The prevalence of PTSD from World War 2 through Modern Day. Thoughts on cause and effect?

SPC Robby Robinson — Thu, 22 Oct 2015 01:48:38 -0400

PTSD disability ratings have tripled since 2000. My question is, I could understand this if military doctrine was the same as it was during World War Two. But it is not.
In WW2, if you wanted to get 100,000 boots on the beach, you started with 150,000. Military doctrine is much different today. Make NO mistake, combat is horrific, in ANY form. Yet being affected by combat, is a natural human condition. To NOT be affected by the horrors of war, would infer a deficiency.
From discussions with other service connected veterans, I am told new PTSD ratings are given immediate 50% SC rating.
From this I cannot make any sense, is combat that much worse than it was during WW2? I would vehemently disagree and would argue the opposite.(Clarification, combat is horrific no matter which conflict. What I am inferring is combat doctrine has evolved from a numbers game to a force multiplier/tactics based strategy)
Do you believe the tripling in PTSD SC ratings have more to do with society today, an increase in the lethality of combat, a changing military doctrine, are today's warfighters less resilient that OUR forefathers, is today's VA more willing to address the stressors of combat rather than looking for the physical aspect of casualties?
As I am reading this question I have posed, I am of the notion that it "could" appear that I am challenging the validity of current PTSD SC ratings. Please understand I am NOT. I am looking for thoughts from the aspect of cause and effect, that being the tripling of PTSD/Battle Fatigue diagnosis's since 2000

Response by Capt Seid Waddell made Oct 22 at 2015 2:06 AM

Capt Seid Waddell — Thu, 22 Oct 2015 02:06:28 -0400

Diagnosis rates have likely changed a great deal since WWII. Also, many vets today served more time in combat than in WWII. Survival rates today are also much improved.

Response by SSG Damon Lightfoot made Oct 22 at 2015 2:07 AM

SSG Damon Lightfoot — Thu, 22 Oct 2015 02:07:14 -0400

I don't think any of them suffered any less than today's veterans, but it's more of a result of better research and outreach to veterans to get help today than there was back then. Their generation was told to basically shut up and deal. Both my grandma and grandpa were WWII vets and both died before I was even born from alcoholism. They were never diagnosed with "war fatigue" but from what I've been told they definitely had the symptoms.

Response by COL Private RallyPoint Member made Oct 22 at 2015 2:21 AM

COL Private RallyPoint Member — Thu, 22 Oct 2015 02:21:34 -0400

Go an watch "Mad Men". A good portion of the main characters portrayed in the series were involved in either WWII or Korea. There was a large amount of drinking during the course of the day. Granted, that was part of the social landscape then, but I think it's very indicative of the way that many veterans of the era, who were now civilians, coped with the PTSD.

Response by SPC Private RallyPoint Member made Oct 22 at 2015 4:16 AM

SPC Private RallyPoint Member — Thu, 22 Oct 2015 04:16:31 -0400

The rates of PTSD have increased because it has become an actual thing. substantial, diagnosable.

Specially from WW2 and even up into the beginning of OIF the brain was not all that well understood. It still isn't. Through sacrifice of our soldiers we (humans/a nation) finally were in a place to really view the brain after mTBI incidents.

Then you also must consider the stigma. Mental health and behavioral health was viewed as being for the nutjobs and crackpots! Not respectable family men!

That isn't true and we all know it. So yea. The probably is set to increase because it's an actual problem now instead of "suck it up, move out" kinda viewing.

Response by MSG Tim Gray made Oct 22 at 2015 7:28 AM

MSG Tim Gray — Thu, 22 Oct 2015 07:28:08 -0400

I'm no doctor by any means, so I don't feel qualified to answer your question but I may add to it. How does today's veteran suicide rate compare to WWII?

