Post-traumatic stress disorder widespread among returning troops

By Jenn Hoffman

Robert Brown's assignment for his English class at the University of Richmond was to describe an experience that had an effect on him. While other students wrote about the goal they scored in a soccer game or the winning lottery ticket they scratched off, Brown's seven-month deployment in Iraq set his paper apart from the others.

"While writing that paper," Brown said, "I went from my computer room to a place in my past dealing with a car bomb that killed 64 people. I had to pick up women's and children's body parts that had nothing to do with combat at all. It was not the best place to go, and I went back to that, and kind of got incapacitated for a little while. When I came to, I was on my knees with tears on my face when writing the paper. I don't think I'll do it again."

Brown, 24, said he blocked out emotions and memories, comparing flashbacks to virtual reality games where you're transported into a new environment with realistic sounds and visuals.

"I have the emotional range of a teaspoon," he said. "I deliberately sit around and say €˜la la la' in my head because if I occupy my mind crunching numbers or doing calculus, I won't think about it. I can either live in the past or I can live now, and I really don't want to live in the past."

Brown, who is originally from Ashland, joined the military in 2002, following in the footsteps of his family and eager to get money toward college.

He is one of 181,000 veterans in Virginia between the ages of 17 and 44. His flashback is a common experience among soldiers returning from war.

Roughly one in five of the U.S. troops who fought in Iraq and Afghanistan suffer from depression or Post-Traumatic Stress Disorder, an intense and ongoing emotional reaction that stems from events that threatened or caused physical or psychological trauma.

This figure jumps with increasing tours, and only about half of these veterans have sought treatment, according to a study by the Rand corporation in a recent Richmond Times-Dispatch article.

Yet, Steven Danish, a psychology professor at Virginia Commonwealth University, said this figure was closer to 30 percent.  Danish created the F.R.E.E. 4 Vets Program, a self-directed rehabilitation initiative for returning soldiers, after one of his doctoral students was deployed to Iraq. The program helps veterans readjust to civilian life by acknowledging combat stress-related injuries, ways to overcome them and how to advance goals and get reacquainted in the workforce.
F.R.E.E. 4 Vets is one of few initiatives that teach veterans that the skills they acquired on the battlefield are directly transferable to the workplace, Danish said. A good employer can teach anyone how to perform a specific task, but qualities fostered in combat€”teamwork, problem solving, initiative, endurance, creativity and work ethic€” not only can't be learned in a cubicle, but are valuable at any job, he said.

Yet many veterans with PTSD struggle with short-term memory loss, anger management issues and sleep disorders, which present obvious issues in the workplace, said Laura Browder, who interviewed 46 female war veterans for her exhibition on women in combat at the Visual Arts Center in Richmond. "If you have a hard time sleeping at night, concentrating during the day at work is difficult," she said.

Many veterans don't want to seek psychological counseling at the Department of Veteran's Affairs because of the stigma involved, Danish said. For others, the VA is simply too far away without missing a day of work.

"There are only three VA's in Virginia," Danish said. "If you live in Richmond, it is okay, but if you live in Staunton, it's a half-day travel at least. That's a day lost at work, and you don't want to tell your boss why you're leaving early."

Danish said was impossible to predict which soldiers would have PTSD.

"We don't know a lot about the lives of the individuals before they go overseas and what effect it will have," he said. "If you have seen a friend in a car accident here, it might be more likely to precipitate something over there. Some people are able to compartmentalize their lives. We all know people who take their work home with them. They're very different from the people who don't."

Danish said stress contributing to PTSD could be physical (such as from dehydration or loud noises), cognitive (from a lack of information or ambiguous roles), emotional (such as the death of a friend), social (isolation or lack of personal space) or spiritual (such as an inability to forgive or a loss of faith).

"While I was there," Brown said, "I was thinking, €˜Okay, how do I live through today?' That was the main goal in life: personal survival. I spent many days plugging people with IV's to get them hydrated. I've been on patrol in 140-degree days in the desert in body armor. You have your helmet, shoulder pads, large amounts of gear, just layers of heat. I drank 28 liters of hot water in eight hours and sweated it right out. You could rub salt out of my uniform from all of the sweat."

Nathan Hancock, 27, who spent 14 months in Iraq and is now a student at University of Maryland in Baltimore City, said he, too, focused on staying alive.

"My inspiration was a calendar," said Hancock, who enlisted in the Army three weeks after Sept. 11 to show his patriotism. "I would put an X on the day at the end of the day. There were a lot of times that I thought I wouldn't make it back, so I was just happy if I made it through the day. I usually put a smiley face or a frown face on the calendar."

Hancock's PTSD symptoms surfaced gradually.

"About six months after I had been back, strange things started to happen," Hancock said. "I had nightmares, and I would lash out, and I became very emotionally unstable. I was dating someone, and I got very angry over something stupid, and I punched with my fist through the drywall where I was living.

"That's when I was diagnosed with PTSD. The past two years, I've struggled with this new battle. It has manifested itself in more classic ways in flashbacks, nightmares, depression and anxiety attacks. One thing that still gets me is if I'm driving down the highway, and I see a cardboard box, my heart starts to race, and I start to panic. I don't do what I used to do, which is swerve across lanes and drive like a madman, but I still think, €˜That's a bomb. That's a bomb.'

