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Frontline Psych with Doc Bender: What Does PTSD Mean To You?

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Doc Bender on top of the Ziggurat of Ur in Southern Iraq, in February 2009.

Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division’s 4th Brigade Combat Team out of Fort Hood, Texas. During his deployment, he traveled through Southern Iraq, from Basra to Baghdad. He writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.

Hi. June 27 is Post-Traumatic Stress Disorder Awareness Day. It’s designed to promote awareness and dialogue about post-traumatic stress disorder (PTSD). Few of the only good things to come out of war are the tremendous advances in the science of treating illness and injuries, both physical and psychological. These advances are due partly to more resources and attention being paid to combat-related injuries and partly due to health care providers, unfortunately, getting a lot more practice in treating these conditions.

PTSD was first recognized as a “real” mental illness in this country in 1980 by the American Psychiatric Association in their Diagnostic and Statistical Manual, a long book that lists every mental condition that’s formally recognized. This disorder was around long before that, ever since combat has been around. There are writings by ancient Greek warriors from the Battle of Marathon about soldiers with no physical ailments who suffered because of the stress they encountered. In the American Civil War, PTSD was called “nostalgia” and treatment consisted of a soldier, especially Southern soldiers who lived close to the battlefield, walking home and taking a few days off before returning to the battlefield. (Interestingly, we still use a similar approach today in certain cases.) In World War I it was called shell shock and in World War II it was called neurosis, an old Freudian term that means anxiety. In the Vietnam Era the symptoms were described as combat stress reaction.

Today, there is more awareness, research and treatment for PTSD. Researchers are working hard to increase our understanding of and treatments for the disorder. New advances in brain imaging have led to remarkable discoveries. For example, PTSD actually shrinks a part of the brain called the hippocampus, which grows back with successful treatment.

Unfortunately, we didn’t always understand or appreciate the effects of PTSD the way we do now. A lot of vets from previous wars were labeled as cowards or fakers for speaking about their symptoms or seeking help. Their voices and demands for research and treatment paved the way for the advances we have today. Vietnam vets in particular lobbied professional groups and legislatures to do something about the problem. I do a lot of outreach and advocacy in my job at DCoE and some of the biggest advocates for this generation’s veterans are Vietnam vets. Several of them have told me, “I want America to treat you better than it treated me.”

So this Monday, I’m going to give thanks to all the warriors who worked tirelessly and effectively to bring this problem to the forefront. As both a clinician and a veteran, I owe them a lot.

Thank you for your service. Those of you in Iraq and Afghanistan, stay safe and cool. Leave me a note if you have any questions or comments.

Comments (6)

  • Wilmer Moore 05 Sep

    Thanks for being there Doc., we need you.
  • Claudio Alpaca 05 Sep

    It is a difficult war, not easily to combat, not ever. I thank medical providers like You for Your constant role on high directive of such a combat also, if possible, on behalf of warriors affected by PTSD. Thanks again, Claudio Alpaca Pieve di Teco, 29.6.2011
  • Tim Tennimon 05 Sep

    It is a real condition that thousands of our soldiers suffer from after being subjected to extreme violence areas and people without a clear definition of why they are having to do this. Only to be brought back and diagnosed and then prescribed so many mood altering drugs that mask the symptoms and cloud their way of thinking and end up in trouble only to have their branch of service turn their backs on them. That's what PTSD means to me.
  • Laurie 05 Sep

    Thank you for your blog. I get daily e-mails from the defense center for excellence and appreciate all the resources that are available. I work at community college and see returning vets regularly in my capacity as a disability specialist. I work with closely with our veterans outreach program. Working closely with vets who describe themselves with a head injury, PTSD, depression, and anxiety who say to me, "I am not crazy, I just have a head injury" is a testament to what we face as a society. This morning I was told by the Vet outreach program that the person I met with yesterday had a breakdown and is being sent to the LA vet hospital. I remember how the student said, "When it comes to numbers, calculations and fine motor work it is difficult because of my memory loss." "I enjoy horticulture classes, it is enjoyable, that is where I belong, that is my niche." Today I feel sad for that young man and hope for the best, and hope that the work you are doing continues to educate others about war and its invisible wounds.
  • DCoE Blog Editor 05 Sep

    We are glad that you find our resources useful, and hope that you continue to check back to the DCoE site for new information and resources to help health professionals and others care for our service members, veterans and their families. We also hope this veteran gets the support he needs and deserves. Thank you for what you do, and please keep sharing!
  • Dr. James Bender 05 Sep

    I’m glad colleges hire people like you to help vets who are going to school. The response you got from your veteran when he said he isn’t crazy is typical of veterans and a very good attitude for him to have. Almost no veteran is “crazy” (usually meaning psychotic or legally insane). Those who do experience PTSD or TBI can usually function well if they find things that they’re good at (much like your veteran did). There are a few DCoE blog entries that may help your veterans. Feel free to disseminate:

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