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Combat Disorders

PTSD and the Legacy of Shellshock

World War I is often identified with the rise of the disorder of “shellshock.” However, both the medical community and the military establishment were dubious of the claim that war could produce psychiatric symptoms.

Combat Disorders

James Dao reports in the New York Times that the military is considering 2 steps to reduce its startling rate of active duty suicides—which is approaching an unacceptable one suicide every day. Both measures are completely sensible, but neither goes nearly far enough.

With understandable urgency, Secretary of Defense Leon Panetta has made suicide one of his top priorities, instructing commanders at all levels to feel acutely accountable for it. The numbers are startling. On average 1 active duty soldier is killing himself each day--twice the number of combat deaths and twice the civilian rate.

I am a civilian psychiatrist who recently finished 20 months working as a contractor for the United States Army. Going into the job, I expected the degree of combat-related stress I saw in our troops. However, I was not prepared for the scope of impact our two long wars have had on military children.

Depression, PTSD, panic disorder, and abuse of alcohol and drugs are more insidious, quieter forms of illness that can cause the same desperation and disability as psychotic disorders.

In 2009, Maj Matthew P. Houseal, a psychiatrist, was in Iraq attempting to help suicidal soldiers when a fellow soldier killed him, a clinical social worker and 3 others at a combat stress center near Bagdad. Paradoxically, Houseal’s accused killer, US Army Sgt John Russell, had earlier threatened to take his own life, according to witnesses’ testimony during a recent investigative Article 32 hearing.

Most military families successfully adapt to a service member's deployments for military duties. Nevertheless, almost a decade of wartime stress associated with the current wars in Iraq and Afghanistan has presented unprecedented challenges for military families.

The latest information released by the US Army reveals that last year American soldiers attempted suicide at the rate of about 5 /day. There were 160 successful suicides last year and during June the rate was 1/day. Military research has reported that one in 10 Iraq veterans may develop a severe case of PTSD.

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