Response by Sgt Aaron Kennedy, MS made Oct 22 at 2015 7:32 AM

Sgt Aaron Kennedy, MS — Thu, 22 Oct 2015 07:32:27 -0400

1) Huge increases in the study of Psychology & Psychiatry
2) Massive changes in the perception of PTS, versus "Battle Fatigue" versus "Shell Shock" etc. George Carlin actually has a skit regarding this from the 70s-80s.
3) Changes in the VA rating system. Injury vs. Condition. It's really easy to give someone a rating for an injury. You can see if someone is missing a leg or has a limp. It's hard to see a Condition. It's hard to see how they are affected by a Condition. This goes back to 1 & 2. As the science & perception changes, the #s go up. More people are able to come forward and say they are affected, and how much they are affected is able to be actually documented.
4) Aside to #3. Things like drug use & alcoholism. We're able to tie them a lot better than we were before. Some of the "old timers" drank to keep the demons away. We know that now. We didn't then.

Response by 1stSgt John Sims made Oct 22 at 2015 7:51 AM

1stSgt John Sims — Thu, 22 Oct 2015 07:51:54 -0400

What has changed is who, and how, PTSD is reported. While seeing the flight surgeon after a deployment I had told him, you know ten years ago I would not have told you any of this. His reply was that we have come a long way haven't we. My point is, back in the old SAC days we would not mention anything about nightmares or having an off month, yes being around the nukes and pulling alert did mess with you a bit. Back then you would lose your line badge, lose your PRP, and pretty much be the squadron joke. Our service members are more comfortable coming forward. However, there are still those trying to fight the ghosts alone, and creating support groups or clinics will not help. Until everyone is comfortable coming forward, without reprisal or being criticized, the services leaders still have a responsibility to change how the unit reacts. The same applies to the VA or any other vetran organization.

Response by Sgt Spencer Sikder made Oct 22 at 2015 8:59 AM

Sgt Spencer Sikder — Thu, 22 Oct 2015 08:59:00 -0400

While some are getting 50% ratings, the schedule of ratings details the level one must exhibit to be awarded that rating. I'm curious now that you inject the combat doctrine as a factor in the increase of PTSD.

PTSD has been around forever and called different names, shell shock, war fatigue, gun shy, and so on. It also is associated with civilian related issues, like traffic accidents, criminal attacks, etc. VA seemed to relate the conditions into PTSD as a result of the prevalence in Vietnam vets.

Response by 1SG Joseph Yorski, MHS made Oct 22 at 2015 10:21 AM

1SG Joseph Yorski, MHS — Thu, 22 Oct 2015 10:21:39 -0400

I guess I'll be "that guy." PTSD is also a major cash cow at the VA. Like MST. You can have no wounds, never have fired your weapon or HEARD a weapon fired in anger and you'll still have a pretty easy time getting that rating. I can't even tell you the number of veterans I know who have done this. Also, our grandparents WERE made of sterner stuff, despite what this generation has fooled itself into believing about itself. The idea of getting a payout for defending their country was repugnant to them. They just wanted to get home alive and resume their lives. We have a LOT of entitled, weak people coming into the military unfortunately and the first place they go on ETS is the VA to "file that claim."

Don't mistake my harsh assessment for anything other than it is. Frustration that actual combat veterans with legitimate needs are getting screwed by their fellow vets with BS claims clogging the system. Let the hating commence...

Response by SFC Private RallyPoint Member made Oct 22 at 2015 11:03 AM

SFC Private RallyPoint Member — Thu, 22 Oct 2015 11:03:16 -0400

There are lots of articles on this; apparently the size of the hippocampus directly affects the brains susceptibility for PTSD.

http://www.psmag.com/politics-and-law/ptsd-brain-studies-look-at-hippocampus-33419

I also believe that PTSD is associated with the brain/persons ability to rationalize traumatic events. Again, lots of articles on this as it is the standard model for psychiatry PTSD treatment and diagnosis.

https://books.google.com/books?id=fFi7DR2hmaIC&pg=PA616&lpg=PA616&dq=PTSD+rationalizing+traumatic+events&source=bl&ots=bVkEXjE8Wa&sig=xq_BRi54-h80IUqGijn22muxIIU&hl=en&sa=X&ved=0CB8Q6AEwAGoVChMI5YHH-qrWyAIVU89jCh1XYw7r#v=onepage&q=PTSD%20rationalizing%20traumatic%20events&f=false

