From "The Last Tour"
By William Finnegan
The New Yorker
Sept. 29 issue:
"It has been called by different names—shell shock, battle fatigue—in different eras, but P.T.S.D., in its combat form, has been around for as long as war has. Odysseus and his men had it. Although Twiggs used the word “paranoid” to describe his mood when he was Stateside, the more accurate term, used by P.T.S.D. researchers, might be “hypervigilance”—a normal adaptive strategy for surviving combat, except that the “on” switch is not easily turned off. Dr. Jonathan Shay, a P.T.S.D. specialist, thinks that even calling it a disorder is misleading: P.T.S.D. is an injury. There are degrees of damage, ranging from standard combat stress, which can be treated with a few days’ rest, to full-blown complex P.T.S.D., which is very difficult to treat, let alone cure. It is best understood, though, as a psychic wound, one that can be crippling, even fatal, in its myriad complications.
Compared with other American wars, the conflicts in Iraq and Afghanistan seem to be producing victims at a high rate. A recent RAND Corporation study estimated that three hundred thousand veterans of America’s post-9/11 wars—nearly twenty per cent of those who have served—are suffering from P.T.S.D. or major depression, and many more cases are expected to surface in the years ahead. This elevated rate is generally attributed to the rigors of a long war being fought without conscription: multiple deployments and heavy use of National Guard and reserve units. And on the ground, at unit level, the discouragement of anyone with stress symptoms from asking for help is intense. The same RAND study found that, mainly because of the stigma still attached to P.T.S.D., only half of those afflicted have sought treatment."