PTSD: The Soldiers Heart

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PTSD The Soldiers Heart
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Diagnostic and Statistical Manual for Mental
Disorders

• Standardized definitions and created checklists
• 1952 1st publication
• 1980 PTSD included in DSM-III
• 2000 DSM IV-TR

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Brief History

• Soldiers Heart (Civil War)
• Shell Shock (WW I)
• Battle Fatigue (WW II)
• Post-Vietnam Syndrome (Vietnam War)
• Included in DSM III (under Spitzer)

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Returning Soldiers

• 1.5 million soldiers deployed
• 1/3 served at least 2 combat tours
• 20-25 (army studies reported by NPR in 2006)
• 16 (2004 Study in New England Journal of
  Medicine)

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Treatment

• Combat Stress Control
• Teams and Telemedicine
• Post-Deployment Survey/Questionnaire and Medical
  Screening
• Support and Advocacy Groups
• Psychotherapy, Exposure Therapy, and/or Drug
  Therapy

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Virtual Reality Therapy
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Concerns

• Redeployment
• Stigma and Military Culture
• Lack of Resources

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• No one notices as Schrumpf, 31, a former Marine
  sergeant who served in Iraq, scans the rows for
  moviegoers who may be wired with explosives under
  their jackets. No one pays attention as a man
  who appears to be Middle Eastern, wearing a long
  coat with bulging pockets, takes a seat in the
  same rowNo one listens as Schrumpf instructs his
  wife to get as low to the ground as you can if
  something happensSchrumpf hears metal
  janglingConvinced he is a suicide bomber about
  to strike, Schrumpf lunges at him. The man jerks
  away and his deadly weapon falls to the floor a
  can of Coke.
• From US News and World Report

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• For some soldiers, simply talking about what
  happened to them can be therapy enough. When
  Zachary Scott-Singley returned from Iraq in 2005,
  he was haunted by the image of a 3-year-old boy
  who had been shot and killed accidentally by a
  fellow soldier. With a son of his own,
  Scott-Singley couldn't get the picture of the
  child and his wailing mother out of his head and
  became increasingly paranoid about his own
  child's safety. I was constantly thinking about
  how people were going to attack me and take him,
  he says. Scott-Singley twice sought mental health
  care from the Army. The first time he says he was
  told that since he wasn't hurting anybody, he
  didn't have PTSD. The next counselor suggested he
  buy some stress-management tapes on the Internet
  and practice counting to 10 whenever he felt
  overwhelmedIronically, Scott-Singley found his
  therapy on the Web anyway, with his blog A
  Soldier's Thoughts (misoldierthoughts.blogspot.com
  ). It feels so much better to know I am not
  alone.
• From US News and World Report

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Fort Carson, CO

• Soldier Tyler Jennings says that when he came
  home from Iraq last year, he felt so depressed
  and desperate that he decided to kill himself.
  You know, there were many times I've told my
  wife -- in just a state of panic, and just being
  so upset -- that I really wished I just died over
  there in Iraq, he said. Cause if you just die
  over there, everyone writes you off as a hero.
• From NPR December 2006

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Fort Carson, CO

• Corey Davis, who was a machine gunner in Iraq,
  says he began freaking out after he came back
  to Ft. Carson he had constant nightmares and
  began using drugs. He says he finally got up the
  courage to go to the Army hospital to beg for
  help. They said I had to wait a month and a
  half before I'd be seen, Davis said. I almost
  started crying right there.
• From NPR December 2006

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Fort Carson, CO

• Alex Orum's medical records showed that he had
  PTSD, but his officers expelled him from the Army
  earlier this year for patterns of misconduct,
  repeatedly citing him on disciplinary grounds. In
  Orum's case, he was cited for such infractions as
  showing up late to formation, coming to work
  unwashed, mishandling his personal finances and
  lying to supervisors -- behaviors which
  psychiatrists say are consistent with PTSD.
• Doctors diagnosed another soldier named Jason
  Harvey with PTSD. At the end of May this year,
  Harvey slashed his wrists in a cry for help.
  Officials also kicked Harvey out a few months ago
  for patterns of misconduct.
• From NPR December 2006

