Post-traumatic stress disorder or PTSD.
Wars: WWI, WWII, Korea, Vietnam, the Gulf Wars, Iraqi Freedom, the War on Terrorism
In the 19th century military medical doctors started to diagnose soldiers with exhaustion after the stress of combat. This exhaustion was characterized by a mental shutdown due to the individual or group trauma.
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Most military leaders and commanders felt that all sailors, airmen, soldiers and Marines were expected to be tough and show no fear of combat. The World Wars and Korea branded its fatigued as cowards and yellow bellied. It wasn't until the Vietnam War that the government realized its findings in combat stress were wrong and that post-traumatic stress disorder was the reason.
The numbers of PTSD cases from the Vietnam War raised from the prior wars of 5 percent to Vietnam at 15 percent. Some of the reasons were:
1. The Vietnam veteran saw combat, in most cases, less than six months from their high school graduation.
2. The Vietnam veteran went to war alone and returned alone. In other wars men all went and returned in units.
3. The Vietnam War demanded body count not territories, so Vietnam veterans had fought for bodies.
4. In Vietnam 19- and 20-year-olds had responsibilities of groups, units and equipment. After coming home, many couldn't land a job or took jobs with little or no responsibility.
Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in a psychological trauma. This event may involve the threat of death to one's self or someone else or to one's own or someone else's physical, sexual, psychological integrity, overwhelming the individual ability to cope as an effect of psychological trauma.
Diagnostic symptoms for PTSD include experiencing the original trauma through flashbacks or nightmares, difficulty in falling asleep, anger and hypertension. Other areas include not wanting to be in a crowded room, never wanting to leave home and fearing harm will come to anyone who stays near the veteran.
PTSD has affected American service men and women from as far back as World War I. With no medical information on this condition, many veterans were marked as cowards and yellow bellies. It wasn't until the Vietnam War that the government finally saw what this condition had done. Most Vietnam veterans went over to a war alone. They attached to units where everyone had a different return to States date and eventually came home alone to a society that was divided in its views of the war. Some Vietnam veterans were assigned to combat units who spent their entire 13 months in the field. Engaging in combat was a daily event at times.
Signs a family can use to determine if their veteran has PTSD:
GAF (Global Assessment of Functioning) - is a numerical scale from 0 to 100 used by mental health clinicians and physicians to subjectively rate the social, occupational and psychological functioning of adults. An example is how well or adaptively is one meeting various problems in living. The scale is presented and described in the DSM IV on page 34. The score is often given in a range as outlined below:
Score 1 to 10: persistent danger of severely hurting self or others (reoccurrence of violence or persistant inability to maintain minimal personal hygiene or have suicidal acts with a clear expectation of death)
Score 11 to 20: some danger of hurting self or others (suicidal thoughts without clear expectations of death, frequently violent, maintains minimal hygiene, gross impairment in communication)
Score 21 to 30: behavior is considerably influenced by delusions or hallucinations, sometimes incoherent, acts grossly inappropriate, suicidal or inability to function in almost all areas (staying in bed all day, no job, no friends)
Score 31 to 40: some impairment in reality or communication, speaks at times illogically or with major impairment in several areas such as school, work and family relations, judgmental thinking or mood swings, depressed, avoids friends, neglects family, at times unable to work
Score 41 to 50: serious symptoms, suicidal idealization, severe obsession, rituals, frequent shoplifting, no friends, unable to land a job or keep one
Score 51 to 60: moderate symptoms, flat effect and circumstantial speech, occasional panic attacks or moderate difficulty in social, occupational or school settings, few friends
Score 61 to 70: some mild symptoms, depressed mood and mild insomnia or difficulty in social, occupational or school functioning, occasional truancy or theft within the family or household
Score 71 to 80: if symptoms are present, they are transient and exceptional reactions to psychosocial stressors, difficulty in concentration after a family argument
Score 81 to 90: absent or minimal symptoms, mild anxiety and generally satisfied with life, no more than everyday problems or concerns
Score 91 to 100: no symptoms, superior functioning in a wide range of activities.
Medical care/treatment - The Veterans Administration uses the above GAF scales to determine the severity of a patient's mental condition as a result of a traumatic experience such as combat, rape or a violent act. We are fortunate in our area that veterans and their spouses with PTSD can receive help.
A veteran, or a veteran's family member who feels help is needed, must take the first step. The first step is to realize that the veteran is different from his normal self and his quality of life is diminishing before his family's eyes by reviewing the GAF scale and seeing the change. The next step is to call the local veteran's outpatient clinic and request an appointment with the clinic's primary doctor. This then, if warranted, will lead to an appointment with a PTSD counselor. After meeting the counselor, it will be determined if the veteran and his family continue will with counseling.
