Treating War's Toll on the Mind
Thousands of soldiers have post-traumatic stress disorder. Will they get the help they need?
Danger zone. There may be no war better designed to produce combat stress and trauma. Operation Iraqi Freedom is a round-the-clock, unrelenting danger zone. There are no front lines, it's impossible to identify the enemy, and everything from a paper bag to a baby carriage is a potential bomb. Soldiers are targets 24-7, whether they are running combat missions or asleep in their bunks. "There is no moment of safety in Iraq," says Andrew Pomerantz, a psychiatrist and chief of the Mental Health and Behavioral Science Service at the VA Medical Center in White River Junction. "That's one of the things we're seeing in people when they come back-a feeling of an absolute lack of safety wherever they are."
Stories of vets who sleep with guns and knives and patrol the perimeters of their homes obsessively are as common as tales of valor. Marine Lt. Col. Michael Zacchea, 38, who trained Iraqi troops and was in about 100 firefights, knows that paranoia all too well. "Every time I get on the road," says Zacchea, who commutes from Long Island to Wall Street, "it's like I'm back in the streets of Baghdad in combat, driving and running gun battles, with people throwing grenades at me." Zacchea, a reservist, is now being treated for PTSD at a VA hospital, but had it not been for chronic dysentery, migraines, and shrapnel wounds in his shoulder, he says he probably would have been redeployed in September, emotional scars and all.
And he still may be. The military's need to maintain troop strength in the face of historic recruiting lows means many service members, including some suffering from psychological problems like Zacchea, have no choice but to return. President Bush recently authorized the Marine Corps to call up inactive reservists, men and women who have already fulfilled their active-duty commitment. "They're having to go deep into the bench," says Robinson, "and deploy some people who shouldn't be deployed."
Multiple tours. Robinson is referring to the increasing number of reports of service members who stock antidepressants and sleeping pills alongside their shampoo, soap, and razor blades. The Defense Department does not track the number of soldiers on mental health medications or diagnosed with mental illnesses. But the military acknowledges that service members on medication who may be suffering from combat-induced psychological problems are being kept in combat. "We're not keeping people over there on heavy-duty drugs," says Army Surgeon General Kevin Kiley, who estimates that 4 to 5 percent of soldiers are taking medications, mostly sleeping pills. "Four to five percent of 150,000, that's still a lot of troops. But if it's got them handling things, I'm OK with that."
Handling things is a relative term. Army Pvt. Jason Sedotal, 21, a military policeman from Pierre Part, La., had been in Iraq six weeks in 2004 when he drove a humvee over a landmine. His sergeant, seated beside him, lost two legs and an arm in the explosion. Consumed by guilt and fear, Sedotal, who suffered only minor injuries, was diagnosed with PTSD when he returned from his first tour in early 2005 and given antidepressants and sleeping pills. Several months later, while stationed at Fort Polk, La., he sought more mental health care and was prescribed a different antidepressant.
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