Iraq & Vietnam War Stories

I saw both of these articles this morning and they definitely caught my attention. This war, that our two leading Republican candidates are making it clear would continue indefinitely if they are elected, is causing increasing tragedies for our soldiers and their families. If you are living in a Super Tuesday state and you need another reason to be sure to vote, here it is. What could already have been accomplished had Bush been gone in the last year to end this insane war? The connection between PTSD and suicide was firmly established in earlier wars, and particularly in the Vietnam War, but as these articles indicate the refusal to acknowledge the need so many currently serving soldiers and veterans have for mental health treatment so as to avoid the expenditure and commitment of resources treatment would require, is having catastrophic consequences. We need to write our Congresspeople and tell them that our soldiers need our support if they are to ever resume the lives they left to serve our country. What they are experiencing in Iraq and Afghanistan is staying with them when they return and leading them to hurt themselves and others. That is unacceptable…

STUDY: PTSD, NOT BRAIN INJURY, MAY CAUSE VET’S SYMPTOMS

• Story Highlights
• Study: Symptoms usually linked to vets’ concussions were actually related to PTSD
• 5 percent of soldiers surveyed reported battle concussions/loss of consciousness
• Critic: Doctors shouldn’t dismiss true brain injury symptoms as psychological only

By Yvonne Lee
CNN

NEW YORK (CNN) — Sgt. Ryan Kahlor has the same nightmare every time, a vision of walls painted in blood and fat, and men on top of houses, throwing pieces of Marines’ bodies off rooftops. It’s a vision he can’t shake, because he lived through it while deployed to Iraq last year.

“I have nightmares. I dwell on it. I think about it all the time,” said Kahlor, 24. “Staying asleep is hard. I associate a bed with the dreams I have. My parents think I’m crazy, but I sleep better when I’m on the floor.”

Kahlor has post-traumatic stress disorder, which can develop after surviving a traumatic event in which a person is physically threatened or injured.

He also experienced concussions while surviving four explosions during his 14 months in Iraq. He said these events left him with a detached retina, vertigo, memory problems and dizziness.

A new military study published Wednesday in the New England Journal of Medicine says soldiers who suffered concussions in Iraq were not only at higher risk of developing post-traumatic stress disorder and depression, but also that the depression and PTSD, not the head injuries, may be the cause of ongoing physical symptoms.

Five percent of the 2,500 soldiers surveyed by Walter Reed Army Institute of Research said they had concussions in which they lost consciousness during combat. Forty-four percent of these soldiers ended up with PTSD.

Researchers were surprised to find symptoms normally associated with concussions — headaches, dizziness, irritability and memory problems — were actually related to PTSD or depression. Watch Dr. Sanjay Gupta explain the study. »

“It isn’t the combat exposure or physical injury, it’s the PTSD that seems to drive these symptoms. That’s a surprise,” said Joseph A. Boscarino, Ph.D., who studies PTSD at the Geisinger Center for Health Research in Danville, Pennsylvania. “You would expect they would have these other symptoms related to traumatic brain injury, that maybe they have a permanent injury, but it’s explained by whether they have PTSD or depression.”

About 8 million American adults have PTSD. A 2003 New England Journal of Medicine Study found that 15 percent to 17 percent of Iraq and Afghanistan veterans were suffering from PTSD, and more than 60 percent of those showing symptoms were unlikely to seek help because of fears of stigmatization or loss of career advancement opportunities.

As of June 30, 2007, the Department of Defense reported 3,294 soldiers in Iraq and Afghanistan suffering from traumatic brain injuries, or TBIs. Bomb blasts caused nearly 70 percent of those TBI cases.

Dr. James Kelly, a neurology professor at the University of Colorado and a co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues.

“I think if people misunderstand or overextend beyond what this survey shows, they could dismiss true brain injury features as psychological only,” Kelly said. “It would be a terrible disservice to our military for that to happen.”

Kahlor is worried this study will make it harder for soldiers to get appropriate medical care.

“The military doesn’t want to diagnose people with brain injury,” he said. “So what they’ll do is play it off as PTSD as the sole injury for everyone, because PTSD and traumatic brain injury have very similar symptoms,” he said. “The disability [compensation] is a lot higher for traumatic brain injury. What the military is saying is, you can’t be diagnosed from a brain injury unless you get better from PTSD. It’s kind of like a paradox.”

Kahlor says he has documents saying he has concussion injuries such as a detached retina, seizure activity in the brain, inner-ear expansion and post-concussion syndrome, which gives him bad headaches. Still, he has been unable to get an official diagnosis of traumatic brain injury.

“A doctor in Fort Irwin looked at me and glanced at my records for 10 minutes and wrote on my records that he thought my symptoms, my claims were psychosomatic, where I made them up myself,” Kahlor said. “He’s basically seen me once. He wanted to send me to a med board to get me out of the Army as soon as possible and pawn me off to the VA system.”

In response to concerns that this study could make it more difficult for soldiers to get a diagnosis of traumatic brain injury, study author Col. Charles Hoge said, “Hopefully it clarifies things a bit, that soldiers who have had concussions with loss of consciousness are at higher risk of PTSD. We want to make sure they are seen and get help. It also clarifies that the symptoms they are experiencing may be multiple reasons for that.”

Kelly said one of the problems with the study is that it describes symptoms such as headache, dizziness and fatigue as possibly psychosomatic and related to PTSD and depression. But these are symptoms also commonly associated with postconcussive syndrome, he said.

