Is PTSD more common among soldiers now than in the past?

Cecil's Columns/Staff Reports
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As someone who suffers from PTSD after a deployment to Afghanistan, I found this article very interesting.

This is anecdotal, but while I was talking to the psychologist about my PTSD, I mentioned having doubts about the worth of my deployment (whether we were doing the right thing being there, etc.). He said that he consistently sees that from the vets that talk to him, from every conflict except World War II (which is as far back as living vets go that would be seen in a small town VA clinic).

I’d be interested in seeing if the shift in the way our nation executes war led to a shift in PTSD, as well. Maybe not even number of cases, but how it presents.

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Link to the column:

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I think it’s more likely that PTSD is more recognized than in the past - history and literature are replete with depictions of what we now call PTSD.

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In addition to being more recognized/diagnosed, it’s also vastly more socially acceptable to admit to having mental issues due to combat than in decades past.

One of the stranger interactions, or lack thereof that I remember with my grandparents was being at their house once, and watching the news with them, and a story about PTSD and Vietnam veterans came on the news. This was about 1986 or so, I’d guess. My grandmother made some kind of snarky, condescending comment about how men of her generation weren’t in for that namby-pamby stuff like PTSD. My grandfather, a veteran of 25 B-17 missions over Germany in 1943, just kind of sat there with as close to an pained or angry look as I ever saw him have, and didn’t say a word for about 20 minutes. Even at the time, I knew by their behavior that they had a deep difference of opinion about it- my guess is that his combat experience led him to a different conclusion about it than she’d come to. But he was a product of his era, so he never said a word.

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Being the son of a WW2 vet (and the nephew of four more) I can give you plenty of anecdotes about veterans of that era who came back with PTSD. Like bump says, they just didn’t talk about it.

But it’s not just combat veterans who experience PTSD. First responders have severe problems with it, even though they have plenty of community support and encouragement in their roles. Accident survivors, violent crime victims and people who were abused as children also have high levels.

If I had to make a guess, I’d guess the problem is more the trauma itself, than the circumstances under which it was suffered.

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The changing nature of warfare might be a factor. Soldiers used to only directly experience of combat on the day of a battle; weeks or months might pass between battles during which they would live a relatively peaceful life.

In the twentieth century, soldiers began to live through campaigns where they were exposed to combat for months at a time without break.

And combat exposure became more indirect. Instead of fighting another soldier face to face for a few minutes, a soldier might experience a week-long artillery barrage where he was in danger of being killed by somebody he never saw.

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One thing to keep in mind is that PTSD is similar to, but distinct from combat stress reaction. From what I’ve read, PTSD is more the product of as few as one very intense episode, while CSR is more the accumulated effects of being under life-threatening stress for an extended period.

So as a result, my guess is that CSR is a much more common thing than in wars of the past, but PTSD is likely just as common.

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“Stats for Korean War vets are a little harder to come by, but over 30 percent of the veterans who responded to a 2010 Australian study met PTSD criteria, with or without accompanying depression.”

TL;DR At that time, it was chic to diagnose war-damaged soldiers with mental illnesses that VA doctors could attribute to a pre-existing condition.

My father met PTSD criteria, but it was 1950, so the Marines confined him to a jail cell on Guam for 3 months. After that, he was returned to a VA hospital in the US, where he was diagnosed with schizophrenia, fed a steady diet of Mellaril and subjected to electroshock therapy and abuse.

In 1984, a young psychiatrist at the VA figured it out at the time of my father’s prostate cancer surgery. My father made a weak suicide gesture after the staff social worker assigned to him recited the statistics related to marriage dissolutions precipitated by such surgery. She had an odd notion that “We don’t think your wife will leave you, though,” was reassuring. It wasn’t.

He had his grandfather’s pocket knife, so he scratched up his wrists, and he ended up in the psych ward, catheter and all.

My mother wanted him out of there, so she called me. The psychiatrist thought he could reason with me, but I told him that my father already had tardive dyskinesia, and nothing about his life was going to change, so it didn’t really matter what his diagnosis was. Really, couldn’t you clowns have realized this when it might’ve done some good?

The hospital administrator called to the scene of my tantrum didn’t want the trouble I threatened to bring, so they discharged him immediately.

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Something I’ve been wondering given events of recent years is how much PTSD there is among he religious nuts of ISIS and such. When you go murdering unarmed civilians, sawing off heads, and throwing homosexuals off buildings because it’s what God wants, do the psychological issues still come up?

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Probably, but since they need a source of terrorists, suicide bombers, and expendable cannon fodder they probably have a different way of dealing with it than our society.

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The WW II vets who had PTSD have probably long since committed suicide, drank themselves to death, etc.

