Post-traumatic stress disorder in the limelight
The case against a United States soldier who is accused of going on a shooting rampage earlier this month in two Afghan villages that left women and children dead has focused global attention on post-traumatic stress disorder (PTSD) and other “invisible wounds of war” and of traumatic events like rape.
The suspect in the case, Staff Sgt. Robert Bales, 38, is being held in Fort Leavenworth, Kansas, even as a military investigation into his case continues. The case has also triggered a system-wide review of mental health facilities in the U.S. defense system.
Court records show that Bales had gone on four tours of duty in Iraq and Afghanistan after he enlisted in the military after the Sept. 11 terrorist attacks. His lawyer, Attorney John Henry Browne, has said he will cite PTSD to defend the serviceman.
What is PTSD?
Post-traumatic stress disorder is a mental illness that results when a person experiences traumatic or life-threatening events — war, rape and other sexual assaults, violent physical attacks, torture, child abuse and even natural disasters such as earthquakes and floods, and automobile or airplane crashes.
People with this disorder are distraught by having to relive in their minds the traumatic event again and again, through nightmares and during the day, disturbing memories. Sometimes, innocuous events that are similar to the traumatic events trigger sudden intrusive flashbacks. When these happen, sufferers lose touch with reality and relive the images, sounds, and other sensations from the trauma.
Others who suffer PTSD may seem emotionally numb and detached, then alternately, irritable and easily startled. Still others may feel guilty about surviving a traumatic event that killed other people. Other symptoms include trouble concentrating, depression and sleep difficulties.
Some PTSD sufferers lash out with unpredictable, angry outbursts at family and friends. Alternatively, they may seem to have no affection for their loved ones.
Called “shell shock” or “combat fatigue” in war veterans, in victims of sexual or physical abuse the disorder is called “rape trauma” or “battered woman syndrome.” The American Psychiatric Association (APA) adopted the current name of the disorder in 1980.
Post-traumatic stress disorder can disrupt a sufferer’s life severely. Aside from the emotional pain of reliving the trauma, symptoms may cause a person to think that he or she is “going crazy.” Symptoms usually begin shortly after the traumatic event — but some people may not show symptoms for several years. The disorder can last for years if it’s left untreated.
PTSD can bring on physical health issues like arthritis and back pain, interpersonal problems, reduced daily functioning, and overall, a lower quality of life. For most sufferers, maintaining employment can be difficult or impossible.
Often, PTSD is accompanied by depression, panic disorder — and because drugs and alcohol are a means of self-medication — substance abuse. People who suffer from PTSD may unwittingly worsen their problems by abusing alcohol or drugs to cope with the symptoms. Others work very long hours to prevent any “down” periods when they might relive the trauma. Mostly, because of their extreme anxiety and distress about the event, they try to avoid anything that reminds them of it.
Less diagnosed to save money?
But because a U.S. service member with the diagnosis becomes eligible for more and substantial financial benefits, U.S. Army psychiatrists may have been overturning diagnoses of post-traumatic stress disorder systematically — in order to save money.
That, at least, is the accusation of Senator Patty Murray (D-Washington) who is chairwoman of the Senate Veterans’ Affairs Committee.
Late in March, Murray’s office said that a review of PTSD cases dating to 2007 found that more than 40 percent had been reversed by a medical screening team. Specifically, of the 1,680 patients screened, more than 690 had been diagnosed with post-traumatic stress disorder –but the military psychiatric team had reversed more than 290 of those diagnoses during that period.