“They don’t know that these soldiers didn’t have post-concussion syndrome,” he said. “They are components of post-concussion syndrome and PTSD… It’s absolutely confusing. My concern with this article is people can over-attribute all the lingering problems to psychological issues only, when it started with a biomechanical brain injury. I think it’s unfair to unlink what happened to the brain and the psychological aftermath of what happened in that scenario.”

In an accompanying editorial, Richard A. Bryant, Ph.D., says this study should encourage doctors to be more cautious when attributing health problems to mild traumatic brain injury, because PTSD and depression may be the problem.

“Incontrovertible evidence now shows that psychological factors play a significant role in postconcussive symptoms,” Bryant said.

“Soldiers should not be led to believe that they have a brain injury that will result in permanent change.”

He said the study also highlights the need for a clear definition of mild traumatic brain injury.

“The study retrospectively assesses for mild traumatic brain injury by inquiring about having a loss of consciousness, being dazed, or not remembering the inquiry. Each of these reactions can be attributed to acute stress,” Bryant said.

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CONCERN MOUNTS OVER RISING TROOP SUICIDES
Story Highlights
Average of 5 soldiers per day tried to commit suicide in 2007, Army figures show
Sen. Jim Webb introduces legislation to improve care for soldiers
Army psychiatrist says soldiers must overcome stigma of treatment
Psychiatrist: “We know that soldiers don’t want to go seek care”
WASHINGTON (CNN) — Every day, five U.S. soldiers try to kill themselves. Before the Iraq war began, that figure was less than one suicide attempt a day.

The dramatic increase is revealed in new U.S. Army figures, which show 2,100 soldiers tried to commit suicide in 2007.

“Suicide attempts are rising and have risen over the last five years,” said Col. Elspeth Cameron-Ritchie, an Army psychiatrist.

Concern over the rate of suicide attempts prompted Sen. Jim Webb, D-Virginia, to introduce legislation Thursday to improve the military’s suicide-prevention programs.

“Our troops and their families are under unprecedented levels of stress due to the pace and frequency of more than five years of deployments,” Webb said in a written statement. Watch CNN Senior Pentagon Correspondent Jamie McIntyre on the reasons for the increase in suicides »

Sen. Patty Murray, D-Washington, took to the Senate floor Thursday, urging more help for military members, especially for those returning from war.

“Our brave service members who face deployment after deployment without the rest, recovery and treatment they need are at the breaking point,” Murray said.

She said Congress has given “hundreds of millions of dollars” to the military to improve its ability to provide mental health treatment, but said it will take more than money to resolve the problem.

“It takes leadership and it takes a change in the culture of war,” she said. She said some soldiers had reported receiving nothing more than an 800 number to call for help.

“Many soldiers need a real person to talk to,” she said. “And they need psychiatrists and they need psychologists.”

According to Army statistics, the incidence of U.S. Army soldiers attempting suicide or inflicting injuries on themselves has skyrocketed in the nearly five years since the start of the Iraq war.

Last year’s 2,100 attempted suicides — an average of more than 5 per day — compares with about 350 suicide attempts in 2002, the year before the war in Iraq began, according to the Army.

The figures also show the number of suicides by active-duty troops in 2007 may reach an all-time high when the statistics are finalized in March, Army officials said.

The Army lists 89 soldier deaths in 2007 as suicides and is investigating 32 more as possible suicides. Suicide rates already were up in 2006 with 102 deaths, compared with 87 in 2005.

Cameron-Ritchie, the Army psychiatrist, said suicide attempts are usually related to problems with intimate relationships, but they are also related to problems with work, finances and the law.

“The really tough area here is stigma. We know that soldiers don’t want to go seek care. They’re tough, they’re strong, they don’t want to go see a behavioral health-care provider,” Cameron-Ritchie said.

Multiple deployments and long deployments appear to exact a toll on relationships, thereby boosting the number of suicide attempts, she said.

Traditionally, the suicide rate among military members has been lower than age- and gender-matched civilians. But in recent years the rate has crept up from 12 per 100,000 among the military to 17.5 per 100,000 in 2006, she said. That’s still less than the civilian figure of about 20 per 100,000, she said.

The “typical” soldier who commits suicide is a member of an infantry unit who uses a firearm to carry out the act, according to the Army.

Post-traumatic stress disorder also may be a factor in suicide attempts, Cameron-Ritchie said, because it can result in broken relationships and often leads to drug and alcohol abuse.

“The real central issue is relationships. Relationships, relationships, relationships,” said U.S. Army Chaplain Lt. Col. Ran Dolinger. “People look at PTSD, they look at length of deployments … but it’s that broken relationship that really makes the difference.”

To reduce suicides, the Army said it is targeting soldiers who are or have been in Iraq for long periods and teaching them to notice signs that can lead to suicide.

That training came too late for Army Specialist Tim Bowman. The 23-year-old killed himself in 2005 after returning from Iraq.

“As my family was preparing for a 2005 Thanksgiving meal, our son Timothy was lying on the floor, slowly bleeding to death from a self-inflicted gunshot wound,” said his father, Mike Bowman, in testimony to a House Veterans’ Affairs committee hearing in December. “His war was now over.”

He said veterans return home to find an “understaffed, under-funded, under-equipped” Veterans Affairs mental health system.

“Many just give up trying,” he said.

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