VA's message: PTSD is 'very treatable'

By MARY MEEHAN | Lexington Herald-Leader, Ky. | Published: July 4, 2012

The most common misconception about post-traumatic stress disorder is that there is no effective treatment.

Dr. Matthew Friedman, executive director of the Department of Veterans Affairs' National Center for PTSD, is working to get the word out that it's "very treatable."

PTSD is more prevalent among service members today, with 17 percent to 20 percent of the troops returning from Iraq and Afghanistan suffering from it, he said. But studies have shown that 80 percent of those, given proper treatment, are without symptoms after five years.

The disease itself is far from new.

"Homer was a vet," he said. "Achilles showed signs of PTSD."

For centuries, he said, it was "the turf of poets and novelists." Shakespeare wrote about it, as did Charles Dickens. It was during the Civil War that doctors coined the term, "soldier's heart." The idea was that a soldier's heart rate, blood pressure and pulse rate were altered by war, and that led to personality changes.

Over the years, the disorder has had several names — shell shock, combat fatigue, combat exhaustion — but it has evolved to be understood as having psychological and physiological roots.

The increase in PTSD patients is tied to the large number of military reservists serving in combat, Friedman said. Having social support — as full-time military personnel do — is one of the things that can prevent a traumatic event from escalating into PTSD, he explained.

For those on active duty, the military is their life and their job. "Citizen soldiers don't have that same kind of support," he said.

It's impossible to pinpoint who might develop PTSD. Most people who serve in a war zone, even those serving multiple deployments, don't get PTSD, he said. Others return home struggling after a single tour.

"What's the difference?" he said. "Some of it's luck. Some of it's resilience."

Two kinds of therapy have been found to be most effective with PTSD, he said. Cognitive processing therapy and prolonged exposure therapy center on helping vets change how they interpret what is going on around them and learn to recognize and tolerate the triggers that can lead to attacks.

Drugs known as selective serotonin reuptake inhibitors have been found to be helpful, he said.

Fortunately, there is "major change" in the past 10 years in the public's level of understanding of PTSD, Friedman said, and "there are thousands of new, well-trained clinicians who are equipped to provide treatment."

Technology, Web-based information sharing, mobile apps and social media make it easier to the get the message out about treatment, he said. The Department of Defense and the VA are working more closely to make sure veterans have access to treatment. The first step, he said, is to seek help.

"There is no wrong door," he said.

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