Patricia Johnson: Without Warning

It was an incredibly bright, beautiful spring day. The temperature was in the mid 70’s with the wind blowing so softly it was almost a whisper. The trees were full with newly formed leaves, and the flowers coming into bloom were vivid shades of red, pink and white.

The day was filled with sunshine and happiness. I was returning from a medical appointment where I had, once again, received good news. Life was great!

While stopped at the intersection, it happened. On the windshield in front of me the entire scene began playing over and over again, like an out of control movie. I sat frozen in time as all the feelings of fear and panic that I initially experienced returned. I could feel myself beginning to scream, but no sound would escape my lips.

Although I was physically sitting in my vehicle my mind was in a different place, in a different time. I was reliving all the horrible fears of that day so long ago. It wasn’t bad enough that the scene would enter my mind whenever it chose, interrupting my train of thought, now it was out of my mind and on the windshield in front of me.

What I experienced is known as a flashback caused from Posttraumatic Stress Disorder (PTSD).

PTSD is caused by a person experiencing an event in their life, so beyond the range of normal human experiences, that it would be distressing to most individuals. A serious threat to a person’s life, harm to a person’s children, seeing a person killed or seriously injured, or destruction to a person’s property, through earthquakes, tornados, hurricanes or fires, are all events that might cause PTSD.

PTSD symptoms are numerous, not always the same in each individual and a difficult illness to diagnose, especially when you don’t tell anyone your symptoms.

The symptoms don’t necessarily all materialize at the same time. One night you might have difficulty sleeping because of a nightmare. A few weeks later you may notice that you’re having difficulty concentrating, a few weeks after that you may notice an exaggerated startle response -- A friend comes up behind you to tease you, and you scream in terror rather than laugh at their antics. You might notice that your interest in normal activities has diminished, or you may feel detached from others, become irritable over little things, or just feel depressed.

The one symptom that is present in all individuals is recurrent recollections of the event, and attempts to avoid reminders of the event.

The longer you avoid treatment, the worse the symptoms become so it is imperative that people experiencing a traumatic event seek treatment as soon as possible. In my case, PTSD was not caused by one single event, but rather a series of events over a relatively short period of time – each being totally outside the range of usual human experiences.

Although the war in Vietnam ended in 1975 it was not until 1987 that the American Psychiatric Association added Posttraumatic Stress Disorder to their Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).

One of the reasons why Vietnam veterans have such severe Posttraumatic Stress is due to the fact that their treatment was not started until many years after they were exposed to traumatic events, due to the fact that the illness was not recognized by the APA.

The New England Journal of Medicine report released July 1, 2004 (click here) is indicating a prevalence of PTSD of 15.6 to 17.1 percent among soldiers returning from Operation Iraqi Freedom.

The percentage indicated by NEJM is conservative for several reasons. (1) PTSD symptoms may lie dormant for many years before surfacing. (2) Our soldiers are no longer fighting a war to liberate people that welcome them with open arms - instead they are fighting groups that do not want them in-country. (3) From the moment they entered the Republic of Iraq the normal ‘war’ fears were present, the fear of being wounded, the fear of being killed, and the fear of being captured. But these soldiers faced an additional fear – the fear of being exposed to chemical warfare.

The majority of PTSD is found in veterans, for obvious reasons. They are subjected to traumatic events day after day during war. The illness is usually treated with medication and intense psychotherapy to reduce symptoms, but the entire process takes a considerable amount of time – generally years.

Every soldier, whether enlisted or commissioned, has an eight year obligation when they join the U.S. Army (click here) the time is often split between active duty and Individual Ready Reserve (IRR). One soldier may sign up for four years, with a four year obligation to the IRR, while another may sign up for six years in the Ready Reserves with another two years in the IRR.

Each branch of service has an Individual Ready Reserve and as of June 22, the Army Ready Reserve pool had a total of 111,323 members. Mailgrams notifying 5,600 members to expect mobilization orders within a week, will be delivered as early as July 6.

Once their order is received, the soldiers will have 30 days, from the date of the order, to take care of personal business before reporting to a mobilization site. The orders call for 18 months of active service, which may be extended to 24 months, if necessary.

The IRR soldiers spend roughly 30 days at a mobilization site to determine if they are qualified. On a historical basis, for each 13, IRR soldiers mobilized, only 10 are deployable, so the total number of soldiers that will be deployed to Iraq and Afghanistan [OIF 3, and OIF 6] is actually 4,400.

While at the mobilization site they are tested for weapons qualification, and receive training in how to recognize improvised explosive devises, IED’s, and how to react in an ambush. They are then sent to a Military Occupational Specialty school for refresher training, for two to four weeks. After the MOS refresher class they join the deploying unit for 30 days of training as a unit. Once trained, these men and women will be deployed to Afghanistan or Iraq in late fall. Future involuntary IRR mobilizations may be necessary for troop rotations.

On July 1, 2004 General George Casey took over command of the 160,000 multinational forces in Iraq, replacing Lieutenant General Sanchez.

How many of these 160,000 troops are eventually going to have PTSD? How many of the IRR troops are going to return home with PTSD? How many of the troops that have already returned from Iraq, will have PTSD symptoms next year or the following year?

We already know the answer -- the number will be astronomical. The next question becomes what measures have been taken, by our government, to pay for treatment for these troops? Under this administration the Veterans Affairs budget has decreased rather than increased.

While you are out celebrating this 4th of July weekend, remember the extreme sacrifices our troops are making for their country and say a prayer for the physical, as well as mental well being of all multinational troops serving in Iraq.

Our returning soldiers deserve a better future than spending years chasing the demons that come back to haunt them day and night. We cannot eliminate PTSD from this group of veterans, but we can do everything in our power to promote the peace for future generations.

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