"It's hard to pin down one thing that happens. Some people become very emotional and some become very emotionally distant. It's not just war veterans who suffer from PTSD, but also rape victims or people after 9/11. They function perfectly fine until something triggers it, and then they go crazy for a little bit."

Yet the symptoms of PTSD may differ, depending on the situation and the role of perpetrator versus passive recipient, Danish said.

"Women who were accosted may have PTSD, but it's different from women in Iraq because they were a participant in the problem rather than passive," he said.

Women in combat was a topic that Browder wanted to bring into the public consciousness. An author and English professor at VCU, she spent two years compiling portraits and stories of female veterans who fought in Iraq and Afghanistan for her exhibition "When Janey Comes Marching Home" at the Visual Arts Center in Richmond.

"The first shock was how many women loved deployment," Browder said. "The bonds within a unit were often stronger than family bonds. One soldier had to come back because her child needed surgery, but she didn't want to return. Her son said, €˜Mom I need you,' but she felt like she was letting her unit down if she left. Those bonds were stronger than the bond we think of as being the strongest in our culture, that between mother and child."

Sgt. Paigh Bumgarner, a 28-year-old veteran in Browder's exhibition, spent one year in Iraq and described her most pain-wrenching experience overseas: the death of her close friend, Ski.

"I was like, €˜Where's Ski?'" Bumgarner's story read. "I looked in the back and there was my buddy, completely in pieces, so I got the body bag and put him in there. I wouldn't let anyone near it because no one else needed to see that."

"That experience superseded all," Bumgarner said in a phone interview. "It's all I think about. There is not a day that goes by where I don't think about it, and I don't think about him.

"Someone else I knew was recently killed this tour, but it doesn't affect me in ways it did with Ski because I didn't have the visual and all five senses right there.

"When I got back home, the first thing I did was go to three months of counseling, and I seemed fine. Then eight months later, I started having really bad nightmares. I went to the VA, and they diagnosed me with PTSD and put me on Zoloft. If I don't take it, I get bad nightmares."

Bumgarner said her PTSD was only manifested in dreams and hadn't affected her at work. Yet a new outlook on life after combat had changed her career goals.

"Before I left to go overseas, I loved my job and I wanted to move up the corporate ladder," said Bumgarner, who worked as a senior coordinator for a company in the fan. When she returned from Iraq, it had been bought out by a bigger company and had become obsessed with revenue, she said.

"When I got back from Iraq, I was more laid back and not as high strung," she said. "I used to have so much anxiety, but now I don't care about those things. It took me about a year and a half before I had the courage to say, €˜This isn't for me anymore.'

I didn't want to work behind a desk the rest of my life and make money for someone else. I decided I wanted to work in nonprofit and joined Habitat for Humanity. My salary is now $10 an hour, but it's completely worth it."

Hancock wanted to help the underprivileged after fighting overseas, too.

"One reason I chose to major in social work is that I've developed this almost unhealthy sense of right and wrong," he said. "I've become very self-righteous at times, and I think that's because I saw so many things that I thought were wrong, and I want to try to fix them. I see that in a lot of other veterans, too. They became militantly self-righteous or the opposite end: They don't care about anything and become more callous and cruel at times or even self-destructive."

Elizabeth Sartain, 32, a veteran in Browder's exhibition, was unable to continue her work in the military because of her PTSD, Browder said. She had anger management issues resulting in conflicts with coworkers, sleep and eating disorders, restless leg syndrome, flashbacks and nightmares. Sartain had been married a few weeks before being deployed to work as a mortuary specialist in Iraq, where she went through 900 human remains in six months.

"When we work on the remains," Sartain's story at the exhibition read, "we go through their personal property. We see letters from their family, pictures, a baby sonogram, and we have to double check to make sure if they have a wedding ring on. I just felt guilty for doing that.

"I became anorexic and lost over 30 pounds in six months. Since I've been back, I still have insomnia and nightmares, and now I overeat. I have gained 40 pounds€”just from the depression.

"I'm angry. I didn't have this PTSD before deployment, and it's a career-ender for me. I know PTSD is so prevalent. There are a lot of people who have it, but they're two years away from retirement, so they don't want to get help. Or they're up for a promotion, so they just end up living with it.

Browder said Sartain told her that people in her unit had ostracized her for PTSD because the military saw it as a sign of weakness.

"A lot of PTSD is undiagnosed," Browder said. "They say no one really tells the truth at the VA. Some don't know the truth yet. Some units are more open, but there are others where members are ostracized. There is an incentive not to open up about it. None of the mothers I interviewed admitted to having PTSD because of the stigma I have to believe about being a bad mother."

Hancock said the public was sheltered from the reality in Iraq and the atrocities of war.

"It's interesting," he said, "because the only people who understand are other veterans, but at the same time you don't necessarily want to be around other veterans because they remind you of everything you're trying to forget. It was quite conflicting at first because I wanted to start a new life and get away from the Army.

"I appreciate everyday life much more, but I don't put too much value in it. I'm pretty much an atheist, and this sounds so gloomy, but I saw so many things that it's really hard to believe that there is something more powerful than us. Some people say I'm more pessimistic, but I just figure it's another day, and you might not have another one because there are a lot of people who don't."

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