If more is needed, the counselor may suggest that the veteran attend the Veterans Administration PTSD clinic located in Batavia, which offers a five-day program that includes classes and information on PTSD that will help the veteran understand the effects PTSD places not only on the veteran but also on his wife, children and family. The program puts the veteran with other veterans who are experiencing the same problems. In this group, the veteran will be given as much information needed to better his way of life.
The courses vary from living with PTSD to understanding. Classes also include abusing alcohol, driving, road rage and any other issues the veteran may be living with. In the group the veteran will be spending the majority of his free time with fellow veterans. After classes the veteran is free to walk the grounds and are on their own. The group is made up of all veterans, some still working, some retired and even younger gulf and war on terrorism veterans. There is plenty of free time to talk with other veterans about their military experiences, what they do now, problems they share and at times, after seeing that the group shares the same life, helps make the veteran start his road to a better life.
After the five-day group is over, it is up to the veteran and the staff to determine if the veteran needs to return for a 28-day program. If the veteran agrees, he will then be part of a program that is more intense and covers a larger area of information. In the 28-day group the veteran is teamed up with nine other veterans and live and work as a group together for the entire time.
At the Batavia PTSD clinic, the Veterans Administration offers a woman's PTSD clinic located in a separate building.
Most veterans will say that everything is OK and in no way do they have PTSD. Some even call PTSD a sickness for cowards.
Nothing could be further from the truth! Our country is now in a war that separates families for four to now even five tours which now causes stress on our heroes. Conventional warfare came to its end with the Korean War. The war training manuals at times were useless due to the fact that our new enemy was this man running around in black pajamas during the night taking sniper shots at will. When the rounds were returning, this new enemy just ran away to fight another day. The next day the same man in the black pajamas could be seen sitting on a bench reading and watching the American GI patrol by. We were now in a war in which we didn't know who the enemy was or where to find him. The same tactics are used against us again in the Gulf Wars and now in our war against terrorism.
The Batavia clinic is always full. Every bed is taken and, at times, one has to be placed on a waiting list. Even now in 2012, there are World War II, Korean War, Vietnam, Gulf War and our latest war veterans attending this clinic. Some veterans come as far away as Alabama and Mississippi to attend. The counselors and staff always find time to talk to the wives or family members to explain the effects of PTSD, what it does to the veteran and what it also does to his family. The first call to the Veterans Administration may be the call that could change everything.
Compensation is offered when a veteran is considered disabled by the Veterans Administration due to a service related condition. The Department of Veterans Affairs will not only treat the veteran's condition, provide prescriptions and supply transportation, but it also offers monetary monthly payments, all based on the rated severity of the condition.
Besides medical attention, when treated for PTSD the veteran is given a full exam and provided prescriptions, mileage, transportation and other items like glasses, hearing aides and wheelchairs. The Veterans Administration also offers monthly monetary payments to its veterans who are rated by the nature of their disability. Monthly payments are given to rated disabled veterans for ratings in scales from 10 to 100 percent disabled. The compensation for a 10 percent rated veteran starts at $126 a month and goes to $2,673 for veterans rated at 100 percent.
I wrote on the Dunkirk V.A. Outpatient Clinic in the spring. A lot of older veterans and their families have the wrong view of the veterans hospital mainly due to the experience they had witnessed themselves. I myself would agree that the Veterans Administration Hospital in the late 60s and early 70s was bad news. You never got to see the same doctor you had last visit, most doctors were from different countries and understanding them was impossible and Vietnam veterans were nothing but problems to them. Waiting for appointments lasted hours. It used to be a nightmare. It was a low budget operation, understaffed and some felt the Vietnam War didn't justify medical help because it was a police action. PTSD didn't exist. If a young veteran came to the hospital and stated he was having problems adjusting to normal life, they were escorted up to the tenth floor which was the mental ward. It wasn't long before the younger veterans got together and passed the word that if you were having problems with the combat you experienced, just suck it up and keep it to yourself! If one got admitted to the tenth floor, his chances of landing a decent job and starting a family would be gone. Most veterans then abandoned the V.A. and went to working 20 hours a day, hiding in a whiskey bottle or just being left alone.
In the 80s the V.A. started its road to being the medical facility it is today. It completely changed. The facilities were brought up to standards used by the nation's best hospitals. The doctors are top notch and care is given to each and every veteran.
The staff is highly trained and the V.A. has specialists to treat any problem that arises. The doctor's visits are on time, always when scheduled and no more than 15 minutes of waiting. The V.A. doctor now spends 30 minutes with each patient scheduled. The staff at the Dunkirk V.A. led by Dr. Nabil Jamil can start the road for a better quality of life for your veteran who may need help with PTSD.
Submitted by John Fedyszyn, Vietnam veteran