Apparently the size of the hippocampus is a relative factor, because PTSD is not strictly limited to the Hippocampus size. Persons with a small hippocampus are simply more susceptible. Apparently a more determinant factor is worldview that allows/rejects traumatic causality. Simply put, if you have a religious belief structure that incorporates a good vs evil dichotomy, and a beneficent universal outcome; then PTSD is significantly less likely

Response by CPT Pedro Meza made Oct 22 at 2015 12:10 PM

CPT Pedro Meza — Thu, 22 Oct 2015 12:10:20 -0400

SPC Robby Robinson, I saw from the 1970's a few WWI and many WWII, along with Korean, and Vietnam Vets, when I worked at the VA, and say that even late in life PTSD vets were still in pain. I believe that the VA and ARMY have recognized that they should have done more.

Response by CPT Topher Murphy made Oct 22 at 2015 1:05 PM

CPT Topher Murphy — Thu, 22 Oct 2015 13:05:30 -0400

Understanding history is important here.
1. PTSD wasn't a diagnosis until 1982
2. Vietnam to present about 24 hrs to return home
3. WW II you get on a boat in Liverpool or Rome, etc. and take 3-4 months of talking with your buddies and sharing your stories (NO MH providers around)
4. Strong local/community support upon returning

Response by MAJ Ken Landgren made Oct 22 at 2015 1:22 PM

MAJ Ken Landgren — Thu, 22 Oct 2015 13:22:34 -0400

I believe the multiple deployments, violence of war, adrenaline, anxiety, stress and lack of sleep causes PTSD.

Response by CPL Brian Clouser made Oct 22 at 2015 1:29 PM

CPL Brian Clouser — Thu, 22 Oct 2015 13:29:20 -0400

I have PTSD and I can tel you it is not fun, I went from being open and friendly that try to h'telp people to being close I don't leave the house unless I have to. I pay all my bills online so I don't to deal with people. When I do leave my house i am armed and at night I sleep with it.
With all this plus so more that I don't want to talk about. VA in their wisdom have cut my rating form 70% to 50%, Why? Because I can pay my bills
The way VA and this nation treats its veterans is a crime. We didn't ask to go to war and do and see the things we did. We were following orders and for that crime we are sweep aside like you would with a piece of trash. This nation does not deserves its veterans

Response by MAJ Ken Landgren made Oct 22 at 2015 7:53 PM

MAJ Ken Landgren — Thu, 22 Oct 2015 19:53:23 -0400

One thing to think about is battle rhythm. Sure units come home from war, but often the year at station requires another train up. The combat units are out in the field a lot training on maneuver, tactics, and gunnery.

Response by SSG Jason Penn made Oct 22 at 2015 7:55 PM

SSG Jason Penn — Thu, 22 Oct 2015 19:55:58 -0400

The point you are missing is the recognition of ailments improve over time. Prior to WWI PTSD was not recognized and the individual was diagnosed as being a coward. WWI veterans fair the best in treatment, but the worst in compensation. PTSD at this time was known as shell shock due to the copious use of artillery. WWII saw a lapse in treatment, but mental issues were starting to garner the soldier with better compensation for incurred mental illness due to combat. At this time, PTSD was known as Combat Fatigue. Recently, the medical community recognized PTSD in that "Combat Fatigue" did not always occur when bullets were flying. Treatment improved, but still lags behind the treatment that doughboys got, however, compensation is the best it's ever been. When most sufferers of PTSD are unemployable due to fits of violence and/or extreme flashbacks, it is only fair to compensate them with so much.

