The Descendants: PTSD and the Latest Generation of War Casualties
Posted Monday, July 02, 2012 8:01 PM
While war may be hell in every generation in which it rears its bloody-horned head, the participants are never the same. There is simply no accounting for the differences between the men fighting in Afghanistan and those who fought in, say, the Guadalcanal. Because of this, we must not treat veterans of the wars in Iraq and Afghanistan as if they have a precedent. They do not. Theirs is a war of insidious casualties, where so much fighting takes place in the days, months and years after they've returned home. Although the same could be said for all modern American conflicts, starting with World War II, the psychological struggles veterans face have seemingly become darker and more daunting in recent years.
A study done by the Congressional Budget Office from 2004 to 2009 found that one in four veterans of recent American wars suffers from post-traumatic stress disorder. If the statistical findings of that study hold for the 2 million veterans of Iraq and Afghanistan, that means at least half a million veterans suffer from PTSD. If this isn't staggering enough, consider this crippling dose of perspective: Veterans are committing suicide 25 times more often than U.S. soldiers are dying in Afghanistan and Iraq; 6,500 veterans commit suicide every year; and Iraq and Afghanistan war veterans are 20 times more likely to kill themselves than average Americans. This is the barrage of shameful truths born out of a pair of obscure wars. These statistics inspire both indignation and perplexity: We should be doing more to help these self-sacrificing heroes. And what exactly is afflicting them that they should so desperately need help in the first place?
The term “post-traumatic stress disorder” has rapidly become so assimilated into the national shorthand when discussing war veterans that most of us never bother to understand it. After all, the words "trauma" and "stress" are right there in the title, and isn't that sufficiently expository? But the malady is far more complicated and ruthlessly elegant than that. On a fundamental level, PTSD is a severe anxiety disorder brought on by exposure to traumatic events.
But the criteria for diagnosis are manifold; if it weren't, the percentage of veterans with PTSD would probably be much higher. People diagnosed with PTSD suffer from flashbacks and nightmares, have trouble sleeping, are emotionally deadened, and struggle painfully to lead normal adult lives. Previously stable relationships, especially with spouses or significant others, splinter and crack like they were under some surreptitious weight. Similar to depression, people with PTSD have feelings of gloom and hopelessness about the future. In fact, they have trouble conceptualizing a future at all: they are tormented by the feeling that their lives will not last very long.
One can trace a cheerless narrative of veteran suicides in recent years: Sgt. Jacob (Jackie) Blaylock, who shot himself in 2007; William Hamilton, who stepped in front of a train in 2010; and more recently and luridly, Abel Gutierrez, who killed his mother, 11-year-old sister, and himself this past March. There are literally thousands more stories like these. In fact, the Army has seen an 80 percent increase in suicides among active soldiers between 2004 and 2008 alone. It's hard to imagine, but there was a time not too long ago when the suicide rate of soldiers was close to that of U.S. civilians. Now that those days are firmly, irrevocably behind us, the government and VA are still trying to catch up. Besides the culprit that immediately springs to mind—PTSD—it’s difficult to discern what else might be responsible for this suicide epidemic. We began diagnosing PTSD after the Vietnam War, and it had traveled under previous names, such as shell shock and the thousand-yard stare, in the two World Wars before that. In other words, post-traumatic stress isn't an explosive, game-changing new disorder. There must be other factors.
We might find a clue in the reported rise of depression and anxiety among soldiers, which could simply be a reflection of the rise of mental illness among Americans in general. Perhaps this, then, tells us that our psychological composition is different than it was during much of the 20th century. As far as the data indicates, our minds are more fragile, more vulnerable to extreme conditions than ever before. Of course a worthy counter-argument could be made that such statistics are sociological, a result of overdiagnosis and a culture that covets prescription medication. But that doesn't explain the increase in veteran suicides. Maybe an age of manic technological overreliance has made us hypersensitive and anxious, hardly traits that prosper under combat conditions or when compounded with severe trauma. Or maybe Americans just have less emotional skin than in decades past, as the meteoric rise in prescription drug use suggests. If Americans have become less resilient, it is not an indictment on them, and certainly not an indictment on combat veterans. It just means that more attention needs to be paid to the ramifications of a more shatterable psyche.
