"The term 'PTSD' has come into the common lexicon in a very non-specific manner, often used to refer to any type of emotional reaction to traumatic or disturbing events," said Dr. David Reiss, M.D., in an interview for IVN. Reiss is a psychiatrist from San Diego currently providing treatment within the Uniform Services Program at The Brattleboro Retreat in Vermont.
It's important to understand that PTSD isn't just an abbreviation on a memo from a bureaucrat's office. It is a debilitating condition to those who live with it.
To those who don't, including those in Washington, it is often just another acronym thrown about in the endless debate on foreign policy and the use of force abroad, or attached to some tragic story on the evening news. But there are some staggering numbers that go along with those letters. It's a very real problem that needs real treatment and affects some of America's bravest men and women.
"Every person suffering from PTSD is a unique individual interacting with a complex society," Reiss said.
According to a report from the Congressional Research Service, as of January 2014, more than 150,000 service members have been diagnosed with PTSD since 2000. Of course, the number is significantly higher when active service members and veterans are combined. Pinpointing an exact number of veterans is difficult because there are many variables, such as when symptoms were reported and the severity of the symptoms.
The rate of PTSD diagnoses among service members is 3-6 times higher in those who were deployed in support of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn.
1 in 5, The rate is substantially higher among Vietnam veterans, with the number being about 3 in 10, or 30 percent. Again, exact numbers are difficult to accurately estimate, especially within the VA health care system. Not every veteran will register with their local VA medical center or seek help through the VA medical center, even if they do register.
According to the VA
"There are different methods by which clinical PTSD can be treated," Reiss said, "and each individual may or may not respond well to specific treatment approaches."Reiss is adamant that there is no "one size fits all" answer and that treatment must be tailored to fit each individual person if it's going to be effective.
"In the most severe situations, effective treatment can be very difficult," he added.
The Congressional Budget Office (CBO) estimates that in 2010 alone, the Veteran's Health Administration (VHA) spent about $2 billion on treating PTSD. The CBO also estimated that by 2012, those costs would be at least $6 billion.
The costs associated with treatment can vary widely from case-to-case and even year-to-year. The availability of treatment can vary based on location as well, making treatment more or less expensive.
A little known condition that can tag along on cases of PTSD is Traumatic Brain Injury (TBI). Between 2000 and 2013, there have been more than 287,000 cases of TBI, most of them mild. However, about 5 percent of those who received treatment from the VHA for PTSD between 2004 and 2009 had both PTSD and TBI. That accounts for almost 27,000 cases.
Research suggests that there is a link between trauma and physical pain. Half of all service members who are diagnosed with PTSD also have some kind of problem with chronic pain. In some cases, the traumatic event and its related physiological changes can trigger the onset of conditions such as Fibromyalgia or Chronic Fatigue Syndrome. This chronic pain can be the result of the traumatic event itself, as in the case of amputees or those with TBI, or it could be the result of the repeated stresses of battle. Sometimes the pain can also be part of another larger problem, as is the case with Gulf War Illness.
According to FacetheFacts.org, a nonpartisan information resource service out of George Washington University, health care costs are 3.5 times higher for veterans with PTSD than those without, and it's easy to see why. Approximately half of those with PTSD have other mental health conditions or chronic health problems. FacetheFacts.org estimates that average health care costs top $8,000 in the first year of treatment.
"Post-Traumatic Stress Disorder is the condition that occurs when memories of a traumatic/disturbing event cannot process into a normal memory – albeit an uncomfortable memory," Reiss said. "The 're-experience' of the situation is then actually re-traumatizing, and again elicits a 'fight or flight' response – even though the danger has actually passed."
One of the leading causes of PTSD is sexual trauma. It is estimated that 71 percent of women who have been to combat develop PTSD as a result of military sexual trauma. And while it is the leading cause of PTSD in women, men are also victimized. Given that service members are often required to remain in a close environment with the perpetrators, it is no surprise that an alarming number of assaults go unreported or unprosecuted, thus leading to a repeated re-victimization.
The Army estimates that one soldier per day takes his own life and between 18 and 22 veterans commit suicide every day. While that number is shocking, what's even more shocking is the 40 percent increase seen in younger vets and the 11 percent increase seen among women between 2009 and 2011.
According to the CBO, just over 50 percent of veterans who have served in Iraq or Afghanistan and are treated at the VHA have some kind of diagnosis of mental illness, most often depression, anxiety, and substance abuse related to PTSD.
PTSD isn't just hard on the service member; it can be devastating to their families too. As spouses face empty beds and moms or dads suddenly become single parents, the long separations of deployment are extremely stressful. That stress increases with the service member gets home but suddenly they aren't the same person that they were when they left.
A 2005 study from the Pentagon estimates that there has been a 78 percent increase in the number of divorces in the military since 2003. Another study found that when Vietnam-era vets returned from Southeast Asia, 38 percent of their marriages ended in divorce within 6 months.
Unfortunately, veterans and service members are not always afforded the same compassion as others facing debilitating illnesses. For example, in April, Colorado failed to pass an initiative that would have allowed veterans struggling with PTSD to use marijuana medicinally without losing their benefits.Despite the fact that marijuana is legal for the general public, it still remains off-limits to vets.
The VA has said before that it would not penalize veterans who were using marijuana medicinally, provided that local law allowed it for the treatment of whatever medical condition the veteran had been diagnosed with.
While more than 20 states have legalized medicinal marijuana, only eight allow it for the treatment of PTSD. The Department of Defense will not allow the prescription of medical marijuana either, even in states where it is legal. Everyone else is just out of luck.
Recently, the federal government approved a research study into the effectiveness of marijuana as a treatment for PTSD. The results of that study and changes in legislation still have a long way to go.
Photo retrieved from AcuTake.