Post Traumatic Stress Disorder (PTSD) is a familiar term, but understanding it is key to survival for combat veterans off the battlefield. Untreated, PTSD increases the risk for depression, substance abuse and suicide. Symptoms can surface shortly after a traumatic event or 50 years later.
According to the U.S. Deptartment of Veterans Affairs, there has been a 25 percent increase in reported cases of PTSD among veterans of the wars in Iraq and Afghanistan compared to Vietnam veterans, indicating a need for further research to find better options for treatment and prevention.
Karl Marlantes, a former Marine and Vietnam veteran, recipient of the Navy Cross and critically acclaimed author of “What It Is Like to Go to War,” describes in layman’s terms what happens when someone goes into combat:
“When a normal person hears a sound, the input goes through the ear and into the cerebral cortex, the thinking part of the brain. As a combat soldier, by the time you’ve completed that thought process, the enemy has pulled the trigger and you’re dead. What the human brain does in response to these massive adrenaline loads is reorder the neural pathways. The input no longer goes into the thinking cerebral cortex, but instead goes straight into the amygdala, the fight-flight-freeze response area of the brain. When there’s a sound, the seasoned soldier no longer thinks, but reacts, turns and fires.”
The problem now is the soldier has adapted to combat. His brain is changed. It took extreme adrenaline loads to rewire those pathways. Now he’s back in civilian life. The problem is getting the brain to change back.
“Somebody shoves you in a bar and you hit him,” Marlantes said. “Now you’re in a bar fight and you’re in jail. Sometimes they use medicine to calm people down, but for the vast majority of people, their brain has undergone a physiological change.”
Recognizing the need to treat this illness, Vet Centers were established by Congress in 1979 to provide free counseling to all eligible veterans and active duty personnel. They are staffed mostly by combat veterans and function autonomously from the VA, meaning even active duty personnel are assured complete confidentiality and protection from the possible stigma expressed by their superiors, peers or subordinates.
Former U.S. Army Sgt. Ed Dvorak of Lakebay said his first PTSD episode came during his 50th birthday celebration, which left him crying uncontrollably as friends and family watched in confusion.
After serving in Vietnam for two years on long-range patrols, Dvorak returned to civilian life and settled into law enforcement. “Ironically, high-adrenaline jobs are a natural draw for many PTSD sufferers, as they are extremely functional under stressful circumstances,” Dvorak said.
As a police officer, Dvorak often dealt with suicides but couldn’t relate to what made people do it. “All that changed upon retirement and I found myself without that structured foundation,” he said. “My PTSD kicked in and I sank into deep depression.”
Dvorak sought help from the Vet Center in Tacoma, where both active duty personnel and veterans are supported on a confidential basis.
After initial one-on-one counseling, Dvorak joined a group of a dozen Vietnam vets with extreme combat service. “We approached it by learning about PTSD, almost like a college course, because you can’t learn to cope without fully understanding the condition,” he said. They signed contracts formalizing their commitment to show up every week no matter what. “We essentially formed a squad and looked out for each other, forming really tight bonds,” he said. “It’s much easier to speak openly with other veterans with similar experiences; the fear of judgment evaporates.”
Marlantes appreciates feeling understood and accepted by other veterans, yet sees our broader culture at war with itself over what we ask our young people to do in our name. “Culturally, our lack of openness and ability to embrace the warrior culture continues to drive these combat experiences underground, which only perpetuates shameful feelings for our returning warriors,” he said. “As veterans, we tend instead to minimize and not talk about what it’s like to go to war.”
In a 2008 interview with Time magazine, Lt. Gen. Eric Schoomaker, the Army surgeon general, described PTSD in service members as “a normal reaction to a very serious set of events in their life.” In 2011, the Army’s No. 2 officer and top mental-health advocate, Gen. Peter Chiarelli, told Time he began referring to PTSD as PTS. “I drop the D,” he said, saying the use of “PTSD” suggests the ailment is pre-existing, when in reality it is a predictable reaction to combat stress.
Marlantes prefers the term PTS without the D. He and many others see it as a natural neurological reaction to extreme adrenaline overload. Removing the “D” normalizes it, he said, though other veterans fear the new term diminishes the severity of the condition and could lead to less support treating it. Marlantes still views it as less a disorder than a remarkable natural adaptation to the extremes of combat.
The Tacoma Vet Center is located at 4916 Center St. in Tacoma and can be reached at 253-565-7038 or 877-927-8387.