically useless as a drug to overdose on, if the goal is suicide. All anti-depressants have been known to give long-time depressed people the energy to kill themselves, and fluoxetine is no different. Many combat veterans go through brief periods of intense despair during the first few months that they are feeling generally better, more alive, and are coming out of their bunkers. Support from other veterans, family, therapists is especially important during those times—nobody should try to go through it alone, or have to. Someone trying to go through it alone might try to kill himself during one of these times of despair. Remember that this is no special risk with fluoxetine, but is a risk when anyone recovers from severe depression. Several vets I’ve treated have had bouts of despair like this, but none has ever tried to kill himself during one, because support and therapy are built into the program I’m a part of. The much-publicized claim that Prozac has special powers make a previously non-suicidal person violently suicidal is without good foundation. Fluoxetine does have side effects, which not everyone can stand, and it doesn’t work for everyone. A full discussion of side-effects, some of which depend on the dose and others not, would be too long for this summary.

Fluoxetine is the first drug of its type to be released for use. Other drugs in the same family have now come along, sertraline (Zoloft) and paroxetine (Paxil). They have been tried by many combat vets around the country, and from what I hear they are not a lot different than fluoxetine as far as main and side-effects. In the relatively limited number of men I have treated with paroxetine and sertraline, this has been what I have heard from them. Paroxetine has a 24 hour half-life and no active metabolites [what the body turns the parent drug into], so if the actions of the drug are otherwise identical to fluoxetine, it will be a superior drug from a safety point of view, because it doesn’t hang around in the body so long. But on the down side, paroxetine may be expected to (and is reported to) have a withdrawal syndrome because it leaves the body so fast.

hawk71049

06-11-2008, 04:03 PM

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Page..2

Saturday, June 07, 2008
Are PTSD-Medicated Veterans Dying in Sleep -- or Committing Suicide? ( "http://ptsdcombat.blogspot.com/2008/06/are-ptsd-medicated-veterans-dying-in.html")…

AP fleshes things out:
There have been at least three accidental drug overdoses and four suicides among soldiers in special units the Army set up last summer to help war-wounded troops, officials said late Thursday.

A team of pharmacists and other military officials met early this week at the Pentagon to look into the deaths in so-called "warrior transition units" - established to give sick, injured and wounded troops coordinated medical care, financial advice, legal help and other services as they attempt to make the transition toward either a return to uniform or back into civilian life.

The Army said officials had determined that among those troops there have been 11 deaths that were not due to natural causes between June and Feb. 5. That included four suicides, three accidental overdoses of prescribed medications, three deaths still under investigation and one motor vehicle accident, the Army said.

Time's Mark Thompson introduces us to Iraq vet Sergeant Christopher LeJeune in "America's Medicated Army:"
LeJeune visited a military doctor in Iraq, who, after a quick session, diagnosed depression. The doctor sent him back to war armed with the antidepressant Zoloft and the antianxiety drug clonazepam. "It's not easy for soldiers to admit the problems that they're having over there for a variety of reasons," LeJeune says. "If they do admit it, then the only solution given is pills."

While the headline-grabbing weapons in this war have been high-tech wonders, like unmanned drones that drop Hellfire missiles on the enemy below, troops like LeJeune are going into battle with a different kind of weapon, one so stealthy that few Americans even know of its deployment. For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan. The medicines are intended not only to help troops keep their cool but also to enable the already strapped Army to preserve its most precious resource: soldiers on the front lines. Data contained in the Army's fifth Mental Health Advisory Team report indicate that, according to an anonymous survey of U.S. troops taken last fall, about 12% of combat troops in Iraq and 17% of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope. ...

[I]f the Army numbers reflect those of other services — the Army has by far the most troops deployed to the war zones — about 20,000 troops in Afghanistan and Iraq were on such medications last fall. The Army estimates that authorized drug use splits roughly fifty-fifty between troops taking antidepressants — largely the class of drugs that includes Prozac and Zoloft — and those taking prescription sleeping pills like Ambien.

In some ways, the prescriptions may seem unremarkable. Generals, history shows, have plied their troops with medicinal palliatives at least since George Washington ordered rum rations at Valley Forge. During World War II, the Nazis fueled their blitzkrieg into France and Poland with the help of an amphetamine known as Pervitin. The U.S. Army also used amphetamines during the Vietnam War. ...

The increase in the use of medication among U.S. troops suggests the heavy mental and psychological price being paid by soldiers fighting in Iraq and Afghanistan. Pentagon surveys show that while all soldiers deployed to a war zone will feel stressed, 70% will manage to bounce back to normalcy. But about 20% will suffer from what the military calls "temporary stress injuries," and 10% will be afflicted with "stress illnesses." Such ailments, according to briefings commanders

Information on the medication-suicide issue:
Last year the U.S. Food and Drug Administration (FDA) urged the makers of antidepressants to expand a 2004 "black box" warning that the drugs may increase the risk of suicide in children and adolescents. The agency asked for — and got — an expanded warning that included young adults ages 18 to 24, the age group at the heart of the Army. The question now is whether there is a link between the increased use of the drugs in the Iraqi and Afghan theaters and the rising suicide rate in those places. There have been 164 Army suicides in Afghanistan and Iraq from the wars' start through 2007, and the annual rate there is now double the service's 2001 rate.

At least 115 soldiers killed themselves last year, including 36 in Iraq and Afghanistan, the Army said on May 29. That's the highest toll since it started keeping such records in 1980. Nearly 40% of Army suicide victims in 2006 and 2007 took psychotropic drugs — overwhelmingly, selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft. While the Army cites failed relationships as the primary cause, some outside experts sense a link between suicides and prescription-drug use — though there is also no way of knowing how many suicide attempts the antidepressants may have prevented by improving a soldier's spirits. "The high percentage of U.S. soldiers attempting suicide after taking SSRIs should raise serious concerns," says Dr. Joseph Glenmullen, who teaches psychiatry at Harvard Medical School. "And there's no question they're using them to prop people up in difficult circumstances."

While we're focused on the DoD, from the VA:
Medication
Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective. SSRIs include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Chemicals in your brain affect the way you feel. When you have or depression you may not have enough of a chemical called serotonin. SSRIs raise the level of serotonin in your brain. There are other medications that have been used with some success. Talk to your doctor about which medications are right for you.

Even though I'm sharing quite a big chunk in the interest of education, head over to the Sidran Institute to read an article on PTSD medications for combat veterans written by military psychiatry expert Jonathan Shay, Md, Phd:
Everything I say here is my point of view, and carries no claim of special authority. Also, what I say here is no way complete. I have left out many important subjects, such as drug interactions, what medical conditions forbid the use of a given drug, overdoses and toxicity, and most specific side-effects. Also, many psychiatrists who also care about combat veterans will disagree with what I say here, particularly about the benzodiazepines like Ativan. Combat PTSD is moral, social, philosophical, and spiritual injury. The biological nature of human beings is to be moral, social, philosophical, and spiritual, so the injury also shows itself as medical disorders.

Healing is psychological, social, spiritual—no medicine can cure combat PTSD. However, healing can never mean a return to 17-year old innocence. Healing means building a good human life with others—a life that a veteran can embrace as his own.

Combat trauma brings about long-lasting changes in brain chemistry. We do not know whether these are permanent or can be reversed by psychological/social healing. A few existing medications can help some men with some symptoms of PTSD. We also do not know whether this changes the long-term outcome for the better, but the human payoff in reduced suffering is unmistakable.

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hawk71049

06-11-2008, 04:07 PM

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Page..1

Saturday, June 07, 2008
Are PTSD-Medicated Veterans Dying in Sleep -- or Committing Suicide? ( "http://ptsdcombat.blogspot.com/2008/06/are-ptsd-medicated-veterans-dying-in.html")…

Important story on the cluster of OEF/OIF veterans who have recently been found to have died in their sleep, or thought to have committed suicide, while heavily medicated and being treated for PTSD. First, a May 23 introduction by Julie Robinson of the Charleston Gazette ( http://wvgazette.com/News/200805230640)...

A Putnam County veteran who was taking medication prescribed for post-traumatic stress disorder died in his sleep earlier this month, in circumstances similar to the deaths of three other area veterans earlier this year.

Derek Johnson, 22, of Hurricane, served in the infantry in the Middle East in 2005, where he was wounded in combat and diagnosed with post-traumatic stress disorder while hospitalized.

Military doctors prescribed Paxil, Klonopin and Seroquel for Johnson, the same combination taken by veterans Andrew White, 23, of Cross Lanes; Eric Layne, 29, of Kanawha City; and Nicholas Endicott of Logan County. All were in apparently good physical health when they died in their sleep.

Johnson was taking Klonopin and Seroquel, as prescribed, at the time of his death, said his grandmother, Georgeann Underwood of Hurricane. Both drugs are frequently used in combination to treat post-traumatic stress disorder. Klonopin causes excessive drowsiness in some patients.

He also was taking a painkiller for a back injury he sustained in a car accident about a week before his death, but was no longer taking Paxil.

In educational interest, article(s) quoted from extensively.

Continuing:
Stan White, father of soldier Andrew White, has become an advocate for families of returning veterans with post-traumatic stress disorder. During his son's struggle with the disorder and since his death, White has tracked similar cases. He knows of about eight in the tri-state area of Kentucky, Ohio and West Virginia.

He and his wife, Shirley, introduced themselves to the Johnsons and Underwoods at Derek's funeral and offered their help. He is in contact with the office of Sen. Jay Rockefeller, D-W.Va., who is a member of the Veterans' Affairs Committee. Rockefeller requested an investigation into these deaths, which is ongoing, said Steven Broderick, the senator's press secretary.

"When I talked to his family about Derek, I realized it was the same old story," said White. "It was all too familiar. He was taking those same drugs as the others, and, yes, I believe they are still prescribing that combination."

After speaking with family members, White wonders if the patients are taking the medicine as prescribed. He said PTSD patients suffer short-term memory loss and shouldn't be relied upon to track their medications.

Georgeann Underwood agrees.

"You shouldn't put vulnerable, mentally unstable people on drugs like that," she said.

An outgoing, personable young man who worked at several jobs to support his young family, Johnson frequently was offered other jobs by customers in the stores where he worked, Underwood said. In 2006, he returned from the Middle East depressed and short-tempered. Johnson had operated an M249 Squad Automatic Weapon, or rapid-fire machine gun, and rarely spoke about his experiences there.

After his military prescriptions ran out, Johnson's medications were prescribed by private physicians because he refused to go the VA hospitals where he said he was required to wait long periods of time for appointments. His grandparents paid for his medications.

"He had a very short fuse," Ray Johnson said. "That was the biggest difference in his personality after he came back."

Until his death, he worked 12 or 16 hours a day. He was an electrical apprentice at the John Amos Power Plant until he was let go when his work hours approached the union limit for apprentices. He was on his way to apply for another job when the car he drove was rear-ended on April 24.

Johnson died May 2.

A similar case today in the Carlsbad [NM] Current Argus:
On May 20, Marine Cpl. Oligschlaeger, 21, was found dead in his barracks room at Twentynine Palms Marine Corps Air Ground Combat Center in California. Oligschlaeger was a mortar man assigned to the 1st Marine Division, and had recently returned from his second tour of duty in Iraq.

While the death was initially viewed as a suicide, Oligschlaeger's family and friends are not ready to concede that he willingly ended his life. The family will wait for the autopsy report from the Marine Corps, Smith said.

"He suffered from post traumatic stress disorder, and he was struggling with it. He was on eight different medications. From what we have learned, there was not much medical supervision on how he was to take the medications," Smith said.

"His Marine friends have said that, knowing Chad and having fought by his side, they don't believe he was capable of committing suicide. Our family feels the same way."
Smith, whose daughter, Julie, was raised in Carlsbad and graduated from Carlsbad High School, said her grandson graduated from McNeil High School in Austin, Texas, and immediately joined the Marines. ...

Oligschlaeger officially became a Marine on July 18, 2004. He graduated from boot camp in October of that year and then headed to the School of Infantry at Camp Pendleton, Calif. On completion of the school, he was designated as a mortar man and was assigned to the 3rd Battalion, 7th Marines, 1st MARDIV based at Twentynine Palms. In 2005, within just a few short months of his enlistment, he found himself deployed to Ar Ramadi in Iraq.

"When he came home, he said he did not want to go back," Smith said, recalling a conversation with him. "Last year, he learned that he was being sent back. He expressed again that he didn't want to go back. He was told that he would follow orders or the alternative would be a dishonorable discharge. So he went back to Iraq." She said when he returned, he struggled to come to terms with what he had seen and done in Iraq and sought help from the military.

"At the age of 18, he had seen more horrors than I have ever seen in my life," Smith said. "I don't know if I could hold someone in my arms that was badly wounded and watch him die, or see dead bodies all around. He really struggled with that after his first tour in Iraq."

She said Oligschlaeger's second tour added to his stress.

But with his enlistment up just before he died, "he was getting ready to get out, marry his fiancée and go to school to become a firefighter and a paramedic."
Since her grandson's death, Smith said she has learned more about PTSD and how little help there is available to service men and women, and their families who are dealing with it.

"I always thought that anyone in the military who has fought in a war is well taken care of if wounded physically or suffering with PTSD," she said. "But that's not the case, I have learned. "They give PTSD patients a bunch of pills. Where's the counseling they need? Where's the compassion for those who come home hurt after fighting for our freedoms? It's not right." ...

"It upsets me to find out that in Chad's case, and probably in many more cases, the military gives these kids suffering from PTSD all this medication and does not monitor them. It's disgraceful," she said.

In February, the Army Times reported:
[T]he Army found a new “trend” as it grouped all of its wounded soldiers into one system where they could be carefully monitored: 11 deaths in that population due to suicide, accidental overdose by prescription medications, and in motor vehicle accidents. Schoomaker said the combination of multiple prescription drugs — usually pain medication — mental health issues, alcohol and no supervision on the weekends are contributing to the problem.

Lt. Gen. Eric B. Schoomaker, the Army’s surgeon general, said there has been “a series, a sequence of deaths” in the new, so-called “warrior transition units.” Those are special units set up last year to give sick, injured and war-wounded troops coordinated medical care, financial advice, legal help and other services as they transition toward either a return to uniform or back into civilian life.

Without giving a number, Schoomaker said the deaths among the convalescing troops were “accidental deaths, we believe, often as a consequence of the use of multiple prescription and nonprescription medicines and alcohol.”

“This isn’t restricted to the military, alone, as we all saw the unfortunate death of one of our leading actors recently,” Schoomaker told Pentagon reporters. ... Schoomaker said he didn’t know whether the number of overdoses among soldiers was on the rise, but would try to provide statistics as soon as possible. The series of deaths was noticed and is getting attention partly because the new units concentrate the Army’s temporarily disabled and ill into special groups, thus making it possible for leaders to track and tabulate their health issues more closely and carefully than ever before.

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dgeezy

06-11-2008, 05:23 PM

copy.........paste
copy..................................paste
copypastecopypastecopypaste

hawk71049

06-11-2008, 05:56 PM

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you know dgeezy,
i know you are suffering from something… i am just not sure how i can help you…
if you can come up with something constructive please share…
i know you are bored… setting in you rack with nothing to do but to roust others….
please do something constructive... and not post your poop on this thread… hawk
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hawk71049

06-12-2008, 02:29 PM

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Suicide Among Former Military ( http://psychcentral.com/news/2007/06/13/suicide-among-former-military/893.html")...

By: Rick Nauert, Ph.D.
Senior News Editor

Reviewed by: John M. Grohol, Psy.D.
on June 13, 2007

Wednesday, Jun 13 (Psych Central) -- An epidemiological study of male military personnel between 1917 and 1994 finds that the former soldiers were twice as likely to commit suicide as people who had not seen combat.

The discovery suggests that medical and mental health professionals take proactive steps to identify suicidal intentions as well as providing overall mental health support for soldiers returning from service in Afghanistan and Iraq.

The study will be published in the July issue of Journal of Epidemiology and Community Health.
Researchers in the United States followed up 320,000 men aged over 18 years for 12 years and found that those who had served in the armed forces at some time between 1917 and 1994 were twice as likely to die from suicide compared with men in the general population.

The risk was highest in veterans who could not participate fully in home, work or leisure activities because of a health problem. Veterans that killed themselves were also more likely to be older, white, better educated and less likely to have never been married than other suicides.

Interestingly, former soldiers who were overweight were far less likely to kill themselves than those of normal weight.

However, a tour of duty in the military did not increase the risk of dying from natural or accidental causes, or of being a homicide victim.

The authors concluded: ‘With the projected rise in functional impairments and psychiatric morbidity among veterans of the conflicts in Afghanistan and Iraq, clinical and community interventions that are directed towards these patients are needed.’

‘Clinicians need to be alert for signs of suicidal intent among veterans, as well as their access to firearms.’
The researchers found that veterans were 58 percent more likely to use a gun to kill themselves than other suicides.

The research was funded with a grant from the US National Institute of Mental Health.

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hawk71049

06-12-2008, 03:20 PM

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Veterans Fail to Seek Care for PTSD ( http://psychcentral.com/news/2008/04/18/veterans-fail-to-seek-care-for-ptsd/2166.html)...

By: Rick Nauert, Ph.D.
Senior News Editor

Reviewed by: John M. Grohol, Psy.D.
on April 18, 2008

Friday, Apr 18 (Psych Central) -- Researchers have determined that nearly 20 percent of military service members who have returned from Iraq and Afghanistan report symptoms of post traumatic stress disorder or major depression, yet only slight more than half have sought treatment.

The new RAND Corporation study discovered approximately 300,000 soldiers exhibit PTSD.
In addition, researchers found about 19 percent of returning service members report that they experienced a possible traumatic brain injury while deployed, with 7 percent reporting both a probable brain injury and current PTSD or major depression.

Many service members said they do not seek treatment for psychological illnesses because they fear it will harm their careers. But even among those who do seek help for PTSD or major depression, only about half receive treatment that researchers consider “minimally adequate” for their illnesses.

In the first analysis of its kind, researchers estimate that PTSD and depression among returning service members will cost the nation as much as $6.2 billion in the two years following deployment — an amount that includes both direct medical care and costs for lost productivity and suicide.

Investing in more high-quality treatment could save close to $2 billion within two years by substantially reducing those indirect costs, the 500-page study concludes.

“There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan,” said Terri Tanielian, the project’s co-leader and a researcher at RAND, a nonprofit research organization.

“Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need.”

The findings are from the first large-scale, nongovernmental assessment of the psychological and cognitive needs of military service members who have served in Iraq and Afghanistan over the past six years. The RAND study is the first to comprehensively assess the current needs of returned service members from all branches of the military.

Researchers concluded that a major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans. The effort must include the military, veteran and civilian health care systems, and should focus on training more providers to use high-quality, evidence-based treatment methods and encouraging service members and veterans to seek needed care.

Since October 2001, about 1.6 million U.S. troops have deployed to the wars in Iraq and Afghanistan, with many exposed to prolonged periods of combat-related stress or traumatic events. Early evidence suggests that the psychological toll of the deployments may be disproportionately high compared with physical injuries.

Tanielian and project co-leader Lisa Jaycox headed a group of 25 RAND researchers who conducted a three-pronged assessment of the needs of returning service members: a national survey of those who had served in Iraq and Afghanistan to assess their psychological and cognitive injuries; economic modeling to estimate the cost not only of providing needed treatment, as well as the costs associated with lost productivity and suicide; and an assessment of treatment services that are available to service members, as well as barriers to treatment.

Researchers surveyed 1,965 service members from 24 communities across the country to assess their exposure to traumatic events and possible brain injury while deployed, evaluate current symptoms of psychological illness, and gauge whether they have received care for combat-related problems.

Service members reported exposure to a wide range of traumatic events while deployed, with half saying they had a friend who was seriously wounded or killed, 45 percent reporting they saw dead or seriously injured non-combatants, and over 10 percent saying they were injured themselves and required hospitalization.

Rates of PTSD and major depression were highest among Army soldiers and Marines, and among service members who were no longer on active duty (people in the reserves and those who had been discharged or retired from the military).

Women, Hispanics and enlisted personnel all were more likely to report symptoms of PTSD and major depressions, but the single best predictor of PTSD and depression was exposure to combat trauma while deployed.

Researchers found many treatment gaps exist for those with PTSD and depression. Just 53 percent of service members with PTSD or depression sought help from a provider over the past year, and of those who sought care, roughly half got minimally adequate treatment.

“If PTSD and depression go untreated or are under treated, there is a cascading set of consequences,” Jaycox said. “Drug use, suicide, marital problems and unemployment are some of the consequences. There will be a bigger societal impact if these service members go untreated. The consequences are not good for the individuals or society in general.”

Service members report many reasons for not seeking treatment. Many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional. Even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities.

The RAND report recommends the military create a system that would allow service members to receive mental health services confidentially in order to ease concerns about negative career repercussions.
“We need to remove the institutional cultural barriers that discourage soldiers from seeking care,” Tanielian said. “Just because someone is getting mental health care does not mean that they are not able to do their job. Seeking mental health treatment should be seen as a sign of strength and interest in getting better, not a weakness. People need to get help as early as possible, not only once their symptoms become severe and disabling.”

Researchers also found an urgent need to train more mental health providers throughout the U.S. health care system on delivering evidence-based treatments to service members and veterans. While many opportunities for treatment exist for active-duty personnel, there is no system in place to monitor the quality of those services to ensure they are getting the latest science-based forms of treatment.

The Department of Defense’s newly created Defense Center for Excellence for Psychological Health and Traumatic Brain Injury may provide a historic opportunity to change the culture of psychological health within the military and to promote and monitor the use of high-quality care to service members.

The RAND report provides information that the center could use to pursue these objectives through the use of innovative care models and performance measurement techniques.

Researchers suggest special training programs are needed to instruct mental health providers in the military, veterans and civilian health systems about the type of evidence-based treatments needed by service members. Only providers with such training should be eligible to treat service members and payment programs should be retooled to reward providers who use science-based treatments.
“It’s going to take system-level changes — not a series of small band-aids — to improve treatments for these illnesses,” Tanielian said.

The RAND study estimates the societal costs of PTSD and major depression for two years after deployment range from about $6,000 to more than $25,000 per case. Depending whether the economic cost of suicide is included, the RAND study estimates the total society costs of the conditions for two years range from $4 billion to $6.2 billion.

The RAND study also estimates that about 320,000 service members may have experienced a traumatic brain injury during deployment — the term used to describe a range of injuries from mild concussions to severe penetrating head wounds. Just 43 percent reported ever being evaluated by a physician for that injury.

While most civilian traumatic brain injuries are mild and do not lead to long-term impairments, the extent of impairments that service members experience and whether they require treatment is largely unknown, researchers said. In the absence of a medical examination and prognosis, however, service members may believe that their post-deployment difficulties are due to head injuries even when they are not.

One-year estimates of the societal cost associated with treated cases of mild traumatic brain injury range up to $32,000 per case, while estimates for treated moderate to severe cases range from $268,000 to more than $408,000. Estimates of the total one-year societal cost of the roughly 2,700 cases of traumatic brain injury identified to date range from $591 million to $910 million.

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hawk71049

06-12-2008, 03:57 PM

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Report: Antidepressants being used more among U.S. troops on front lines ( http://www.stripes.com/article.asp?section=104&article=55445)...
Stars and Stripes
Mideast edition, Wednesday, June 11, 2007

For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan, according to a report in Time Magazine.

In its June 16 cover story, the magazine reports that the medicines are intended not only to help troops keep their cool but also to enable the already strapped Army to preserve its most precious resource: soldiers on the front lines.

Citing the Army’s fifth Mental Health Advisory Team report, using an anonymous survey of U.S. troops taken last fall, Time wrote that about 12 percent of combat troops in Iraq and 17 percent of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope.

Escalating violence in Afghanistan and the more isolated mission have driven troops to rely more on medication there than in Iraq, military officials told Time.

The Army estimates that authorized drug use splits roughly fifty-fifty between troops taking antidepressants — largely the class of drugs that includes Prozac and Zoloft — and those taking prescription sleeping pills such as Ambien, Time wrote.

The magazine noted that the high number of soldiers on antidepressants is mirrored by that of the general population.

Time also reported that there are sharp divisions among military physicians: Some have said that the effects of using such prescriptions on soldiers in war zones are not adequately understood, while others contend that using prescriptions for mild depression symptoms avoids costly removals of soldiers from the fight.

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hawk71049

06-12-2008, 04:40 PM

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Page..2

Time Magazine

The Military’s Secret Weapon

America's Medicated Army ( http://www.time.com/time/nation/article/0,8599,1811858,00.html)...Jun. 16, 2008 | By MARK THOMPSON

The Trauma of War

Before the advent of SSRIs — Lilly's Prozac was the first to be approved by the FDA, in 1987, followed by Zoloft from Pfizer, Paxil from GlaxoSmithKline, Celexa from Forest Pharmaceuticals and others — existing antidepressants had many disabling side effects. Impaired memory and judgment, dizziness, drowsiness and other complications made them ill suited for troops in combat. The newer drugs have fewer side effects and, unlike earlier drugs, are generally not addictive or toxic, even when taken in large quantities. They work by keeping neural connections bathed in a brain chemical known as serotonin. That amplifies serotonin's mood-brightening effect, at least for some people.

In 1994 then Major E. Cameron Ritchie, an Army psychiatrist, was among the first to suggest that SSRIs should deploy with Army combat units. In a paper written and published after she returned from a combat deployment to Somalia, Ritchie noted that the sick-call chests used by military doctors "contain either outdated or no psychiatric medications." She concluded, "If depressive symptoms are moderate and manageable, medication may be preferable to medical evacuation."

By 1999, military docs were debating the matter among themselves. Nash, a Navy psychiatrist, wrote that Navy doctors — who also provide Marines with medical care — had "sharp differences of opinion" over letting troops in war zones use SSRIs. Skeptics argued that their "real safety" in combat had not been proved. Supporters countered that their use could "avoid depleting manpower resources and damaging individual careers through unnecessary removals from operational duty." Nash reviewed the medical literature and reported that SSRIs "can be safely administered to deploying and deployed personnel."

The trickle of new drugs became a flood after the invasion of Iraq in 2003. Details of America's medicated wars come from the mental-health surveys the Army has conducted each year since the war began. If the surveys are right, many U.S. soldiers experience a common but haunting mismatch in combat life: while nearly two-thirds of the soldiers surveyed in Iraq in 2006 knew someone who had been killed or wounded, fewer than 15% knew for certain that they had actually killed a member of the enemy in return. That imbalance between seeing the price of war up close and yet not feeling able to do much about it, the survey suggests, contributes to feelings of "intense fear, helplessness or horror" that plant the seeds of mental distress. "A friend was liquefied in the driver's position on a tank, and I saw everything," was a typical comment. Another: "A huge f______ bomb blew my friend's head off like 50 meters from me." Such indelible scenes — and wondering when and where the next one will happen — are driving thousands of soldiers to take antidepressants, military psychiatrists say. It's not hard to imagine why.

Repeated deployments to the war zones also contribute to the onset of mental-health problems. Nearly 30% of troops on their third deployment suffer from serious mental-health problems, a top Army psychiatrist told Congress in March. The doctor, Colonel Charles Hoge, added that recent research has shown the current 12 months between combat tours "is insufficient time" for soldiers "to reset" and recover from the stress of a combat tour before heading back to war.

Colonel Joseph Horam says antidepressants have made "a striking difference" in the way troops are treated in war. A doctor in the Wyoming Army National Guard, Horam served in Saudi Arabia during the first Gulf War and has been deployed to Iraq twice during this war. "In the Persian Gulf War, we didn't have these medications, so our basic philosophy was 'three hots and a cot'" — giving stressed troops a little rest and relaxation to see if they improved. "If they didn't get better right away, they'd need to head to the rear and probably out of theater." But in his most recent stint in Baghdad in 2006, he treated a soldier who guarded Iraqi detainees. "He was distraught while he was having high-level interactions with detainees, having emotional confrontations with them — and carrying weapons," Horam says. "But he was part of a highly trained team, and we didn't want to lose him. So we put him on an SSRI, and within a week, he was a new person, and we got him back to full duty."

It wasn't until November 2006 that the Pentagon set a uniform policy for all the services. But the curious thing about it was that it didn't mention the new antidepressants. Instead, it simply barred troops from taking older drugs, including "lithium, anticonvulsants and antipsychotics." The goal, a participant in crafting the policy said, was to give SSRIs a "green light" without saying so. Last July, a paper published by three military psychiatrists in Military Medicine, the independent journal of the Association of Military Surgeons of the United States, urged military doctors headed for Afghanistan and Iraq to "request a considerable quantity of the SSRI they are most comfortable prescribing" for the "treatment of new-onset depressive disorders" once in the war zones. The medications, the doctors concluded, help "to 'conserve the fighting strength,'" the motto of the Army Medical Corps.

These days Ritchie — now a colonel and a psychiatric consultant to the Army surgeon general — thinks the military's use of SSRIs has helped destigmatize mental problems. "What we're trying to do is make treating depression and PTSD — especially PTSD, which is quite common for soldiers now — fairly routine," she says. "We don't want to make it harder for folks to do their job and their mission by saying they can't use these medications." Ritchie, who communicates "six times a day" with her colleagues in the war zones, says she is unaware of "any bad outcomes" resulting from soldiers taking SSRIs.

William Winkenwerder Jr., who issued the 2006 policy as the Pentagon's top doctor before stepping down last year, says the new medicines are working well. "Combat presents some unique and important caveats — obviously, those who are being treated have access to firearms, and they may be under significant stress, so they need to be very carefully evaluated, and good clinical decisions need to be made," Winkenwerder tells TIME. "It's my belief that is happening."

"In a Total Daze"
And yet the battlefield seems an imperfect environment for widespread prescription of these medicines. LeJeune, who spent 15 months in Iraq before returning home in May 2004, says many more troops need help — pharmaceutical or otherwise — but don't get it because of fears that it will hurt their chance for promotion. "They don't want to destroy their career or make everybody go in a convoy to pick up your prescription," says LeJeune, now 34 and living in Utah. "In the civilian world, when you have a problem, you go to the doctor, and you have therapy followed up by some medication. In Iraq, you see the doctor only once or twice, but you continue to get drugs constantly." LeJeune says the medications — combined with the war's other stressors — created unfit soldiers. "There were more than a few convoys going out in a total daze."

About a third of soldiers in Afghanistan and Iraq say they can't see a mental-health professional when they need to. When the number of troops in Iraq surged by 30,000 last year, the number of Army mental-health workers remained the same — about 200 — making counseling and care even tougher to get.

"Burnout and compassion fatigue" are rising among such personnel, and there have been "recent psychiatric evacuations" of Army mental-health workers from Iraq, the 2007 survey says. Soldiers are often stationed at outposts so isolated that follow-up visits with counselors are difficult. "In a perfect world," admits Nash, who has just retired from the Navy, "you would not want to rely on medications as your first-line treatment, but in deployed settings, that is often all you have."

And just as more troops are taking these drugs, there are new doubts about the drugs' effectiveness. A pair of recent reports from Rand and the federal Institute of Medicine (iom) raise doubts about just how much the new medicines can do to alleviate PTSD. The Rand study, released in April, says the "overall effects for SSRIs, even in the largest clinical trials, are modest." Last October the iom concluded, "The evidence is inadequate to determine the efficacy of SSRIs in the treatment of PTSD."

Chris LeJeune could have told them that. When he returned home in May 2004, he remained on clonazepam and other drugs. He became one of 300,000 Americans who served in Iraq and Afghanistan and suffer from PTSD or depression. "But PTSD isn't fixed by taking pills — it's just numbed," he claims now. "And I felt like I was drugged all the time." So a year ago, he simply stopped taking them. "I just started trying to fight my demons myself," he says, with help from VA counseling. He laughs when asked how he's doing. "I'd like to think," he says, "that I'm really damn close back to normal."

