Returning Troops May Not Seek Treatment

August 15, 2004

http://www.nynews.com/newsroom/081204/a0112ptsd.html

Returning troops may not be seeking treatment

Getting helpFor further information about PTSD or help with other veterans' issues, call:• Rockland County Veterans Service Agency, 845-638-5244. • Westchester Chapter 49, Vietnam Veterans of America, 914-682-4949.• VA Veterans Outreach Center, White Plains, 914-682-6250. • Trudy O'Dell, Iraqi Freedom administrative coordinator, VA Hudson Valley Health Care System, 845-831-2000, Ext. 5413.

•Returning troops may not be seeking treatment•97th District candidates pay scant heed to county •Day-care center parents upset at board•Six workshops to lead up to Rockland Black Summit•Olympics, past and present•Rockland doused by rain•Man wants burial site restored•BOCES seeking volunteers for science program•Bridge over Pascack Brook to re-open tomorrow•Town's name rooted in rock By NANCY CACIOPPO THE JOURNAL NEWS (Original publication: August 12, 2004)

Navy Reserve Capt. Richard King spent 55 days in Iraq last year attached to the Marine Corps' Task Force Tarawa. When the Congers doctor returned home to resume life and his family practice in Valley Cottage, he could function at home and at work. But he soon recognized the symptoms of post-traumatic stress disorder. "I had a problem going out at night," he said. "I couldn't take crowds at the malls or in the movies. And I had to see their hands." With a recent study indicating that up to 20 percent of troops returning from Iraq and Afghanistan are at risk for developing post-traumatic stress disorder, some veterans worry that those most in need of treatment are not seeking help. The study published in the New England Journal of Medicine suggests that up to one-fifth or more of troops who have experienced intense military combat may suffer the symptoms of PTSD — flashbacks, sleep disorders, panic attacks, emotional numbness and violent outbursts. The study, based on anonymous psychological assessments, found that less than half of such veterans look for treatment, and those with the most symptoms were the least likely to seek help. In addition, the study showed that soldiers from the National Guard and reserves had higher levels of PTSD than active military after the first Gulf War because they were not as prepared and trained for battle. Other causes that figured into the percentages of risk for PTSD included troops who were dealing with the change from a war of liberation to the current battle against insurgency and extended tours of duty. King experienced what many returning service members felt. "Whenever anybody came back, they filled out a questionnaire," King said. "Did we require counseling? Were we depressed? If you said 'Yes,' they kept you. So everyone answered 'No.' I don't know how many people have been turning up at the VA," King said of the Department of Veterans Affairs. "But no one from the 2nd Marine Division was discharged with PTSD." King wasn't afraid to seek help. "I was very uncomfortable for months," he said. "But I went to a psychologist for counseling. And I have no problem talking about it. Being a physician, you're considered a superman. Then you find out you're just like everyone else." Larry Kolman, a Vietnam veteran who served in the Air Force in 1965-66, worked as a clinical psychologist for the VA for 15 years. Today, he maintains a private practice in New City, specializing in PTSD. Kolman said he was not surprised by the study's findings. "This is the first time the National Guard and reserves have been used so extensively, which reflects the cutbacks in the regular military," he said. "But all the training in the world is not the same as combat. You can never be fully prepared." Kolman's clients include veterans from many conflicts besides Iraq, including World War II, Korea, Vietnam and Desert Storm. He also counsels police, firefighters, emergency medical technicians and crime victims who may show signs of PTSD. As Kolman noted, the "post" in post-traumatic stress disorder can represent an indefinite time. "The VA saw a dramatic increase in World War II veterans exhibiting symptoms in 1995 on the 50th anniversary of the end of the war," Kolman said. "A major 1987 study suggested that the lifetime prevalence of PTSD in Vietnam veterans, many of whom ignored or denied their symptoms, was 50 percent. And those who went into the police or fire services and finally retired suddenly found themselves flooded by intrusive thoughts." Kolman said PTSD can manifest itself as rage, the inability to abide authority figures and the loss of interest in loving feelings. "It doesn't mean they don't feel," Kolman said. "But what they feel is disconnected. It's a protective defense that can become a habit." That's why early intervention is critical, Kolman said. Unless veterans' wartime disturbances can be worked through early, they can fester and grow. "Veterans will often say, 'It didn't bother me' or 'I don't want to talk about it,' " Kolman said. "But not dealing with it does not resolve it. And, like an emotional boil, it eventually explodes." PTSD, which has been added to the VA's list of service-connected disabilities, usually is treated with therapy and medication. Suggestions emerging from the study include integrating mental-health care into medical clinics, training troops to recognize signs of mental disorders and using more therapists who are independent of the military. Alan Hitt, a spokesman for the VA Hudson Valley Health Care System at the VA hospitals at Montrose and Castle Point, said veterans have a two-year window of opportunity from their point of discharge from the service to register for VA treatment for a service-related problem, which can include PTSD. "We have two coordinators who can help assess the problem, will give assistance in filing a claim and will offer follow-up," Hitt said. Vietnam veteran Jerry Donnellan, Rockland County director of veterans affairs, was critical of the government's handling of returning veterans. "Although the Department of Defense admits there is PTSD and that it should be treated right away, the only people getting exit physicals are those who have line-of-duty injuries. They're not getting psychological debriefings. If you're concerned about depleted uranium, respiratory problems or other symptoms, they will hold you over for a week or a month for additional tests. So a kid who's been in Iraq for a year, if given the choice to stay another month, will decide to go home. Or else the DOD tells you, 'If you have any concerns, see the VA.' But half won't go." Donnellan said the stigma of PTSD keeps many veterans from seeking treatment, particularly if they want to do police work, join the FBI or work in areas that need security clearance. "It's a shame, because treatment would head off further problems," he said. "That's what screwed up Vietnam veterans — there was no treatment for PTSD for so many years. You can't drop someone into a combat zone and have them live like an animal fighting for survival every day, and then put them back in the world and expect them not to bring back baggage." Vietnam veteran Rick Burns of Thornwood is among veterans who feel that, as brothers in combat, their mission is to help one another, no matter the conflict they fought in. Through the years, Burns said, he and other members of Westchester Chapter 49, Vietnam Veterans of America, have helped 35 to 40 veterans to obtain resources available through their organization and the Department of Veterans Affairs. "The Vietnam veterans' legacy is that no other group of veterans will be forgotten," Burns said. And that includes the latest crop of veterans back from Iraq, who are often confronted with a new set of challenges. "Are there issues because of the 'backdoor draft' extending the reserves?" Burns asked. "And when they come home, are their jobs gone? Is there any debriefing? Are they coming back as units or straggling home?" Whatever their situation, Burns added, "As veterans, we welcome them with open arms, to make sure they don't go through what we did. This time — unlike Vietnam — we're not blaming the war on the warriors."

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