In its 2012 Policy Agenda, the Iraq and Afghanistan Veterans of America (IAVA) points to a clear collection of facts that might explain suicide culture among recent veterans. After men and women have returned home from tours in Operation Enduring Freedom and Operation Iraqi Freedom, they immediately face a panorama of obstacles. These include unemployment, which for veterans is somewhere between 12 and 17 percent, well above the national average; homelessness, which affects twice as many veterans between the ages of 18 and 30 as it does civilians in that same demographic; marital problems; physical and neurological afflictions; and, of course, post-traumatic stress, depression, and other mental health issues.
In other words, almost every single challenge that makes life difficult for civilians is magnified for veterans. As if it weren't hard enough for them to endure one or more years of harrowing fear, anxiety and trauma overseas, many of them come home to a new bitter crucible. It's really no wonder they are giving up on their lives. What's more, these two wars are completely obscured from the public. We don't talk or even argue about them anymore; they don't drive political or, dare I say, cultural debate; and the media would rather turn her burnishing eye to big personalities than anonymous vets. We simply act like they do not exist. We've turned our heroes into misfits and ghosts.
The U.S. Army is still trying to wrap its head around the causes of suicides among soldiers, as evidenced by recent investments into research on the epidemic. They're finally beginning to understand that these soldiers are different. They come from a long line of U.S. war veterans, but as no American generation is the same, from Beatniks to Hippies to Generations X and Y, no generation of U.S. soldier is the same. In a 2012 survey by the IAVA, 37 percent of the members who completed the survey said they personally knew a soldier who committed suicide. That is a frightening statistic that points to a rising suicide culture among veterans, one that veterans are aware of, but that people on the outside never stop to fathom. In addition, nearly two-thirds of respondents said they knew a veteran who needed care for mental health issues. But when asked if veterans were getting the care they needed for such mental health injuries (which are of course part and parcel with suicides), two-thirds said they were not.
We know that mental health problems and the suicides they can culminate in are sweeping through the veteran ranks, and that not nearly enough is being done about it. So where does the buck stop? Well, technically it stops at the U.S. Department of Veterans Affairs. The VA has rightly come under heavy fire for perceived negligence in the face of the climbing suicide toll. But really, we can't put all the blame on the government. There is a national culpability here that should be addressed.
While average Americans can dispute the virtues and tangible benefits of overseas conflicts ad infinitum, they cannot argue with the fact that young men and women are sacrificing themselves for the betterment of our country. Soldiers risk everything, and in so many cases give up everything, for their country and its citizens. Rarely do the country and citizens offer repayment; when they do, it is never in full. The VA might cobble together a benefits package, health care, and some mental rehabilitation for individual veterans, but it’s often not enough, especially when dealing with PTSD. Veterans should be part of the political discourse and national conversation, and these voices should drive improved benefits, services and an enduring expression of gratitude.
The American government and its citizenry alike should feel responsible for the well-being of their broken heroes. They sacrificed for us, and hardly do we ever sacrifice for them. The devastating horrors of war are hidden inside hospitals, houses and morgues, instead of being illuminated by the media. Americans fight for less taxes, more job opportunities, and in the case of election-year partisanship, fighting's sake, and don’t raise a finger in defense of the mentally afflicted soldiers who protected us.
It's one thing to reject the political act of war-waging, but it’s very much another to reject (or forget, blow off, evade, it's all the same) the people who fought for you. Veterans of Iraq and Afghanistan are killing themselves not because of some incipient phantom cost of war that we're yet to discover, but because we're not there for them.
Mike Mariani, a Highbrow Magazine contributor, is an adjunct English professor and freelance writer.
Photos: New America Media; Rafiq Maghbool (AP).