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hawk71049

06-12-2008, 04:44 PM

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Page..1

Time Magazine

The Military’s Secret Weapon

America's Medicated Army ( http://www.time.com/time/nation/article/0,8599,1811858,00.html)...Jun. 16, 2008 | By MARK THOMPSON

As wars in Afghanistan and Iraq have stretched the U.S. military to the breaking point, the Pentagon has quietly okayed the use of antidepressants by stressed-out troops. A TIME investigation reveals combat's heavy toll on their mental health--and why the

Seven months after Sergeant Christopher LeJeune started scouting Baghdad's dangerous roads — acting as bait to lure insurgents into the open so his Army unit could kill them — he found himself growing increasingly despondent. "We'd been doing some heavy missions, and things were starting to bother me," LeJeune says. His unit had been protecting Iraqi police stations targeted by rocket-propelled grenades, hunting down mortars hidden in dark Baghdad basements and cleaning up its own messes. He recalls the order his unit got after a nighttime firefight to roll back out and collect the enemy dead. When LeJeune and his buddies arrived, they discovered that some of the bodies were still alive. "You don't always know who the bad guys are," he says. "When you search someone's house, you have it built up in your mind that these guys are terrorists, but when you go in, there's little bitty tiny shoes and toys on the floor — things like that started affecting me a lot more than I thought they would."

So LeJeune visited a military doctor in Iraq, who, after a quick session, diagnosed depression. The doctor sent him back to war armed with the antidepressant Zoloft and the antianxiety drug clonazepam. "It's not easy for soldiers to admit the problems that they're having over there for a variety of reasons," LeJeune says. "If they do admit it, then the only solution given is pills."

While the headline-grabbing weapons in this war have been high-tech wonders, like unmanned drones that drop Hellfire missiles on the enemy below, troops like LeJeune are going into battle with a different kind of weapon, one so stealthy that few Americans even know of its deployment. For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan. The medicines are intended not only to help troops keep their cool but also to enable the already strapped Army to preserve its most precious resource: soldiers on the front lines. Data contained in the Army's fifth Mental Health Advisory Team report indicate that, according to an anonymous survey of U.S. troops taken last fall, about 12% of combat troops in Iraq and 17% of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope. Escalating violence in Afghanistan and the more isolated mission have driven troops to rely more on medication there than in Iraq, military officials say.

At a Pentagon that keeps statistics on just about everything, there is no central clearinghouse for this kind of data, and the Army hasn't consistently asked about prescription-drug use, which makes it difficult to track. Given the traditional stigma associated with soldiers seeking mental help, the survey, released in March, probably underestimates antidepressant use. But if the Army numbers reflect those of other services — the Army has by far the most troops deployed to the war zones — about 20,000 troops in Afghanistan and Iraq were on such medications last fall. The Army estimates that authorized drug use splits roughly fifty-fifty between troops taking antidepressants — largely the class of drugs that includes Prozac and Zoloft — and those taking prescription sleeping pills like Ambien.

In some ways, the prescriptions may seem unremarkable. Generals, history shows, have plied their troops with medicinal palliatives at least since George Washington ordered rum rations at Valley Forge. During World War II, the Nazis fueled their blitzkrieg into France and Poland with the help of an amphetamine known as Pervitin. The U.S. Army also used amphetamines during the Vietnam War.

The military's rising use of antidepressants also reflects their prevalence in the civilian population. In 2004, the last year for which complete data for the U.S. are available, doctors wrote 147 million prescriptions for antidepressants, according to IMS Health, a pharmaceutical-market-research firm. This number reflects in part the common practice of cycling through different medications to find the most effective drug. A 2006 federally funded study found that 70% of those taking antidepressants along with therapy experience some improvement in mood.

When it comes to fighting wars, though, troops have historically been barred from using such drugs in combat. And soldiers — who are younger and healthier on average than the general population — have been prescreened for mental illnesses before enlisting.

The increase in the use of medication among U.S. troops suggests the heavy mental and psychological price being paid by soldiers fighting in Iraq and Afghanistan. Pentagon surveys show that while all soldiers deployed to a war zone will feel stressed, 70% will manage to bounce back to normalcy. But about 20% will suffer from what the military calls "temporary stress injuries," and 10% will be afflicted with "stress illnesses." Such ailments, according to briefings commanders get before deploying, begin with mild anxiety and irritability, difficulty sleeping, and growing feelings of apathy and pessimism. As the condition worsens, the feelings last longer and can come to include panic, rage, uncontrolled shaking and temporary paralysis.

The symptoms often continue back home, playing a key role in broken marriages, suicides and psychiatric breakdowns. The mental trauma has become so common that the Pentagon may expand the list of "qualifying wounds" for a Purple Heart — historically limited to those physically injured on the battlefield — to include posttraumatic stress disorder (PTSD). Defense Secretary Robert Gates said on May 2 that it's "clearly something" that needs to be considered, and the Pentagon is weighing the change.

Using drugs to cope with battlefield traumas is not discussed much outside the Army, but inside the service it has been the subject of debate for years. "No magic pill can erase the image of a best friend's shattered body or assuage the guilt from having traded duty with him that day," says Combat Stress Injury, a 2006 medical book edited by Charles Figley and William Nash that details how troops can be helped by such drugs. "Medication can, however, alleviate some debilitating and nearly intolerable symptoms of combat and operational stress injuries" and "help restore personnel to full functioning capacity."

Which means that any drug that keeps a soldier deployed and fighting also saves money on training and deploying replacements. But there is a downside: the number of soldiers requiring long-term mental-health services soars with repeated deployments and lengthy combat tours. If troops do not get sufficient time away from combat — both while in theater and during the "dwell time" at home before they go back to war — it's possible that antidepressants and sleeping aids will be used to stretch an already taut force even tighter. "This is what happens when you try to fight a long war with an army that wasn't designed for a long war," says Lawrence Korb, Pentagon personnel chief during the Reagan Administration.

Military families wonder about the change, according to Joyce Raezer of the private National Military Family Association. "Boy, it's really nice to have these drugs," she recalls a military doctor saying, "so we can keep people deployed." And professionals have their doubts. "Are we trying to bandage up what is essentially an insufficient fighting force?" asks Dr. Frank Ochberg, a veteran psychiatrist and founding board member of the International Society for Traumatic Stress Studies.

Such questions have assumed greater urgency as more is revealed about the side effects of some mental-health medications. Last year the U.S. Food and Drug Administration (FDA) urged the makers of antidepressants to expand a 2004 "black box" warning that the drugs may increase the risk of suicide in children and adolescents. The agency asked for — and got — an expanded warning that included young adults ages 18 to 24, the age group at the heart of the Army. The question now is whether there is a link between the increased use of the drugs in the Iraqi and Afghan theaters and the rising suicide rate in those places. There have been 164 Army suicides in Afghanistan and Iraq from the wars' start through 2007, and the annual rate there is now double the service's 2001 rate.

At least 115 soldiers killed themselves last year, including 36 in Iraq and Afghanistan, the Army said on May 29. That's the highest toll since it started keeping such records in 1980. Nearly 40% of Army suicide victims in 2006 and 2007 took psychotropic drugs — overwhelmingly, selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft. While the Army cites failed relationships as the primary cause, some outside experts sense a link between suicides and prescription-drug use — though there is also no way of knowing how many suicide attempts the antidepressants may have prevented by improving a soldier's spirits. "The high percentage of U.S. soldiers attempting suicide after taking SSRIs should raise serious concerns," says Dr. Joseph Glenmullen, who teaches psychiatry at Harvard Medical School. "And there's no question they're using them to prop people up in difficult circumstances."

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I'm His Lucky Charm....

06-12-2008, 10:32 PM

Military Diagnosing More Post-Traumatic Stress

http://www.washingtonpost.com/wp-dyn/content/article/2008/05/27/AR2008052701512.html

hawk71049

06-13-2008, 12:24 AM

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Judge to consider VA e-mail about PTSD diagnoses ( http://www.washingtonpost.com/wp-dyn/content/article/2008/06/05/AR2008060503653.html)...

By PAUL ELIAS
The Associated Press
Thursday, June 5, 2008; 9:20 PM

SAN FRANCISCO -- A federal judge considering a lawsuit that alleges inadequate medical care for veterans ordered government lawyers Thursday to explain an e-mail by a Veterans Administration psychologist suggesting that counselors make a point to diagnose fewer post-traumatic stress disorder cases.

The hearing ordered by U.S. District Judge Samuel Conti follows a two-week trial that ended last month. Veterans groups had sued the VA, saying it inadequately addressed a "rising tide" of mental health problems, especially post-traumatic stress disorder and suicides.

The plaintiffs asked Conti to reopen the case in light of the e-mail discovered after the trial ended.

The judge agreed, saying "the e-mail raises potentially serious questions that may warrant further attention." He ordered lawyers for both sides to appear in court Tuesday to discuss whether the e-mail has any bearing on the case.

The document in question is a March 20 memo written by Norma Perez, who helps coordinate a post-traumatic stress disorder clinical team in central Texas.

"Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Perez wrote to VA counselors. "We really don't or have time to do the extensive testing that should be done to determine PTSD."

The e-mail was forwarded to VoteVets.org, an Iraq and Afghanistan war veterans lobbying group opposed to the Bush administration's handling of the war and veterans issues.

Lawyers for the veterans groups argue that Perez's e-mail goes to the heart of their case, showing the VA's indifference to treating mental health.

"This is not Joe the janitor writing this," vets' lawyer Arturo Gonzalez said. "This is a supervisor, and it shows how the VA thinks."

Gonzalez wants the judge to add the e-mail to the evidence given to him at the non-jury trial in support of the lawsuit.

Government lawyers for the VA didn't return a telephone call Thursday. But on Wednesday, Justice Department lawyer James Schwartz wrote the judge a letter arguing that the e-mail was a mistake, that Perez had been "counseled" and that it has nothing to do with the lawsuit.

"It was the action of a single individual that in no way represented the policies of VA, that, once discovered, was dealt with quickly and appropriately," Schwartz told the judge.

Perez told senators Wednesday at a Senate Veterans Affairs Committee hearing called to investigate the e-mail that her message was poorly written and that she meant to remind counselors that they could initially diagnose patients with a less severe stress condition known as "adjustment disorder."

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hawk71049

06-14-2008, 01:49 AM

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The Washington Post

PTSD High Among Witnesses to 9/11 (http://www.washingtonpost.com/wp-dyn/content/article/2008/06/13/AR2008061301823.html?sub=new)...

Friday, June 13, 2008; 12:00 AM

FRIDAY, June 13 (HealthDay News) -- Two to three years after the World Trade Center terrorist attacks, one in eight residents who lived near the site had signs of post-traumatic stress disorder (PTSD), a New York City Health Department study reports.

This rate, 12.6 percent, among Lower Manhattan residents is three times the usual rate and matches the 12.4 percent rate reported among rescue and recovery workers. Residents who were injured during the attacks had the highest rate of PTSD symptoms (38 percent), followed by those who witnessed violent deaths and those caught in the dust cloud after the towers collapsed on Sept. 11, 2001.

The most commonly reported PTSD symptoms were hyper-vigilance, nightmares and emotional reactions to reminders of 9/11.

The study, based on surveys of 11,000 residents through the World Trade Center Health Registry, also found that divorced people reported PTSD symptoms at twice the rate of married people (21.5 percent vs. 9.5 percent), possibly because divorced people received less emotional support, the researchers suggested.

Women were affected at a higher rate than men (15 percent vs. 10 percent), Hispanics (24.7 percent) and blacks (20.6 percent) were affected more than whites (10.7 percent) and Asians (8.9 percent), people with less than a high school diploma (18.3 percent) were affected more than college graduates (11.1 percent), and those who earn less than $25,000 a year (19.8 percent) were affected more than those who earn $50,000 to $74,999 (11.3 percent).

"These findings confirm that the experience of 9/11 had lasting consequences for many of those affected by it," Dr. Thomas Frieden, New York City Health Commissioner, said in a prepared statement.
The study, the first to measure the WTC attacks on the mental health of residents, was published online this week in the Journal of Traumatic Stress.

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hawk71049

06-14-2008, 02:53 AM

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Reactions split on awarding medal for PTSD (http://www.stripes.com/article.asp?section=104&article=62536&archive=true)...
Some say Purple Heart would no longer be special
By Jeff Schogol, Stars and Stripes
European edition, Sunday, June 01, 2008

ARLINGTON, Va. — The question of whether troops with post-traumatic stress disorder should be eligible for the Purple Heart is not an easy one.

Currently, PTSD is one of the injuries that does not merit the Purple Heart, along with trench foot, heatstroke and self-inflicted wounds.

But when a reporter recently asked Defense Secretary Robert Gates about a military psychologist’s suggestion that troops with PTSD be eligible for the award, Gates said: "It’s an interesting idea. I think it’s clearly something that needs to be looked at."

Awards experts and other officials will review the matter at a meeting in June, but they are not expected to make a recommendation on the matter, said Lt. Col. Jonathan Withington.

"The department’s long-standing policy is not to create a new award or modification that would dilute the recognition provided by our existing awards and thereby lessen their prestige," Withington said in an e-mail on Friday.

Stars and Stripes asked readers for their input on whether troops with PTSD should be eligible for the Purple Heart. Over two weeks, Stripes got 68 responses through e-mail, most of which opposed such a move.

Some readers said it would be too easy for troops to be awarded the Purple Heart by faking PTSD symptoms.

"Some people WILL lie just to get the medal and other benefits," said Army Sgt. 1st Class Christopher Russell, based at Forward Operating Base Warhorse, Iraq. "The good of the few definitely doesn’t outweigh the good of the many or the good of the institution in this case. Give them their own medal but it will be clear what it’s for."

Other readers said awarding the Purple Heart to troops with PTSD would cheapen the award.
"The Purple Heart would no longer be special; it would be like the freaking AAM (Army Achievement Medal)," said Army Spc. Ebony Martin, at Camp Virginia, Kuwait.

Vietnam veteran Dewey E. Du Bose said the Purple Heart is only for troops killed or wounded in combat.
"PTSD is not an injury to the physical body, it could be called a mental injury, but so could my jumping whenever I hear a loud noise. Are we going to call PTSD a mental illness?" said Du Bose, a retired Army sergeant major.

"If that’s the case then we will have to ‘award the [Purple Heart]’ for everyone who has ever been discharged from the military because on mental stress and other mental problems. Why award the medal to one group of mental patients and not the rest of them?"

But fellow Vietnam veteran Edward Stump said that troops suffering from PTSD that came as a result of enemy action should be awarded the Purple Heart.

"Not all wounds are on the outside of the body," Stump said. "Those can be treated and are more likely to heal. The wounds from PTSD are different. They affect the hardest place in the body to treat: your mind."
Stump said he served in Vietnam with the Marines from 1966 to 1967.

"My wounds do not bleed but they have as many scars as a lot of other wounds," he said. "These wounds will never heal anymore than the scars, from any that are from combat-related fighting, will disappear."

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hawk71049

06-14-2008, 06:44 AM

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Havre Daly News
Serving North-Central Montana founded 1914

Tester, Schweitzer team up on veterans’ issues ( http://www.havredailynews.com/articles/2008/06/13/local_headlines/state.txt)...

(Created: Friday, June 13, 2008 1:56 PM MDT)
HDN Staff and wire report

Continuing his fight to increase benefits for military veterans, Sen. Jon Tester teamed up with Montana Gov. Brian Schweitzer in the U.S. Senate Thursday. Tester introduced Schweitzer during a hearing of the Joint Economic Committee, which examined the Iraq war’s impact on rising health care costs for veterans, a release from Tester’s office said. Schweitzer talked about the “unseen costs” of caring for veterans wounded in the war, especially veterans living in Montana and rural America. “Having more than a third of your state’s Guard out of the country is a tough situation to inherit,” Tester told the Committee, noting that when he was elected in 2004, more than 1,500 members of the Montana National Guard were serving in Iraq. “We know the sacrifice for service- members and their families, and especially for Montana’s National Guardsmen and Reservists.” Last week the Senate unanimously passed legislation sponsored by Tester, a member of the Senate Veterans Affairs Committee, to officially raise the VA’s mileage reimbursement rate for disabled veterans from 11 cents to 28.5 cents per mile — the first increase in more than 30 years, the release said. In his testimony Thursday, Schweitzer focused on the difficulties of providing care for veterans in a state the size of Montana. Schweitzer told the committee about the difficulty veterans in small towns face in finding mental health professionals able to treat posttraumatic stress disorder and the extra burden on veterans and their families presented by the travel distances to both mental health and other medical services. Schweitzer also spoke about Chris Dana, a 23-year old Iraq veteran from Helena who took his own life in March 2007 after struggling with PTSD. In response to Dana’s suicide, the Montana National Guard established a PTSD task force and began working on a plan to better council Guardsmen who suffer from PTSD. Representatives of the Montana National Guard were in Havre last month to tell people about the program the Guard is putting in place — one of the two most-watched programs in the country, along with a program being developed by the Guard in Minnesota, they said. “We can’t put a value on the cost of losing Chris Dana,” Schweitzer said in his written testimony. “The greatest cost to Montana from the Global War on Terror, is, of course the immeasurable loss of soldiers, marines and sailors. Nor can we easily quantify the cost to our families, communities and economy of soldiers and airmen unable to return to their job.” Schweitzer also testified on the impact on readiness. He said it would cost nearly $28 million to make the National Guard 100 percent ready for future missions, including its key role in the state’s response to wildfire season, both for human resource and equipment and material.

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hawk71049

06-15-2008, 04:22 AM

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Time Magazine

Talking Out Trauma: Not Always a Help ( http://www.time.com/time/health/article/0,8599,1812204,00.html)...
Thursday, Jun. 05, 2008 By KATHLEEN KINGSBURY

Talk it out. That's the first advice most victims are given in the wake of trauma. Conventional wisdom would suggest that burying one's emotions after a violent incident — such as a school shooting or terrorist bombing — will only lead to deeper anxiety later on. Yet, while mental health practitioners widely subscribe to this truism, it has rarely been tested outside a laboratory setting — past studies have found a lack of convincing evidence to support the use of psychological debriefing to mitigate trauma — and some experts think the theory doesn't hold up in every situation.

Researchers at the University at Buffalo and University of California, Irvine, explored the question by compiling survey data from a random sample of 2,000 Americans after the September 11, 2001, terrorist attacks. What they discovered surprised them — participants who chose not to discuss their feelings right after the attacks often fared better over the subsequent two years than those who did. "We constantly tell people it's wrong to hold feelings inside," says lead author Mark Seery, a psychology professor at Buffalo. "But our findings [suggest] the exact opposite."

Using an online survey, Seery and his colleagues gave Americans the opportunity to write about their thoughts on the 9/11 terrorist attacks, both on that day and for a few days afterward. Of some 2,000 people surveyed, about three-quarters choose to articulate their emotional response to the events. Older participants agreed more readily than younger ones, and people who had experienced relatively more trauma in their lives tended to write longer reactions. The researchers then followed both groups, evaluating their mental and physical well-being on several occasions over the next two years. A clear pattern soon emerged: compared with those who stayed mum, people who openly responded after 9/11 tended to report more symptoms of post-traumatic stress and general stress, as well as more physician-diagnosed ailments. Indeed, the more in-depth the participant's initial response, the worse off he or she was physically and mentally in the following years.

The study, which was funded by the National Science Foundation and the National Institute of Mental Health, will be published in this month's Journal of Consulting and Clinical Psychology.

Seery and his colleagues did not delve specifically into why demonstrative participants experienced worse outcomes than the less expressive ones. His best conjecture is that the former group was more deeply affected by the event at the outset, and therefore, naturally inclined to suffer more stress in the long term.

That hypothesis is based on the fact that survey respondents who lived closer to the World Trade Center as well as those who were most directly affected were more likely than others to share their feelings. These groups also exhibited poorer mental health over time. But that relationship wasn't consistent: in some instances, people who lived closest to the New York City attacks were the most resilient. "Most likely, some of these [participants] were concerned citizens after 9/11, but not traumatized people," says Richard Tedeschi, a professor and expert on trauma at the University of North Carolina at Charlotte. "Their decisions about how to react will vary based on how significant the event was to them. That judgment has to be taken into account."

Seery admits his study had other limitations: for one, participants were asked to self-select whether or not they wrote about their feelings — rather than being randomly assigned to do so — which was necessary to assess each person's decision-making process, but created an inherent bias.

Participants were also asked to discuss their feelings on just one occasion and immediately following the terrorist attacks; clinical practice, however, is to diagnose post-traumatic stress disorder (PTSD) in patients no earlier than one month after an ordeal. As Tedeschi notes, "Some people just need more time to process their feelings and decide whether to take action."

Perhaps the most significant drawback of the report is that the researchers had no method of measuring whether people who discussed their feelings actually got any benefit from it — in other words, it's possible that having the opportunity to emote protected respondents from suffering even worse outcomes than they would have otherwise. Previous research shows how important that distinction may be. About 10% of people who experience a trauma will eventually develop PTSD, a life-altering chronic condition, and some 5.2 million Americans suffer PTSD in any given year, according to the American Psychological Association. A recent Pentagon report showed also that military personnel appear are particularly vulnerable to PTSD, with about 20% of service members returning home from Iraq and Afghanistan exhibiting symptoms.

Repeatedly, scientists have shown that the most effective means of treating PTSD is through immediate and comprehensive psychiatric counseling. "Post-trauma counseling is more than just expression-based interventions," says Robin Goodman, a New York City–based psychologist who worked with 9/11 survivors. "You also have to equip patients with skills to cope, methods to manage the pain they're experiencing."

Seery agrees that his study shouldn't discourage anyone from seeking counseling after a trauma, if they believe they will benefit from it. Instead, he stresses that what the new findings do reinforce is that no one should be pressured into therapy against their will either. "The implication of our work is that people handle bad situations differently and we need to accept that reality," Seery says, adding, "There's no single solution that fits everyone."

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I'm His Lucky Charm....

06-15-2008, 09:41 PM

http://www.mca-marines.org/gazette/jun08_twiggs.asp

hawk71049

06-16-2008, 03:57 AM

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Time Magazine

Purple Hearts for Psychic Scars? (http://www.time.com/time/health/article/0,8599,1812757,00.html)...

Sunday, Jun. 08, 2008 By MARK THOMPSON/WASHINGTON

For every solder killed or physically wounded in Iraq or Afghanistan, some 10 others come home psychically scarred. The Pentagon has diagnosed roughly 40,000 troops with post traumatic stress disorder (PTSD) since 2003, and tens of thousands of others are dealing with it on their own or ultimately will be diagnosed. With the war taking such a heavy psychological toll, some inside the military are starting to ask if men and women who become mentally injured in the service of their country deserve the Purple Heart. To some traditionalists, the idea is absurd on its face, but it is not a theoretical debate —the Pentagon is now weighing a change in policy that would make PTSD, in a term only the military could invent, a "qualifying wound" for the medal.

The Purple Heart, created by General George Washington in 1782, has historically been limited to those physically wounded or killed in combat. The Army classifies PTSD as an illness, not an injury, which means it doesn't qualify for the honor. But John Fortunato, an Army psychologist at Fort Bliss, Texas, argued in early May that PTSD affects soldiers by physically damaging their brains, making the condition no different than conventional wounds. Soldiers with PTSD often have suffered as much "as anybody with a traumatic brain injury, as anybody with a shrapnel wound," he said. Their ineligibility for a Purple Heart "says this is the wound that isn't worthy, and it is." Advocates of the change like Fortunato believe it would help encourage soldiers with symptoms of PTSD, many of whom are afraid of being blacklisted and having their chances for promotion limited, seek out the help they need.

The suggestion has garnered high-level Pentagon attention. "It's an interesting idea," Defense Secretary Robert Gates recently noted. "I think it is clearly something that needs to be looked at." The Defense Department's awards advisory group, which previously ruled that PTSD doesn't merit a Purple Heart, is now studying the issue again.

The traditional veterans' groups don't want the rules loosened. "We vehemently disagree" that PTSD is a physical wound that warrants a Purple Heart, says Joseph Palagyi, the national adjutant of the Military Order of the Purple Heart, who earned the medal in Vietnam on June 2, 1968. "We feel that the purity of the medal must be maintained." The American Legion agrees. "Unless PTSD crosses the line and is shown to be an injury—with a direct relationship to the enemy—we support the current policy," says Phil Riley of the Legion. Michael Wysong, the director of national security issues for the Veterans of Foreign Wars, likens PTSD to the Gulf War syndrome that afflicted troops following that 1991 war. "Not to diminish the illness or effects of PTSD," he says, "but it is the VFW's belief that awarding the Purple Heart for PTSD is not consistent with the original purpose and would denigrate the medal."

The Army surgeon general didn't venture into this minefield when TIME offered him the opportunity. "They haven't asked my opinion about it," Lieutenant General Eric Schoomaker said May 27 of the Pentagon panel reviewing the question. When pressed on the question—shouldn't the Army's top doc have an opinion on whether or not PTSD warrants a Purple Heart?— he punted. "Whether or not a medal should be awarded is not in my purview," he said. "The senior operational commander in the Army needs to decide that." It's evidence of the sensitivity of the issue that even the army's senior doctor suggests a second opinion.

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hawk71049

06-17-2008, 12:52 AM

Military Times

Bill seeks more counseling to prevent PTSD ( http://www.militarytimes.com/news/2008/06/military_ptsd_counselingtests_061608w/)...

By Rick Maze - Staff writer
Posted : Monday Jun 16, 2008 21:28:34 EDT

Fort Carson, Colo., and Fort Leonard Wood, Mo., would become test beds for predeployment counseling programs aimed at reducing the risk of combat stress under legislation sponsored by two Colorado lawmakers.

Reps. Mark Udall and John Salazar, both Democrats, are urging the creation of pilot programs at the two Army bases to try to prevent post-traumatic stress disorder in combat troops, and to provide early detection and treatment for PTSD when it happens.

“Providing prompt and effective treatment to our returning troops can help prevent many of the negative effects related to PTSD and depression,” Udall said. “It is the least we can do to repay them for the sacrifices they have made.”

The bill they introduced June 12, HR 6268, also gives active-duty service members access to readjustment and mental health counseling from veterans centers, provide grants for nonprofit groups who provide counseling services for the survivors of service members or veterans, extends military survivor benefits to families of service members who commit suicide after a history of combat-related health problems, and creates a new scholarship program to train behavioral health specialists about mental health treatment for service members and veterans.

The wide swath of initiatives complicates passage. The bill was referred to the House Veterans’ Affairs Committee, but its provisions fall under the jurisdiction of two other panels — the Armed Services Committee that is responsible for military benefits, and the Ways and Means Committee that oversees grants for nonprofit groups.

The bill is similar to S 3008, a measure introduced May 12 by Sens. Barbara Boxer, D-Calif., and Christopher Bond, R-Mo. Boxer and Bond might offer their package as an amendment to the 2008 defense authorization bill when the Senate takes up that measure in about two weeks. Senate passage of the legislation would provide a legislative shortcut that would avoid giving three House panels the chance to consider — and possibly change — the bill.

Udall said Congress needs to do more. About 40,000 Iraq and Afghanistan veterans have been diagnosed with PTSD, with more than 600,000 reporting symptoms of PTSD or severe depression.

“With many of our service members deploying for their third or fourth tours to Iraq, we can expect these numbers will continue to rise,” Udall said.

Udall, who serves on the House Armed Services Committee, said the Defense Department and Veterans Affairs Department are not doing enough.

“It is clear that Congress needs to step in to ensure that our service members and veterans suffering from the invisible wounds of PTSD and major depression are getting the support they deserve,” Udall said. “They should not have to fight another war to get proper care once they return home.”

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hawk71049

06-17-2008, 01:08 AM

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Marine Corps Times

Family of dead corporal: Corps failed to help ( http://www.marinecorpstimes.com/news/2008/06/ap_oligschlaeger_061508/)...

The Associated Press
Posted : Monday Jun 16, 2008 8:02:58 EDT

AUSTIN — The family of a Marine found dead in his barracks accuses the military of ignoring his obvious problems and calls for help after returning from two tours of duty in Iraq.

“They wouldn’t give Chad the help he needed,” said the Marine’s father, Eric Oligschlaeger of Round Rock, told the Austin American-Statesman. “But he was wounded, every bit as wounded as someone who lost an arm or leg.”

In May, Cpl. Chad Oligschlaeger was found dead in his room at the Twentynine Palms Marine base. He was 21.

A Marine Corps spokesman, First Lt. Curtis Williamson, said Corps’ policy prohibits commanders from discouraging Marines to seek mental health treatment or failing to treat physical or mental problems.

Williamson said Oligschlaeger’s cause of death can’t be released to the family or public while the case is under investigation. He said the family’s allegations “will be taken very seriously.”

The complaints by Oligschlaeger’s family mirror those of veterans’ advocates, who say that even with more awareness and better treatment for post-traumatic stress disorder, soldiers and Marines don’t always get proper care for mental health problems.

A study published in April by the RAND Corp. found that one-third of service members sent to Iraq or

Afghanistan return suffering from severe depression, stress syndrome or brain injuries, and only half who need care seek it.

Others remain silent, often fearing stigmatization or retribution, and treatment for many of those who ask for it is often minimal, the researches said.

According to family members, Oligschlaeger returned from Iraq haunted by the memory of a fellow Marine wounded by a roadside bomb. Oligschlaeger helped load the Marine into the back of a Humvee, but there was a momentary delay because the stretcher was too wide. When the man died three days later, Oligschlaeger blamed himself, friends told the newspaper in Sunday editions.

Back in the United States, Oligschlaeger began drinking heavily, and told friends a superior accused him of faking symptoms to avoid his next deployment. Later, he told family members the dead Marine was talking to him.

This spring, two years after the nightmares began, Oligschlaeger told his family that doctors had diagnosed him with post-traumatic stress disorder and put him on at least six medicines. The Marines sent him to alcohol rehabilitation and were arranging treatment at a mental health clinic.

But when Oligschlaeger declined to re-enlist, his unit left him unsupervised and with nothing to do for days on end, family and friends told the newspaper. They said he called at all hours and couldn’t remember what medications he had taken.

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hawk71049

06-17-2008, 05:05 PM

.

Time Magazine

Troops Offered Free Psych Help ( http://www.time.com/time/health/article/0,8599,1809598,00.html)...

Tuesday, May. 27, 2008 By AP/PAULINE JELINEK

(WASHINGTON) — Thousands of private counselors are offering free services to troops returning from Iraq and Afghanistan with mental health problems, jumping in to help because the military is short on therapists.

On this Memorial Day, America's armed forces and its veterans are coping with depression, suicide, family, marital and job problems on a scale not seen since Vietnam. The government has been in beg-borrow-and-steal mode, trying to hire psychiatrists and other professionals, recruit them with incentives or borrow them from other agencies.

Among those volunteering an hour a week to help is Brenna Chirby, a psychologist with a private practice in McLean, Va.

"It's only an hour of your time," said Chirby, who counsels a family member of a man deployed multiple times. "How can you not give that to these men and women that ... are going oversees and fighting for us?"

There are only 1,431 mental health professionals among the nation's 1.4 million active-duty military personnel, said Terry Jones, a Pentagon spokesman on health issues.

About 20,000 more full- and part-time professionals provide health care services for the Veterans Administration and the Pentagon. They include psychiatrists, psychologists, psychiatric nurses, social workers and substance abuse counselors.

According to veterans groups and health care experts, that is not enough for a mental health crisis emerging among troops and their families.

"Honestly, much is being done by the Department of Defense and the Department of Veterans Affairs," said retired Army Brig. Gen. Stephen Xenakis, a psychiatrist. "But the need to help these men and women goes far beyond whatever any government agency can do."

