Through his experience embedded with US military service members in Afghanistan, war correspondent Sebastian Junger discovered that Post Traumatic Stress Disorder can develop and take hold of a life as much at home as it does on the battlefield.
In May, Junger shared how he came to terms with his acute, short-term PTSD in an essay for Vanity Fair, co-published with an abbreviated audio narration (below). What began as a mental health issue caused by a "horrific" work environment turned into panic attacks when he returned home to New York. "I was far more scared than I had ever been in Afghanistan," Junger notes.
According to the US Department of Veterans Affairs, 6.8 percent of adult Americans will experience PTSD in their lifetime. Junger's essay is a must-read to understand the connections between PTSD and exposure to violence in war zones as well as risk factors in other factors — including being a woman. Among others, here are four facts from Junger's essay about PTSD that don't often get enough front-page attention:
The US military could save lives with mental health screenings for recruits
The most accurate predictor of post-deployment suicide, as it turns out, isn’t combat or repeated deployments or losing a buddy, but suicide attempts before deployment. The single most effective action the U.S. military could take to reduce veteran suicide would be to screen for pre-existing mental disorders.
The House of Representatives passed a bill in 2014 that would require mental health screenings for recruits, but was not enacted; similar legislation was introduced in both the Senate (S. 646) and House (H.R. 1465) in 2015. Both current bills are scheduled for committee review.
There's no one ubiquitous manner in which PTSD expresses itself:
How it develops is based on many factors, before and after traumatic experiences.
Combat is generally less traumatic than rape but harder to recover from. The reason, strangely, is that the trauma of combat is interwoven with other, positive experiences that become difficult to separate from the harm.
There's no direct correlation between combat and PTSD:
It seems intuitively obvious that combat is connected to psychological trauma, but the relationship is a complicated one. Many soldiers go through horrific experiences but fare better than others who experienced danger only briefly, or not at all. Unmanned-drone pilots, for instance—who watch their missiles kill human beings by remote camera—have been calculated as having the same PTSD rates as pilots who fly actual combat missions in war zones, according to a 2013 analysis published in the Medical Surveillance Monthly Report.
This doesn't mean, of course, that combat veterans don't ever experience PTSD or suicidal thoughts. But it's important we recognize that mental disorders are complex and vary from person to person, especially as we seek to learn more through longitudinal studies across ethnic, gender, and cultural backgrounds.
Some people naturally carry amino acids that help them cope with stress:
Elite soldiers have higher-than-average levels of an amino acid called neuropeptide-Y, which acts as a chemical buffer against hormones that are secreted by the endocrine system during times of high stress. In one 1968 study, published in the Archive of General Psychiatry, Special Forces soldiers in Vietnam had levels of the stress hormone cortisol go down before an anticipated attack, while less experienced combatants saw their levels go up.
Junger spoke about the complex connection between popular culture, veteran life, and America's war in Afghanistan at the 2014 TED Conference: