ATLANTA, GA. — The Fort Hood shooting has once again focused national attention on the various and often violent ripple effects of the Iraq and Afghanistan wars on the “home front.” Michelle Chen’s Saturday post examined the severe economic challenges facing vets, including unemployment and foreclosure.
In Atlanta, where thousands of mental health professionals from around the world gathered for the annual International Society for Traumatic Stress Studies conference from Thursday to Saturday, a few days ahead of Veterans Day, the Fort Hood shooting became a possible example of the subject under discussion: Post-Traumatic Stress Disorder.
Could the Fort Hood shooter have suffered from PTSD given his work experience so far? Evidence and research discussed at the conference show how the triggering and manifestation of PTSD as an occupational hazard can be much more complicated than people might realize.
Scientists described how PTSD is actually a manifestation of a biological survival instinct: heightened, highly charged memories of traumatic or dangerous events help animals and humans respond quickly or avoid such situations in the future, increasing their chances of survival in a harsh world. Such responses may still be considered beneficial for dealing with situations that might arise in every day life.
But war introduces a new factor: the responses and memories a soldier develops on the battlefield are no longer relevant to civilian life, yet he or she can’t choose to turn off the stress hormones that course through the body at the sight of, for example, a package along the side of the road or a car backfiring.
The ongoing and debilitating symptoms of PTSD are now well known— sleeplessness, irritability, anger, nightmares, flashbacks, anxiety — often manifested in failure to hold jobs or maintain relationships, or even violence against family members or strangers. Recent research also shows that the constant state of arousal which characterizes PTSD can cause or increase the risk of cardiovascular disease, diabetes, obesity and other health problems, since the body isn’t meant to maintain this physiological response on an ongoing basis.
Stress hormones released by arousal can actually damage the hippocampus, the part of the brain that regulates or inhibits the release of such hormones by the amygdala, meaning a vicious circle wherein neurological damage caused by PTSD further inhibits the body’s ability to curb this debilitating response.
Recent research discussed at the conference has also revealed some people are predisposed to PTSD genetically, and early childhood experiences including abuse can also make someone physiologically more prone to PTSD.
When confronted with novel or extreme stimulus, the brain has to decide whether to react with fear or tolerance. When a baby is protected by their mother in the early days of life, theoretically they have no reason to fear; the switch to deciding between fear and tolerance kicks in later. Scientists believe interference with the mother-child bond or any kind of early abuse can confuse this response, making someone prone to exaggerated physiological fear reactions for the rest of their life.
The number of traumatic experiences one suffers, at any age, also increase the likelihood of developing PTSD. Various studies have shown members of the military, especially women, are disproportionately likely to have suffered abuse or violence, meaning they are more at risk than the general population for developing PTSD.
The Grady Trauma Project, an ongoing study out of Emory University focusing on patients at Atlanta’s public hospital, suggests that minority populations are more at risk of PTSD because of everyday experiences with violence and abuse in impoverished neighborhoods. For socioeconomic and political reasons, this same demographic is disproportionately likely to join the military.
In the past few years there has been growing understanding of PTSD as a serious health and societal problem with a clear physiological basis.
Karestan Koenen at the Harvard School of Public Health said PTSD affects one in nine women and one in 20 men nationwide, causing an average 3.6 days of impairment at work for sufferers and costing the country $3 billion a year in lost productivity and other effects. (On her blog and in a forthcoming book, Georgia author Cilla McCain describes the effects of PTSD and also other social and mental health problems infecting the military, which she says are too often lumped in with PTSD.)
Even so, many troops and veterans are still prevented from getting help because of stigma, bureaucracy, general lack of access to healthcare and fear of how their career or reputation will be affected by acknowledging the disorder.
Scientists and doctors at the conference described multiple ways of ameliorating or easing PTSD, including therapies or programs (like caring for an abused animal) that can ease symptoms and even facilitate repair of physical brain damage. As more and more veterans return home, advocates and doctors say awareness of and access to mental healthcare with particular focus on PTSD is essential not only as a basic worker’s right, but for the good of society as a whole.