About 300,000 of those who have served in Iraq and Afghanistan are estimated to have anxiety or post-traumatic stress, a recent private study said. Add in spouses left home to manage families and households without their partner as well as children deprived of parents during long or repeated tours of duty, and the number with problems balloons to 1 million, Xenakis said.

The VA says it has seen 120,000 Iraq and Afghanistan veterans who have symptoms of mental health problems, half with post-traumatic stress disorder. Although rates are high from those two wars, most of the 400,000 patients seen in VA last year for PTSD were Vietnam-era veterans, officials said.

Civilian groups are trying to step in for troops from the current conflicts.

"There are over 400,000 mental health professionals in our great country," said Barbara V. Romberg, a clinical psychologist who practices in Washington. "Clearly, we have the resources to meet this challenge."

Romberg founded Give An Hour, a group of 1,200 mental health professionals donating one hour of free care a week to troops, veterans or family members. They have to commit to doing it for a year.

Romberg, in cooperation with the American Psychiatric Foundation, hopes to find 40,000 volunteers over the next three years, or about 10 percent of available civilian professionals. The effort to get the word out to those who need the help and to recruit and train volunteers is being backed by a $1 million grant from the Lilly Foundation.

Romberg's group is the largest of a number across the nation.

Nearly 200 also have volunteered for the Soldiers Project, started by psychiatrists at the Ernest S.

Lawrence Trauma Center of the Los Angeles Institute and Society for Psychoanalytic Studies — and now operating in Chicago, Seattle and New York.

The Coming Home Project in the San Francisco area has dozens of volunteers. A group of veterans, psychotherapists and interfaith leaders, it offers everything from retreats and workshops to yoga and other stress management programs as well as the counseling.

"Thousands of therapists across the country are donating their time to give vital treatment and support to our soldiers, sailors, airmen, Marines, veterans and families," Xenakis said at a recent news conference announcing the Lilly grant. "These young men and women volunteered to defend our nation, and now our nation can volunteer to serve them."

The government acknowledges there might be a place for such groups.

"While the military health system does not endorse volunteer health care organizations, we recognize that groups such as this one offer more options for our warriors and their families," said the Pentagon's Jones.

"If these mental health caregivers are willing to give and learn about our warriors, they may be more willing to become TRICARE providers," he said, referring to the network of more than 300,000 physicians and specialists and 55,000 pharmacies that support the department's military medical facilities and uniformed medical corps.

The military health care system serves about 9.2 million people — active duty, and guard and reserve components for all the services, as well as their families and retirees and their families.

Jones said there are 3,000 mental health professionals available under TRICARE in addition to the 1,431 in uniform. The VA said it has 17,000 full- and part-time mental health workers, 3,800 of which it has hired in the past few years.

The services are trying to hire about 575 more. Also, about 200 mental health officers from the U.S. Public Health Service will be detailed temporarily to the Pentagon to work in military facilities, Jones said. An agreement between the Pentagon and the Health and Human Services Department is to be signed in the coming weeks to finalize the arrangement.

The Pentagon has made a special effort to hire since a yearlong task force last year found it had neither enough money nor staff to support the military and family mental health needs during peacetime, let along during war.

Staffing was not the only issue. Officials have worked to change the military culture in which there is a stigma in seeking help and a fear doing so will harm careers.

They have tried to make mental health care more accessible, embedding more workers with troops, offering suicide prevention training and advising troops how to recognize mental problems in themselves and others.

The military also is working to assess mental health among troops, screening them before and after deployments and sending mental health teams to the front each year to measure morale, the amount of mental health problems, availability of care and related matters.

Programs to help families with housing, child care and other issues have been bolstered. Troops get mental-health training in a program called "Battlemind" that teaches about common problems to expect at home as they readjust to domestic life.

Still, some emotional difficulties are a normal reaction to war.

"No one who goes to war comes home the same person," said Patrick Campbell, a medic for an infantry unit who served in Iraq in 2004-2005. "There are things you have to unlearn to emotionally feel again."

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hawk71049

06-18-2008, 05:20 AM

Time Magazine

Vietnam Vets: Helping Iraq War Trauma ( http://www.time.com/time/nation/article/0,8599,1813593-1,00.html)...

Wednesday, Jun. 11, 2008 By ELISABETH SALEMME / OCEANSIDE

Bill Rider knows the look. The hollow, unfocused eyes, the sharp jawline formed from teeth pressed together like they're bound by cement, the pinned-back shoulders whose titanium stiffness mask sadness and fear. Rider knows the look because he possessed it after he returned from Vietnam. Now 63, he spent many years after that war sleeping with weapons by his side, seeking satisfaction in mindless sexual conquests, pursuing danger as an undercover narcotics detective. It took him 30 years to recognize that his emotional numbness and hypervigilance were wounds, deep war injuries that needed to be and could be healed. And he doesn't want America's 800,000 new veterans returning from Iraq and Afghanistan to have to go through the same dark wandering in the wilderness.

Rider and a handful of other Vietnam veterans in La Jolla, Calif., founded American Combat Veterans of War (ACVOW) shortly after Sept. 11, 2001, as a support group for those who had seen combat during their lives — or were about to in the war in Afghanistan. Thousands across the country joined the organization, but on March 20, 2003, when President Bush deployed the first U.S. troops to Iraq, the Vietnam vets who ran ACVOW knew the group would have a new, vital role. Says Rider: "We knew what it was like to be imprinted negatively by war, and we felt we had to use ourselves as a paradigm for future veterans of what not to be and what not to do."

The plight of returning soldiers is dire, based on testimony before the House of Representatives. A Department of Veterans Affairs e-mail indicated that 1,000 veterans each month attempt suicide; of the 300,000 veterans of the wars in Iraq and Afghanistan who have sought medical care through the VA system, about 60,000 have been given a preliminary diagnosis of post-traumatic stress disorder (PTSD); a new Rand study found that 1 in 5 soldiers suffers from PTSD or major depression. While the VA has some programs in place, the rising rates of suicide, homelessness (http://www.time.com/time/magazine/article/0,9171,1015909,00.html) and violence among veterans is propelling groups like ACVOW forward. The Vietnam warriors believe they possess what the government can't offer: insight and genuine empathy, some of the most valuable resources for the psychologically wounded.

Though it doesn't receive government funding, ACVOW is recognized by the VA and the Department of Defense, and in 2006 the Marine Corps asked Rider and his team to provide PTSD debriefings for San Diego–area Marines returning from the Middle East. The meetings began in November 2007, and ACVOW started hosting weekly outreach meetings. Rider joined forces with Nico Marcolongo, 37, a former Marine intelligence officer who knew that peer support and the wisdom of older veterans could be a valuable combination. Marcolongo himself is recovering from debilitating depression; he spent six months in bed after returning from his second stint in Iraq in 2006, and during that time, he became so disconnected that his then 3-year-old son told his wife Lisa, "Daddy's still in Iraq."

On Thursday nights, about a dozen Iraq-war vets and a handful of Vietnam and Korea vets cram into the stark white room of an Oceanside, Calif., hospice — a blank canvas for colorful war stories. The support-group meetings are facilitated by Tim Jordan, a Gulf War vet with full facial hair and a graying ponytail, who's earning his master's in psychology. He tells them to try to meditate for just five minutes each day, to go to the ocean and concentrate on the waves. The advice seems a little Zen-like to these iron-tough soldiers, but most say they will try it. "Sometimes I think, Is there anything really wrong with me?" says Marcolongo, who also uses techniques like acupuncture to heal. "Then I go to the meetings, and I realize what other people are saying is exactly how I feel. I know I have to keep going to get it all out."

Rider and the older vets wait until the meetings end to talk privately to those who have opened up in a new way, who seem especially distressed or who simply display the look that Rider knows so well. "I don't want to be presumptuous and say, 'Here's the answer,' because the answer isn't the same for everyone," Rider says. "It's better if they come to it themselves."

When two meeting regulars, war buddies Scott Stanco, 36, and Josh Thomas, 32, returned from Iraq in October 2006, their nightmares were so intense that they slept with weapons by their bedsides and patrolled their homes — armed — in the middle of the night. Even worse, they stopped feeling love for their wives (each has been married for more than 10 years). "When I got home, I didn't feel comfortable talking to the civilian population," says Thomas, whose vehicle was struck by an IED in Iraq, causing a severe concussion and facial burns. "I have anger issues with them. It just bothers me that they go about their daily lives, going to Starbucks and stuff." The two friends have found a counselor and sounding board in Rider, the Vietnam vet. "They call me at home like I'm a doctor," says Rider, who keeps up that doctor-patient act outside group meetings. Says Thomas: "If I don't show up for a week, Bill calls me, e-mails and says, 'Hey, warrior, where have you been?' " Thomas, who still wants to return to Iraq with the Marines, says, "I meet him all the time for lunch and dinner. Because who else would we have? We only have each other."

"Veterans in the Vietnam generation have a lot to offer," says Dr. Ira Katz, director of mental health for the VA. "Whether it's mentorship of veterans from prior eras or peer support, seeking that help is an important step." ACVOW, one of dozens of similar groups and hundreds of individual Vietnam veterans nationwide are using their experience to guide the new generation of veterans with group therapy and by pointing them in the direction of good professional help.

The legacy of the Vietnam vets may extend farther into the future. Marcolongo knows that no veteran should ever feel isolated or alone again. He realized this soon after his first meeting with ACVOW. His wife Lisa remembers his instant relief: "His shoulders just came down from his ears, and he was immediately breathing easier." He knows that the Iraq war won't be the last war and that it's his responsibility as a combat veteran to be a resource for the next generation. "He's going to continue the Vietnam vets' mission," Lisa says. "We certainly don't want a whole other generation of vets realizing much later that they have psychological problems. Let's nip this in the bud now."

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hawk71049

06-18-2008, 05:21 AM

.

Time Magazine

Behind the Veterans' Legal Battle ( http://www.time.com/time/nation/article/0,8599,1646753,00.html?iid=sphere-inline-sidebar)...

Tuesday, Jul. 24, 2007 By MICHAEL WEISSKOPF

It took a few seconds for an Iraqi roadside bomb to rattle Sergeant Steve Edwards' head in December 2004. But it took 14 months for the U.S. Department of Veterans Affairs to compensate him for post-traumatic stress disorder (PTSD). During one stretch, Edwards called the VA weekly to plead for assistance. "I was saying we're about to be homeless," he says, "and all I got was some schmuck on the other line who says they're trying their best."

Now Edwards, along with hundreds of thousands of other veterans, is part of class action lawsuit against the VA asserting that that just isn't good enough. Filed Monday by a California public interest group and law firm on behalf of vets diagnosed with PTSD, the suit is the first to accuse the federal department of constitutional violations and to seek sweeping changes in its processing of disability claims. The VA is charged with "shameful failures ... to meet our nation's legal and moral obligations to honor and care for our wounded veterans" who fought in Iraq and Afghanistan. Without systematic reform, the suit contends, "the costs to these veterans, their families and our nation will be incalculable," and will contribute to a new generation of unemployed and homeless veterans and a burden on local social services.

Melissa Kaznitz, managing attorney for Disability Rights Advocates, a Berkeley nonprofit organization that is representing the vets, says the suit focuses on PTSD as a signature wound of ongoing wars. No court has previously been asked to order a systematic restructuring of the claims process at the VA, Kaznitz says, adding, "The VA has a culture of fighting the claims of veterans instead of fixing problems for the veteran. We're trying to fix the system."

The VA has seen its backlog of disability claims swell to 600,000 as soldiers return from ongoing wars, a logjam blamed for financial dislocation, despair and even suicides of vets. The suit says the claims system is "riddled with inconsistent and irrational procedures" that violate the due process rights of injured vets seeking care and compensation. For example, the VA employs the same officials both to challenge and judge claims.

According to the suit, the biggest casualties of this bureaucratic morass are the unprecedented number of troops returning with PTSD, a mental disorder especially prevalent in soldiers stationed in Iraq and Afghanistan, where they're faced with multiple tours of duty, invisible battle lines and the "moral ambiguity of killing combatants dressed as civilians." The military says more than a third of the 1.6 million men and women who have served in Iraq or Afghanistan report mental health issues ranging from PTSD to brain injuries, yet only 27 of the nation's 1,400 VA hospitals have programs dedicated to treating PTSD. Worse yet, the complex process of applying for disability payments is especially daunting for these patients, who often experience memory lapses and disorientation.

VA Secretary Jim Nicholson, who is named in the suit, recently ordered the hiring of new mental health personnel, amid criticism that he dropped the ball on soldiers returning from Afghanistan and Iraq; he also directed all VA hospitals to screen for PTSD among vets from those wars. Last week, however, he announced his resignation from the VA. The department declined to comment on the suit, saying only that it is "committed to meeting the special needs of our latest generation of heroes" and that it has given "priority" to disability claims.

Edwards, 41, an Army National Guardsman from San Jose, Ca., began suffering migraine headaches soon after the December 29, 2004, attack in central Iraq left him stunned and nauseous. He returned home in February 2005 and continued to have other PTSD symptoms, including nightmares, rage, sleeplessness and anxiety. Unable to return to his work as an audiovisual technician, he lived for several months on state unemployment compensation and the paycheck his wife brought home as an executive assistant for a software company. For months, Edwards didn't know he could qualify for disability payments until another vet suggested it.

He submitted a claim to the VA in June 2005, as his family struggled to make rent, student loans, car payments and clothing bills for his 10-year-old daughter. He waited for a response for 14 months. In August, 2006, Edwards received a rating of 80% disability and a monthly payment of $2,711. Frustrated by the year-plus delay, he says, "It didn't take me more than a week to get into the military. It shouldn't be that way" for the military getting compensation to its injured.

The lawsuit, filed in a San Francisco federal court, challenges the constitutionality of the claims system, citing a lack of neutral judges and prohibitions on vets' hiring lawyers at the initial phase of a case or demanding that the VA produce documents and witnesses that might shore up their claims. The plaintiffs seek no monetary damages, only an order requiring the VA to stop "illegal policies and practices," such as the months-long delays in reviewing claims and providing care to PTSD victims.

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hawk71049

06-18-2008, 05:43 PM

.

Md. Offers Vets Back From War Guidance to Mental Health Help ( http://www.washingtonpost.com/wp-dyn/content/article/2008/06/03/AR2008060304158.html?tid=informbox)...

New Program Aims to Improve Access to VA Treatment

By Steve Vogel
Washington Post Staff Writer
Thursday, June 5, 2008; Page PG02

Concerned that military veterans in need of mental health care are falling between the cracks in the federal system, Maryland launched a program this week to help service members get treatment.

The legislation to create the program, an initiative of Gov. Martin O'Malley's administration, was signed into law May 22 and went into effect Sunday.

Under the $2.8 million program, state coordinators will help Maryland veterans from the Iraq and Afghanistan wars get access to mental health treatment from the U.S. Department of Veterans Affairs. In cases where federal services are unavailable or too slow, the state will pay private providers for the services.

"What we are seeing is either the inability or the unwillingness of the federal government to provide these services," Lt. Gov. Anthony G. Brown (D), who spearheaded the effort, said in an interview.

Brown, who served a tour in Iraq as an officer with the Army Reserve, said it was appropriate for Maryland to delve into the traditionally federal role of caring for veterans.

"When they take off their uniforms, they are Marylanders, and they belong to us," Brown said. "Maryland wants to hold itself out as a state that supports the effort of its veterans. The state of Maryland is saying that we're putting our money where our mouth is, and we're getting in the game."

The legislation grew out of discussions among state officials in the fall about shortfalls in services for veterans returning from overseas. "We were concerned that these veterans coming back to rural areas of Maryland would not have the behavioral health care they needed," James A. Adkins, Maryland's secretary of veterans affairs, said in an interview.

"Everybody agrees that it's a federal responsibility to take care of these veterans when they come home to Crisfield or Leonardtown or wherever," said Adkins, who on Sunday took on a second role with the state as adjutant general overseeing the Maryland National Guard, replacing the retiring Maj. Gen. Bruce F. Tuxill. "We weren't comfortable the need was being met."

Coordinators hired by the state's Department of Health and Mental Hygiene will serve as liaisons between veterans and the federal government, trying to get veterans suffering from post-traumatic stress disorder access to and information about behavioral, health and substance-abuse services.

"The coordinators will plug the veterans into the federal VA," Adkins said. "If the individual needs the service, they are going to get that service, no matter who has to pay for it."

Although the assistance is available for veterans statewide, the program is focused on rural areas.

The legislation also establishes a Veterans Behavioral Health Advisory Board to identify gaps in services.

Board members, whom O'Malley will appoint this month, will have open meetings at several places throughout the state to gather information and provide a report to the General Assembly by the end of the year, Brown said. "There is an expanding gap between the need and the services being provided," he said. The legislation, known as the Veterans Behavioral Health Bill, was one of several initiatives passed by the General Assembly this year and signed into law by O'Malley (D).

An $800,000 integration program is meant to help Maryland National Guard members return to their families and civilian jobs after deployment. Other bills expand scholarship opportunities and provide motor vehicle excise tax credits to veterans returning from overseas.

"Veterans returning to Maryland today are facing greater challenges than seen in a generation with repeated deployments at levels not seen since World War II," O'Malley said in a statement upon signing the bills.

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hawk71049

06-18-2008, 06:03 PM

Specialists, patients critical of PTSD care ( http://www.navytimes.com/benefits/health/military_ptsd_070523w/)...

Navy Times

By Kelly Kennedy - Staff writer

Experts told the House Veterans’ Affairs Committee that reliable methods exist to immediately diagnose and treat post-traumatic stress disorder — but they’re not used.

At a May 16 hearing, the experts predicted a future filled with loneliness, health complications and societal breakdowns such as divorce, substance abuse or homelessness for veterans with PTSD if the nation does not address the issue now. And, they said, the long-term financial costs could be as much as $500 billion in health care for veterans with an illness that can be treated — even cured — for much less if dealt with immediately.

Even as the experts spoke, soldiers diagnosed with PTSD railed against their treatment during a simultaneous news conference at Fort Carson, Colo. They described undergoing the treatment methods the experts said should not be used, overwhelmed doctors and examples of how the stigma against PTSD persists in military culture.

DISCUSS
Post-deployment suicide: A closer look

Several factors complicate the issue: PTSD often does not show up until months or years after the battles have ended; troops sometimes don’t mention mental health problems because they want to stay with their units while deployed or they fear it will kill their careers; those filling out health surveys in Iraq may avoid answering questions accurately because they just want to go home.

Moreover, proper diagnosis depends on a trained clinician, but often comes from a primary-care physician, which can cause problems because those with PTSD tend to have other mental health issues, such as depression, making treatment tricky. And if service members don’t receive proper care within six months of developing symptoms, doctors have lost their best opportunity to cure them.

The experts said they have possible solutions.
“What’s missing is the diagnostic piece ... standardized tests,” said Saul Rosenberg, associate professor of medical psychology at the University of California.

And he’s not talking about the surveys troops fill out to see if they might need to talk with a counselor. He recommended that every service member returning from a war zone take the Minnesota Multiphasic Personality Inventory, a test the Veterans Affairs Department already uses.

It’s a self-test, and veterans home from combat could take it online. He recommended just-returning service members take it with a psychologist present to talk about the answers to questions such as, “I usually feel that life is worthwhile,” or “Most of the time I wish I were dead.”

Those are important questions, he said, because 5,000 veterans kill themselves every year. People with PTSD tend to try to numb their feelings with alcohol, which lessens impulse control and makes them more likely to follow through on suicidal thoughts.

“With that kind of procedure, I am absolutely confident we would save lives,” Rosenberg said.

The way people think about mental health diagnoses also needs to change, he said, because mental health testing is as good for diagnosing mental problems as physical health testing is for physical problems.

There are also prescribed methods for treating PTSD. One recommended by experts and the VA is called Eye Movement, Desensitization and Reprocessing, based on talking through bad experiences to desensitize people to the pain associated with those memories.

“PTSD is very treatable … people do get well,” said Linda Rosenberg, president of the National Council for Community Behavioral Healthcare, who has no relation to Saul Rosenberg.

But the soldiers speaking from Fort Carson showed why getting help can be a problem.

Staffers from nine senators’ offices interviewed nine soldiers the week of the hearing to hear about what problems they face following an investigation by Veterans for America. The Government Accountability Office is looking at alleged bad treatment of soldiers there who have PTSD or traumatic brain injuries.
DISCHARGE OFFERED

During the May 16 news conference, one soldier said he had been diagnosed with chronic PTSD, but had been offered a quick way out with a personality disorder discharge. But if he takes it, he loses his VA benefits and may never receive treatment for his disease.

The soldier said he only received half an hour of one-on-one counseling a month, and usually received group therapy.

“Group therapy is not the most effective way to treat PTSD,” said Suzanne Best, a research psychologist in the Posttraumatic Stress Disorder Research Program at the VA Medical Center in San Francisco. “It would be difficult to treat anyone in half an hour or less. If someone says they can, they are not clinicians who treat PTSD.”

Best participated in the telephone conference at Fort Carson.

Steve Robinson, legislative liaison for Veterans for America, said only one clinician at Fort Carson is trained in EMDR, but doesn’t have time to use it because he has so many patients.

The panelists recommended allowing troops to seek private care if a military or VA hospital doesn’t have time for them, or if they fear problems with their command, and called for bringing family members into counseling with the veterans.

And they also recommended educating society — and military leadership — about PTSD as a normal reaction to the death and destruction service members witness — not as a disorder claimed by people who “can’t handle” war or who are trying to get over on the system.

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hawk71049

06-19-2008, 04:35 AM

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Married to the Military:
More must be done for veterans, family members ( http://www.navytimes.com/community/family/military_married_wartax_070730/)...

Navy Times

By Kathie Hightower and Holly Scherer - Special to the Times

We hear discussions about “bringing the troops home now,” and one thought keeps coming to mind: Many Americans seem to think that when the troops come home and the war is over, we can all go on with life as usual.

Unfortunately, military spouses know better.

Those who care for troops recovering from injuries or suffering from post-traumatic stress disorder, and those who lost a service member in combat, will continue to face major challenges, regardless of whether the war ends. Many will need help for a long time — in many cases, a lifetime.

Many great programs are being developed by sincere, caring individuals — often military spouses — but funding is always a big issue. The country as a whole needs to step in.

Navy spouse and author Kristin Henderson presents a great idea in a column published Feb. 9 in The New York Times, “Your Money at War.” (You can read it at http://www.kristinhenderson.com/essays.htm).

Henderson proposes a war tax so that all Americans, not only military members and their families, would be involved in the sacrifices required of a country at war. This would be a tax dedicated to financing the support services needed by military families and combat veterans.

“Perhaps it would be more accurate to call it a long-term costs-of-war tax,” Henderson wrote, “because the tax I’m proposing, like the needs it’s intended to meet, will not end when the war ends.”

As she describes it, military families would be exempt from the tax. The funds would be put toward efforts such as combat trauma counseling, respite child care, part-time jobs for spouses trying to make ends meet and marriage counseling.

If we all write our representatives, maybe we can make this idea a reality. (To easily send a letter directly to your state representatives, visit http://www.house.gov/writerep).

Here are two examples of important programs that have found initial funding and deserve to be funded in full so they may benefit all wounded warriors and their families:

•Wounded Warrior Wives Project, through Cinchouse.com and Operation Homefront. This is for spouses as well as care-giving mothers, sisters and girlfriends, a place to find the ongoing support structure and resources they need.

•The Bridge Retreat. Susan Davis is a longtime Army spouse who is finishing her master’s degree in energy medicine and transpersonal psychology. She has a concept for retreats intended to help warriors and families heal. She is partnering with a retired chief petty officer, Desiree DelMonte, who is finishing a doctorate in the same study area.

Under the umbrella of a Colorado nonprofit organization, the pair will offer their first retreat in spring 2008. This three-week retreat in Emerald Valley, Colo., will include 20 discharged service members who have been diagnosed with PTSD or a traumatic brain injury. (For information, send an e-mail to susan@colo-nes.com or des@colo-nes.com.)

The retreat will incorporate methods from work by Dr. Ann Nunley and Dr. C. Norman Shealy that provide an alternative to antidepressants in treating depression.

Also to be included in the retreat will be activities such as journaling, hiking, horseback riding, fishing, therapeutic massage, chaplain visits and just plain relaxing. The aim is to provide a safe environment away from stressors for participants to put their lives back together.

“For more than two years, we have attempted to implement alternative therapies for our military and their families suffering from anxiety, anger, sleeplessness, depression and PTSD,” Davis said. “We are thrilled to finally have this initial opportunity. We hope it’s the first of multiple retreats we can eventually implement into the military system. For our nation to be ‘mission ready,’ we need to redefine how to prepare to be ready — emotionally, physically and spiritually, before and after war.”

And those are preparations needed for military members and family members alike.

Kathie Hightower and Holly Scherer are military spouses who have written articles and presented workshops based on their research and experience for more than 10 years. They are the authors of “Help! I’m a Military Spouse — I Get a Life Too!” now in its second edition. Send your questions and suggestions to marriedtomilitary@atpco.com.

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hawk71049

06-19-2008, 08:44 AM

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Struggling with work after war (http://search.airforcetimes.com/sp?aff=1100&skin=200&keywords=ptsd)...

Navy Times

By Chad Graham - Gannett News Service

Charles Thomas came to dread his morning commute on the Red Mountain Freeway. The Arizona desert resembled the Middle East, and his mind would return to the battlefield of Iraq.

He would clench the wheel of his truck en route to his job at Phoenix’s Water Services Department. Someday, he hoped, this feeling would go away.

But a year after returning from combat, the 42-year-old still is trying to get his bearings as a security administrative assistant.

Thomas is not alone. Hundreds of National Guard and military reserve members who have returned after fighting in Iraq and Afghanistan are having a tough time making the mental leap from the battlefield back to the workplace.

Many are in a quiet struggle. They are unable to concentrate, are irritable with co-workers or make mistakes at jobs they once did with ease, according to Veterans Affairs officials and mental health experts.

In more serious situations, the vets replay the hell of combat. Some drink heavily and use illegal drugs. Others suffer from post-traumatic stress disorder (PTSD) or severe brain injuries.

“You’re taken out of a regimen where you’re always on your toes, you work seven days a week, and then you’re put back as a civilian,” said Thomas, an Army National Guard platoon sergeant who commanded 60 soldiers during a combat tour from February 2005 to March 2006. “There’s no transition.”

Experts worry that employers have little experience on how to help the estimated one in three veterans who has returned with some sort of readjustment issue.

Once they’re back, veterans are “disbursed across all branches of the economy, and you may have one or two at companies,” said Phil Potter, a former military psychologist who is an assistant dean at the College of Public Programs at Arizona State University. “Human resources people may not know how to deal with one or two, or they might be less apt to develop programs to help them.”

Potter added: “It’s not anybody’s fault. This is simply a different situation than anything companies have encountered.”

Some employers assume their standard benefits are adequate to treat veterans’ mental health problems. Others assume veterans are seeking more specific care. That is not always the case.

“A lot of our veterans really think they can deal with (mental health problems) themselves, but it’s not going away,” said Patricia Tuli, case manager for the Carl T. Hayden VA Medical Center in Phoenix.

“I think there’s a tendency not to worry the employers,” she said. “These employers have kept these jobs open for them while they were at war. And they’re reluctant to take time off work, and they’re reluctant to alarm their employers.”

Companies that are successfully helping veterans adjust back to civilian life are doing far more than sending care packages overseas. They are educating staff about the role of members of the Guard and reserves and getting to know their employees’ commanders. They are revamping personnel policies, forming support groups and ensuring their benefits packages meet veterans’ needs.

Thomas thought he could handle returning to work. His military career spans 21 years and includes the first Gulf War and the conflict in Somalia.

“Iraq was definitely the worst,” said Thomas, a married father of two who lives in Mesa, Ariz. “The urban warfare was very unpredictable. With Baghdad as crowded as it was, it was a lot easier for someone to blend in with a vehicle bomb.”

So during that first week of commuting on Loop 202, he scanned the sandy ground, the dirt blowing across the highway, the tan overpasses and the palm trees. It looked like a highway he used to travel outside Baghdad.

“This is stimulus-driven behavior,” said Matthew Friedman, executive director of the National Center for PTSD in White River Junction, Vt.

“In Iraq, you’re worried about the roadside bombs. You’re driving as fast as you can. You’re constantly checking under the bridges and by the side of the road in fear there’s going to be some kind of an IED (improvised explosive device) there.”

But Thomas is one of the lucky ones.

He has the support of family, friends and co-workers who monitor his transition back to civilian life after a year spent fighting in Iraq. Also, his employer, the city of Phoenix, provides additional support for workers who are veterans.

“As best as he can come back into the world and adjust, he’s certainly made the effort to do that,” said Barbara Cole, a co-worker at the Phoenix Water Services Department.

Thomas’ son Daniel, 19, is now serving in Afghanistan with the Army National Guard. Some of Charles Thomas’ advice to his son:

• Communicate with your squad leader if something is bothering you.
• Do not bottle up what you experience.
• Call or write and be blunt about what is going on.

When Daniel returns, Thomas will be waiting. “I’ll already know how to help him out and guide him.”

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ericslilmnkygrl

06-19-2008, 03:04 PM

I posted this elsewhere and was guided here. I want to share my life with PTSD. I have fought the shame my husband has felt through this and I have to argue it at times still. We have been delaing with PTSD since November and since I did not clarify this in the last place I posted I will here. The following is actually an improvement as to where we began in November. I have switched my husbands treatment by FIGHTING the Army many steps of the way until I have been emotionally, mentally, and physically at my breaking point. He is currently in a VA program that I hope will help with some of the following issues. I would love any feedback as to where I go from here from someone who has been in my shoes. I always seem to handle him too gently or push him to do to much. That being said here is my story....

The man I knew previous to PTSD was a man full of self confidence, he was both intelligent and articulate, an extroverted and social individual; he was kind, patient, and gentle with others. This is not the man who I am married to now. My husband spends most of his time preferring to be in our home. He would not get out of bed each day if he was not required to do so. He would rather spend his days locked in our house, wearing his pajama pants and a t-shirt not getting out of the bed at all. There are days that I have to pester him to shower and take care of himself. My husband does not function in environments which include a crowd of people, loud noises of any kind, sudden noises or light changes, and any new environment is an uncomfortable event for our family because he cannot handle being there for more than 30 minutes or so.
he has panic attacks in the car when we drive on the highway and for many months we were unable to ride on the highway at all because we were had to stop at every exit or every time there was something in the road or on the median. We were taking back roads to all of our destinations and even on those we were stopping every town we came to or every twenty minutes whichever happened to be first. He is back to the point in which he is unable to drive himself and gets very restless, distressed, and flustered when riding in our car. My husband paces most of the time whether we are at home, at church, at appointments. If he is not pacing then he is sitting down and his legs are generally shaking because his anxiety level stays pretty elevated. We try different activities to lower the anxiety such as going to the gym, taking a walk, finding something around the house that can be done to try and keep his mind off of the nervous and agitated state in which is currently his way of life, we have yet to find a solution that works for more than a brief period of time. He has nightmares that send him running out of bed and down the hallway and sees people standing in front of him or out of the corner of his eyes when there is not anyone in the room other than us. He frequently has paranoia tendencies and feels as if he is being watched and at times he has felt as if he was being followed. He trusts very few individuals and has developed and obsessive tendency to not allow something to drop that is bothering him (such as the answer to a question that he wants to know). He will go on and on about whatever it is that is bothering him until he either gets an answer or I finally snap at him to let it rest. At this point he may not discuss it with me for that current time being but it is brought up again until he is satisfied that the answer or whatever he is obsessing about has been taken care of. He has developed OCD features and frequently repeats steps of just about everything that he does. He does things in sets of fours such as flipping light switches, closing doors, walking in and out of rooms, walking up and down the stairs, setting items down. Just about everything that he does is done in a multiple of four and if he is constantly asking me to tell him to stop what it is he is doing because he cannot make himself refrain from what he is doing.
My husband is easily frustrated with himself and others. He frequently snaps at me and our children when a few minutes previous to that everything seemed to be going well. He gets agitated and then when confronted about the agitation he either gets overly agitated at one of us or angry with himself for snapping at us. He has to spend a huge amount of time isolating himself from us because he does not want to take out his frustrations on us and this is extremely difficult on our children to understand. I have had phone calls from my husband in which I have had to tell him to leave the house because he has been so frustrated that he has wanted to kill one of our dogs. He has the presence of mind to call me, so far, when he has felt like this but I do fear that one day our children could come home to a loved pet who is no longer there and a father who cannot explain to them why this has happened. He has admitted to me that our family is the only reason he is alive and that even with our family there are times that he would like to hurt himself.
He has a hard time forming words and finishing his thoughts out loud. He is unable to focus on even the smallest tasks and frequently has to ask me what it is that he is doing or was planning to do. He repeatedly asks me the same question because his short term memory does not function as it should. He has been able to accomplish many college courses previous to PTSD and is presently unable to sit in a classroom and focus or complete an online class that would require any amount of focus on a text book. With this illness my husband is almost like a young child with substantial anger issues. I love my husband and I vowed to stand by his side through sickness and in health. I will continue to do so because he is my heart and I know the man who he was and I know that this is not the man who he wants to be. I need you to understand that this sickness has deeply affected our household in a negative manner. I am fully aware that my husband may never be the man who I met again and that this will be an extensive period of healing and adjustment for our household. My husband will need continuous counseling and medication for an indefinite period of time. He is unable to function in public settings and holding down a job is going to be impossible for him in his current state of being. I do not know how else to convey to you the severity of the situation my family lives with and that my husband bears daily.

hawk71049

06-22-2008, 06:37 AM

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US Department of Defense, Military Health System

Defense Centers of Excellence For Psychological Health & Traumatic Brain Injury (http://www.health.mil/DCoE.aspx)...