For many years, Patrick Stewart spoke out about domestic violence and alcoholism, and he now knows that his WW II - vet father had PTSD and that was how he chose to deal with it, not having or knowing about other alternatives. :frowning:

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I know a young man who did several tours in Iraq and Afghanistan, and he has this. He never experienced or even saw a second of combat, but he was in a state of constant hyperawareness because they never knew when something would strike, and for him, dry summer heat is a trigger because of the climate in the areas where he served.

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WWII vets had a different view of life and death. They had lived very different lives than people who went to Vietnam and later wars. Chances were very good that a WWII vet had lost a sibling or childhood friend to polio, smallpox, measles, diphtheria, or strep throat, or a blood infection from a cut or blister. A much greater number of them had lost a parent at a young age. A much greater number of the had hunted for sustenance, and had participated in the slaughter of farm animals, or had shopped at butcher shops, where they had to order cuts in such a way that it was clear they were asking the butcher to cut a hunk off a once-living animal. They bought chickens and geese with the heads still attached.

The world that WWII veterans came from was a lot harsher than the one that their children and grandchildren who went to Vietnam faced, and very, very far-removed from the world of Gulf War and Iraq soldiers.

Another consideration is that the average of a WWII recruit was about 27, while a Vietnam recruit was about 19. That made a huge difference between those to generations.

In the Gulf and Iraq, we were back to an average age of about 25-6, but then, we had people who had had really sheltered lives by that point, compared to the conditions in war, plus weapons of terrible destruction, and from Vietnam through Iraq, more of a blur between military and civilian targets.

My husband was in Iraq. The truck drivers he worked with were told to keep driving even if there was a child in the road, because insurgents would deliberately place a child in the road to stop drivers, and then shoot them, or shell the truck. WWII vets didn’t face things like that.

Also, WWII vets came home to ticker tape parades. Vietnam vets got spit on. Gulf and Iraq vets came home to people saying “Thanks for serving,” but to unemployment, for as long as they remained in the reserves. My husband got turned down for job after job, and limped along on Manpower, and a part-time security job. As soon as he was discharged from the reserves, he got the next job he applied for.

Everything I said applies to WWI and Civil War vets as well.

And yet, there still was “shell shock,” and “battle fatigue.” So it was not as though there was NO PTSD, but I think there were reasons that complicated and multiplied it in later wars.

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It certainly seems that way, and one big reason that has not been touched on yet, is the fact that many more military members are surviving their wounds. Combatants in earlier generations who were not killed outright in battle often died from medical complications days or weeks later. Medevac and trauma treatment technology has lately advanced to where that category of combat fatalities is much, much lower than ever before. Now people are surviving wounds that meant certain death only a couple of decades ago.

That’s a big factor when they are lying in a hospital bed with PTSD setting in. I don’t buy the part about people never seeing combat having PTSD. Everybody has to deal with stress.

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Different people have different capacity for dealing with stress. I find it possible someone could suffer PTSD without seeing actual combat.

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+1
And if you read contemporary medical literature, they were aware of this fact at the time and attributed it. One of them looked at dispatches from regiments who had served throughout the length of the Peninsula War(1808-1814) and calculated that it was on average a few days of combat, a year, while a unit which served even one rotation at the forward trenchs would see much more.

Also, the helplessness the soldiers felt during bomardments also led to trauma. When fighting, they could at least shoot back, here they had to sit and ride it out.

And unlike the poster up thread, I disagree modern soldiers are from “soft” backgrounds. The hardship of daily life pales in comparison to the stresses of combat, regardless of era.

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WW1 soldiers described the worst thing as being sitting through artillery bombardment being helpless as to anything. Going over the top was preferred, at least then the had the illusion of control.

Sitting in a base which is under periodic bombardment probably ain’t much fun either.

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My father on whether a wife beating fellow officer had PTSD " guy was a scoundrel before he saw combat and one after. If you have propensity to such violence then you’ll express it. I suppose it’s easier for Sir Patrick to say his dad did what he did due to PTSD then the alternative.

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Indeed I know of someone who was in the UK in an administrative role while fellow soldiers were on active service in Bosnia. He spoke of having a vastly increased workload as they were taking up the duties of their absent colleagues and at the same time the loss of some of those colleagues and finally seeing the state in which their colleagues return. How does it go… they also serve who only stand and wait.

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I have PTSD and have never been in active combat. Fairly generally speaking, I am pretty much okay, with the occasional nightmares and low-key anxiety. I have had a lot of help to get to this point. I find the major difference is the ones that got the right help at the right time are doing well now. The ones that didn’t are not. I hope some day they will be.