Post-Traumatic Stress Disorder

QUESTION: I didn't go to Vietnam, but a group of my old buddies did. Well,
it's nearly 20 years since they got out, but they still seem to be messed up
and stressed out because of it. Several of them are still into drugs, while
others are alcoholics. Some of them seem to be in trouble with the law all
the time, and can't hold jobs. I've been told this is typical. Is it, and
what can be done to help?
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ANSWER: It sounds to me like some of your friends are suffering from
post-traumatic stress disorder. The disorder is seen in some veterans of all
wars, but seems to be most common in Vietnam Vets. Those who suffer from this
problem experienced an unusual, life-threatening experience that evoked
extreme distress. Since life-threatening experiences were a regular way of
life for combat vets in Nam, this disorder is associated with abnormal
autonomic nervous system conditioning, high unemployment, marital problems,
alcoholism, drug abuse and the inability to adjust after war-induced trauma.
Doctors who've studied vets with post-traumatic stress disorder say the
victims report recurrent dreams of combat, sweaty palms, jumpiness,
irritability with children, family problems, fatigue, palpitations, started
responses and difficulty in holding jobs. Studies in which combat vets and
university students were subjected to combat sounds and light flashes, showed
distinctly different responses in the nervous system. The vets reacted to the
combat sights and sounds with increased pulse and respiratory rates. In
another similar study, the combat vets reacted with intense feelings of fear,
rage, sadness and guilt. Noncombat veterans did not react with intense
emotions.
Some of the reasons Vietnam veterans suffer from this problem more often
than other vets include the continuous stress of guerilla warfare, atrocities,
terrorism, language barriers, the limited and vague military objectives of the
war in Vietnam, and the failure to debrief troops returning to the U.S.
A national survey of more than 1,300 Vietnam Vets showed combat
experienced soldiers had a 23% post-combat arrest rate and 12% conviction
rate--much higher than for noncombat soldiers. Treatment of post-traumatic
stress disorder involves a combination of psychotherapy and pharmacotherapy
(drug therapy). Readjustment depends on integrating the vets' pre-Vietnam and
post-Vietnam experiences.
Some veterans are getting disability benefits that would end if they
recover. Some drugs appear to be promising in treating this disorder, helping
the patients to feel more relaxed, and less angry. The psychotherapy must
also take into account severe feelings of guilt that many combat vets suffer.
Many are haunted with thoughts that they might have killed innocent people.
There's also something called survivor guilt--feeling guilty that they
survived the war, while their friends in the battlefields were killed.
We are learning now that all of the statistics of the costs of war are
not easily added up into neat columns that provide mere dollar amounts and
casualty numbers. The pain and human suffering continues long after the
battles have ceased and affect civilian and combatant alike.