Under the leadership of Brigadier General Loree K. Sutton, Special assistant to the Assistant Secretary of Defense (Health Affairs) Psychological Health and Traumatic Brain Injury, the Defense Centers of Excellence leads a collaborative effort toward optimizing psychological health and traumatic brain injury (TBI) treatment for the Department of Defense (DoD). The DCoE establishes quality standards for: clinical care; education and training; prevention; patient, family and community outreach; and program excellence. DCoE Mission To maximize opportunities for warriors and families to thrive through a collaborative global network promoting resilience, recovery, and reintegration for PH and TBI.

DCoE Mission

To maximize opportunities for warriors and families to thrive through a collaborative global network promoting resilience, recovery and reintegration fo PH and TBI.

------------------------------------------------------------------------

be sure to see the video

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hawk71049

06-23-2008, 02:06 PM

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A private battle public made (http://www.militarytimes.com/news/2008/06/army_nate_self_062308w/)...

Veteran hopes account of war, PTSD struggle helps other troops
By Sean D. Naylor - Staff writer
Posted : Monday Jun 23, 2008 10:55:57 EDT

After surviving one of the most vicious firefights in the war in Afghanistan, Capt. Nate Self knew he had to write about it.

Self led a Ranger platoon in a daylong battle on Takur Ghar mountain that claimed the lives of seven U.S. servicemen on March 4, 2002.

Self said that “as soon as we came off the mountain,” he felt there was a message he had to spread. “There was kind of a personal side of the story and what the Rangers had experienced leading up to it that needed to be told,” he said in an interview with Army Times.

What he could not have guessed was that by the time he finished writing his story, it would have expanded to encompass the tale of another tough battle — his own with post-traumatic stress disorder, which continues to plague him.

Now 32, Self, who left the Army in 2004, gives his account of both battles in “Two Wars,” a book published this month by Tyndale House Publishers Inc.

Although others, including this writer, have written detailed accounts of the Takur Ghar battle, Self is the first combatant to publish his version of events. His tale of the battle is searing, but for many military readers, Self’s description of how PTSD almost destroyed his life and his family will make an even deeper impression.

As Self recounts in the book, the PTSD sneaked up on him over the months and years following the hellish battle on Takur Ghar’s frozen mountaintop.

By the time he was back in Iraq as a staff officer in the 101st Airborne Division (Air Assault) in 2004, his sleep was troubled by dreams of combat and his motivation was slipping. When he returned to the U.S., he took command of a company in the 101st but soon decided to leave the service, the beginning of a four-year battle with PTSD that he is now winning.

“What has been added to the story now is the struggles I’ve had after combat, which I think a lot of soldiers could relate to, which has become one of the major purposes of why I wrote the book,” he said.

But his purposes were not entirely selfless, he acknowledged.

“I wrote, in many ways, for catharsis, for therapy of my own,” he said. “I began writing little-bitty scenes … in PTSD small group [discussions] at my church — we were writing for therapy. We would talk to each other, we would read it to each other and give feedback as a way to try to declare the traumatic experiences, put parameters on them — this is when it started, this is when it ended, this is what it was, this is what it wasn’t.

“That process at first was really jarring for me, and provocative, but then I got to where I felt like I needed it, so I just kept writing and kept writing,” he said

It’s an experience Self recommends for veterans struggling with PTSD.

“My guess is, from an anecdotal perspective, that if a veteran is struggling, if he actually goes through the writing process, that it will help,” he said.

But he acknowledges that for many veterans, writing about their trauma will seem counterintuitive at first.

“It’s hard to begin the writing process, because you resent the fact that you’re writing about these things, and part of the symptoms of PTSD is to avoid the experiences, and so if you’re going to sit down and brainstorm and meditate on these things and try to write about them, that’s not avoiding the experiences at all, that’s diving into them,” he said. “I felt that resistance even in myself.”

Self, whose PTSD caused him to gain so much weight he could no longer fit into his old uniforms, credits several factors with helping him come to terms with and start to overcome his stress disorder:

* The help he received from the Department of Veterans Affairs hospitals. “The VA was great for me. As soon as I admitted that I had a problem, and agreed to go see someone, I got right in to the VA, got a diagnosis and got treatment right away … The education I received about PTSD, about the symptoms, about coping with those symptoms, was fantastic.”

* His religious faith. “When I really struggled the most was when I turned away from a life of faith, and so the church played a huge role in me getting better … I found answers in the Bible that gave me a lot of comfort and hope, knowing that warriors throughout all time, even according to the Bible, had mental anguish … that they really needed help with.”

* Maj. Randy Kirby, who had been Self’s chaplain in the 75th Ranger Regiment and is still serving. “When I got out and I got to the lowest point that I could ever have been at, my family called him and he really turned into the spiritual medic on the battlefield for me and my family over the phone — daily, sometimes hours at a time … He helped get me through the roughest times, and he was still in the Army.”

* Talking about how to cope with PTSD to veterans groups and soldiers who are yet to deploy. “Turning my experiences into a means to help other people has made a big difference for me, too.”

Self, who now works in leadership development and support for the Praevius Group, a defense contractor, hasn’t fully recovered from his PTSD. He continues to dream of combat every night.

“It’s just something I’ve gotten used to, but it’s still disturbing,” he said. “I’m still startled at times by loud noises — I don’t know if I’ll ever get over that — and certain smells will bring back images.

“That’s not all bad, either, I don’t think,” he added. “I wouldn’t want this stuff to completely go away because it’s just a part of what I lived through, and it’s a reminder of things that happened, and there’s a lot of positive things that can come out of those painful reminders.”

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hawk71049

06-23-2008, 06:57 PM

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Military Times
Bill seeks more counseling to prevent PTSD ( http://www.militarytimes.com/news/2008/06/military_ptsd_counselingtests_061608w/)...

By Rick Maze - Staff writer

Posted : Tuesday Jun 17, 2008 5:42:20 EDT

Fort Carson, Colo., and Fort Leonard Wood, Mo., would become test beds for predeployment counseling programs aimed at reducing the risk of combat stress under legislation sponsored by two Colorado lawmakers.

Reps. Mark Udall and John Salazar, both Democrats, are urging the creation of pilot programs at the two Army bases to try to prevent post-traumatic stress disorder in combat troops, and to provide early detection and treatment for PTSD when it happens.

“Providing prompt and effective treatment to our returning troops can help prevent many of the negative effects related to PTSD and depression,” Udall said. “It is the least we can do to repay them for the sacrifices they have made.”

The bill they introduced June 12, HR 6268, also gives active-duty service members access to readjustment and mental health counseling from veterans centers, provide grants for nonprofit groups who provide counseling services for the survivors of service members or veterans, extends military survivor benefits to families of service members who commit suicide after a history of combat-related health problems, and creates a new scholarship program to train behavioral health specialists about mental health treatment for service members and veterans.

The wide swath of initiatives complicates passage. The bill was referred to the House Veterans’ Affairs Committee, but its provisions fall under the jurisdiction of two other panels — the Armed Services Committee that is responsible for military benefits, and the Ways and Means Committee that oversees grants for nonprofit groups.

The bill is similar to S 3008, a measure introduced May 12 by Sens. Barbara Boxer, D-Calif., and Christopher Bond, R-Mo. Boxer and Bond might offer their package as an amendment to the 2008 defense authorization bill when the Senate takes up that measure in about two weeks. Senate passage of the legislation would provide a legislative shortcut that would avoid giving three House panels the chance to consider — and possibly change — the bill.

Udall said Congress needs to do more. About 40,000 Iraq and Afghanistan veterans have been diagnosed with PTSD, with more than 600,000 reporting symptoms of PTSD or severe depression.

“With many of our service members deploying for their third or fourth tours to Iraq, we can expect these numbers will continue to rise,” Udall said.

Udall, who serves on the House Armed Services Committee, said the Defense Department and Veterans Affairs Department are not doing enough.

“It is clear that Congress needs to step in to ensure that our service members and veterans suffering from the invisible wounds of PTSD and major depression are getting the support they deserve,” Udall said. “They should not have to fight another war to get proper care once they return home.”
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Hero

06-24-2008, 01:09 PM

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Military Times
Bill seeks more counseling to prevent PTSD ( http://www.militarytimes.com/news/2008/06/military_ptsd_counselingtests_061608w/)...

By Rick Maze - Staff writer

Posted : Tuesday Jun 17, 2008 5:42:20 EDT

“It is clear that Congress needs to step in to ensure that our service members and veterans suffering from the invisible wounds of PTSD and major depression are getting the support they deserve,” Udall said. “They should not have to fight another war to get proper care once they return home.”
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AMEN to that brother!!!

hawk71049

06-24-2008, 03:29 PM

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Washington Post

VA to warn veterans about anti-smoking drug ( http://www.washingtonpost.com/wp-dyn/content/article/2008/06/19/AR2008061902978.html)...

By LOLITA C. BALDOR
The Associated Press
Thursday, June 19, 2008; 6:49 PM

WASHINGTON -- The Veterans Affairs Department is sending letters to about 33,000 veterans who are taking the anti-smoking drug Chantix, warning them about possible side effects, including thoughts of suicide.

VA Secretary James Peake told reporters in a conference call Thursday that agency doctors will continue to prescribe the drug because they are seeing no serious problems or trends with its use.

He defended the VA's use of the drug to treat some of the veterans with stress disorders who were participating in a study to stop smoking. Of the 143 veterans with post traumatic stress disorder who took Chantix in the study, he said that three _ or 2 percent _ experienced thoughts of suicide. Of the roughly 800 veterans in the study who did not take Chantix, 35 had suicidal thoughts _ or about 4.4 percent, he said.

The letter going out to the veterans Thursday urges anyone who is experiencing side effects or is worried about continuing to use the drug, to consult with their doctor.

"This is a very important drug for our clinicians to be able to use when appropriate for patients," Peake said, adding that if VA officials thought that using the drug was hurting veterans, they would stop immediately.

Reports this week raised concerns that the VA may not have told patients in the study about the side effects of the drug quickly enough.

According to the VA, the PTSD and smoking cessation study was aimed at determining whether it is easier to stop smoking when smoking cessation treatment is combined with PTSD therapy, or whether the two therapies are more effective if they are provided separately.

VA officials noted that Chantix is approved by the Food and Drug Administration.

The issue was first reported this week by The Washington Times and ABC News.

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hawk71049

06-24-2008, 04:11 PM

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Marines Move On, Never Forget ( http://abcnews.go.com/Nightline/story?id=4922555&page=1)...

ABC News, Nightline'

Nightline' Revisits Three Members of One Unit Five Years After the Invasion of Iraq
REPORTER'S NOTEBOOK By MIKE CERRE
May 26, 2008

It started with a cell phone message on the fifth anniversary of the Marines taking Baghdad. It was from former Cpl. Michael Elliot, one of the Marines in the Fox 2/5 unit I've been embedded with in Iraq on several occasions since the invasion in 2003.

The message was typical Elliot -- upbeat, positive about the future, and his way of keeping our relationship alive. Knowing from our previous contacts that he had been treated for post traumatic stress disorder the past two years, the message was all the more reassuring, and was the impetus for my checking in with some of the other Marines I had been with.

During my first assignment with Fox 2/5 in 2003, the unit was involved in a civilian tragedy at a hastily erected road block on the outskirts of Baghdad. Ten civilians were killed, four of them children. It remains one of Elliot's most haunting memories.

Elliot wrote about the experiences that haunted him in his journal. "My thoughts and opinions are changing every day. Last night, a bus tried to breach our barricade, and we shot at the bus until it went off the road, killing almost everyone inside. When we move down the streets, we shoot at anything that moves. I even killed three people yesterday. I didn't see their weapons, and I didn't hesitate to look for them."

When Elliot was eventually diagnosed with PTSD, he was put on an 85 percent veteran's disability. He was initially so reluctant to get treatment he confessed to driving out to the VA hospital for nearly a year and sitting in the parking lot before mustering the courage to share his problems with professionals.

Now Elliot works at a foster home for abused children. They, too, have a tough time sleeping through the night as they deal with their demons.

"They have seen some of the things I've seen. Maybe they haven't been in combat or witnessed those types of situations, but they have had family violence and things that have severely traumatized them. And having had my own personal trauma, I can help treat them. They can understand where I've been, and I can understand them and be more effective in their treatment," Elliot said.

Recuperating After a Devastating Injury

For some of the older Marines, such as Gunnery Sgt. Jack Sigman, the novelty of living in the desert and preparing for war wore thin as the diplomatic ultimatums played out before the invasion. I went back with Sigman and Fox 2/5 for their second tour of duty in 2004-05 to a war they thought they had won and was over for them and the Iraqis.

"On the second go around there wasn't nearly as much confidence that the Iraqi person on the street was exactly who he pretended to be," Sigman said. "There'd be Mr. Joe nodding his head and waving at you. Tonight he might be the guy shooting at you."

Sigman was one of the unlucky ones. "An RPG [rocket propelled grenade] was fired a hundred meters behind me and came up, hit me in my calf and detonated in my calf."

My last contact with Sigman was while he was recuperating in Walter Reed Hospital after losing his leg on that second tour of duty. He promised he would find some way of staying in the Marines until he could retire, and he did. I was able to reconnect with him in the Mojave desert, where he was training Marines on a new weapons system before they headed back to Iraq. His only disappointment was not being able to go back with them.

Songs About War

The first time I met Cpl. Josh Hisle was at a talent show in the middle of the Kuwait desert the week before the invasion of Iraq. His original composition about wanting the war to start so him and his fellow Marines could start the countdown for going home hit a real chord with the rest of the Corps.

Many of his original compositions are about his experiences in Iraq, especially during his second tour of duty when he started questioning the mission.

"It was more about survival. We were hooking and jabbing with guys we didn't know who they were. They would shoot at you and change clothes and waltz right by you. There was nothing you could do about it. It was a scrap and all-out cockfight," Hisle said. "This time I'm definitely watching my own ass a lot more because I want my kid to have a dad."

Going back to Iraq was the last thing Hisle had in mind while composing and recording the new single he recently mailed me. Hisle has since left the Marine Corps and is now trying to make it as a singer-songwriter in the Cincinnati area. Most of his songs are about his experiences in Iraq and how he wouldn't wish them on anyone, least of all his fellow Marines, some of whom are on their fifth tours of duty to the "sandbox," as many of them call it.

Hisle shared with me how he somewhat reluctantly turned down a five-figure bonus to re-enlist in the Marines for a third tour in Iraq, mostly for family reasons but also because of his growing disenchantment with the war.

"The songs are about war, in some aspects, as far as seeing suffering and pain and seeing death. I don't think anyone should ever have to see that. The war now is the lowest on the totem poll. Our boys are still over there taking rounds in the chest and all that we can talk about here is that Obama is a black dude, Hillary is a woman and McCain is a hundred years old."

Five Years Later

As I flew around the country on my mission to reconnect with these three different Marines to see how much the war had changed their lives, I felt somewhat alien among the other travelers on business trips, spring breaks and family reunions.

Most would be hard-pressed to remember where they were or who they were with when Saddam's statue came down, when Iraq held its first elections or when the United States passed the 4,000 fatalities milestone.

Five years of the Iraq War might be ancient history for most Americans but not for the three Marines profiled. Like myself, it has been an indelible experience and a story that seems to never end.

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hawk71049

06-24-2008, 04:22 PM

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Congress: Stop Drug Testing on Vets Now and Investigate ( http://abcnews.go.com/Blotter/Story?id=5192891&page=2)...

ABC News, Nightline

Veterans Groups Also Calling for an Immediate Stop to Government Tests on Vets Using Suicide-Linked Drug

By VIC WALTER and MADDY SAUER
June 18, 2008

At least three more members of Congress are calling for an immediate suspension of government tests on veterans involving an anti-smoking drug that has been linked to suicide.

"Nearly 40 suicides and more than 400 incidents of suicidal behavior have been linked to Chantix, yet the VA has chosen to continue the study and administer Chantix to veterans with PTSD," said Congressman Bob Filner (D-CA).

"The VA must immediately suspend this study until a comprehensive review of the safety of the protocol is conducted," said Rep. Filner.

Rep. Filner along with Rep. Ed Markey (D-MA) and Rep. Paul Hodes (D-NH) sent a letter to the Secretary of Veterans' Affairs today expressing their concern over the ABC News report and asking, among other things, for copies of consent and notification forms related to the study.

"Allowing, even encouraging, military veterans who have already made enormous sacrifices for our country to participate in drug studies that may cause serious, long-lasting health effects is tantamount to breaking our national promise to honor and support our veterans," said Rep. Markey today.

Yesterday, a report on Good Morning America revealed that mentally distressed veterans from Iraq and Afghanistan are being recruited for government tests on pharmaceutical drugs linked to suicide and other violent side effects. The report was the result of a joint investigation by ABC News and The Washington Times.

In one of the human experiments, involving the anti-smoking drug Chantix, Veterans Administration doctors waited more than three months before warning veterans about the possible serious side effects of Chantix, including suicide and neuropsychiatric behavior.

"Lab rat, guinea pig, disposable hero," said former US Army sniper James Elliott in describing how he felt he was betrayed by the Veterans Administration.

Elliott, 38, of suburban Washington, D.C., was recruited, at $30 a month, for the Chantix anti-smoking study three years after being diagnosed with Post Traumatic Stress
Disorder. He served a 15-month tour of duty in Iraq from 2003-2004.

Months after he began taking the drug, Elliott suffered a mental breakdown, experiencing a relapse of Iraq combat nightmares he blames on Chantix.

Veterans groups are also expressing their anger over the study.

Veterans groups are also expressing their anger over the study and are also calling for the studies to be ceased and for an investigation.

"Our nation's veterans are not guinea pigs," said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America. "It is unacceptable for even one veteran to have been misled about the possible side effects of Chantix."

The executive director of Veterans for Commons Sense said that this is yet another example of the VA failing America's veterans.

"VA should have done a better job protecting the human rights of our veterans," said Paul Sullivan of VCS.

"While VCS supports research to assist veterans, VA must bear a heavy burden of responsibility with these experiments on veterans diagnosed with PTSD," said Sullivan, who is also calling for an immediate suspension of the study.

Meanwhile, the VA is calling the ABC News/ Washington Times report "inaccurate and misleading".

"In our PTSD and smoking cessation study, our research is to learn if it is easier to stop smoking when smoking cessation treatment is combined with PTSD therapy, or whether the two therapies are more effective if they are provided separately," said a statement posted on the VA website.

"In either case, patients are receiving treatment recommended by their own doctors using counseling with or without FDA approved medication that includes Varenicline (Chantix). Participation in this program is voluntary, and all participants are closely monitored clinically by mental health professionals who provide smoking cessation methods patients agree to use," the VA statement said.

The VA also said that it passed on warning about Chantix in a timely manner in November of last year after the FDA issued a statement on Chantix.

'VA immediately passed along that concern to practitioners at all of our medical centers. On February 1, FDA issued a 'Public Health Advisory,' to providers, providing more information on potential side effects of which clinicians and patients should be aware. VA distributed this alert to pharmacists in its system on that same day, and to researchers on February 5," said the statement.

The VA also said that it wrote a letter to participants that while not specifically warning of the suicide links, requested that they discuss possible side-effects with their doctors. The VA said the team that wrote the letter "felt that the issue of suicide should be discussed in a clinical setting, not in a mailing to a group of patients."

Chantix is one of the drugs being used in an estimated 25 clinical studies using veterans by the VA.

Pfizer maintains that 'the benefits of Chantix outweigh the risks" and that it continues to do further studies on the drug.

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hawk71049

06-24-2008, 04:34 PM

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'Disposable Heroes': Veterans Used To Test Suicide-Linked Drugs ( http://abcnews.go.com/Blotter/Story?id=5180437&page=2)...

An ABC News and Washington Times Investigation Reveals Vets Are Being Recruited for Government Tests on Drugs with Violent Side Effects
By BRIAN ROSS and VIC WALTER
June 17, 2008

Mentally distressed veterans from Iraq and Afghanistan are being recruited for government tests on pharmaceutical drugs linked to suicide and other violent side effects, an investigation by ABC News and The Washington Times has found.

The report will air on Good Morning America and will also appear in The Washington Times on Tuesday.

In one of the human experiments, involving the anti-smoking drug Chantix, Veterans Administration doctors waited more than three months before warning veterans about the possible serious side effects, including suicide and neuropsychiatric behavior.

"Lab rat, guinea pig, disposable hero," said former US Army sniper James Elliott in describing how he felt he was betrayed by the Veterans Administration.

Elliott, 38, of suburban Washington, D.C., was recruited, at $30 a month, for the Chantix anti-smoking study three years after being diagnosed with Post Traumatic Stress Disorder. He served a 15-month tour of duty in Iraq from 2003-2004.

Months after he began taking the drug, Elliott suffered a mental breakdown, experiencing a relapse of Iraq combat nightmares he blames on Chantix.

"They never told me that I was going to be suicidal, that I would cease sleeping. They never told me anything except this will help me quit smoking," Elliott told ABC News and The Washington Times.

On the night of February 5th, after consuming a few beers, Elliott says he "snapped" and left his home with a loaded gun.

His fiancee, Tammy, called police and warned, "He's extremely unstable. He has PTSD."

"Do you think that he is going to shoot or attack the police?" the 911 dispatcher asked.
"I can't be certain. I don't know," she said. (click here to hear part of Tammy's 911 call)
"He was operating as if he was back in theater, in combat theater," she told ABC News. "And of course, a soldier goes nowhere without a gun."

When police arrived, they found Elliott in the street, with the gun in the front pocket of his hooded sweatshirt.

"Are you going to shoot me? Shoot me," Elliott said, according to the police report.

Police used a Taser gun to stun Elliott and placed him under arrest.

It wasn't until three weeks later that the Veterans Administration advised the veterans in the Chantix study that the drug may cause serious side effects, including "anxiety, nervousness, tension, depression, thoughts of suicide, and attempted and completed suicide."

The VA's letter to the veterans, on February 29, 2008, followed three warnings from the FDA and Chantix' maker Pfizer, that were issued on November 20, 2007, January 18, 2008 and February 1, 2008.

"How this study continued in the face of these difficulties is almost impossible to understand," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.

Doctors at the Veterans Administration say they acted as quickly as they could.

"This didn't justify an emergency warning at that level," said Dr. Miles McFall, co-administrator of the VA study.

Dr. McFall said there is no proof that Elliott's breakdown was caused by Chantix and he sees no reason to discontinue the study. Some 140 veterans diagnosed with Post Traumatic Stress Disorder continue to receive Chantix as part of a smoking cessation study.

Dr. McFall says the VA decided to continue the Chantix study because "it would be depriving our veterans of an effective method of treatment to help them stop smoking."

Caplan, one of the country's leading medical ethicists, said he was stunned by the VA's decision to continue the Chantix experiment.

"Why take the group most a risk and keep them going? That doesn't make any sense, once you know the risk is there," he said.

Chantix is one of the drugs being used in an estimated 25 clinical studies using veterans by the VA.
Pfizer maintains that "the benefits of Chantix outweigh the risks" and that it continues to do further studies on the drug.

The FAA has prohibited commercial airline pilots from using Chantix because of its possible side effects.

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hawk71049

06-24-2008, 04:56 PM

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VA testing drugs on war veterans

Experiments raise ethical questions

An ABC News and Washington Times
Audrey Hudson (Contact)
Tuesday, June 17, 2008

Read the full story, complete with
links (http://www.washingtontimes.com/news/2008/jun/17/va-testing-drugs-on-war-veterans/?page=1)...also see the video

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hawk71049

06-26-2008, 03:13 AM

Older veterans now helping vets of Iraq and Afghanistan ( http://abcnews.go.com/International/CSM/story?id=5033219&page=1)...

ABC News

Having 'been there' themselves, Vietnam veterans are better able to listen to and counsel younger vets troubled by their combat experience.

By Jill Carroll
La Jolla, Calif.

William Rider had never seen the young stranger standing in his office doorway. But as a Vietnam veteran who'd spent decades helping himself and other vets struggling with psychological injuries, he knew that face.

"I saw a look in his face like terror. He didn't know what he was going to say or if he was going to be judged," says Mr. Rider, who cofounded American Combat Veterans of War (ACVOW), a volunteer group that counsels and advocates for combat vets diagnosed with psychological injuries. "He sat down and started telling us about his combat trauma and he was there for over four hours.... He's been coming back ever since."

Using veterans who have recovered from psychological injuries to help others through the healing process is a novel, even a controversial approach. But there's growing evidence of its effectiveness, and it's now gaining greater acceptance in the US and abroad.

The approach is both simple and profound: Providing a safe, nonjudgmental place where someone who's "been there" can simply listen.

"There is this enormous chasm of understanding between people who have been to war and civilians," says Jonathan Shay, an author and psychiatrist who treated psychological injuries during a 20-year career with the US Department of Veterans Affairs (VA).

Rider's group is one of many formal and informal government and civilian efforts helping a new and growing generation of veterans recover from psychological injuries that disrupt their lives and, at a growing rate, end them.

ACVOW's 20 volunteers lend an empathetic ear for hours on end; pull veterans on the brink out of bars, jails, or fights at home; and give briefings to groups returning from war. As fellow warriors, ACVOW members believe they can earn the trust of troubled young veterans who are wary of civilian care providers and convince them to get help.

One concern is that without such help, today's combat veterans might experience the difficulties that continue to trouble many Vietnam vets.

Army suicides hit record in 2007

Last year saw the highest rate of suicide among soldiers on record, according to Army data. That year also saw rates of post-traumatic stress disorder (PTSD) diagnosed by the Army jump 50 percent. There have been 172 suicides among all branches of active-duty military while they were assigned to operations in Iraq or Afghanistan as of May 3, according to the Department of Defense.

The Department of Veterans Affairs counted 144 suicides among veterans of the Iraq and Afghanistan wars being helped within the VA system. But that count is only through 2005, and there is no nationwide tracking of suicides among all veterans.

More than 35,000 troops who served in those wars have been diagnosed with PTSD, says the Office of the Surgeon General (see chart). But a RAND Corp. report estimates that some 300,000 of them are experiencing PTSD or major depression, both considered factors in suicide. RAND reports that another 320,000 may have sustained a traumatic brain injury (TBI), usually caused by an explosion and associated with memory loss and personality changes.

Repeated and extended deployments to Iraq and Afghanistan are driving psychological injuries upward, say military and civilian doctors, despite a spectrum of new government programs aimed at preventing and treating them.

With the advent of the wars in Iraq and Afghanistan, the Army started programs to teach soldiers how to identify signs of PTSD, prepare mentally for combat, and remove the stigma of seeking help.

The VA recently announced the creation of a panel to advise the agency on improving its suicide-prevention effort. Last year it created positions at each VA medical center to oversee suicide prevention and started a suicide hot line.

There is also research involving new treatments. At the Naval Medical Center in San Diego, Cmdr. Scott Johnston, director for clinical research, just completed a three-year study using virtual-reality technology to help veterans overcome fear, anxiety, and flashbacks. After five to 10 weeks of treatment, 80 percent of the participants no longer had PTSD symptoms.

But for some vets struggling to overcome psychological injuries, an important element of treatment involves their peers. The Canadian government and the United Kingdom's Royal Marines have both adopted programs based on veterans helping other veterans with psychological injuries. In the US, informal veterans groups are providing similar services.

"It's not that credentialed professionals have no role," says Dr. Shay, who won a MacArthur Foundation grant for his treatment of Vietnam veterans diagnosed with combat trauma. "It's that they don't belong on center stage."

ACVOW's volunteers, who work from a tiny room in the La Jolla VA hospital as well as a facility on the Camp Pendleton Marine Corps base in San Diego, use their own money and some modest donations along with their credibility as combat veterans to help the new generation address psychological injuries and navigate the VA system. They see firsthand the cost of shortfalls in the mental-health care system.

"What we're seeing is marines committing suicide by motorcycle, or car," or by forcing police to shoot them, says Rider. "They are fed up with the fact they can't get some peace and quiet in their head."

ACVOW formed in 2001. Following the terrorist attacks of 9/11, many veterans of past wars reported troubling flashbacks.

"They were coming out of the woodwork," says Michael Sloan, a cofounder of the group. These days the La Jolla office is usually bustling with young men dropping by, cautiously looking for help.

How one marine got help

Josh, the Marine reservist who appeared at ACVOW's door at the La Jolla VA hospital and asked that his last name not be used, says he found what he was looking for – people who "get it."

The regular group meetings held by ACVOW got him through the week, he says. The group's office was also a place he could vent his anger. Fellow vets were there for him when he hit bottom in April.

As Josh tells it, he and his wife were arguing again, a new development in their relationship since he returned from Iraq in October 2006, and something snapped. His wife called the police, and he found himself in jail on several charges including domestic violence.

When Rider heard Josh was arrested, he contacted an officer in charge of the jail and explained Josh's injuries. "I guess I made an impression because after that they were all very nice to him and understanding.

I do that because I know Josh would not tell them," says Rider. "Josh didn't do this because he's a bad person. He did this because he has combat stress and TBI."

Josh and his wife have separated, but hope for reconciliation is still in the air. Anger, distrust and sadness still course through him, he says, but lately he's been a little more at peace.

"He is 100 times more calm than a month ago," says Tim Jordan, a Gulf War veteran and ACVOW volunteer who started the group meetings that Josh regularly attends.

Last month, Josh and a Marine Corps buddy took the first steps to start a company they hope will be able to employ veterans and use its profits for charitable veterans causes. For now, Josh is living at the VA hospital, but he hopes to become one of ACVOW's volunteers. "It's like I need to find a new mission," he says. Being part of helping other veterans, "That's kept me more sane than anything."

It's a feeling Rider and the other ACVOW volunteers understand well. Rider is a decorated veteran of the infamous 1st Battalion, 9th Marines that suffered many casualties in Vietnam.

