Tragic Baghdad Shooting Rekindles Combat Stress Debate

Yesterday's tragic shooting of five mental health counselors at Camp Liberty in Iraq has reopened the national dialogue on combat stress. Immediately following the news out of Baghdad that a U.S. service member took the lives of five of his fellow troops, speculation began as to the causes of such a heinous act. This morning, we learned that the soldier was a patient at the clinic struggling to cope with combat stress.

On CNN and the BBC yesterday, I reiterated the fact that combat stress and traumatic stress are germane to the combat experience. Where a veteran's reaction to combat stress develops into "post-traumatic stress disorder" is when a veteran becomes overwhelmed by the stressors, or cannot put experiences into the proper context, leading to patterns of self-destructive behavior.

When I returned from Iraq, I faced my own hurdles in coping with combat stress running the gamut from self-medication, to panic attacks, nightmares, anger and avoidance issues. However, I was able to quickly enroll with the VA health care system and sought proper counseling.

Don't get me wrong. This was by no means a "cure-all" to coping with combat stress. Anger issues still crop up, as do bouts with insomnia and avoidance. However, by working with the VA, I have been able to adapt properly.

In the military, we are taught to be tough, to be strong. These are necessary character traits when faced with the dangerous situations and difficult decisions that come in the heat of battle. When you're deployed to the combat zone, your body is at a chemically heightened state of alertness. Recent studies have even demonstrated that thought patterns may literally change to respond to now commonplace life-threatening situations.

When troops return home, this heightened state of alertness does not simply "go away." In fact, it's the natural reaction to such a profound experience. In this state, returning veterans may find that what had been commonplace in civilian life can now trigger thoughts and reactions reminiscent of combat--whether it's adverse reactions to crowded situations, unexpected loud noises, traffic, or even something as benign as traditional Muslim garb.

For troops who seek proper counseling and discuss their experiences, reintegration after combat often goes smoothly. However, troops who are unwilling to admit that they have gone through a life-altering experience, or who choose to self medicate as a coping mechanism will often degrade into patterns of self-destructive behavior, as I did in the beginning. In fact, the VA has acknowledged that PTSD is the leading cause of substance abuse and homelessness among veterans.

If you are a veteran who has had difficulty readjusting, the responsible course of action is not to "suck it up and drive on." The responsible course of action is to seek counseling from the VA.

Over the years, AMVETS has fought to dispel the negative stigma associated with seeking treatment for mental health issues. Many troops believe they are tough enough to face these challenges on their own and that seeking treatment will somehow have a negative effect on their military or private sector careers. Many times, this is not the case.

Today, the Department of Defense has made significant strides in identifying potential combat stress issues and implemented new policies designed to encourage troops to seek treatment, rather than punishing those who admit they have trouble coping with combat-related issues. The department has also acknowledged that long, repeated deployments only exacerbate the situation, and Defense Secretary Gates has taken steps to alleviate the strain on service members and their families.

Recently, AMVETS testified before Congress on PTSD and pointed out the importance of proper implementation of the VA's recommendations outlined in the Uniformed Mental Health Services Handbook.

Over the last five years, VA has looked into discrepancies across the board in their treatment of combat stress, and a recent report suggests that progress has been slow coming. AMVETS hopes that the implementation of a new uniformed service and health record for DoD and VA will help alleviate some of the enrollment shortfalls for VA, but AMVETS also reiterates the need for additional counselors and increased access to services for rural and remote veterans.

We've heard all sorts of horror stories from veterans around the country in regards to enrollment with the VA, difficulty in scheduling appointments, and frustration over paperwork inconsistencies and bureaucracy. Many of these complaints are quite valid and have driven the work of AMVETS National Headquarters to demand systemic change.

Fortunately, we have made significant progress and leaders in Washington seem to recognize the gravity of this issue. Plus, AMVETS offers a cadre of national and state service officers who stand ready to assist veterans at VA Regional Offices across the country. An up-to-date list of service officers and contact information can be found by Clicking Here.

Some people think that PTSD is a new issue and have attempted to discredit those who seek treatment through the VA. However, I want to point this out: I've noted several times that simply discussing your experiences and placing them into the proper context is often the best step in alleviating combat stress issues.

When the WWII generation returned from war, not only were they the majority of the adult male population in the United States, but they were organized. AMVETS developed out of WWII with posts all across the country where veterans could gather socially and discuss their time overseas.

