PTSD: Memory with the volume on high

According to a Rand study released last April, nearly 20 percent of military service members who have returned from the wars in Iraq and Afghanistan—300,000 in all—reported symptoms of post-traumatic stress disorder (PTSD) or major depression, yet only slightly more than half have sought treatment. Those numbers, which boil down to about 1 out of 5 soldiers, are troubling. In addition, another 19 percent reported experiencing a possible traumatic brain injury (TBI) while deployed, with 7 percent reporting both a probable brain injury and current PTSD or major depression.  

For the past four months I've been interviewing veterans of the wars in Iraq and Afghanistan who are struggling with PTSD. I've also been speaking with expert researchers, Veterans Administration (VA) therapists, and military psychologists/psychiatrists to help me better understand the disorder and the issues returning soldiers are facing. My interviews have revealed complex issues facing both veterans and caregivers. From the veterans' perspective, re-adjusting to civilian life can prove more difficult than imagined. Leaving behind the sights, sounds, and smells of the battlefield becomes, for many, a daily challenge. Marked by panic attacks, uncontrollable anger, and flashbacks, many veterans affected by PTSD may not even realize it at first. On the caregivers' side, treating the disorder often takes a trial and error approach. Though neurologists studying the disorder via brain imaging (spurred by funding from the Department of Defense to better address PTSD) are making great progress, clinical treatments based on those findings are a ways off. VA therapists on the ground level, however, continue to rely on "evidence based" treatments such as CPT (Cognitive Procesing Therapy) and PE (Prolonged Exposure) therapy.

My initial interest in this topic originated after reading about the rising suicide rate among U.S. troops. Which, incidentally, is on track to surpass Vietnam War era highs by year end [click here]. I initially wondered what factors were contributing to this spike, and how the military was handling it. As far as the contributing factors are concerned, there are many, chief among them: multiple deployments, an all-volunteer force stretched dangerously thin, and intense fighting that can only be likened to the brutal guerilla warfare Vietnam veterans experienced.

PTSD is a sensitive subject within the military, mainly because mental health treatment is generally seen as a blot on a soldier's record (which is primarily problematic for career miltary who wish to advance in rank). Although the military is attempting to address the stigma associated with PTSD, immediate relief is needed.

After having multiple in-depth conversations with a veteran and former Naval mortician, something she said really resonated with me. She explained how a fellow veteran once told her that PTSD was like "memory with the volume on high." It gave such powerful context to the other experiences she had relayed about her PTSD—the perpetual reliving of certain memories; fear/anxiety triggered by loud noises or large crowds; and flashbacks triggered by certain smells in the air. An example she had previously given regarding a panic attack she experienced during a fourth of July fireworks display, came to mind. After unexpectedly bursting into tears in the middle of the display, she had to get away from the noise. A short time later, when she felt it was safe to go back to where her friends and family were seated, the smell of the residual sulfur began creating the anxiety all over again. Examples like this are common for the thousands of veterans from Iraq and Afghanistan who are dealing with PTSD in their new civilian lives. Photo credit: Zoriah Miller