Both grateful and tormented for surviving war, he views the work today as a kind of penance and a duty. "It's like a balm that you put on the soul," he says.

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hawk71049

06-26-2008, 03:16 PM

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Stress Disorder in Troops Jumps ( http://online.wsj.com/article/SB121191874367423651.html)...

The Wall Street Journal.
By YOCHI J. DREAZEN
May 28, 2008; Page A14

WASHINGTON -- The number of troops diagnosed with post-traumatic stress disorder increased more than 46% last year, according to military data, highlighting the far-reaching psychological impact of the wars in Iraq and Afghanistan.

The increases pushed the military's five-year total for PTSD cases to more than 38,000, the Pentagon said Tuesday. Officials, releasing PTSD statistics for the first time, said the actual numbers might be higher because many soldiers and Marines keep the malady to themselves to protect their careers.

Army Surgeon General Eric Schoomaker told reporters that the military doesn't yet "have good numbers" about the true prevalence of the psychological disorder.

A Pentagon official said the PTSD increases stemmed from the fact that more troops saw combat in 2007 than in the previous years of the wars in Iraq and Afghanistan. The Bush administration's troop "surge" sent an additional 30,000 military personnel to Iraq, pushing the U.S. presence there to a record high. Last year was also the bloodiest since the U.S. invasions of Iraq and Afghanistan, which meant that troops were more likely to have seen or caused casualties.

Military officials said that PTSD, which is characterized by depression, anxiety and sleeplessness, is an especially serious problem for the Army and Marine Corps, whose forces are doing the bulk of the fighting in Iraq and Afghanistan.

The Army reported more than 10,000 new diagnoses of PTSD in 2007, compared with 6,800 the previous year. In the past five years, more than 28,000 soldiers have been diagnosed with PTSD, which can result in suicide or other violence.

The Marines, meanwhile, reported more than 2,100 new instances of PTSD last year, up from 1,366 in 2006. All told, more than 5,000 Marines have been diagnosed with the disorder.

"These young men and women have seen the worst things the world can throw at them, and some of them will be overwhelmed by it," former Surgeon General Richard Carmona, a Vietnam veteran, said in an interview. "That's not a sign of weakness. It's the reality."

Some Bush administration officials have begun arguing that PTSD is being overdiagnosed, with veterans and mental-health professionals confusing normal post-deployment anxiety, which may quickly disappear on its own, with full-blown PTSD. "One of my concerns...is this notion of overlabeling a generation of wonderful veterans," Veterans Affairs Secretary James Peake told reporters earlier this month.

The American Psychological Association first recognized PTSD in 1980, and the term became a shorthand way of referring to veterans psychologically scarred by their experiences in Vietnam.

PTSD is emerging as one of the signature maladies of the long wars in Iraq and Afghanistan, which lack clear front lines and pit U.S. forces against enemies who fight out of civilian areas.

A recent study by the Rand Corp., a California research institution, concluded that 19% of the 1.6 million troops who have served in the war zones have symptoms of PTSD, almost the same percentage seen among Vietnam veterans.

Rand estimated the total number of PTSD cases from Iraq and Afghanistan at about 300,000, a smaller figure in raw terms than the Vietnam-era numbers, when far more soldiers and Marines were mobilized for combat.

Many doctors say PTSD cases from Iraq and Afghanistan are overwhelming the military's mental-health system, which is struggling to hire enough therapists and counselors to keep pace.

"The volume of eligible veterans has increased so much that the system is unable to accommodate the demand," Stanley Luke, a psychologist who helps run a mental-heath organization in Hawaii, said at a Senate hearing last week. "Those with PTSD...are left untreated and their illnesses and injuries get worse."

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hawk71049

06-26-2008, 05:04 PM

page 2
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From the Baltimore Sun

Facing demons in 'Virtual Iraq' ( http://www.chicagotribune.com/news/nationworld/bal-te.virtual22jun22,0,5302997.story?page=1)...

Chicago Tribune

By David Kohn | Sun reporter
June 22, 2008

A 3-D simulator in which soldiers see, hear and smell the rigors of combat may help ease war-induced stress

--------------------------------------------------------------------------------------

Nationwide, only about 50 soldiers have undergone the treatment in the past three years - leading some critics to say the treatment is still unproven.

In Iraq, Lt. Cmdr. Robert McLay, a Navy psychiatrist stationed at Camp Fallujah in Anbar province, has used the treatment on eight soldiers. He says all have gotten better.

"I'm getting very good success," he said. The number of potential patients is enormous. Experts say post-traumatic stress disorder - a debilitating ailment that leaves patients panicky, angry and haunted by battle memories - is or will be a significant problem for many of the 1.7 million soldiers who have served in Iraq and Afghanistan.

A study in the New England Journal of Medicine found that between a quarter and a third of all veterans from these conflicts will suffer from the disorder and other mental health problems.

Last month, the Rand Corp. estimated that up to 300,000 soldiers will experience post-war mental health problems.

Virtual Iraq immerses patients in the harsh world that produced their symptoms.

After putting on virtual-reality goggles and earphones, patients are transported to two scenarios: a Humvee convoy through the desert or a foot patrol through a desolate city.

They use a video game handset to control their movements, and by turning their heads they can change what they see within that environment.

The therapist, who controls all variables in the environment except the patient's movement, slowly ratchets up the stress level by adding sirens, sniper fire and explosions.

This digital world is not only full of threats and stressors - roadside bombs, insurgents firing grenades, a bleeding U.S. soldier slumped in the Humvee's passenger seat - but also the mundane details that evoke everyday life for a soldier in Iraq.

Patients hear the sound of a Muslim prayer call and see Iraqi women walking to market in traditional clothes.

The setup also engages other senses. Under the patient's chair are powerful bass speakers embedded in a platform; when a bomb explodes onscreen, the concussion is palpable. Next to the computer console is a toaster-size odor machine; by inserting pellets, Roy can create a variety of aromas, including sweat, burning trash and Middle Eastern spices. He suspects that the scents and noise might be the most effective elements in evoking Iraq. The brain areas that process odor and sound are closely networked with the regions that play a key role in fear and memory - two key components of post-traumatic stress.

The originator of Virtual Iraq is Albert "Skip" Rizzo, a psychologist and researcher at the University of Southern California. He got interested in the approach 15 years ago, while trying to rehabilitate people who had suffered traumatic brain injuries. One day he was surprised to see a patient completely engrossed in a handheld computer game. Generally, brain injury patients have trouble concentrating on a task for any stretch of time.

Rizzo realized that virtual treatments could increase patients' interest and improve their performance. He was so taken with this idea that he left his job as a clinical psychologist to become a low-level researcher at USC; his salary dropped from more than $80,000 to $30,000. He began working with computer coders, developing virtual software for therapy, and within a few years had created a number of applications, including one for stroke patients and another for children with attention deficit disorder.

In 2003 Rizzo, by now a USC professor, realized that the Iraq war would likely last for years and probably produce large numbers of post-traumatic stress disorder patients. He began work on Virtual Iraq, and linked up with other researchers, such as Roy, who shared his vision.

As concern over soldiers' mental health has grown, virtual therapy has gotten more attention. The Department of Defense is spending about $5 million to fund research at six sites around the country, including Walter Reed and the Weill Cornell Medical College in New York.

The most persuasive study so far involved a group of 14 New Yorkers suffering from PTSD after the Sept. 11 World Trade Center attacks. The subjects, most of whom had tried other treatments without success, improved significantly after virtual therapy.

Roy is conducting the first controlled study, comparing 15 patients who get virtual therapy with another 15 who receive more traditional psychotherapy. Previous research has examined virtual therapy without comparing it directly to other approaches.

Rizzo, Roy and other researchers regularly incorporate ideas from soldiers to make the experience more realistic. Programmers at USC will add the potential for friendly fire and a version that resembles Afghanistan, with more mountains. At the suggestion of patients, the researchers also added a weapon, a training model that has no trigger but is the same weight and size as an M-16 or M-4.

"They like to have a gun in their hand," says Roy. "It makes it more realistic." Many soldiers hold the gun and crouch while on virtual patrol. There's no digital firing: Roy says that would undercut the goal of teaching patients to reduce stress.

Rizzo and others say the digital approach can help the many patients who have trouble accessing the frightening memories that lie at the core of the illness. The most commonly used treatment, known as exposure therapy, asks patients to remember events that trigger panic and stress. Over several sessions, patients go through this process repeatedly, slowly draining the thoughts of their haunting power.

Many people with post-traumatic stress disorder have trouble facing their terrifying memories. A significant percentage - Roy estimates as many as half of all patients - either refuse to enter into traditional therapy or don't finish it.

It is this group that will most benefit from virtual therapy, proponents say. Once immersed in the digital Iraq, patients can more easily recall painful emotions and events. They must still endure the difficult process of imagining and talking about what happened to them, Roy says, but they have help with the crucial first steps.

"Seeing it [on the computer] is definitely not enough," says Roy. "We want them to use it as a stimulus to describe experiences and feelings."

Some researchers are skeptical that the new method improves on traditional therapy.

"We don't have empirical evidence that virtual treatment is needed. And it's quite expensive," says University of Pennsylvania psychologist Edna Foa, an expert on exposure therapy. "I want to see what motivates this, other than a fascination with gadgets."

Foa, who works with PTSD patients - including soldiers - in both the U.S. and Israel, says the images in virtual therapy may be too generic to effectively elicit patients' own memories.

Rizzo says the entire virtual set-up - computers, software and other equipment - costs about $7,000. He argues that each one would pay for itself if it helps even a handful of patients. He and others also say the program provides ample realism.

The military doesn't allow mental health patients to talk with the news media. But others who have seen combat say Virtual Iraq elicits powerful emotional responses.

Navy psychologist Scott L. Johnston spent nine months in Iraq in 2006 and 2007, helping soldiers overwhelmed by acute stress. Because treatment works best when it given soon after combat, Johnston spent most of his tour embedded with Marine infantry units in Ramadi and Fallujah. When he returned to Naval Medical Center in San Diego, he picked up his virtual therapy research.

When he put on the virtual reality goggles, he found that the environment triggered a visceral sense of being in combat.

"It brought me back to what I'd experienced," he says. Although Johnston didn't develop full-blown post-traumatic stress disorder, he did experience some symptoms after returning to the U.S.: He was hyper-aware while driving, easily frustrated, and had trouble focusing. He says the problems have since dissipated.

Johnston now has two virtual therapy studies under way, with 30 subjects. He says early results show that in 80 percent of patients, symptoms decreased significantly; in more than half, the problem disappeared altogether.

Johnston says that from what he has seen, Virtual Iraq produces a response from any soldier who has seen action in Iraq, whether or not he has PTSD. "If they've been in combat, they get very serious while they're playing," he says. "It seems to be provoking memories."

david.kohn@baltsun.com

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hawk71049

06-26-2008, 05:07 PM

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page 1

From the Baltimore Sun

Facing demons in 'Virtual Iraq' ( http://www.chicagotribune.com/news/nationworld/bal-te.virtual22jun22,0,5302997.story?page=1)...

Chicago Tribune

By David Kohn | Sun reporter
June 22, 2008

A 3-D simulator in which soldiers see, hear and smell the rigors of combat may help ease war-induced stress

---------------------------------------------------------------------
Washington - To a soldier who has been in Iraq, the sights, sounds and smells are familiar: the pop of an AK-47, the flash of a bomb, the stench of cordite.

The location, however, is not.

Here, in a small, windowless room at the Walter Reed Army Medical Center, researchers are using the latest video game technology - plus a smell machine and a vibration platform - to help patients suffering from post-traumatic stress disorder.

Known as "Virtual Iraq," the treatment may help many soldiers who don't find relief from medication or traditional psychotherapy.

"It really jogs their memory," says Col. Michael Roy, who runs the digital therapy program at Walter Reed. "It puts them back there very powerfully and makes them realize a lot of things they had consciously or subconsciously repressed."

Proponents of the new treatment say that once these memories are available, patients can begin to talk with therapists, eventually rendering the phantoms less terrifying.

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hawk71049

06-26-2008, 05:13 PM

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High-tech testing for war vets with post-traumatic stress disorder (http://www.chicagotribune.com/news/local/chicago/chi-vets-trauma-center_both_26jun26,0,3069101.story)...

'Magnetic stethoscope' will search for brain injuries in soldiers

By Kristen Kridel | Chicago Tribune reporter
11:13 PM CDT, June 25, 2008

An Elk Grove Village hospital plans to use brain-imaging technology to determine whether combat veterans with post-traumatic stress disorder also might suffer from undiagnosed traumatic brain injuries.

A "magnetic stethoscope" primarily used to study epilepsy and autism will help determine how brain function is altered by PTSD, officials at Alexian Brothers Medical Center said Wednesday.

The MEG technology—short for magnetoencephalography—allows doctors to read magnetic signals produced by the brain when exposed to visual or auditory stimuli, said Jeffrey Lewine, director of the Alexian Center for Brain Research.Those signals appear to differ in a veteran who only has PTSD compared with one who has PTSD and traumatic brain injury, Lewine said.

The combination can be hard to diagnose but critically affect proper treatment, according to Lewine. "You have to know what you're treating to get the right treatment," Lewine said. "Behavioral testing doesn't always distinguish the different components. We need to look at the biology."

He hopes to develop diagnostic techniques that will lead to faster treatment.

Almost 20 percent of soldiers who have returned from Iraq and Afghanistan—nearly 300,000—have reported symptoms of post-traumatic stress disorder or major depression, according to a recent study by the RAND Corp., a non-profit that researches issues associated with policy problems.

About 19 percent said they thought they might have suffered a traumatic brain injury while deployed, according to the study.

The Elk Grove hospital's veterans imaging program will be part of an expanded support system aimed at serving veterans in the northwest suburbs suffering from duty-related neurological and psychiatric problems, officials said.

Participating in the hospital's effort are the Illinois Department of Veterans Affairs, the Veterans Administration and the Northwest Suburban Veterans Advisory Council.

State funding approved last year targets veterans with PTSD, officials said.

"Isn't it about time we do this in the United States of America?" said state Sen. Dan Kotowski (D-Park Ridge), who sponsored the legislation.

"This is the one thing we can agree on."

Lt. James McCormick, 36, experienced symptoms of post-traumatic stress disorder after suffering combat injuries in Afghanistan, said his father, Daniel McCormick, a lay member of the Alexian Brothers, a Catholic religious order. His son returned to the United States four months ago.

Daniel McCormick, director of vocations for the Alexian Brothers, said PTSD-related difficulties that soldiers face range from being jumpy or nervous to the inability to hold a job.

"As long as there are people, men and women will have to go to war," he said. "And when they come home, we have to take care of them."

Researchers will use MEG with magnetic resonance imaging (MRI) and electroencephalography (EEG), Lewine said. Together, the technologies will allow clinicians to generate sophisticated 3-D images of brain activity.

It's important to know which medical issues a soldier is dealing with because treatments differ. Those suffering from both afflictions would be oversensitive to medications usually prescribed for someone with only PTSD.

kkridel@tribune.com

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hawk71049

06-26-2008, 05:36 PM

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VA struggles to care for female vets ( http://www.chicagotribune.com/features/lifestyle/chi-female-vets-wn-0618jun18,0,1399487.story?page=2)...

Chicago Tribune
By Les Blumenthal | McClatchy/Tribune newspapers
June 18, 2008

WASHINGTON—Two memories haunt Robin Milonas.

While serving in Afghanistan in 2004 as an Army Reserve civil affairs officer, the former lieutenant colonel got lost in a minefield while leading a small convoy delivering school supplies to civilians. Even more troubling is the memory of a man who arrived at the main gate of Bagram Air Base carrying a young boy whose leg had been blown off by a land mine.

"I was an outgoing, energetic, determined good soldier who wanted to make the Army a career," said Milonas, of Puyallup, Wash., who just turned 50. "Now I am broken."

Milonas is one of roughly 180,000 women who have been deployed to Afghanistan and Iraq. Though they don't officially serve in combat, they have experienced life in a war zone where there are no front lines.
And as they return home, they're increasingly turning to an already overtaxed Department of Veterans Affairs for help. Last year, the VA treated more than 255,000 female veterans. The number is expected to double within five years.

VA officials say they're better prepared to handle female patients than they were several years ago. But they acknowledge "continual challenges" as they move to open the door to a man's world, where Pap tests and mammograms could become as common as prostate exams. And where "military sexual trauma" would be treated as a serious and growing mental health problem, rather than as a subject to be avoided.

Difference of opinion

"It's not your father's VA—it really isn't," said Patricia Hayes, the VA's national director of women's health care issues. "We have geared up and are gearing up. But there are places that may have gaps."

Others say the agency is far from prepared. And given the VA's chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.

"They aren't ready," U.S. Sen. Patty Murray (D-Wash.) said of VA officials. "Absent a proactive, concerted effort, and knowing their limited resources—[VA officials] are struggling with so much—this might get lost."

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation that requires studying how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

The legislation also would require the VA to start caring for newborn children of female veterans who are receiving maternity care. Currently the VA doesn't cover newborn costs.

In addition, the legislation would require increased training for VA personnel dealing with military sexual trauma and post-traumatic stress disorder in women.

Combat's aftermath

"It's a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn't be in the military," Murray said. "But as more women transition home from the physical and mental wounds of war and step back into lives as mothers, wives and citizens, the VA must be there for them."

Robin Milonas says she has been stopped three times by police for erratic driving. When she sees a dark spot in the road, she thinks it's a land mine and swerves. Except for her job teaching special education, she stays home. She constantly checks to see whether the doors and windows are locked.

Milonas has been diagnosed with PTSD and receives therapy at the veterans center in Tacoma, Wash. But three times she has been denied a disability rating from the VA, which says Milonas hasn't proved her problems are related to her service in Afghanistan.

Milonas believes the Veterans Administration has yet to recognize that even though women are barred from combat, it's hard for them to avoid the trauma associated with serving in a war zone such as Afghanistan.

"The battle is everywhere," she said. She thinks the government's attitude is that "because women aren't allowed in combat, they can't have PTSD. It must be depression or women's issues like PMS."

Denies bias

VA officials say there's no double standard when it comes to disability ratings for PTSD.

"This is the first group of women's vets we have seen with this intensity of experience," Hayes said. "We are not sure what the long-term effects will be."

The VA has begun a long-term study of 12,000 female veterans.

Female veterans have faced a number of problems, ranging from clinics that don't have full-time obstetrician/gynecologists to uncomfortable group therapy sessions where men outnumber women and topics can include sexual assault and harassment.

Concern is mounting over the number of female veterans suffering from military sexual trauma, which can include rape, assault and harassment.

According to the VA, nearly one in five female veterans seeking care has been diagnosed as a victim of military sexual trauma, though some believe the figure could be nearer to one in three.

Women-only sessions

The VA now offers women-only group therapy sessions. In addition, female vets can request female counselors, and women-only entrances to clinics are being provided.

"A lot of women are reluctant to come into a hospital," said Jan Buchanan, a women's veterans program manager for the VA's Puget Sound region. "It seems too military to them. They fear they might see their perpetrator."

But they are coming, and it's the younger veterans in particular.

So far, 41 percent of the women who have served in Iraq and Afghanistan have sought medical help at least once at the VA. That compares with 14 percent of older women and 22 percent of male veterans.

They want birth control, infertility and family planning advice, child care for when they're being treated and coverage for their newborns, VA officials say. There's also increasing concern about homeless female veterans.

"The old saying was, 'If the Army wanted you to have a baby, it would have issued you one,' " said Lourdes Alvarado-Ramos, who rose to the rank of sergeant major in the Army Medical Corps and now is deputy director of the Washington state Department of Veterans Affairs. "But that has changed. The system has been geared to males. Bricks and mortar, clinics and hospitals—they were all thought of as a male place. We need to make women veterans more comfortable with the system."

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hawk71049

06-27-2008, 04:21 AM

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VA officials answer criticisms in Congress ( http://www.stripes.com/article.asp?section=104&article=62618&archive=true)...

By Leo Shane III, Stars and Stripes
Pacific edition, Friday, June 06, 2008

WASHINGTON — For the second time in a month, Department of Veterans Affairs leaders testified before Congress about an embarrassing e-mail which implied a cover-up of serious health problems among servicemembers.

This time, Democratic senators and veterans advocates called for an independent investigation of the department, saying they believe leaders have created a toxic culture for veterans seeking care.

"There is a sense, whether it’s perception or reality, that [VA officials] make decisions based on money and not on whether veterans are getting the best health care they need," said Sen. Patty Murray, D-Wash. "It’s disconcerting when we see things like this."

Jon Soltz, chairman of VoteVets.org, said a VA bonus program to reward clinics that process the most cases has only exacerbated the problem, unintentionally encouraging managers to cut corners and opt for less-costly treatments.

But VA officials denied those charges. Dr. Michael Kussman, undersecretary for health at the department, said recent controversy surrounding the department is the result of poor publicity from a few missteps, but not a lack of effort by employees treating veterans.

"Any suggestion that we would not diagnose a condition, any condition, is unacceptable," he said. "Not only was there no systemic effort to deny diagnoses, there was not an individual effort to that end."

Last month Dr. Norma Perez, a psychologist and coordinator at a department’s clinic in Central Texas, circulated an e-mail warning colleagues not to diagnose post-traumatic stress disorder in new patients too quickly, noting the growing number of "compensation seeking veterans" coming in.

Instead she suggested diagnosing adjustment disorder — a condition which carries no disability rating — and following up with further PTSD tests.

On Wednesday she appeared before the Senate Veterans Affairs Committee to clarify her memo, insisting it was more about providing accurate and timely treatment options for patients than about costs for the department. The clinic does not perform any disability ratings or compensation work.

But senators on the committee said were skeptical of that explanation, pointing to lingering concerns with e-mails written by department Mental Health Director Ira Katz that were made public in April.

Those notes concerned higher-than-expected suicide rates among veterans. Last month Katz told a House committee that those memos — one note’s subject line reads "Shh!" and asks "Is this something we should carefully address … before someone stumbles on it?" — were poorly worded but not an effort at a cover-up.

"I’m very frustrated by the fact that whether I’m asking about veterans’ suicides or construction of a new clinic, the answer from the players at the VA bureaucracy seems to be the same: ‘It’s no big deal,’ " said Sen. Jon Tester, D-Mont. "It’s a big deal to me."

After the hearing, a pair of combat veterans spoke out about their problems navigating the system. Retired Army Pfc. Kenneth Gumm, who served in Iraq in 2005, said since then he has received several conflicting diagnoses from Perez’s clinic. The last one was for PTSD, which could mean a higher disability rating down the road.

"Money is nice," he said, "but I’d rather not have my problems."

Kussman said the department has made tremendous strides in treating mental health disorders in recent years, including hiring nearly 4,000 new psychologists and counselors since 2005. But he acknowledged the department still has more work ahead.

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hawk71049

06-28-2008, 02:36 AM

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Prior Assault Boosts PTSD Risk After Combat (http://abcnews.go.com/Health/wireStory?id=4821181)...

ABC News
May 9, 2008

NEW YORK (Reuters Health) - Men and women who were assaulted before entering military service are more than twice as likely to develop post-traumatic stress disorder (PTSD) after combat deployment, Navy researchers report.

It's estimated that as many as 1 in 10 veterans returning from the current conflicts in Iraq and Afghanistan have symptoms of PTSD. Some investigators have suggested that past stressful events can protect people from developing PTSD via "stress inoculation," while others argue that such stresses actually make people more vulnerable.

To investigate the effect of having been assaulted before combat exposure on the likelihood of developing PTSD, Dr. Tyler C. Smith of the Naval Health Research Center in San Diego and colleagues looked at 5,324 men and women participating in the Millennium Cohort study. All were in military service as of October 1, 2000, were deployed to Iraq or Afghanistan, and were free from PTSD when they entered the study.

Of the 881 women included in the study, 28 percent study had been experienced a violent or sexual assault, or both, compared to 9 percent of the 4,443 men in the study.

Overall, 13 percent of the women exposed to combat developed PTSD, while 22 percent of those who had been assaulted developed PTSD. Seven percent of the men developed PTSD, as did 12 percent of the men who had been assaulted before the study's outset.

When the researchers adjusted for level of education, age, problem drinking and other factors that could influence both the risk of developing PTSD and the likelihood of having been the victim of an assault, women with a history of assault were still 2.3 times more likely to develop PTSD. The "adjusted" PTSD risk for male assault victims was doubled.

"Though the PTSD risk conferred by combat exposure and heightened by previous life events may not be preventable, these subsets of individuals who seem to be even more vulnerable deserve closer attention from the medical community," Smith and his team conclude.

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hawk71049

06-30-2008, 02:00 AM

MAYO CLINIC

PTSD can be related to other medical conditions ( http://www.chicagotribune.com/features/lifestyle/chi-0629_docjun29,0,5323553.story)...

Chicago Tribune Media Services
June 29, 2008

Q: I'm a Vietnam veteran being treated for post-traumatic stress disorder, high blood pressure and cardiovascular disease. Are they related?

A: Those three conditions can be related. Post-traumatic stress disorder (PTSD) takes a physical toll on your body. In some cases, its effects may lead to other medical problems or make the symptoms of those problems worse.

Post-traumatic stress disorder is a type of anxiety disorder that develops in response to a traumatic event. It may affect people involved in war, as in your situation. But other events can trigger PTSD, too. For example, it can affect survivors of sexual or physical assault, a natural disaster or a vehicle crash. Rescue workers involved in an event that includes mass casualties or other tragedies may also develop the disorder.

Many people who are involved in or witness traumatic events have a brief period of difficulty adjusting and coping afterward. But with time, and some healthy coping methods, such traumatic reactions usually get better on their own. After about a month, if people exposed to a traumatic event haven't reverted to their normal functioning, they may have post-traumatic stress.

There are three basic groups of PTSD signs and symptoms. The first involves avoidance: avoiding events, activities or interactions that might stimulate your memories of and reactions to the original event. For example, some people like you who've been exposed to combat might avoid fireworks displays because the noise and lights may create anxiety and increase nightmares.

The second group of symptoms involves recollections that create the feeling of reliving the traumatic event. This can happen when you're awake, and you re-experience the traumatic event because you're around a reminder of the event, or it can take the form of nightmares or dreams.

The third group of symptoms is activation. Certain areas of the brain are activated when your levels of anxiety, fear and vigilance increase. The body responds physically, as if it's being exposed to a current threat, even if a threat isn't present at the time. You may experience a faster heart rate, rapid breathing, sweating and dry mouth. These symptoms are all part of what we call the fight-or-flight response, when your body prepares to deal with a threatening situation. Prolonged, repeated bouts of activation may lead to other medical problems, or exacerbate symptoms of existing conditions, such as high blood pressure and heart disease.

It's crucial that people with post-traumatic stress disorder seek medical care. Treatment with a combination of medication and psychotherapy can often be effective at reducing symptoms. Medication can be particularly helpful for targeting certain symptoms of PTSD, especially sleep problems, depression, irritability and anxiety.

Psychotherapy, either in an individual or group setting, can help you learn more about why you have certain feelings and thoughts, and how to replace them with more positive and realistic thinking. You may also gain skills in stress management and healthy coping. Through psychotherapy, you can learn ways to cope so that you don't feel overwhelmed by thoughts and feelings related to your traumatic experience.

Staying physically fit and active can also help reduce post-traumatic stress disorder symptoms. Strong social support is an important factor, as well. Staying connected with supportive and caring family and friends, or joining a support group where you can connect with others going through similar experiences, may help ease PTSD effects.

Because it's impossible to erase your memories, you may continue to experience some reactions to them, even with effective treatment. But, treatment can improve your overall quality of life and, in the process, possibly reduce your risk factors for other medical conditions.

—James Rundell, MD, psychiatry, Mayo Clinic, Rochester, Minn.

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care. E-mail a question to medical edge@mayo.edu , or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207.

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hawk71049

07-01-2008, 01:36 AM

Page 2

Veteran suicide rates highlight heroes’ tough battle at home ( http://www.kansascity.com/105/story/684709-p4.html )...

By LEE HILL KAVANAUGH
The Kansas City Star

“Despite what the media has been saying about us, we’re working really, really hard and trying to hit every angle, trying to listen to everybody we can to reach our veterans,” Kemp said. “Hopefully, the message is getting out to veterans. … If we can touch just one life today, it’s worth it. It takes the courage and the strength of a warrior to ask for help. That’s our motto around here.”

One change the VA instituted is to have its suicide coordinators meet veterans at the door or elevator, trying to make a personal connection.

In Kansas City, that person is Durkin. She’ll greet veterans, walk them to their appointment and introduce them to their initial psychologist. She also is the one who will call back a veteran who reached out to the suicide prevention hot line.

“I try to make (getting help) as easy as possible for them,” she said. “Helping them feel comfortable here is important. If they feel like there’s a personal investment, that’s what will keep them coming back.”

She’ll talk with spouses about other ways to find help if the veteran doesn’t trust the VA or fears his medical records won’t remain private from the military.

She hears about the veterans who didn’t make it, like Davis. Looking at his medical records, which his family provided to The Star, she points out that he stopped going for treatment.

“Veterans need to follow through, too,” she said. “Getting them back here is hard, especially once they start feeling better.”

Depression doesn’t turn off like a switch, she said.

“It’s not off one day and on the next. It’s there, but nobody notices, except maybe close family members.”
Donna Davis looked down, her eyes puffy and red.

In her Raytown living room, she caressed stacks of photos and newspaper clippings of her oldest child, along with an American flag, neatly folded into a triangle.

There’s a CNN photo of him manning a machine gun. Dwayne Davis was fighting in Afghanistan.
“He told me he was in Pakistan. And then I saw him on the news,” she said with a little laugh. “He thought he could fool me.”

And there’s a snapshot of a grit-covered Davis, the driver of a Humvee, carrying perhaps his most famous passenger, Geraldo Rivera. Both are mugging for the camera.

Donna Davis has plans to make a scrapbook. Her stack is growing daily. She’s already dug out many of Dwayne’s school photos. First grade: grinning so wide that the gaps caused by his missing baby teeth show. High school: a football player, down on one knee, dimples deep, eyes glinting. He graduated from Raymore-Peculiar High School in 1998.

She paused at each, memories crashing into her thoughts. But then her eyes grew dark, her brow furrowed.

Being in war “killed him just as surely as any bomb,” she said. “All those bodies he saw in Iraq, Afghanistan and Kosovo.”

Her voice trailed off. She wonders what she could have done. How she could have changed this. She had plans to see him. Maybe if she’d been there.

Almost the same thoughts come from his grandparents. Eleanor and Jim Poindexter of Belton had helped raise Dwayne since his 14th birthday — he was too wild for his single mother. They, too, are saddened beyond words. Not a day passes without tears.

“I think our government owed him to help him out as much as possible,” Eleanor Poindexter said. After some of his deployments, “he couldn’t even stand firecrackers on the Fourth of July.”

“This has been a horrible experience for us. I hope no other family has to go through it.”

The grass at Fort Leavenworth National Cemetery rippled like waves on the ocean.

The widow squinted into the sunshine, shielding her eyes, searching. She recited its location from memory: “Section 53, row nine, 11th grave.”

There. Her eyes focused on one headstone, on a name her hand had written so often: Sgt. Dwayne D. Davis. She stared, seeing the sign, erected just days ago, for the first time.

“So strange to see it,” Cara Davis said, unable to catch a tear. Unable to explain how stark this feels, how strange, how final.

Workers nearby stopped digging the newest grave. Stopped talking. Interlopers in her private moment, they cast their eyes downward as if trying to render themselves invisible.

“Sometimes I’m angry at what he did, you know? Then I’ll remember how lovable he was.”

She twirled the wedding ring he gave her. She touched the gold locket on her neck. She traced her fingers across his name on the stone, feeling its chiseled coldness.

“I will never, ever be the same.”