Response by SFC Private RallyPoint Member made Oct 22 at 2015 10:42 PM

SFC Private RallyPoint Member — Thu, 22 Oct 2015 22:42:01 -0400

As with most questions that have a number of influencing factors, it's not as simple an answer as a one sentence Facebook meme. It's essentially comparing apples to oranges.
1. PTSD now and PTSD then are comparatively different. Under old definitions, it was PTSD if you were basically non-functional. Now, PTSD is viewed as a range on a scale.
2. There is no automatic rating for almost any disability.They are based on to what degree that disability affects your daily operation. That's why back injury could be 10% or it could be 50%
3. Others will say that our grandparents were made of sterner stuff... but most of those old vets you ask will tell you that today's generation is the greatest generation. They will also tell you that there is no way they would jump into a DZ with a 100 pound ruck, or patrol for 3 days straight in the mountains wearing a 65 pound vest.
4. More survivors. You have a greater than 90% survival rate if you're wounded, ever since the military invested so heavily in it's medevac system and body armor. In fact, unless you are killed instantly, you are almost guaranteed to survive.
5. The VA reps at retirement and transition all but coach you on what to claim. Right now 50% of new vets are claiming disability with up to 14 claims per patient
https://www.bostonglobe.com/news/nation/2012/05/27/almost-half-new-veterans-seek-disability-benefits/sYQAAY00ddXBRoqfsKMheJ/story.html

Almost half of new veterans seek disability benefits - The Boston Globe

America’s newest veterans are filing for disability benefits at a historic rate, claiming to be the most medically and mentally troubled generation of former troops the nation has ever seen. A staggering 45 percent of the 1.6 million veterans from the wars in Iraq and Afghanistan are now seeking compensation for injuries they say are service-related. That is more than double the estimate of 21 percent who filed such claims after the Gulf War....

Response by MSgt John Carroll made Oct 23 at 2015 11:02 PM

MSgt John Carroll — Fri, 23 Oct 2015 23:02:55 -0400

I believe you are missing a huge part of this. In previous wars (WWI, WWII, etc) you got done fighting, got on a boat, and spent the next month boating home. You and everyone else that is on that boat has nothing better to do than talk. You have someone to relate to. Someone that knows your pain. Fast forward to OEF/OIF. Monday you are in a firefight on your way back from the FOB. Tuesday you are on a plane home. Wednesday you are on your couch drinking a beer on your couch. You never got that decompression time of a month on a boat. Now who do you talk to? Do you tell your wife that a few days ago you saw your buddy get shot in the face? Do you tell her about the Post Blast analysis you did of a suicide bomber last week at a market? No you don't. You don't because she wont understand and cant relate. Instead you bottle it up and then deploy again next year (or sooner) and get more fantastic memories, smells, and tastes drilled in your head.

It's not that war is more graphic now than it was back then. Dead is dead. Blood is blood. Sure we have a lot more TBI cases now but that is because theses were IED wars more than anything else. But back to the original question, Older vets had the opportunity to vent. We didn't!

Response by SMSgt Thor Merich made Oct 24 at 2015 7:49 PM

SMSgt Thor Merich — Sat, 24 Oct 2015 19:49:39 -0400

This is a great question.
I believe that it could be a cultural issue. I think that past veterans were tougher individuals because everyone was tougher back then. At least in America, we are more sensitive then ever before. We are not allowed to judge others, everyone gets a trophy, and we are brought up to believe that we are all equal.

War is the toughest of environments and only the string survive, both mentally and physically.

I may be wrong, but I wonder what about the other combatants of Iraq/Afghanistan? They all fought in the same place and experienced the same things. Do they have high levels of PTSD as well? We will probably never know as the US probably tracks it and treats it better than anyone else.

Response by 1SG VonErick Trim made Oct 31 at 2015 5:01 PM

1SG VonErick Trim — Sat, 31 Oct 2015 17:01:22 -0400

PTSD and their ratings has nothing to do with war or combat. There is a arbitrary list of questions that require "ZERO" proof or validity. As long as you can tell a good story and be half a good actor, all the drugs you can abuse and $3200 a month await you. The question is how many would seek treatment if they werent paid to be sick

Response by SFC Jim Mergott made Nov 2 at 2015 9:57 PM

SFC Jim Mergott — Mon, 02 Nov 2015 21:57:34 -0500

I like the issue you bring to the table. I have thought about this before. As a matter of fact I am taken aback by some of my comrades that I served with and their "claims" of PTSD. I think a lot of it has to do with the age and life experience of the individuals that are exposed to traumatic stress. And the levels of that stress. A combination of those three factors. Hey, we all have our breaking points. I do find it strange when some guy who survives incoming rockets one time in a 9 month tour has PTSD and collects from the VA because of it. But hey, we all have our breaking points.