Tuesday, November 9, 2010
SAN DIEGO My conversation with Afghan War veteran Hamed Dost reminded me of the great collection of combat vets who are believed to suffer post-traumatic stress disorder.
Sonya Norman is a psychiatrist at the V.A. San Diego Medical Center. She says 30 percent of the veterans of Iraq and Afghanistan who use their services suffer from PTSD.
Hamed’s PTSD was expressed through nightmares and co-morbidities like depression and alcoholism. Norman says it can also be expressed through guilt and isolation. Some people with PTSD are constantly on edge, as if they are constantly in danger.
“That light switch that most of us have – where we feel in danger when there’s actual danger and turn it off when we feel safe again – they don’t have the light switch anymore,” said Norman.
Post-traumatic stress disorder didn't make it into the Diagnostic Manual of Mental Disorders until 1980. I asked Norman if that meant veterans of World War II and World War I didn’t get PTSD.
“After every war or every conflict there would be some recognition of some disorder," she said, adding that "war fatigue" was one thing they used to call PTSD. I asked if “shell shock” might have been another name for it. Norman said it probably was.
Not everyone who suffers PTSD has served in a war. A lot of the literature about it comes from studying rape victims. Norman says PTSD has been studied a long time, and there are some tried-and-true ways of treating it. One method is called “prolonged exposure therapy.” That’s making the patient confront the behaviors and thoughts that PTSD sufferers typically avoid.
The other method is “cognitive processing therapy.” As Norman explains it, you do this by convincing people that the unreasonable thoughts and behaviors they get from PTSD are…. well, unreasonable.
Sonya Norman says she likes to talk about treating post-traumatic stress because she wants people to know that treatments do exist and they actually work.
But this brings me back to a sad note about Hamed Dost. Although Hamed served in Afghanistan and suffers PTSD as a result of seeing comrades killed and being trapped by enemy fire, he can’t afford to receive treatment because he doesn’t qualify for V.A. benefits.
Hamed worked as a translator and he was not a member of the armed forces. He was a military contractor employed by BTG, which became part of Titan Corporation. He received military training before he went to Afghanistan and he was in the middle of the fight. But he can’t get his PTSD treated.
If you think he’s alone, you should know that as recently as a year ago nearly half of all American forces in Iraq and Afghanistan were private contractors, not military personnel. Contractors have worn the black hats in many of our stories of the Iraq and Afghan wars, thanks to the follies of the Blackwater corporation.
But if you think that’s the only story of American contractors in wartime, think about Hamed Dost.