She is now seeing the same counselor who would have talked with her husband, if he’d continued. She’s on medication to make her feel better.

“She’s helping me,” said Davis, but she struggles with wanting to sleep a lot.

“I’ve been going through all those stages of grief, and I’ve been thinking about suicide, too. But I’m not going to act on it. Those thoughts are normal after this.”

She feels the pain. Tries to roll with it. Let it out. Grieve.

“I’m like a lost little girl, taking one day at a time.

“That’s all I can do.”
________________________________________
Call for help
•The National Suicide Prevention Lifeline at 1-800-273-TALK (8255) is available for anyone. Additional resources are available if you press 1 and identify yourself as a member of the military.
•The Crisis Intervention Hotline, 1-888-899-9377, is for Missouri and Kansas residents who need assistance for anything from prescriptions to counseling, not just suicide issues. Calls will be redirected to helping agencies.

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hawk71049

07-01-2008, 01:40 AM

Page 1

Veteran suicide rates highlight heroes’ tough battle at home ( http://www.kansascity.com/105/story/684709-p4.html)...

By LEE HILL KAVANAUGH
The Kansas City Star

ALLISON LONG | The Kansas City Star

Cara Davis’ grief has led her often to her husband’s grave at Fort Leavenworth National Cemetery, where headstones recently were completed. Sgt. Dwayne Davis survived Kosovo, Afghanistan and Iraq, but he killed himself in April while fighting post-traumatic stress Cara Davis knew her husband was still at war.

In the night, he would yell out his name — Dwayne D. Davis! — followed by his rank and serial number. He’d shout that he would never be taken hostage. Four times he tried to choke her because, in his nightmares, she was al-Qaida.

She knew what she had to do.

As gently as she could, she told him: I think maybe you have that disease, that post-traumatic stress thing. I think maybe you need some help.

“We talked about it,” she recalled. He had never told his buddies. “He said he was afraid if he did, the other
soldiers would call him a coward.”

Finally, the pain was too much.

In December, a year after he got out of the Army, he asked for help. He spent 30 minutes talking with a psychology intern at a Veterans Affairs hospital. He told how he felt edgy and had trouble sleeping. He told about his rage and depression, his fatigue, his difficulty with crowds. He told about keeping a gun under his pillow and carrying a blade everywhere he went.

He had cleared the first hurdle, taken the first step.

But he never took a second.

Instead, two days after his 30th birthday, the Raytown native and Army veteran of four tours of war — two in Iraq, one in Afghanistan, one in Kosovo — became part of a grim litany of veteran suicide statistics.
Each day, 18 veterans kill themselves, according to the latest estimate from the Department of Veterans Affairs. No firm numbers are available, such as breakdowns of veterans’ suicides by the decade in which they served. There’s no unified nationwide system to track veterans’ deaths.

But 18 suicides each day translate to more than 6,500 deaths a year — and 21 percent of all U.S. suicides. Veterans make up about 8 percent of the U.S. population.

Now, with the fighting in Afghanistan and Iraq lasting longer than World War II, the number of troops returning home with some form of mental illnesses is increasing.

On April 22, Sgt. Davis came home after an 80-hour week in an Oklahoma oil field. He’d had car trouble. In a rage, he grabbed a rifle and shot out the windshield of his wife’s car outside their Elk City, Okla., home. Then he asked where his handgun was. She had hidden it earlier.

When she looked into her husband’s normally crystal-blue eyes, she shuddered. They “just looked black,” she said. She ran outside and hid in the backyard bushes. Before police arrived, she heard one shot.

And knew.
Her husband had killed himself.
Cherie Durkin knows the hurting souls are out there.

Ten months ago, she became Kansas City’s suicide prevention coordinator for the VA. She goes to work each day hoping to connect with just one more veteran.

She smiled as she told about three Kansas City veterans alive today because of a telephone call each man made.

“They were rescued,” she said. The men had called the National Suicide Prevention Lifeline, 1-800-273-TALK (8255).

Durkin’s message to veterans and their families is to make the call for help.

“It’s a hurdle, I know. I’ve heard the word ‘cowardice’ so many times. But if your loved one can’t make the call, you as their spouse can,” Durkin said.
Spouses need to know that someone believes them when they say their military hero seems on the brink of mental illness, she said.

“We will try to help them any way we can.”

A recent Rand Corp. study of veterans of the Iraq and Afghanistan wars concluded that 19 percent of veterans suffer depression or stress disorders — an estimated 300,000 veterans among the 1.6 million who have served in those wars. By comparison, the American Mental Health Association estimates that about 6 percent of the U.S. adult population suffers depression.

Many veterans go without treatment. And the Rand study noted that mental disorders are more widespread and deeply rooted among vets than health care professionals had previously thought, often surfacing long after a veteran returns to civilian life.

Suicide among veterans “has been a moving target in the news lately,” said Janet Kemp, the VA’s national suicide prevention program coordinator. In the past few months, almost every week has brought new information regarding veterans, post-traumatic stress and suicide. Among them:

•The “Shh!” e-mail by Ira Katz, a top VA official for mental health, on the subject of the number of suicide attempts among veterans. Katz wrote: “Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our medical facilities.”
That contradicted the number the VA reported publicly: 790 attempted suicides in 2007.
“Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?” Katz wrote.

•A congressional hearing this spring titled “The Truth About Veterans’ Suicides.” Rep. Bob Filner, a California Democrat and the chairman of the committee, was highly critical of the VA’s handling of mental health patients. The VA admitted at the hearing that its suicide numbers were higher than it previously had thought.

•Since the VA opened its suicide hot line last year, it has assisted more than 49,500 people who indicated they were veterans and has performed more than 1,000 rescues.

• Earlier this month, the VA put together two panels of experts to share ideas on ways to improve suicide prevention, research and education.

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hawk71049

07-01-2008, 03:53 PM

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Page 2

Treating Wounds You Can't See ( http://www.washingtonpost.com/wp-dyn/content/article/2008/06/27/AR2008062702863_4.html?sub=AR&sid=ST2008063000520&pos=)...

Washington Post.Com
By Linda Blum
Sunday, June 29, 2008; Page B01

The lieutenant refused to fill out the paperwork and wouldn't sit in the waiting room in case someone in his unit saw him. Recently returned from the war zone, he was visibly shaky. He was in his 30s and had worked in the mental-health field as a civilian. When he went home, he had felt only numbness, a chilling emptiness, when he saw his wife and young children. He'd touched his wife's arm and been flooded with memories from the past year in Iraq: a neck wound, blood, severed body parts. He couldn't have sex with her.

In my office, he seemed bewildered, almost shocked. "Why is this happening?" he asked.

"You have PTSD, full-blown PTSD," I told him. And I wondered how he could have missed his own diagnosis. He had given combat-stress briefings and counseled hurting soldiers.

We went back over his Iraq deployment, which had involved bloody rescue missions and constant mortar fire at his unit's base. He'd been protective of his troops. "I didn't like sending people out on missions," he said, "so I went out myself." As the months rolled on, he felt increasingly remote from his family, who seemed to be going on with life without him. And the vortex of war trauma ultimately engulfed him so fully that he lost the capacity to observe himself.

The unwarranted sense of shame, of depleted self-esteem he conveyed, troubled me. "If you went out on missions instead of sending other people out, you're a hero," I said the second and last time I saw him. He finally smiled.

* * *An older soldier came in, looking pale, a couple of days after getting off the plane. The hardest part of his deployment? "Just riding in a tank," he said. "The confinement. I was afraid we'd get hit from above."

I hadn't heard that before. "Did it remind you of anything?"

He reflected for a moment. "Khe Sanh," he said. "We were in underground bunkers. I thought they'd blow out the entrance, and we were all going to die." He had been 19 when he went to Vietnam; 38 years later, he was in Iraq as an officer in the National Guard, his hair gray, his face seamed and rough. "My wife said, 'It took you 20 years to get over the last war,' " he told me. " 'How long will it take this time?' "

In the 1980s, years after Vietnam, he and his wife had attended a talk on PTSD at their local Veterans of Foreign Wars post. "They were talking about me, that was what I had," he told me. "But before then, we just didn't know."

Years of treatment followed. But the military kept its hold on him; he stayed in the Guard and became an officer after getting his college degree. In Iraq, he recalled, uneasiness and sometimes grief gripped him, rooted in his current experience but also emerging ghostlike from the past.

The young soldier had been at Rustamiyah, known as perhaps the most mortared U.S. base in Iraq; two months after coming home, when he closed his eyes, he would hear the whish-boom of the mortars coming in. "The clarity is phenomenal," he said, as if describing a recording.

* * *Another soldier, a captain, choked up in my office, describing a day in Iraq nearly two years earlier. "They were just kids, 18, 19 years old," she said. "They were playing like kids all day, jumping, swinging from a rope. And then that night, just a few hours later, they died."

"Did you send them out?" I asked.

Silence.

'Am I Going to Get Better?'

I was continually struck by the different coping techniques, including humor and irony, that my patients employed.

* * * Three soldiers were sightseeing in a Philadelphia park when a water main ruptured nearby, making a noise like an explosion. They recounted that one soldier dove for the wall, another hit the ground and the third ran. "People must have thought we were crazy," one told me. They felt safer indoors, so they went to the Betsy Ross House. "We spent two hours at the Betsy Ross House," another said. "We saw everything."

* * *Another soldier had PTSD and probably a traumatic brain injury; his injuries and the array of medications he was taking had seriously impaired his short-term memory and concentration. Like an amnesiac in the movies, he had notes posted all over his room detailing his appointments and medication schedule.

"Am I going to get better?" he asked urgently. He was just back from the war and would likely improve significantly in the months to come. But I couldn't tell him with any certainty whether he would one day function at his prior level. He was having so much difficulty concentrating that it took him eight hours to watch a movie. "It saves money on DVDs," he said.

* * * When the command for the Warriors Transition Unit -- for the soldiers who were at Fort Dix on medical hold -- scheduled a mandatory holiday party, some recently returned soldiers were terribly anxious about the crowd and noise. They worried for the whole week before the party. I was considering writing waivers to excuse them from going, but I hesitated to reinforce their anxiety. A former squad leader from Iraq resolved the issue: "We will get a table in a quiet corner," he told them. "We will all sit together and we will make it through this party."

* * *One soldier, a medic, recalled a particularly traumatic deployment that had involved collecting numerous bodies of both Iraqis and members of his own unit.

He brought his wife in to see me one day. She complained that he was cold, withdrawn, hostile; he would sit in the darkened bedroom all day. She wanted to know why I wasn't helping him more. I'd been working with him for four months; what was I doing?

There had been some gains, I told her. His mood was brighter, and he was no longer weeping daily, but he was still in great distress. "Your husband has had severe trauma," I said. "It's going to take a long time."

'All You Have To Do Is Stay Alive'

Something that still surprises me is the fact that many soldiers wanted to go back to war. Some thought of the inexperienced soldiers who needed their guidance; some talked about providing for their families. But mostly, they told me the same thing about why they wanted to go back: "You get up every day, and all you have to do is stay alive."

Ordinary daily life -- sustaining once-stable relationships, seeing old friends, paying bills, shopping -- could seem excessively burdensome when they returned. Minds that had been on high alert for so long had become better adapted to war than life at home.

"We're subject to state, federal and military law here [on post]," a soldier said in group one day, though he had never been arrested and was considering going to nursing school. He feared both other people's unpredictability and his own reactions, and he was not alone. Generally, my patients had more control than they thought they did. But in that group, one person had received a recent DUI charge, and another had been demoted after a verbal confrontation with a Department of Defense police officer.

"But what do you think would happen?" I asked the soldier who was worried about running afoul of the law.

"It could be anything," he said. "You let your guard down in the States."

I pressed: "But what might happen?"

"Anything. You just don't know."

Like other soldiers, he was troubled by the changes he noticed in himself.

I told him then what I have said to my patients again and again, trying to explain what had happened to their brains in battle: "If you put enough stress on your back, 10,000 pounds on your back, it doesn't matter how strong your back is. It's going to break. The brain is the same way -- it can only take so much stress." A broken back may not seem like a reassuring analogy, but at least it addresses the shame that my patients so often harbor.

"The brain can't just change the channel, like a TV remote," I tell them. Why do people expect their brains to be endlessly pliable, to be able to heal rapidly and perfectly after such trauma? Perhaps it's because a mental injury is invisible, which encourages the fantasy that it will go away overnight. But the change in emotional reactions and behavior cuts so close to the sense of self. For my patients, the trauma isn't something that happens to you. It is you.

lblum101@verizon.net

Linda Blum is a clinical psychologist in New Jersey.

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hawk71049

07-01-2008, 03:57 PM

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Page 1

Treating Wounds You Can't See ( http://www.washingtonpost.com/wp-dyn/content/article/2008/06/27/AR2008062702863_4.html?sub=AR&sid=ST2008063000520&pos=)...

Washington Post.Com
By Linda Blum
Sunday, June 29, 2008; Page B01

On the wall in my office at Fort Dix, N.J., hung a row of nature photos and some historical documents for my patients to look at: a land grant signed by James Madison, another signed by Abraham Lincoln's secretary in his name, a Lincoln campaign ballot. The soldier from Ohio studied the wall carefully. It was amazing, he said, how much the layout of those picture frames resembled the layout of the street in Tikrit that was seared in his memory; the similarity had leapt out at him the first time he came in for a session. He traced the linear space between the frames, showing me where his Humvee had turned and traveled down the block, and where the two Iraqi men had been standing, close -- too close -- to the road.

"I knew immediately something was wrong," he said. The explosion threw him out of the vehicle, with his comrades trapped inside, screaming.

Lying on the ground, he returned fire until he drove off the insurgents. His fellow soldiers survived, but nearly four years later, their screams still haunted him. "I couldn't go to them," he told me, overwhelmed with guilt and imagined failure. "I couldn't help them."

That soldier from Ohio is one of the nearly 40,000 U.S. troops diagnosed by the military with post-traumatic stress disorder after serving in Iraq and Afghanistan from 2003 to 2007; the number of diagnoses increased nearly 50 percent in 2007 over the previous year, the military said this spring. I saw a number of soldiers with war trauma while working as a psychologist for the U.S. Army. In 2006, I went to Fort Dix as a civilian contractor to treat soldiers on their way to and return from those wars. I was drawn by the immediacy of the work and the opportunity to make a difference. What the raw numbers on war trauma can't show is what I saw every day in my office: the individual stories of men and women who have sustained emotional trauma as well as physical injury, people who are still fighting an arduous postwar battle to heal, to understand a mysterious psychological condition and re-enter civilian life. As I think about the soldiers who will be rotating back home from Iraq this summer as part of the "pause" in the "surge," as well as those who will stay behind, I remember some of the people I met on their long journey back from the war.

'We Are Marked'

A high-ranking noncommissioned officer had waged tank warfare during both the 1991 Persian Gulf War and the Iraq war. This soldier remains in immense distress, like many of the people I treated who needed to grieve for lives they had taken in combat. Once, after he killed at least nine people in one week, he experienced acute anxiety and depression and was taken off work for a week. "They had me pet a dog," he said.

Pet a dog? That struck me as fairly mild treatment, although association with pets has been shown to lower blood pressure and other stress indicators.

"How was that, petting the dog?" I asked.

"It was okay, I think it helped some," he said. "I don't know how it was for the dog."

* * * Another soldier, a sergeant, seemed to be living under a thick, dark cloud. He would come in every week, talk some, then periodically stare off into space. He had injured his back and shoulder and was trying to accept that many of his favorite activities were over: He couldn't run, play tennis, play basketball with his son.

He was always lucid, on point, but since his return from Iraq, he had been having auditory hallucinations in which he'd hear his name being called.

He seemed so lost in his own world that I nagged him to come to a group to try to open him up. When he finally did join us, he was transformed -- talkative, funny, smiling, strikingly different than I'd ever seen him. But later, he told me he'd hated the group: He couldn't stand hearing everyone's problems; he had felt that he had to cheer everyone up; it had been unbearable. He never went back.

Shortly before he left Fort Dix, he said to me: "We [combat vets] are marked. People see us and they know. . . . They know we're different."

Sadly, he was leaving with guilt-driven thoughts. He was in chronic pain, partially disabled, but the thought of separation from the National Guard left him deeply dejected.

He joined when he was 18. The Army had given him years of memories, an identity, a sense of belonging and purpose, a way of life. "My military career is over," he said sorrowfully.

He was medically discharged with a 60 percent disability rating. He came up to say good-bye with his papers in hand. "I'm on my way," he said.

'You Have PTSD, Full-Blown PTSD'

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hawk71049

07-02-2008, 04:26 AM

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Alienated by PTSD (http://www.militarytimes.com/community/opinion/airforce_backtalk_ptsd_070708/)...

Military Times
By Beth Wilson

Many service members are getting the message: Post-traumatic stress disorder is not an automatic career-killer. It is not a sign of weakness, and it is not mental illness.

Recent statistics released by the Rand think tank show that at least 300,000 service members who have served in Iraq and Afghanistan suffer from PTSD or major depression. These numbers are expected to climb as deployments continue.

Is America prepared to receive this generation of war fighters experiencing PTSD? Perhaps not. Just as the military recognized the need to combat the incorrect perception that PTSD is a mental illness, I wonder if a similar campaign is needed for civilians.

I was recently asked a disturbing question while sponsoring a project to send military couples on the honeymoon they never had. We hope to send 50 military couples on a six-day honeymoon cruise. In my fundraising efforts, one company asked, “Will you screen winners for PTSD? We can’t have a service member shoot up the ship.” What?

This conversation was a conference call with members of the company’s management team. I was shocked at the misunderstanding of the military and PTSD. They apparently thought all service members take their M16s with them everywhere. They also had the perception that those battling PTSD are dangerous, prone to “going postal.”

They also believed that families and spouses were in great danger from their combat-experienced service member.

People who have been raped, victims of violent crime, victims of car accidents, witnesses of such events and first responders are all known to experience PTSD in the aftermath. Do we label them as mentally ill? Do we assume they are dangerous? No, we recognize that they are traumatized and offer them support, understanding and compassion. Why, then, would we view combat-related PTSD any differently? Sadly, with less than 1 percent of the total population serving in the armed forces, many Americans do not have a direct connection to someone who serves. This lack of connection can foster these misconceptions.
This brings me back to my question: If the management of a major corporation holds the views and misconceptions I mentioned, what does the local police department, the future employer or the neighbor believe about those who bravely served their country?

The writer, the wife of an active-duty petty officer first class, hosts “Navy Homefront Talk!” an Internet talk show for Navy spouses, weekly at http://www.blogtalkradio.com/nht. Her e-mail address is beth@homefrontinfocus.com.

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hawk71049

07-02-2008, 07:11 AM

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Specialists, patients critical of care PTSD ( http://www.militarytimes.com/benefits/health/military_ptsd_070523w/)

Military Times
By Kelly Kennedy - Staff writer

Experts told the House Veterans’ Affairs Committee that reliable methods exist to immediately diagnose and treat post-traumatic stress disorder — but they’re not used.

At a May 16 hearing, the experts predicted a future filled with loneliness, health complications and societal breakdowns such as divorce, substance abuse or homelessness for veterans with PTSD if the nation does not address the issue now. And, they said, the long-term financial costs could be as much as $500 billion in health care for veterans with an illness that can be treated — even cured — for much less if dealt with immediately.

Even as the experts spoke, soldiers diagnosed with PTSD railed against their treatment during a simultaneous news conference at Fort Carson, Colo. They described undergoing the treatment methods the experts said should not be used, overwhelmed doctors and examples of how the stigma against PTSD persists in military culture.

DISCUSS
Post-deployment suicide: A closer look
Several factors complicate the issue: PTSD often does not show up until months or years after the battles have ended; troops sometimes don’t mention mental health problems because they want to stay with their units while deployed or they fear it will kill their careers; those filling out health surveys in Iraq may avoid answering questions accurately because they just want to go home.

Moreover, proper diagnosis depends on a trained clinician, but often comes from a primary-care physician, which can cause problems because those with PTSD tend to have other mental health issues, such as depression, making treatment tricky. And if service members don’t receive proper care within six months of developing symptoms, doctors have lost their best opportunity to cure them.

The experts said they have possible solutions.

“What’s missing is the diagnostic piece ... standardized tests,” said Saul Rosenberg, associate professor of medical psychology at the University of California.

And he’s not talking about the surveys troops fill out to see if they might need to talk with a counselor. He recommended that every service member returning from a war zone take the Minnesota Multiphasic Personality Inventory, a test the Veterans Affairs Department already uses.

It’s a self-test, and veterans home from combat could take it online. He recommended just-returning service members take it with a psychologist present to talk about the answers to questions such as, “I usually feel that life is worthwhile,” or “Most of the time I wish I were dead.”

Those are important questions, he said, because 5,000 veterans kill themselves every year. People with PTSD tend to try to numb their feelings with alcohol, which lessens impulse control and makes them more likely to follow through on suicidal thoughts.

“With that kind of procedure, I am absolutely confident we would save lives,” Rosenberg said.
The way people think about mental health diagnoses also needs to change, he said, because mental health testing is as good for diagnosing mental problems as physical health testing is for physical problems.

There are also prescribed methods for treating PTSD. One recommended by experts and the VA is called Eye Movement, Desensitization and Reprocessing, based on talking through bad experiences to desensitize people to the pain associated with those memories.

“PTSD is very treatable … people do get well,” said Linda Rosenberg, president of the National Council for Community Behavioral Healthcare, who has no relation to Saul Rosenberg.

But the soldiers speaking from Fort Carson showed why getting help can be a problem.

Staffers from nine senators’ offices interviewed nine soldiers the week of the hearing to hear about what problems they face following an investigation by Veterans for America. The Government Accountability Office is looking at alleged bad treatment of soldiers there who have PTSD or traumatic brain injuries.

DISCHARGE OFFERED
During the May 16 news conference, one soldier said he had been diagnosed with chronic PTSD, but had been offered a quick way out with a personality disorder discharge. But if he takes it, he loses his VA benefits and may never receive treatment for his disease.

The soldier said he only received half an hour of one-on-one counseling a month, and usually received group therapy.

“Group therapy is not the most effective way to treat PTSD,” said Suzanne Best, a research psychologist in the Posttraumatic Stress Disorder Research Program at the VA Medical Center in San Francisco. “It would be difficult to treat anyone in half an hour or less. If someone says they can, they are not clinicians who treat PTSD.”

Best participated in the telephone conference at Fort Carson.

Steve Robinson, legislative liaison for Veterans for America, said only one clinician at Fort Carson is trained in EMDR, but doesn’t have time to use it because he has so many patients.

The panelists recommended allowing troops to seek private care if a military or VA hospital doesn’t have time for them, or if they fear problems with their command, and called for bringing family members into counseling with the veterans.

And they also recommended educating society — and military leadership — about PTSD as a normal reaction to the death and destruction service members witness — not as a disorder claimed by people who “can’t handle” war or who are trying to get over on the system.

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hawk71049

07-02-2008, 02:18 PM

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i received a most interesting question this morning… (please see below, in untitled quote) should anyone wish to discuss the articles, or research i have provided in this thread… please feel free to do so… either on this thread or through my Private Message (through this forum) or through my e-Mail (also through this forum). i/we have also had some communication regarding this topic on Yahoo IM. while i have discussed this subject on private messages, with several of you… understand, a couple of us are working with 2 Marines (at this very moment) with symptoms of this illness… it is obvious that someone feels left out… for that i apologize. it is not obvious that these discussions go on behind closed doors… and these discussions will continue to be PRIVATE in every meaning of the context of PRIVATE.

is this a discussion thread or just yor own personal post any article i can find thread. people try to engage you in discussion and you dismiss them by not responding .

dear, whoever you may be… well… this thread is both… it is what you wish it to be…
a discussion thread…
or a thread…
to post personal or any and all articles and or research so pertaining to the subject matter, even personal accounts, and or discussions. this is a public forum, please follow the guidelines of this forum.

please understand if i posted every article regarding this topic on this forum… Military Times memory system would need much additional memory, in order to contain such material. my hopes and prayers are that through getting this text out into the open that many will see that they are not alone… and help is on the way.

i have made every attempt to provide any and all of the latest information pertaining to this subject. in many cases the articles i have provided fairly well speak for themselves. this is a very sensitive subject with many, and carries with it the stigma… both from the military and civilian communities… being such… this topic is most difficult to discuss here on the forum, or in private, as well.

also understand i am not a mental health professional or student of such… nor am i educated in this field…i am a male, little over 58 years old, who proudly served in the USMC in the late sixties… to the late seventies… i have been under counseling and medication for over fifteen years… off and on throughout my life… is this condition curable… i think not… is it manageable… absolutely!

so to that individual that so presented the above question… i say this… i am not offended at all by your lack of understanding… or your questions… i would only ask that you present your questions openly so all of us can respond… i only ask that we keep it professional… and not use this thread as a bashing party, for those in need.

also know, on average i spent 3 ½ hours a day regarding this topic, either collecting data for this thread or helping someone through this most difficult time in their live. i hope i have answered your questions, if not lets continue on with this discussion… happy trails... hawk

----------------------------------------------------------------------------------------------------------

why do u think every thing has to be a discusion with u. if they wanted to discus it they would have. funny how u only want to discus neg rep. who the hell cares .

dear, whoever you may be,

i am not sure how i can help you…
discussion is a two way street, isn’t it…
you hide and strike from behind…
and say how i only discuss neg rep…
how dare you…
please do us all a favor and get help… hawk

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hawk71049

07-04-2008, 01:14 PM

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Soldier in photo dies after PTSD struggle (http://www.militarytimes.com/news/2008/07/military_suicidedwyer_070308w/)...

Military Times

By Kelly Kennedy - Staff writer
Posted : Thursday Jul 3, 2008 17:03:09 EDT

During the first week of the war in Iraq, a Military Times photographer captured the arresting image of Army Spc. Joseph Patrick Dwyer as he raced through a battle zone clutching a tiny Iraqi boy named Ali.

The photo was hailed as a portrait of the heart behind the U.S. military machine, and Doc Dwyer’s concerned face graced the pages of newspapers across the country.

But rather than going on to enjoy the public affection for his act of heroism, he was consumed by the demons of combat stress he could not exorcise. For the medic who cared for the wounds of his combat buddies as they pushed toward Baghdad, the battle for his own health proved too much to bear.

On June 28, Dwyer, 31, died of an accidental overdose in his home in Pinehurst, N.C., after years of struggling with post-traumatic stress disorder. During that time, his marriage fell apart as he spiraled into substance abuse and depression. He found himself constantly struggling with law, even as friends, Veterans Affairs personnel and the Army tried to help him.

“Of course he was looked on as a hero here,” said Capt. Floyd Thomas of the Pinehurst Police Department.

Still, “we’ve been dealing with him for over a year.”

The day he died, Dwyer apparently took pills and inhaled the fumes of an aerosol can in an act known as “huffing.” Thomas said Dwyer then called a taxi company for a ride to the hospital. When the driver arrived, “they had a conversation through the door [of Dwyer’s home],” Thomas said, but Dwyer could not let the driver in. The driver asked Dwyer if he should call the police. Dwyer said yes. When the police arrived, they asked him if they should break down the door. He again said yes.

“It was down in one kick,” Thomas said. “They loaded him up onto a gurney, and that’s when he went code.”
Dwyer served in Iraq with 3rd Squadron, 7th Cavalry Regiment as the unit headed into Baghdad at the beginning of the war. As they pushed forward for 21 days in March 2003, only four of those days lacked gunfire, he later told Newsday. The day before Warren Zinn snapped his photo for Military Times, Dwyer’s Humvee had been hit by a rocket.

About 500 Iraqis were killed during those days, and Dwyer watched as Ali’s family near the village of al Faysaliyah was caught in the crossfire. he grabbed the 4-year-old boy from his father and sprinted with him to safety. Zinn grabbed the moment on his camera. The image went nationwide and Dwyer found himself hailed as a hero.

He did not see it that way.

“Really, I was just one of a group of guys,” he later told Military Times. “I wasn’t standing out more than anyone else.”

According to Dwyer, he was just one of many who wanted to help after the terrorist attacks of Sept. 11, 2001. He’d grown up in New York, and when the towers came crashing down, he went to see a recruiter.
“I knew I had to do something,” he said. Just before he left for Iraq, he got married.

But when he returned from war after three months in Iraq, he developed the classic, treatable symptoms of PTSD. like so many other combat vets, he didn’t seek help. In restaurants, he sat with his back to the wall.

He avoided crowds. He stayed away from friends. He abused inhalants, he told Newsday. In 2005, he and his family talked with Newsday to try to help other service members who might need help. He talked with the paper from a psychiatric ward at Fort Bliss, Texas, where he was committed after his first run-in with the police.

In October 2005, he thought there were Iraqis outside his window in El Paso, Texas. When he heard a noise, he started shooting. Three hours later, police enticed him to come out and no one was injured.

Dwyer promised to go to counseling, and promised to tell the truth. He seemed excited about his wife’s pregnancy.

But the day he died, he and his wife had not been together for at least a year, Thomas said.

And almost exactly a year ago — June 26, 2007 — Dwyer had again been committed to a psychiatric ward. Thomas said police received a 911 call that Dwyer was “having mental problems relating to PTSD.” “We responded and took him in,” Thomas said. “He’s been in and out.”

Military Times could not reach Dwyer’s family, but his wife, Matina Dwyer, told the Pinehurst Pilot, “He was a very good and caring person. He was just never the same when he came back, because of all the things he saw. He tried to seek treatment, but it didn’t work.”

She told the paper she hoped his death would bring more awareness about PTSD.
In 2003, Dwyer was still hopeful about the future, and about his place in the war.

“I know that people are going to be better for it,” he told Military Times. “The whole world will be. I hope being here is positive, because we’re a caring group of people out here.”

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hawk71049

07-04-2008, 01:21 PM

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Bush Opens New Chapter for Hospital ( http://www.washingtonpost.com/wp-dyn/content/article/2008/07/03/AR2008070301513.html)...

By Daniel de Vise
Washington Post Staff Writer
Friday, July 4, 2008
President Bush broke ground on a $1 billion expansion of the National Naval Medical Center in Bethesda yesterday, a project that will elevate the campus into what federal officials say will be the nation's premier military medical site and a destination for wounded service members returning from Iraq and Afghanistan.

The Walter Reed National Military Medical Center, set to open by 2011, will supplant the aging Walter Reed Army Medical Center in the District, which is scheduled to close. The scale and cost of the project has grown in proportion to concern for conditions at Walter Reed, documented last year in a Washington Post series. The District facility has been strained by the volume of casualties returning from the Middle East.

Bush stood yesterday in the shadow of the hospital's landmark tower, built according to a design by President Franklin D. Roosevelt. Roosevelt laid the cornerstone of the building at a ceremony in 1940, voicing hope that the "striking" architectural style would meet approval. The tower will be preserved.

Bush addressed an audience including several dozen injured service members.

"At this new center, the Americans who fight for our freedom will get the compassion and support they deserve," Bush said.

The expanded facility will house a 345-bed medical center outfitted with state-of-the-art equipment and services to treat brain injuries and post-traumatic stress disorder, common maladies among troops returning from Iraq, and to rehabilitate amputees.

"In many fields, you are far ahead of civilian medicine," Bush said at a morning ceremony. "And when Bethesda and Walter Reed merge into one campus across from the National Institutes of Health, this will be the site of many more promising breakthroughs that will benefit not only our troops, but all mankind."

Replacing Walter Reed with an expanded Bethesda campus was a decision approved in 2005 by a Pentagon commission charged with base realignment and closure, known as BRAC. It is part of a larger $2 billion undertaking that includes construction of an Army hospital at Fort Belvoir.

The new military hospital will sit across Rockville Pike from NIH, a remarkable concentration of medical knowledge -- and traffic. With an additional 2,500 workers and double the current daily visitors, the medical center is expected to strain already congested roadways.