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Fort Carson, CO

• Sergeant Nathan Towsley told NPR, When I'm
  dealing with Alex Orum's personal problems on a
  daily basis, I don't have time to train soldiers
  to fight in Iraq. I have to get rid of him,
  because he is a detriment to the rest of the
  soldiers.
• From NPR December 2006

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A Step Forward

• We are afraid that statements made about PTSD in
  the NPR piece by two Ft. Carson-based sergeants
  embody the misconceptions that must be changed if
  we hope to ensure the mental health of our
  countrys brave service members.
• Press Release from Senators Boxer, Bond, and
  Obama on December 7, 2006
• Pentagons Task Force on Mental Health Study (May
  2007)

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Update on NPR Report

• Similar reports from Fort Knox, KY (March 2007)
• New program _at_ Fort Carson to teach military
  leaders to identify and help soldiers w/ PTSD
• Senate bipartisan group calls for investigation
  by Government Accountability Office (April 2007)

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Pentagon Task Forces FindingsMay 2007

• The system of care for psychological health that
  has evolved in recent decades is not sufficient
  to meet the needs of todays forces and their
  beneficiaries, and will not be sufficient to meet
  the needs in the future
• Call for focus on prevention and screening
• Final report to Defense Secretary Robert Gates in
  June 2007

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Not only a problem for war veterans

• Natural Disasters
• Terrorist Incidents
• Serious Accidents
• Violent Personal Assaults

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Statistics

• Estimated 7.8 of Americans will experience PTSD
  at some point in their lives, with women twice as
  likely as men to develop PTSD.
• From National Center for PTSD, Department of
  Veterans Affairs

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Off to War Episode 9 Summary

• As their deployment in Iraq nears its end, the
  men begin to count the remaining days, as do
  their families on the home front. Back in
  Arkansas, the Hertleins and the Jacksons eagerly
  prepare for the return of Matt, Ronald and Tommy,
  but wonder how much their loved ones have changed
  and what the future will hold. Sergeants Curtis
  Rohrshceib and David Short are already plagued by
  nightmares of men they have lost in combat, and
  they worry about how their experiences will
  affect them later on. But the soldiers arent
  home yet, and they have to survive one more
  convoy to Kuwait on the most dangerous highways
  in Iraq. When they arrive back in the States,
  members of the Guard are sent to Fort Sill,
  Oklahoma, to debrief, and are warned of the
  difficulties they will face readjusting to life
  as civilians. Clarksville is festooned with
  yellow ribbons as the men finally return to
  Arkansas to a heroes welcome back in the arms of
  their families.
• From Discovery Times Channel Online

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Off to War Episode 10 Summary

• After returning home from Iraq, the soldiers of
  the Arkansas National Guard try to settle back
  into their civilian lives. Sergeant Ronald
  Jackson rejoins his wife on the turkey farm that
  she managed to keep afloat in his absence.
  Suzanne Hertlein helps her son Matt get ready to
  take his high school girlfriend to the prom. Matt
  Hertlein and Tommy Erp left Arkansas for Iraq as
  teenagers almost two years ago. Now they have to
  figure out how to start their lives as young men
  changed by war. After taking three months off to
  get to know his wife and children again, Sergeant
  David Short returns to duty as a police officer.
  Sergeant Curtis Rohrscheib spends every day
  getting to know his baby boy Garrett, and
  continues to battle with nightmares that followed
  him home from Iraq. All of the citizen soldiers
  struggle with how different they feel now after
  an 18-month deployment in a combat zone and a set
  of experiences to which few back home can
  relate.
• From Discovery Times Channel Online

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Sources

• NPR
• http//www.npr.org/templates/story/story.php?stor
  yId6576505
• PBS Frontline
• http//www.pbs.org/wgbh/pages/frontline/shows/hea
  rt
• US News and World Report
• http//www.usnews.com/usnews/health/articles/0610
  01/9ptsd.htm
• MSNBC
• http//www.msnbc.msn.com/id/17835861/
• Washington Post
• http//www.washingtonpost.com/wp-dyn/content/arti
  cle/2007/05/03/AR2007050301402.html
• National Center for PTSD
• http//www.ncptsd.va.gov/ncmain/index.jsp
• Discovery Times Channel