Organizations such as AMVETS provided an acceptable outlet for veterans to place wartime experiences into the proper context and our country became considerably stronger for it.

Today, AMVETS and our 1,200 posts nationwide have the unique opportunity to offer this kind of support once more to our newest generation of war heroes. So to find a list of AMVETS posts near you, Click Here.

Sometimes all it takes is a sympathetic ear who can tell you that everything is just fine.

-Ryan

If you are a veteran in immediate need of counseling, call the VA's 24-hour hotline at 1-800-273-TALK (8255). Press "1" for veterans.

If you have any questions or comments for AMVETS on the issue of combat stress, please post below. We read every comment and we do our best to respond to every question in a timely fashion.

Women in Service: Air Force Lt. Col. Martha McSally

For the next installment of our Women in Service series, American Veteran has chosen to highlight Air Force Lt. Col. Martha McSally, America's first female combat pilot and the first woman to command an Air Force fighter squadron.

The U.S. military lifted the ban on women flying in combat 1991 and McSally was among the first female selectees to attend fighter training school. McSally graduated from the program in 1993 and was given her first combat assignment in 1995 with an operational A-10 Thunderbolt II squadron in Kuwait.

During her tour, McSally flew combat patrols over Iraq to enforce the no-fly zone in support of Operation Southern Watch. In 2000, she returned to the Middle East with another operational squadron stationed in Riyhad, Saudi Arabia fulfilling the same enforcement role.

In 2004, McSally broke another benchmark for female aviators when she assumed command of the 354th Fighter Squadron for a combat deployment to Afghanistan. In a recent interview with Air University, McSally recalled her most memorable moments in Afghanistan, providing close air support for troops on the ground, and engaging the enemy.

According to Air University, McSally's unit flew nearly 2,000 sorties and compiled more than 7,000 combat flight hours during their tour in Afghanistan. For their accomplishments on the tour, McSally and her unit received the Air Force Association's David C. Shilling Award for "best aerospace contribution to national defense."

McSally is a native of Warwick, R.I. and a graduate of the U.S. Air Force Academy. She continues to serve in the U.S. Air Force and expects to pin on Colonel later this month. She is currently a student at the Air War College at Maxwell Air Force Base in Alabama and her name is currently on the list for Air Force Group Command.

(Photo: McSally stands for a photo alongside her A-10 Thunderbolt II aircraft. U.S. Air Force photo.)

Ecstasy to Treat PTSD???

This morning, Military.com reported on a South Carolina psychiatrist exploring the affects of the party drug MDMA, or ecstasy, on PTSD sufferers. After reading the story, I, personally, think there may be some merit to this study. Patients were under the watchful eye of qualified physicians, and the drug seemed to help them properly connect with their emotions. As a veteran of the war in Iraq, and having dealt with this issue first-hand, I realize that confronting suppressed memories and properly connecting with emotions are often the most difficult hurdles in treating combat stress. Why shouldn't the VA give MDMA a look, since its primary function is to enhance emotional response?

Today, most doctors prescribe a barrage of antidepressents and anxiety meds for PTSD sufferers. To me, this seems like the easy way out. I've never been a fan of antidepressents or their side-effects. I find it hard to believe that these drugs would be the only answer. The former Army Ranger quoted in the story said, "I don't want to be part of the Prozac nation. I know some of those people and they don't feel up or down or anything at all."

PTSD has long been an issue for the military, dating back to cases of "shell shock" in WWII. Vietnam Veterans were hung out to dry when they sought to address their mental health issues. It didn't really come to the forefront until this conflict. Unfortunately, the VA still seems to be struggling to adequately treat the condition, as evidenced by recent studies showing a dramatic rise in soldier suicides.

MDMA, like any other pharmaceutical, can have dire consequences if used inappropriately. However, there could be a proper clinical use for the drug after all. I've seen first-hand the kind of effects PTSD can have on troops when they come home. If there's a viable treatment out there, I think the VA should investigate. (Though I guess I can understand their skepticism, in light of last year's Chantix dabacle.)

-Ryan

PS-If you're suffering from combat stress, DO NOT TAKE ECSTASY ON YOUR OWN. The South Carolina study was conducted in a controlled environment and properly sanctioned by the FDA. Ecstasy is still ILLEGAL, and, like any drug, if self-medicate with it, you could DIE. If you're having issues, call the VA. Their 24-hour number is at the bottom of this blog.

(Official DEA photo)