Cars already back up along the pike and two major cross streets near the hospital, Jones Bridge Road and Cedar Lane, said Ilaya Rome Hopkins, president of the East Bethesda

Citizens Association. Gridlock sends cars onto residential streets such as Chelsea Lane at a rate of more than 500 cars over a two-hour evening rush, she said.

"This is not a problem that's created by BRAC, but it will be exacerbated by BRAC," she said.

Maryland has budgeted $43 million to improve traffic flow at four of the most congested intersections, said Phil Alperson, BRAC coordinator under Montgomery County Executive Isiah Leggett (D).

There has been debate over what, if any, of the traffic burden should fall to the military. County officials hope the Pentagon will pay for a new Metro entrance on the east side of

Rockville Pike. Metro riders now exit the Medical Center Station of the Red Line across the street at NIH. That work, plus a new turn lane for vehicles, will cost at least $21 million, Alperson said.

"There are costs that should be picked up by the Defense Department," said Rep. Chris Van Hollen (D-Md.), who attended the ceremony.

The new center will pool the resources of the Army, Navy and Air Force. Service members said the consolidation will eliminate the need for families to travel between Bethesda and the District to see specialists.

"In the past, I've definitely had to go from Walter Reed to Bethesda to Walter Reed to Bethesda," said Army Sgt. Eric Ortegren, who returned from Afghanistan with a traumatic brain injury and PTSD. "And bringing the two together will definitely make a difference."

Ortegren said he prefers the environment at Bethesda, where services are spread across a larger and somewhat more orderly campus. The prospect of a new facility will raise spirits across the armed services, he said.

"Today soldiers are coming back with quite a lot more emotional damage than we had in the past," he said. "And knowing they're custom-designing a facility to take care of soldiers with those specific needs, that's a huge relief."

Staff researcher Alice R. Crites contributed to this report.

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hawk71049

07-04-2008, 01:58 PM

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Page 2

Outlook: Still a Long Way From Home ( http://www.washingtonpost.com/wp-dyn/content/discussion/2008/06/27/DI2008062702712.html)...

Vignettes of Iraq Veterans' Post-Traumatic Stress Disorder
Washington Post
Linda Blum
Clinical Psychologist
Monday, June 30, 2008; 12:00 PM

_______________________
Anonymous: My wife is a clinical psychologist working in a VA PTSD clinic and sees a lot of returning vets who come back and get hooked on meth. She theorizes they were given amphetamines in large amounts while in the service. Do you see this, or is it a function of our poor rural populace?

Also, when are we going to start hearing about how this war has been retriggering PTSD in the Vietnam guys?

Linda Blum: I haven't heard much about meth abuse in the service. I saw soldiers who tested positive for other illegal substances, but not for meth -- I can't speak more specifically than that. Your wife may know more.

I've read a couple of accounts of the current conflicts reriggering symptoms in Vietnam vets with PTSD, but I'd like to add that the Vietnam vets also often have been a tremendous help to soldiers returning from Iraq and Afghanistan. There is a group of Vietnam vets who visit soldiers on medical hold and have done a tremendous job of boosting morale.

_______________________
Silver Spring, Md.: A few years ago, my husband and I dealt with his major depression with the healing nature of Yoga Nidra, which is being offered to returning soldiers at Walter Reed National Medical Center. Can you please address the need for "alternative" healing methods to be introduced to those who might see them as "lite." The healing of the brain, as you point out in the last paragraph of your moving article, requires patience, prayer and restructuring of the actual neurons. I cannot imagine what some of our returning soldiers have had to deal with, and I also think of the medical professionals who are doing their best to patch up these broken bodies. What an extraordinary toll they must carry!

What is the most appropriate way to acknowledge one's gratitude to soldiers when one sees them on the street? We encounter a few amputees at cultural events, and I often feel a great need to thank these young men and women for what they have endured. The fact that they are outdoors with buddies or family seems to be a great stride toward healing, but I think they must often look around at our carefree enjoyment and wonder at our ignorance of what they have had to endure halfway around the world. Thank you so much for your article!

Linda Blum: There is ample empirical evidence of the benefits of yoga, so perhaps we need not even refer to it as an alternative treatment at this point, though it is certainly nontraditional.

"Alternative" suggests that it might replace other forms of treatment -- talk therapy, medication -- rather than be used in conjunction with them. I would urge people to look at the research, and employ whatever treatment works for them personally.

_______________________
Washington: When I was in Baghdad (with the government, not the military), many of my career soldier friends told me that counseling was frowned on institutionally, and could result in a black mark on their records. Whether that's true or not, it certainly seemed like a common belief.

Is there anything being done to improve the military's perspective on counseling?

Linda Blum: The military recently has changed policy on requiring personnel to report counseling and psychotherapy, and hopefully the new policy both reflects and will encourage a changed mindset.

_______________________
Boston: How would approach someone whom you think may need to talk about their experiences in Afghanistan or Iraq, but who doesn't seem keen on discussing anything? In the meanwhile his personal relationships are being destroyed because of his actions.

Linda Blum: I would suggest letting the person know you care and are open to discussion, but not pressuring them. You don't say what your relationship to the person is, and the level of intimacy and trust of course makes a huge difference.

_______________________
Vienna, Va.: Everything I've read indicates a strong connection between depression and PTSD. PTSD apparently occurs in civilian life as well. Are people inclined towards depression more susceptible to PTSD? It seems to me that studying this link may lead to better treatments.

Linda Blum: Depression is one of many personality factors found to increase the risk of PTSD.

I would add, though, that exposure to life-threatening events is the most crucial factor, and beyond a certain stress threshold everyone is going to experience symptoms, as the condition is rooted in the basic neurobiology of the human brain.

_______________________
Astoria, N.Y.: My father served in World War II, and my brother in Vietnam. My father said Patton wouldn't tolerate this post-traumatic stuff -- he would call you a coward if you try to get out of the military using that as a excuse. My brother -- who just passed away -- used his post traumatic crutch his whole life. It's a bunch of bull, these guys complaining about battle fatigue -- all they need is a kick in the ass and a smack in the face. Get over it already -- life goes on.

Linda Blum: It is certainly true that there are people who exaggerate their symptoms or develop a sense of entitlement as a result of a PTSD diagnosis -- but that is true of any medical condition.

While I did see some malingerers, from my experience there were more people denying or minimizing their symptoms. Someone would come in and say "well, I've had some insomnia," and you soon see that's the tip of the iceberg.

May I say that I doubt that your attitude was helpful to your brother, though I certainly understand your frustration.

_______________________
Washington: Thank you for your article. I truly believe that Americans need to pay more attention to our soldiers and become more involved in the sacrifices they are making. What would you suggest to someone who wants to get into a career field assisting our military and their families?

Linda Blum: There are many ways to make a contribution, and I would say only that you should follow your own interests and abilities. You might be interested in working on administrative aspects, might be interested in working with children and families, etc.
Good luck to you.

_______________________
Arlington, Va.: Great article addressing a topic I've had on my mind a lot because I have a son doing his first rotation in Iraq. An observation: In some ways it seems a good sign that members of our Armed Forces are so troubled by their experiences in war; it's a sign that they haven't lost empathy or their ability to identify with other people, even if their behavior after returning seems mostly to be withdrawal and lack of willingness to connect with family and friends. I also wonder if vets of past wars found their "talk therapy" informally at the VFW post, and what that experience might teach us now.

Linda Blum: These are very good points, which I would agree with. I have no doubt that the VFW and other veterans' groups have served a crucial therapeutic purpose in giving vets an arena to talk, share experiences, and maintain their bonds with each other (without any conscious awareness of providing "therapy."

_______________________
Washington: I was surprised to read about the mandatory holiday party. Have you found many instances such as this, where something supposed to be fun becomes compelled and tortuous? Can you talk to the top officials there to get them to see this point of view?

Linda Blum: I think the purpose of having a mandatory party was to promote socialization and fight the tendency of some vets to withdraw -- but, yes, compulsion/coercion is problematic and in this case it did generate quite a bit of unneeded anxiety.

_______________________
San Diego: What can the average person do to help these veterans?

Linda Blum: Your attitude of respect and interest is in and of itself helpful. Beyond that, I would suggest, follow your own interests and background, contact local vets' groups and see what their needs are.

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Tampa, Fla.: Do you know the estimate of Iraqis with PTSD?

Also, I hate to sound cold here, but what business did these soldiers think they were in? They are in the killing business. Was their some confusion when they joined the service? That said, I'm not that cold -- they should be treated because they are suffering humans. But somehow I feel that nobody cares much about the Iraqis who have been dragged out of their homes to interrogations, had their doors kicked down in the middle of the night and basically have been terrorized by our troops. Somehow I feel that nobody is going to be tallying the number of PTSD victims in Iraq. Do you?

Linda Blum: I don't know the stats on Iraqis with PTSD, but I imagine it's quite high.

From my experience, many of our soldiers do care a great deal about the Iraqi people.

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Linda Blum: I'll have to sign off, now. Thanks to all.
Linda Blum
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Editor's Note: washingtonpost.com moderators retain editorial control over Discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions. washingtonpost.com is not responsible for any content posted by third parties.

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hawk71049

07-04-2008, 02:09 PM

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Page 1

Outlook: Still a Long Way From Home ( http://www.washingtonpost.com/wp-dyn/content/discussion/2008/06/27/DI2008062702712.html)...

Vignettes of Iraq Veterans' Post-Traumatic Stress Disorder
Washington Post
Linda Blum
Clinical Psychologist
Monday, June 30, 2008; 12:00 PM

"Nearly 40,000 U.S. troops [have been] diagnosed by the military with post-traumatic stress disorder after serving in Iraq and Afghanistan from 2003 to 2007; the number of diagnoses increased nearly 50 percent in 2007 over the previous year, the military said this spring. ... What the raw numbers on war trauma can't show are what I see every day in my office: the individual stories of men and women who have sustained emotional trauma as well as physical injury, people who are still fighting an arduous postwar battle to heal, to understand a mysterious psychological condition and re-enter civilian life."

Clinical psychologist Linda Blum was online Monday, June 30 at noon ET to discuss her Outlook article recounting the stories of the Iraq veterans she met and treated at Fort Dix, N.J., and psychological therapy for the persistent nagging mental trauma of war.

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Linda Blum: Hi, I'm here to discuss "Treating Wounds You Can't See."

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Garden Grove, Calif.: What happens when we don't treat them? Will the symptom go away with time?

Linda Blum: Often symptoms will diminish with time, particularly in milder cases, but treatment very definitely promotes healing.

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San Antonio: What can I say to help my son overcome his sorrow for killing an old Iraqi man who sped through his roadblock? How does he get over carrying dead buddies back to his Humvee after roadside explosions? And there is so much more ... how can I help him? What can I say?

Linda Blum: These are the toughest questions, but your son's communication with you, and your desire to help him, are very positive signs. Too often, soldiers put up a wall in attempting to shield family members from their pain.

I would urge your son to seek counseling -- if he has not already -- to help process these experiences. Group therapy, in which he can get help from other soldiers who have been through similar experiences (and help them, too), is often highly effective.

These traumatic memories will remain with your son, but in time he will move closer to acceptance, and hopefully will be able to extract some meaning from these experiences that can guide his future life. All the best luck; my thoughts are with you.

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Mandatory counseling?: Thank for this article. Do you think all returning military members should have mandatory counseling? On the one hand, it might ferret out men and women in trouble before they fall further, but obviously it also would put an enormous strain on already-scarce resources.

Linda Blum: I don't believe in mandatory counseling, except in those cases when lives are in danger -- both because coercion is rarely effective clinically and for ethical reasons.

We need to ensure that treatment is widely available, let people know that treatment is available, and continue efforts to destigmatize PTSD, so that vets and their families won't be reluctant to seek treatment.

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Ashburn, Va.: I have a minor role in a large study being undertaken by the International Association of Chiefs of Police that is looking at issues surrounding veterans returning to their law enforcement agencies after being deployed to a combat zone. I have two questions: First, our initial observations are that law enforcement officers seem to suffer less from PTSD than other veterans. Have you had any experience in that area? If our observations are valid, could this mean that, in general, police are more stress-inoculated, or that we cover it up better than others? My second question is, if you could implement one requirement for returning veterans that would assist in re-integrating into their pre-deployment jobs, what would it be? Thanks in advance!

Linda Blum: I treated several National Guard vets with long prior careers in law enforcement, suffering from severe PTSD after particularly rough deployments, so I know that law enforcement personnel are not completely immune to PTSD. However, it's possible that the police officers do, over time, develop adaptive, self-protective responses to stress, danger and violence. I would love to see a study of this issue.

Regarding readjustment, I would urge vets to avail themselves of treatment, which is a benefit they have earned, as well as communicate as much as possible with family, friends and supportive colleagues.

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Kensington, Md.: The number quoted in the lead-in to this chat (40,000) low-balls the estimate from the Rand study earlier this year (300,000) by an order of magnitude. Is the 40,000 figure just those who actually have gone in, seen someone and met the diagnosis? In any case, thank you for this compilation of frank vignettes from your patients' lives.

Linda Blum: I believe the 40,000 figure represents diagnosed cases, and the other figure you quote is an estimate.

Thanks for your kind words about my article.

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Millington, Tenn.: Why all the guilty feelings about those you left behind in Iraq? I sure don't want to return, but feel compelled to do so, like I have unfinished business or I've let my comrades down.
Linda Blum: It sounds as if you are experiencing both empathy and guilt.

Empathy for others in difficulty is certainly among of the most admirable aspects of human nature, and guilty feelings, though painful, also can serve important purposes, individually and societally -- but it's important to remember that your individual service cannot in and of itself help the large numbers of soldiers over there now. In that sense, your guilt is irrational.

Whatever decision you make for the future, remember that you've done your part in serving, and I would like to express my appreciation.

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Richmond, Va.: I have many friends and relatives who have served, and some of them show some signs of a stress disorder, if not PTSD.

How is PTSD treated so that people can try to cope with it and return to some normalcy?

What kinds of specific coping techniques do you suggest to your patients?

Linda Blum: Really, there are numerous treatments. Even for mild, subclinical PTSD, which seems to be what you are describing, talk therapy can help and medication need not be ruled out. Relaxation exercises and yoga are often helpful.

I would encourage people to minimize life stress as much as possible and work to maintain a positive social support system, even when the tendency is to withdraw from others.

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Philadelphia: In today's newspaper, it states there is a Veterans Administration backlog of 400,000 claims for disability, and that it may take six months until the VA gets to a claim.

Does this VA backlog affect the health care that veterans are receiving?

Linda Blum: The delays in obtaining benefits and the arduous process involved certainly add to the stress level for many injured vets, but they can begin psychological treatment through the VA or Veteran's Centers before getting disability.

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Lyme, Conn.: I would like it if you would be able to confirm or explain stories that returning Iraqi veterans have told me. I think if these comments are accurate, it may help the public to better understand the degree to which post-traumatic stress disorders and other mental challenges are even more of an issue than most realize. First, I understand some of the bombs that the soldiers are exposed to cause atmospheric rattling, which literally rattles the brain.

Second, these soldiers go on patrol and face potential fire on such a regular basis that many have faced more days of combat than did soldiers in previous wars. Third, the body gear saves lives but is not protecting limbs, meaning we have a higher survival rate yet a higher severe injury rates. Are all of these points true? These veterans are returning home, and some of them will have very serious issues they are bringing back with them, and we need to be there for them.

Linda Blum: All of the above are true. I would add, though, that soldiers in Iraq and Afghanistan have a very broad array of experiences, with some going out on daily missions with constant exposure to danger, and others more protected on post.

Additionally, some U.S. bases are subject to considerably more incoming mortars and rockets than others.

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hawk71049

07-04-2008, 03:44 PM

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For 4th of July, war vets seek peace and quiet ( http://www.chicagotribune.com/news/nationworld/chi-vets-fireworks_02jul02,0,7870442.story)...

Chicago Tribune
Among traumatized troops who've seen what fireworks only simulate, the holiday can be stressful
By Julie Sullivan | Newhouse News Service
1:39 AM CDT, July 2, 2008

PORTLAND, Ore. — The "Minefield" explodes with glittering red tips. "War and Peace" unloads alternating rounds of color and fire. "The Torrent" promises "360 degrees of pyro" in a spectacular barrage.

As Americans stock up on 4th of July fireworks with battlefield themes, those with actual war experience are adopting safety plans instead. Combat veterans say they are heading to quiet campsites, small family gatherings or basements. They'll pre-stage their dreams before bed, visualizing different endings.

Depression, anxiety and drinking all spike around the 4th of July, counselors say. "This time of year is stressful —period," said Jim Sardo, a two-tour military psychologist who manages the PTSD, or post-traumatic stress disorder, Clinical Team and Substance Abuse Services at the Portland Veterans Affairs Medical Center. Unexpected bursts of noise, summer heat, crowds, traffic, forced gaiety and coolers of cold beer all contribute.

But many veterans are bothered less by the booms, Sardo said, than the deeper questions the displays raise about what it means to go to war and lose a limb, friends or a view of the world as a healthy place.

"I hear patriotic music or the Pledge of Allegiance, I start crying," said Ken Kraft, 43, who earned a Bronze Star in the Iraq War. "It's a respect and reverence for the rights we have and the really good people trying to defend this country. But I'm not pro-war, and anyone who is has never been to war."

On the last family vacation before he deployed, Kraft drove his wife, Brenda, their children and grandchildren to Disneyland for the 4th of July. The next fireworks he saw were over Camp Slayer, the former Radwaniyah presidential complex and Baath Party enclave near the Baghdad airport. Kraft oversaw security, coordinated defense and intelligence agencies' needs, and at one point, helped local Iraqis open a shopping mall.

It wasn't until he got off the plane in Puerto Rico en route home in 2005 that doctors discovered the pain and swelling he'd masked with Motrin were caused by four herniated discs and extensive blast damage to both knees. Kraft returned home to Oregon and underwent 22 surgeries, including two knee replacements. He spent nearly a year in a hospital bed. The aftershock came when he had to retire for medical reasons from the Army and from his civilian job as a sheriff's deputy.

With a master's degree in counseling, Kraft understood that he needed tools to cope. But even with counseling, he couldn't stand the school bus blocking the driveway and thus, his exit. He gave his mystified wife massive garden stones for her birthday—strategically placed to defend against an attack.

Finally, "I realized I had to find something positive." He found peace being with other vets, joining the Veterans of Foreign Wars, the American Legion and running a vets group for the Elks Club. He volunteers at a veterans home. And he has joined the Welcome Home Project, a retreat program that uses art, storytelling and conversations to help soldiers re-enter civilian life.

For Scott Kaney, the 4th of July symbolizes images of war — and peace. The Iraq War veteran married Amber Alford between combat tours on the holiday. After three combat tours, he returned unable to talk about the "ghosts" that followed him. Finally, after a particularly rocky New Year's Eve 2006, Kaney agreed to visit a veterans center. "It wasn't comfortable," the 28-year-old admits. "But every time I went in, I felt better, like I'd accomplished something."

This 4th of July, they'll celebrate their fifth wedding anniversary by returning to the river where they wed. In a mind often pocked with memory gaps, he sees their wedding clearly: the sun slowly setting on the Clackamas. The serenity. The peace.

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hawk71049

07-05-2008, 07:44 AM

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Giving Back to Veterans ( http://www.time.com/time/magazine/article/0,9171,1820127,00.html)...

Time Magazine
Thursday, Jul. 03, 2008 By JOE KLEIN

In the spring of 2007, Fred Wilpon, the owner of the New York Mets, accompanied his team on a visit to the wounded troops at Walter Reed Army Hospital. Wilpon was haunted by the experience, especially by a lieutenant who had just arrived at the hospital after being severely wounded in Iraq a week earlier. The doctors said the lieutenant would have bled to death in previous wars, but the efficacy of the battlefield medical care in Iraq and Afghanistan was remarkable. "I'd say it was a miracle that kid was still alive," Wilpon says, but then he realized he was in a hospital full of miracles. As he thought about this afterward, Wilpon figured--as others involved in the care of veterans have--that there was going to be an unprecedented need for psychological counseling for the survivors of horrific wounds. "The other thing that struck me was how removed most Americans are from the troops," Wilpon says. "Most people don't think much about the war. When I was a kid during World War II, we were always being asked to do something for the troops. I wanted to reconnect the public with the military."

Wilpon went to work, talking to military leaders about what the returning troops needed most--and to his fellow baseball owners about organizing a massive program to help out. The result, unveiled this July Fourth weekend, is an ambitious effort to raise $100 million to provide free psychological counseling for returning veterans and jobs for those who need them. The scope of the problem is enormous: upwards of 20% of combat veterans are coming home from Iraq and Afghanistan with posttraumatic stress disorder (PTSD). As recently reported in TIME, the military is prescribing antidepressants to troops downrange to help blunt the psychological effects of combat. "There's just a tremendous need for counseling," says Paul Rieckhoff of Iraq and Afghanistan Veterans of America. "The [Department of Veterans Affairs'] psychological-counseling program is overwhelmed. The suicide rates for returning vets are just off the charts. If Major League Baseball can get this program up to scale, we could save thousands of lives."

Psychological counseling is a sensitive subject in the macho world of the military. "There's tremendous stigma attached," says retired general David Grange, president of the McCormick Foundation, which will administer the program for Major League Baseball. "In my day, you'd never ask for psychological help because you'd be disqualified for command." To eliminate the stigma, a few regular Army units have started to make psychological counseling mandatory for soldiers returning from combat. "We decided to do it after those murders at Fort Bragg," said retired general B.B. Bell, who initiated mandatory counseling when he commanded the U.S. Army in Europe. (Bell was referring to the three returning soldiers who murdered their wives in 2002.) There is a similar program at Fort Lewis, Wash. According to Dr. Charles Hoge in the New England Journal of Medicine, such programs can significantly reduce the number of soldiers reluctant to go for counseling.

But those are isolated programs. And the need is even greater in the National Guard and Reserves.
Because of the all-volunteer Army, "we've never had so many Guard and Reserves involved in combat," Grange says. These troops tend to be less well trained and yanked out of settled civilian lives and therefore more susceptible to psychological stress. "They also come home totally removed from the base of support that regular troops have. They're all alone," he says. Indeed, a disproportionate number of Guard and Reserve service members have civilian jobs as first responders--police, firefighters, emergency workers--and they can be removed from their posts, sent to desk jobs or medical leave, if they seek psychological counseling for PTSD. "A lot of these people come home and find that their jobs are no longer there," says Grange, explaining why Major League Baseball included a jobs component in its program. "Ideally, if this thing works, we'll be able to link up a returning veteran with a job and counseling--and prospective employers can be reassured that the veteran isn't going to go postal on them."
With Veterans Affairs overwhelmed by two wars, it may be a good thing, spiritually, for the rest of us to help those who have sacrificed so much in Iraq and Afghanistan. A few years ago, a colonel who had just returned from combat told me, "Over there, it always felt like we're stuck in hell and the country is at the mall." Part of the responsibility for the disconnect lies with President George W. Bush, who never asked us to sacrifice for the war effort. It's time to rectify that. "I'd like to see every kid in America give part of their allowance to help the troops," Wilpon says. As an elderly kid, I'm giving part of mine. If you want to help, please visit welcomebackveterans.org

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hawk71049

07-10-2008, 02:04 AM

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Special court for vets addresses more than crime
( http://www.chicagotribune.com/news/nationworld/sns-ap-veterans-court,0,4348879.story?page=2")...

By CAROLYN THOMPSON | Associated Press Writer
Chicago Tribune
July 6, 2008
BUFFALO, N.Y. - The first clue that the Tuesday afternoon session in Part 4 of Buffalo City Court is not like other criminal proceedings comes just before it starts.

Judge Robert Russell steps down from his bench and from the aloofness of his black robe. He walks into the gallery where men and women accused of stealing, drug offenses and other non-violent felonies and misdemeanors fidget in plastic chairs.

"Good afternoon," he says, smiling, and talks for a minute about the session ahead.

With the welcoming tone set, Russell heads back behind the bench, where he will mete out justice with a disarming mix of small talk and life-altering advice.
While the defendants in this court have been arrested on charges that could mean potential prison time and damaging criminal records, they have another important trait in common: All have served their country in the military.

That combination has landed them here, in veterans treatment court, the first of its kind in the country.

Russell is the evenhanded quarterback of a courtroom team of veterans advocates and volunteers determined to make this brush with the criminal justice system these veterans' last.

"They look to the right or to the left, they're sitting there with another vet," Russell said, "and it's a more calming, therapeutic environment. Rather than them being of the belief that `people don't really understand me,' or `they don't know what it's like' -- well, it's a room full of folks who do."

If the veterans adhere to a demanding 1- to 2-year regimen of weekly to monthly court appearances, drug testing and counseling for any combination of Post Traumatic Stress Disorder, depression, substance abuse or anger management, they could see their charges dismissed, or at least stay out of jail.

After counting 300 veterans in the local courts last year, the judge tailor-made the treatment court to address not only vets' crimes but their unique mental health issues.

Charles Lewis, who stood before Russell at a recent session, may be exactly the kind of defendant the judge had in mind. The 25-year-old acknowledged walking out in frustration from his last counseling session.

"We all know that you're a good person who at times has done some inappropriate things," Russell told him. "It's time to get past the nonsense, don't you think?"

Lewis nodded in agreement. A jet mechanic four years into what he thought would be a 20-year Navy career, he severely injured his leg on the flight deck of the carrier USS Theodore Roosevelt in 2004 and was discharged.

Forced to rethink his future before his 22nd birthday, he returned to Buffalo, where he found work as a laborer and in the concrete business before starting his own concrete company. After taking on more work than he could handle, Lewis said he found himself charged with petit larceny in December for keeping a $3,000 deposit from a customer for a job that never got done. A daily habit of prescription pain pills for the plates and pins in his leg compounded the problems of someone who had known only the rigidity of the military from the time he was 18.

"It was hard to adjust," Lewis said later at his home in Buffalo's north end. "I was used to that structure. That whole time (in the Navy) I was doing what I was supposed to do, then I got out and it was just not working."

Admittedly stubborn -- he walked out of counseling because he got tired of hearing people complain -- the 25-year-old father of four is only now addressing anxiety and attention disorders linked to his wartime service and the toll it took on his leg and hearing. A 30-day stay in rehab to get off prescription drugs began his path through veterans treatment court.

"I'm doing really good now," he said.

Russell believes the need for courts like his will only grow, pointing to the 1.6 million troops who have served in Iraq and Afghanistan. It has been highly praised by the VA and other veterans organizations.

"What I appreciate about this is this isn't letting people off for what they do, it's just getting them the care that they need," said Patrick Campbell, legislative director for Iraq Veterans of America.

The group has been working with Massachusetts Sen. John Kerry, a decorated Vietnam War veteran, on legislation that would provide grants for the creation of veterans treatment courts like the one in Buffalo.

"A lot of veterans, when they come home, find the transition difficult and we all turn to different things to get through those times," said Campbell, who served in Iraq in 2004-05. "If we're not lucky enough to have a strong family social network to hold us together in those difficult times, people turn to drugs, turn to alcohol.

"All of a sudden they find themselves in a position where, instead of being the outstanding patriot who's always been the person everyone looks to, they find themselves on the other end of the law," Campbell said. "This is going to get service members back to serving their country again."

Buffalo has other courts that take a treatment approach, and they have saved taxpayers money by producing lower rates of repeat offending than other courts, said Hank Pirowski, the vets court's project director.

"For our Buffalo drug treatment court, our recidivism rate for four years out from graduation is about 16 percent. For graduates from mental health treatment court, it's about 4 percent," Pirowski said. He and Russell are confident the veterans court, which began in January, will produce results in the same range.
Although the judge is not a veteran, he noticed a bond between vet defendants and Pirowski, who served in Vietnam -- and so he built a mentor program into this court. Twenty mentors take turns sitting in on the court sessions and meet individually with defendants to help them keep up with appointments and benefits applications, or just to talk.

"It's that battle buddy mentality, that teamwork. Who do you want in your foxhole? It's going to be another veteran," said Pirowski, whose stage-whispered "good job" and handshakes are a reassuring presence.

Mentor Jason Jaskula's best friend, Staff Sgt. Christopher Dill, was killed while the two were in Iraq in 2005, and Jaskula had the wrenching duty of accompanying the 32-year-old Buffalo firefighter's body home. Jaskula is convinced the numbers of troops returning with PTSD -- 40,000 since 2003, by the Department of Defense's count -- are underestimated.

"I can see for a younger kid just getting out, they don't know how to deal with it," he said. The 37-year-old is a detective with the Department of Veterans Affairs police but would rather help fellow service members get past their problems than put them in jail.

"If you've done something that deserves to be punished, by all means you're getting punished. This isn't a get-out-of-jail-free card," Jaskula said. "But if you're hitting some stumbling blocks, I'd rather help you out.

"With mentors," he said, "it's not just some bureaucrat talking to you. I'm saying, `Listen, this is what I've done. These are the potholes that I hit and the dead-ends that I hit so we're going to go and take this route.'"

Jaskula mentored a father of three who was arrested for selling marijuana to supplement his fast-food restaurant wages after returning from Iraq.

"He's going from making money and having an important role to coming back to a society that's saying, `Go flip burgers for minimum wage and if you can't make it, oh well,'" Jaskula said.

Also in the courtroom is Donna Leigh, a substance abuse treatment specialist from the Department of Veterans Affairs. A laptop gives her direct access to defendants' records, allowing her to instantly make and track appointments and link veterans with the government benefits and services they often don't know about.

On the bench, Russell is the ever-encouraging father figure.

One defendant said he was nervous about enrolling in college because he'd never been much of a student.

"Just give yourself an opportunity," the judge replied. "This might be different for you now... We're going to help you."

Public defender Danielle Maichle stood nearby, explaining at the outset: "This is a courtroom where I'm your attorney but I'm not going to do all the talking. You're going to be speaking one-on-one with the judge in every session."

The approach cultivates a sense of trust and understanding, said Guy LaPenna, a 40-year-old veteran with a history of stealing and drug violations. The high-stress life of Navy duty aggravated problems he had before, but he said he left the service an angry alcoholic battling mental health issues.

Russell is "appreciative that we're working so hard," said LaPenna, a high-energy personal trainer. He is following the veterans court program to see a petit larceny charge dismissed, "but the real reward is getting my life back and functioning as a member of society, a productive member of society," he said.

Jack O'Connor, a Vietnam veteran who is on the advisory board of Buffalo's VA hospital, has no problem finding veteran mentors for the sessions.

"We didn't have it when we got out. We were kind of spit on," O'Connor said. "I think these guys know that they don't want that to happen to this group.

"I got arrested when I got out. A lot of us did," he said. "I wish we had a Judge Russell to listen."

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hawk71049

07-15-2008, 03:01 PM

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Page… #4

A wave of disbelief

McKinney’s men evacuated him to Forward Operating Base Apache in Adhamiya, where he died at the aid station.

Floyd heard it was an accidental discharge. And then he got a phone call.

“I was shocked,” Floyd said. “There were so many signs. I think he should have gone to mental health.”

After McKinney died, Seashore and Lefurgy worked for Floyd. “They told me it was almost like he was in a trance,” Floyd said. “They were in disbelief. He’s the father figure. He’s the one who takes care of everything.”

At home in Texas, Charles McKinney watched as military men walked up his sidewalk.

“It’s burned into my mind,” he said. “I knew why they were here. I screamed. I ran to the back of the house and told Rhonda not to let them in.”

The couple expected to hear there had been a roadside bomb or a sniper.

“An IED — you halfway expect that,” Rhonda McKinney said.

But she questions why no one in his command chain stepped in earlier to force her stepson to get help. “For them to watch it happening … it was almost a betrayal. They let him down.”

The family questions it all, poring through files and trying to reconcile what happened in Iraq with the man they knew.

