After his left leg was shattered and right leg ripped open, Jordan Sherwood used crutches to  move around cautiously.

Sam Dean | The Roanoke Times

After his left leg was shattered and right leg ripped open, Jordan Sherwood used crutches to move around cautiously.

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Tuesday March 28, 2006

The mental trauma of war

One in eight U.S. troops returning from Iraq has been diagnosed with post-traumatic stress or other mental illness linked to combat, Army research shows.

With American forces expected to stay in Iraq for at least several more years, the war's psychological toll may continue to rise, mental health specialists say.

Many veterans don't report psychological problems or exhibit symptoms of post-traumatic stress until several years after they return home.

In the most comprehensive study yet, a Walter Reed Army Institute of Research study in February found that nearly 20 percent of soldiers and Marines returning home reported symptoms of post-traumatic stress, depression or other psychological problems during the first year of the Iraq war.

More than a third of the Iraq war veterans sought counseling, and 12 percent were diagnosed with a mental health problem.

Post-traumatic stress disorder -- known as "soldier's heart" in the Civil War, "shell shock" in World War I and "battle fatigue" in World War II -- can include hypervigilance, anxiety, nightmares, flashbacks, anger, emotional numbness, paranoia, depression and insomnia.

PTSD, which is a psychological reaction to war and other trauma, was not recognized clinically until 1980, long after many Vietnam War troops came home. Nearly a third of Vietnam veterans reported psychological problems in the 20 years after the war.

Today, counseling is available through the Defense Department and the Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder.

"It's much different today because the VA's really making an effort to let veterans know there's care available," said Bob Cox, director of the PTSD program at the VA Medical Center in Salem. "But there's still a double message: You're supposed to be superheroes with no feelings or it's a sign of weakness."

Yet more than half of troops returning from Iraq and Afghanistan with mental health problems are not getting treatment despite steps to improve treatment, according to 2005 studies in the Journal of the American Medical Association and the New England Journal of Medicine.

Troops are screened for physical and psychological problems before, during and after deployments. Mental health combat teams are stationed in Iraq and Afghanistan.

The screenings began in 1997 and were expanded in 2003 in an effort to prevent the kinds of health ailments reported by Persian Gulf War veterans.

Some veterans, however, say bureaucratic red tape and a macho military culture still discourage them from getting help.

Cox, a Vietnam veteran who is leading a PTSD study of Iraq and Afghanistan war veterans, said the mental health toll probably will not be known for years.

"You can't take memories away."