“For me, it’s all just questions,” Rhonda McKinney said.

The autopsy shows no medications in McKinney’s system, causing family members to wonder whether he slept at all the night before he died, or if he came out of a daze as sleeping medication wore off.

One detail remains etched for Charles McKinney.

“I saw him,” he said. “The wound was like he turned his head.”

Investigators closed the case, ruling it a suicide.

Floyd wondered what he could have done differently.

“I’m upset with me for not being in better touch,” he said. “I watched my own men more carefully. I was more in tune to looking out for them.”

He sent a couple of his men, including one who witnessed McKinney’s death, to the combat stress clinic, where they could rest and talk for a couple of days.

“The doctors actually called me to talk about the state the guys were in to make sure I understood,” Floyd said. “I had majors and lieutenant colonels telling me what we should do when the soldiers got back.”

A few days after McKinney died, another Bradley rolled over a deep-buried bomb in Adhamiya, and four more Alpha Company men died: Sgt. 1st Class Luis Gutierrez-Rosales, Spc. Zachary Clouser, Spc. Richard Gilmore III and Spc. Daniel Gomez.

“It’s very shocking to a soldier,” Floyd said. “A lot of them didn’t want to go out in sector after that. But only a couple of times did I hear, ‘Sergeant, I’m not going.’ I was very proud of them by the time we came home.”

When fear did set in, Floyd and Greaves went out with the men on missions.

Greaves “was upset [about McKinney’s death],” Floyd said. “He did show a lot of emotion.”

But for whatever reason, Greaves has yet to speak personally to Chrissi McKinney, even though they have attended some of the same events since the unit returned home. The family feels hurt by that distance.

But Floyd, who also worked for Greaves, holds no grudge.

“Greaves was my commander, and the commander that I worked with was a commander I wouldn’t put the blame on. But I don’t know why he let him go out there,” he said. “I know he saw changes. But it’s not easy for a commander to say, ‘First sergeant, you can’t do that.’ I’ve never had a commander say that to me.”

Reynolds, the battalion commander, said Greaves does intend to meet with Chrissi McKinney but noted that it has taken Greaves time to deal with what happened himself.

“Jesse Greaves is a very warm person and a gentle giant,” Reynolds said. “I do not know why [McKinney] did what he did. Not sure we will ever find out. His duty position and responsibilities as a leader indicate he was very good at what he did — a leader of soldiers and men.”

Chrissi McKinney sought out her husband’s men when they returned from Adhamiya.

“I wanted to tell them I was sorry for what they witnessed,” she said. She met Seashore and Lefurgy, and they talked for a long time. They told her he always sang a special song from Sesame Street on patrol, but on that fateful day, he didn’t sing.

She told them her husband never would have hurt them if he had been himself, and they told her they knew that.

But she saw pain in their faces.

“They were different after that,” she said.

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hawk71049

07-15-2008, 03:07 PM

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Page… #3

Tragedy strikes

On June 21, one of Charlie Company’s Bradleys rolled over a roadside bomb. The explosion flipped the 30-ton armored vehicle upside-down and sent flames so high that no one could get near it to help the soldiers trapped inside.

McKinney and a platoon of men from Alpha Company tried to help, but five soldiers died that day: Sgt. Alphonso Montenegro, Sgt. Ryan Wood, Spc. Daniel Agami, Spc. Anthony Hebert and Spc. Thomas Leemhuis.

“He was out there picking up dead soldiers,” Floyd said. “Having done that myself, it is not an easy job.”

McKinney’s medic, Sgt. Gary Pritchett, told investigators that this “seemed to be the first of a few incidents that affected” the first sergeant.

The second was another large roadside bomb June 24 that went off about two feet in front of his vehicle, Seashore said.

“There is no doubt that if this IED had struck the vehicle, we would all have been killed,” he told investigators.

Then, on June 26, Spc. Jay Fain lost his right leg at the hip to an explosively formed projectile as he was leaving the unit’s forward operating base to go on leave, Floyd said.

McKinney went with Seashore to the combat hospital in Baghdad’s Green Zone to check on Fain. Fain’s father worked as a contractor in Iraq and also rushed to the hospital.

McKinney “began to cry, asking for forgiveness,” Seashore said, while Fain’s father “kept telling him this was not his fault.”

But these events — all within the space of a week — weighed heavily. McKinney didn’t sleep or eat for days on end.

“I think all that contributed,” Floyd said. “If somebody had raised concerns, I think things would have been different.”

Pritchett said Greaves told him McKinney had not been sleeping. After consulting a physician assistant, Pritchett gave McKinney Ambien.

Pritchett later found McKinney sitting on a bunk in the aid station, where he had been for 2½ hours. He asked McKinney to go talk with the physician assistant, but, according to the investigative report, he did not.

On July 7, McKinney went on a night mission and acted the way his men like to remember him, “singing the Oreo song and the Brady Bunch song, joking around, yelling at me for not singing along,” Seashore said. “We were having a great time.”

But when they got back, McKinney stayed up all night preparing for the battalion’s change of command the next day, when Lt. Col. John Reynolds would take over.

“He believed if it wasn’t perfect that himself and [Greaves] would get relieved,” Seashore told investigators.

The change of command went perfectly, but over the next few days, McKinney “seemed to be upset,” Seashore said. “I would ask him all day, ‘Hey, what’s up, first sergeant?

What’s on your mind? He would just reply with, ‘This place is a mess. I’m failing this company.’”

Seashore reassured him he was the best first sergeant he’d ever had, but McKinney said, “I feel like I’m useless, like I don’t have a real job.”

“That wasn’t Jeff,” Charles McKinney said. “He was squared away. But there was ... death all around him and he couldn’t do anything about it, and he didn’t want anyone else to get hurt.”

The Sunday before he died, McKinney called his wife.

“He was really strange,” she said. “I said, ‘What’s wrong?’ He said, ‘I don’t want to tell you.’”

But she pushed him to talk. “He said, ‘I feel really weird. I can’t think straight. I’m not doing a good job,’” she said.

She pushed him to rest. “‘Close your eyes and think of me and Jeremy and James,’” she told him. “He laughed and said, ‘OK. I’ll do that.’” He promised her he would see a doctor.

In the meantime, McKinney visited Greaves to tell him he was failing the company. “His complaints were unfounded and I explained that to him each time,” Greaves told investigators. “He refused to sleep and had, on several occasions, ‘zoned out’ for several hours.”

‘Falling apart’

At that point, McKinney’s family says, he should have been sent to a combat stress unit for evaluation.

“My son was falling apart, and no one helped him,” Watson said.

“They should have sent him to the doctor,” Chrissi McKinney said.

On July 10, Greaves ordered McKinney to take some sleeping medication and get 10 hours of sleep. “I told him he was on the verge of endangering soldiers by not sleeping and that he would not leave unless he complied with my guidance,” Greaves told investigators. “He looked horrible. I knew he hadn’t slept in a while.”

Greaves said McKinney slept from 5:45 p.m. to 2 a.m.

Greaves also said he believed McKinney suffered a traumatic brain injury when the roadside bomb exploded in front of his vehicle June 24. TBIs can cause a person to feel angry by affecting the part of the brain that controls that emotion.

McKinney’s driver said he got a visit from his platoon sergeant, who told him to watch McKinney on the next day’s mission because he had noticed that McKinney “wasn’t himself.”

The next morning, McKinney showed up at Greaves’ room at 2 a.m., and Greaves went over the mission with him, as scheduled. After the platoon had gathered, Greaves asked McKinney to give the final casualty evacuation rehearsal. “The first sergeant gave me a blank look when I asked him to lead us through it, so I conducted the rehearsal,” Greaves told investigators.

Still, McKinney went on patrol.

“I think he just basically showed up at his vehicle and said he was going out,” said Floyd, who took over as Alpha’s first sergeant after McKinney’s death.

Greaves told investigators why he allowed McKinney to patrol. “If I would have sent First Sergeant McKinney back to his rack, I’m afraid his soldiers would have lost confidence in his leadership. … I believe this would have broken him and his self-confidence. There were no apparent indications that First Sergeant McKinney was not capable of completing the mission we had before us.”

On patrol, McKinney shook and acted confused when he got a call on the radio, so Greaves took it.

“He kept looking at his hand mike and taking deep breaths,” his gunner, Pfc. Roberto Lefurgy, told investigators.

He played with a round from his weapon and didn’t say a word to his soldiers. At one point, he seemed to be asleep.

Seashore said he asked McKinney what was wrong. “He stopped playing with the round, threw it to the ground in anger, opened the door, and as he got out, he yelled, ‘F--- this.’

Then he turned around looking at me. He had the muzzle [of his M4] under his chin, and as he pulled the trigger, I saw in his face that he realized what he was doing and did not want to do it.

“He tried to move his head, but still the round caught him,” Seashore said. “We could not believe what just happened. I pushed him over so I could help treat the wound. I watched his eyes close, and I began to shake and slowly back up.”

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hawk71049

07-15-2008, 03:13 PM

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Page… #2

Troubling changes

McKinney proved himself long before his arrival in Schweinfurt, Germany, home of the 1-26. He worked his way through all the tabs: Airborne, Air Assault, Ranger. He tried for Special Forces, but a torn knee ligament kept him from finishing and he couldn’t try again because he had passed the maximum age limit during the course.

When Charles McKinney and his wife, Rhonda, talk about him, they never stop smiling, as if even the misery of his death can’t overcome the happiness of the memories. Pictures of him and his family fill their Texas home.

“It feels good to talk about him,” his father said. “He could be so gentle. And patient — like Job.”

Watson said her son “had an inward pride that you don’t see in a lot of people. He wanted everyone to shine, not just him.”

By the time McKinney served with the 1-26 in Samarra, Iraq, in 2004, he had an unbreakable bond of trust with his soldiers.

“Those were his kids,” Watson said. “He looked out for them.”

But after Samarra, he was different. He refused to talk to his wife about what he experienced.

“I’m sure I don’t know 20 percent of what he saw,” she said.

Charles McKinney said his son once told him he went out with a squad, and they took automatic fire from inside a school. The soldiers responded in kind. The insurgents got away, but children died in the crossfire.

“The cries of the mothers stayed with him,” his father said. “He was still talking about it a year and a half later. He said, ‘After Samarra, I’ll never be the same again.’”

But when it was time to go back in the fall of 2006, McKinney and Floyd made plans to serve together as tactical operations center battle captains. They had been pulled from their companies just weeks before deployment for the new job.

And McKinney and his wife made plans to expand their family. They had met 10 years before, although Chrissi, a German, resisted falling for an American.

“I didn’t want to be with an American or a soldier, but then it just happened,” she said. “He made me laugh. He was really sweet and understanding.”

She said the need to keep him with her influenced their decision to have a child. “I said, ‘I just want to have something of you if something happens.’ Now I really have something from him.”

At the tactical operations center, he and Floyd drew up the battle plans. But every time someone died, McKinney put the blame on himself.

“He was depressed because he couldn’t be out there with his men,” his mother said. “That’s all Jeff wanted to do — be part of a team, and he wasn’t getting to do it. Then the casualties hit, and Jeff couldn’t do anything.”

As it turned out, McKinney’s battalion was hit harder than any other Army battalion since Vietnam.

In 15 months in Iraq, 31 men were lost. Military Times featured the unit late last year in the series “Blood Brothers.”

Into the fight Adhamiya, where Charlie and Alpha companies patrolled, was a Sunni insurgent stronghold.

Roadside bombs were common. In May 2007, McKinney would get his wish to be out with the troops — he was moved from the TOC to Alpha Company to serve as first sergeant.

In general, McKinney said he inherited a good company, but he realized he had some work to do.

The company commander, Capt. Jesse Greaves, had taken over about a month before McKinney arrived.

“Seems like a pretty good company on the surface, but there are a lot of issues that have come out recently which would make you think otherwise,” McKinney wrote to a friend in an e-mail. “I’ve got guys getting drunk in sector, dudes taking drugs, huffing inhalants, stealing and one who will probably get court-martialed.”

Floyd said McKinney worked quickly to deal with the troublemakers. “It got better, and that was all because of Jeff,” Floyd said.

McKinney also sought to protect his men by trying to take more time to plan out missions.

Greaves “was very new” when McKinney arrived, Floyd said. “He was a young officer who took over a unit in combat — gung-ho, high-speed. Jeff was always saying, ‘Sir, we need to slow this down.’ He was encouraging him to engage in tactical patience.”

Greaves declined to be interviewed for this story, saying only that the investigative report on McKinney’s suicide makes clear what happened after McKinney came to Alpha Company. A copy of the report was provided to Military Times by McKinney’s family.

To Seashore, his driver, McKinney was a father figure. “The first two weeks, he was very aggressive, always making sure the soldiers ... were taken care of,” Seashore told investigators.

McKinney talked with each soldier returning from patrol to make sure he was OK and “always took care of his soldiers before himself,” Seashore said.

At one of their forward operating bases, soldiers struggled with unreliable air-conditioning units in their building. McKinney’s always worked, but even when the heat reached an unbearable 120 degrees, he refused to turn his on if his soldiers’ units didn’t work. If his men were short food or water, he refused to eat.

But he couldn’t always protect them.

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hawk71049

07-15-2008, 03:18 PM

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Page… #1

The warning signs
All the warning signs were there, but could anyone have saved 1st Sgt. Jeff McKinney? (kellykennedy@militarytimes.com)...

By Kelly Kennedy - militarytimes.com
Posted : June 09, 2008

In a home movie, 1st Sgt. Jeff McKinney sings softly to his new son while his wife, Chrissi, gives the baby a bath. McKinney teases tiny Jeremy about this, his first nude video.

Someday, McKinney sing-songs, the family will show off the footage to Jeremy’s first girlfriend.

“’Cause that’s how our parents did us,” McKinney sing-songs. “You’ll be 15, 16 years old, and you have your first date ... .”

It won’t ever play out that way, though. The McKinneys made the movie during his two weeks of home leave halfway through what was supposed to be a 15-month Iraq war deployment. He spent the break bonding with his new son and talking to his 18-year-old son, James, about going to college.

But everything changed July 11 in the bright sunshine of Adhamiyah, Iraq. That day, while out on a simple meet-and-greet patrol, McKinney stepped out of his Humvee and yelled.

“F--- this!”

He raised the barrel of his M4 to his chin and squeezed off one shot.

The first sergeant — who sang Sesame Street songs to his men and teased them just enough to make them feel like family — left his soldiers shattered.

At first, they scrambled to find the sniper who they believed must have fired the shot. When they realized the truth, they wondered how Top could have deserted them.

“That’s not First Sergeant McKinney,” his driver, Spc. Anthony Seashore, who witnessed his death, later told investigators. “Never.”

His family also felt blindsided. McKinney had no history of mental health issues. But as his parents and wife accumulated documentation from the investigation into McKinney’s death, the case became clearer.

The leadership demands of an Army at war, the untold emotional and physical injuries of combat and the unrealistic stoicism of a dedicated soldier all collided in tragedy.

McKinney had been on the scene after a 500-pound bomb left five of his soldiers and an Iraqi interpreter dead; he was in a vehicle when another bomb blew up just two feet away, almost killing him and his men; he had consoled a soldier who lost a leg to a roadside bomb.

And he had stopped eating, stopped sleeping and become convinced he was not doing enough to keep his soldiers safe.

But even after a soldier found him sitting in a wooden supply shack, staring emptily into space, even after his face grew gaunt from weight loss, even after he was unable to form the thoughts necessary to give a morning briefing, McKinney kept going out on patrol.

And that is the part that everyone — soldiers, commanders and family — must now struggle with, each and every day.

‘Jeff would never do that’ As of May 3, 139 soldiers, 25 Marines and seven sailors have killed themselves in the Iraq and Afghanistan war zones, according to Pentagon data.

Thousands, perhaps tens of thousands, more suffer from depression, post-traumatic stress disorder, traumatic brain injury and other problems. But getting combat vets to seek help is difficult.

Studies by the Army, the Defense Department, Rand Corp. and others cite the same reasons why troops with mental health issues don’t seek help: fear of being seen as “weak,” inadequate access to care, concern that asking for help can hurt a career, and guilt about letting battle buddies go out on patrol without them.

Among the troubling factors is that, like McKinney, many of those who choose suicide aren’t young first-tour junior troops. Forty-seven percent of soldiers who have killed themselves in theater are older than 30.

And half were in paygrades E-5 or above. Experts are concerned that it’s harder to spot signs of potential suicide in such war-hardened veterans.

McKinney’s family believes that if his chain of command had paid closer attention to the symptoms, his death might have been avoided. And they hope that by talking about it now, months after his death, they might help prevent other suicides.

“It will not be in vain if it helps just one soldier to get the help they need,” said McKinney’s mother, Kay Watson. “And I want everyone to know what a good man he was.”

Chrissi McKinney had a second reason: If her husband had been in his right mind, he never would have hurt his men like that.

“The most important thing to know is Jeff was not himself,” she said. “Jeff would never do that.”

McKinney came to Bravo Company, 1st Battalion, 26th Infantry Regiment, at the request of a friend. He first met 1st Sgt. Kevin Floyd at Fort Polk, La., where, Floyd said, there was nothing to do but fish and hang out with friends.

This was a guy, Floyd recalled, “who had his act together.” They spent all their time together and enjoyed competing as platoon sergeants within the same battalion — but always helped each other out. Floyd said McKinney liked to play, but he also wanted everything just so.

For example, McKinney had thousands of KinderEggs — chocolate eggs filled with toys that are popular with soldiers in Germany — but they were perfectly spaced and dusted.

Within the new battalion, McKinney quickly earned a reputation for knowing his job. He played the drill sergeant, ragging a soldier until he got it right. But he inevitably earned their respect along the way, according to several of his men.

“He definitely liked to joke with the soldiers — to try to make it feel like they were family,” Floyd said. “As a senior leader, that’s pretty unusual. In Alpha Company, he’d know who was married, who had kids. He had 140 people and he knew all the names and faces.”

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jagmedic

07-16-2008, 06:02 PM

Gulf war Vet get new Committee to address their issues
Yet they remain silent and fail to communicate said Jagmedic

Department of Veterans Affairs (008A1)
ATTN: Advisory Committee on Gulf War Veterans
810 Vermont Ave
Washington, DC 20420
202-461-5758
lelia.jackson@va.gov ,Lelia P. Jackson, Board memeber

hawk71049

07-19-2008, 06:09 PM

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Page #2

As wars in Iraq and Afghanistan lengthen, emotional toll on military families deepens (http://www.chicagotribune.com/news/nationworld/sns-ap-military-scarred-families,0,5121572.story?page=1)...

Chicago Tribune
By DAVID CRARY | AP National Writer
12:44 PM CDT, July 19, 2008

"Somebody who's violent and controlling of his partner before he leaves will spend a lot of time while he's away wondering what she's doing, worrying that he doesn't have that day-to-day control," said Debbie Tucker, who co-chaired the Pentagon's domestic violence task force. "He comes back with the attitude that it needs to be re-established as firmly as possible."

Despite the stresses, a study published in April by Rand Corp. concluded that divorce rate among military families between 2001 and 2005 was no higher than during peacetime a decade earlier. But the study doesn't reflect the third and fourth war zone deployments that have strained many military marriages over the past three years.

Maj. Mike Oeschger gets a closer look at struggling marriages than he'd like in his role as rear detachment commander for the 1st Brigade Combat Team at Fort Campbell. Dealing with family crises while the brigade is in Iraq is a critical part of his job.

"The biggest problems usually revolve around money — the husband may not have given the wife access to funds," he said.

Oeschger, a husband and father who served in Iraq himself, has seen infidelity in multiple forms. Some wives at the base are preyed on by men who know the husbands are overseas; some war-zone soldiers pursue extramarital affairs over the Internet.

"Often the guy comes back, tells his wife, 'I'm not interested in you any more. I think we're done,'" Oeschger said.

He'd rather stay out of his soldiers' personal lives, but that's not always an option.

"There's almost nothing that's private in the Army," he said. "Once it starts to affect performance, I'm involved and want to know every detail. It's miserable stuff ... but it's my job."

Col. Ronald Crews, one of several chaplains called from the reserves to help with family counseling, said long-distance marital crises became so severe for two Fort Campbell soldiers recently that they were sent home from Iraq to handle them.

"Their commander said they wouldn't be of any use until the problems were resolved," Crews said. The soldiers were required to meet with him weekly. One returned to Iraq and the other did not.

For some time, chaplains have been conducting marriage workshops for soldiers back from deployment. Now, says Crews, married soldiers also are being required to attend such workshops before they leave.

"Deployments don't help in strengthening a marriage, but they do not have to kill marriages," Crews said. "That's a choice a couple has to make."

Medical personnel, meanwhile, have been directed to be more aggressive in screening spouses of deployed soldiers for depression. More than 1,000 "family readiness support assistants" are being added, as are dozens of marriage and family therapists. A respite child care program is expanding to provide more relief to stressed mothers.

However, for families living off-base, there are often far fewer support programs readily available.

Advocacy groups also say more must be done for families of wounded and traumatized soldiers who leave the service. At a recent congressional hearing, Barbara Cohoon of the National Military Families Association suggested the Veterans Administration is not meeting these needs, and said the anguish of wounded soldiers' children "is often overlooked and underestimated."

Stacy Bannerman, an anti-war activist whose husband served with the Washington State National Guard in Iraq, says many Guard members and reservists don't get adequate treatment when — like her husband — they are diagnosed with PTSD.

"The families are scattered everywhere, and we don't have the support networks that active duty does," Bannerman said. "There's very little attention paid to reintegration — bammo, you suddenly go back to your civilian life. I haven't spoken to anyone who hasn't experienced some degree of stress on a marriage."

Her own marriage nearly became one of the casualties. She and her husband, Lorin, were separated for more than a year, but now — after finding a counselor outside the military — are working at reconciliation even as Lorin faces a second deployment to Iraq in August.

"It's been a long, arduous process," said Bannerman, who has moved to Oregon to work at an animal sanctuary which is seeking to involve traumatized veterans in its programs.

Many returning soldiers experience some form of depression, lapsing into substance abuse, sleeping fitfully, withdrawing from family activities. Children may feel their father is too distant, or unsettlingly changed.

"The kids may not really recognize their parent," said Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general. "Their expectations build up, and then expectations aren't met."

The Army would like to beef up psychiatric care for children, Ritchie said, but is hampered by a national shortage of child psychiatrists.

"The children of these families are suffering damage emotionally and a lot of them aren't getting any help," said Lee Rosen, whose North Carolina law firm handles many military divorces. "We're going to have fallout from this for a long time."

Rosen says the breaking point for many couples often arrives with a second or third deployment.

"To go off for one deployment for a year is difficult, but when that soldier comes back, people are able to adjust, to heal," he said. "When you go a second time, and are threatened with the possibility of a third, it's just devastating."

Yet many marriages don't survive even a first deployment.

While 1st Lt. Mike Robison was serving in Iraq in 2003-04, his wife, Candance, depicted him as a "good, brave man" in a letter she wrote to President Bush. But the marriage fell apart after Robison's return home to Texas. Candance said they argued over her role managing the household and how he treated her 10-year daughter from a previous relationship.

"It absolutely changed him," Candance said of his deployment. "I still struggle every day — that year has affected every single aspect of my life."

Andrew Brown, an Army Reserve sergeant from Pennsylvania, says his marriage failed to survive the effects of his Iraq deployment in 2004-05. Returning home, he was diagnosed with PTSD and deduced that his wife, lonely in his absence, had been having an affair.

"With the mental state I was in, I was relying on her to provide support, and she wasn't ready to do that," Brown said.

"What I went through is not an isolated incident," he added. "Guys came back — they'd shut down, turn to the bottle, have lots of fights with their spouses."

At their small ranch house near Fort Campbell, Staff Sgt. Brian Powell and his wife, Krystal, expressed determination to keep their marriage on track as they raise two young sons and as Brian faces a second deployment — this time to Afghanistan — starting in December.

Brian was in Iraq when his eldest son, Jamison, was born in 2006. He got home on a brief leave three days after the birth.

"It was just two weeks," Brian said. "You don't want to get attached because you know you have to go back."

"It's a really hard transition, coming back from blood, death, corruption to a wife and baby. You feel you don't know each other," Krystal added. "But if you have faith, you get through it."

___

On the Net:

Army family-support programs: http://www.behavioralhealth.army.mil/

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hawk71049

07-19-2008, 06:12 PM

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Page #1

As wars in Iraq and Afghanistan lengthen, emotional toll on military families deepens (http://www.chicagotribune.com/news/nationworld/sns-ap-military-scarred-families,0,5121572.story?page=1)...

Chicago Tribune
By DAVID CRARY | AP National Writer
12:44 PM CDT, July 19, 2008
FORT CAMPBELL, Ky. (AP) _ Far from the combat zones, the strains and separations of no-end-in-sight wars are taking an ever-growing toll on military families despite the armed services' earnest efforts to help.

Divorce lawyers see it in the breakup of youthful marriages as long, multiple deployments in Iraq and Afghanistan fuel alienation and mistrust. Domestic violence experts see it in the scuffles that often precede a soldier's departure or sour a briefly joyous homecoming.

Teresa Moss, a counselor at Fort Campbell's Lincoln Elementary School, hears it in the voices of deployed soldiers' children as they meet in groups to share accounts of nightmares, bedwetting and heartache.

"They listen to each other. They hear that they aren't the only ones not able to sleep, having their teachers yell at them," Moss said.

Even for Army spouses with solid marriages, the repeated separations are an ordeal.

"Three deployments in, I still have days when I want to hide under the bed and cry," said Jessica Leonard, who is raising two small children and teaching a "family team building" class to other wives at Fort Campbell. Her husband, Capt. Lance Leonard, is in Iraq.

Those classes are among numerous initiatives to support war-strained families. Yet military officials acknowledge that the vast needs outweigh available resources, and critics complain of persistent shortcomings — a dearth of updated data on domestic violence, short shrift for families of National Guard and Reserve members, inadequate support for spouses and children of wounded and traumatized soldiers.

If the burden sounds heavier than what families bore in the longest wars of the 20th century — World War II and Vietnam — that's because it is, at least in some ways. What makes today's wars distinctive is the deployment pattern — two, three, sometimes four overseas stints of 12 or 15 months. In the past, that kind of schedule was virtually unheard of.

"Its hard to go away, it's hard to come back, and go away and come back again," said Dr. David Benedek, a leading Army psychiatrist. "That is happening on a larger scale than in our previous military endeavors. They're just getting their feet wet with some sort of sense of normalcy, and then they have to go again."

Almost in one breath, military officials praise the resiliency that enables most families to endure and acknowledge candidly that the wars expose them to unprecedented stresses and the risk of long-lasting scars.

"There's nothing that has prepared many of our families for the length of these deployments," said Rene Robichaux, social work programs manager for the U.S. Army Medical Command. "It's hard to communicate to a family member how stressful the environment is, not just the risk of injury or death, but the austere circumstances, the climate, the living conditions."

An array of studies by the Army and outside researchers say that marital strains, risk of child maltreatment and other problems harmful to families worsen as soldiers serve multiple combat tours.

For example, a Pentagon-funded study last year concluded that children in some Army families were markedly more vulnerable to abuse and neglect by their mothers when their fathers were deployed in Iraq and Afghanistan.

In Iraq, the latest survey by Army mental health experts showed that more than 15 percent of married soldiers deployed there were planning a divorce, with the rates for soldiers at the late stages of deployment triple those of recent arrivals.

For the Army, especially, the challenges are staggering as it furnishes the bulk of combat forces. As of last year, more than 55 percent of its soldiers were married, a far higher rate than during the Vietnam war. The nearly 513,000 soldiers on active duty collectively had more than 493,000 children.

Jessica Leonard at Fort Campbell says family support programs there have improved since her husband's first combat tour, helping her feel more self-reliant. Yet she's convinced that domestic violence and divorce are rising at the base, which is home to the 101st Airborne Division.

"Infidelity is huge on both sides — a wife is lonely, she looks for attention and finds it easier to cheat," she said. "It does make even the most sound marriages second-guess."

Among soldiers coming home, whether for two-week breaks that often end with wrenching good-byes or for longer stays, she sees evidence of lower morale and rising depression.

"They come home, and find that problems are still there," she said. "Instead of a refreshing R-and-R, a nice little second honeymoon, it's battle for two weeks."

There have been some horrific incidents shattering families of soldiers back from the wars — a former Army paratrooper from Michigan charged with raping and beating his infant daughter; a sergeant from Hawaii's Army National Guard accused of killing his 14-year-old son as the boy tried to save his pregnant mother from a knife attack by the soldier.

In one of the saddest cases, a recently divorced airman who served with distinction in Iraq chased his ex-wife out of military housing with a pistol in February before killing his two young children and himself at Oklahoma's Tinker Air Force Base. Tech. Sgt. Dustin Thorson's former wife had sought a protection order against him, saying he threatened to kill the children if she filed for divorce.

Officials at Tinker, while confirming that Thorson had been getting mental health care, would not say whether those problems related to his service in Iraq.

His brother, Shane Thorson, a sheriff's deputy from Pasco, Wash., who also served in Iraq, has no doubt Dustin's war experiences contributed to the tragedy.

"He didn't want to go — he was afraid, but he had a job that he'd signed up to do and he went and did it," Shane said. "I do think it led up to everything that happened. ... It opened up a world of death and chaos and uncertainty."

Shane, who is married and has an 8-year-old daughter, is sure the deployments have damaged many marriages.

"My wife and friends, they tell me I'm not the same person before I came back — not as loving," he said. "You really realize how insignificant you are in this world, and life moves on whether you're there or not."

Overall, the Army says its domestic violence rates are no worse than for civilian families. However, critics say there is a lack of comprehensive, updated data that reflects the impact of war-zone deployments and tracks cases involving veterans, reservists and National Guard members.

The Miles Foundation, which provides domestic-violence assistance to military wives, says its caseload has more than quadrupled during the Iraq and Afghan conflicts.

"The tactics learned as part of military training are often used by those who commit domestic violence," said the foundation's executive director, Christine Hansen, citing increased proficiency with weapons and psychological tactics such as sleep deprivation.

Jackie Campbell is a nursing professor at Johns Hopkins who served on a Defense Department task force examining domestic violence. She says the military's data on the problem is based only on officially reported incidents, and should be supplemented with confidential surveys such as some that were conducted before the Iraq war.

"They have no clue what the rate of domestic violence is — they only know what's reported to the system, and that's always lower than the actual rate," Campbell said. "I'm disappointed.... I know the system is stressed to the umpteenth degree. But I do think they need to do the right kind of research so they can keep up with this."

One complication, she said, is the high rate of post-traumatic stress disorder among service members returning from war. She said PTSD raises the risk of domestic violence, yet many soldiers and their spouses don't want to acknowledge PTSD or any domestic crises for fear of derailing the soldier's career.

"They know the power of the military will come down on them," Campbell said. "The women are often reluctant to have that happen."

At Fort Campbell, Family Advocacy Program director Louie Sumner — who's in charge of combatting domestic violence — has encouraged people to report suspected abuse, to the point where many allegations turn out to be unsubstantiated.

But Sumner said his program, though considered one of the Army's best, should do more outreach with the majority of families who live off the huge base, in subdivisions, apartments and trailer parks where many couples' troubles may go undetected.

Sumner is sure that the repeated deployments heighten the risk of family violence. "When the soldier goes overseas three, four times, the fuse is a lot shorter," he said. "They explode quicker, and the victim gets hurt worse."

He marveled that some of the hasty marriages by youthful soldiers survive the rigors of deployment.

"My wife and I have been married 38 years," he said. "I'm not sure we could have stood being apart 30 of the next 42 months at the start of our marriage. That's a long time when you're real young."

The independence that wives develop at home alone leads to friction when a returning husband seeks to restore the old order in household decision-making.

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