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PTSD in the military: There’s no easy fix

by David Bercuson

The Globe and Mail
November 12, 2015

Canada’s new Defence Minister, Harjit Singh Sajjan, knows the reality of war, and knows the impact of combat on soldiers afterward. He was a “trigger puller” in the Canadian Army during the war in Afghanistan, a combat officer who saw Canadian soldiers killed and wounded fighting the Taliban.

More to the point, he was also the commanding officer of a militia regiment in British Columbia after returning to Canada. That is no doubt why, as one of his first acts as minister, he has ordered that suicide prevention among war veterans be a top priority for our military.

What military leaders will likely find is that suicide among combat veterans is closely connected to post-traumatic stress disorder. This is not a new development; historians and medical specialists who have studied this condition suspect that PTSD, no matter how labelled, has been a part of soldiering ever since humans engaged in war somewhere back in prehistoric times.

The condition arises when a soldier has seen too much combat without relief, or seen close friends killed or maimed in action, or barely survived an intense battle or brush with mortal danger. Research has also found that killing the enemy, or seeing large numbers of civilian casualties, or simply being in a constant state of tension and anxiety arising out of ongoing danger can also bring on PTSD.

Research into Union soldiers hospitalized during the U.S. Civil War has found a far higher percentage of “melancholia,” as doctors in the 1860s called it, than was previously believed, ranging from 10 per cent to 40 per cent of patients. No one knows what the impact was on Canadians who served in the South African War (Boer War) of 1899 to 1902, but the condition, then labelled “shell shock,” was widespread among members of the Canadian Corps in the First World War.

During that war, psychiatry progressed to the point at which the condition was recognized and treated, but a number of Canadian soldiers were shot for showing cowardice in the face of the enemy, rather than being treated as normal people put in abnormal circumstances for far too long.

In the Second World War, “shell shock” came to be known as “battle exhaustion” or “battle fatigue,” and even the most hardened senior officers came to recognize it as a very real and, in most cases, treatable condition. Even so, Lieutenant-General Guy Simonds, who commanded the Canadians through most of the Normandy campaign, warned his subordinates to take care lest malingerers used battle exhaustion as a means to escape combat.

Canadian air crew, especially those serving with the RAF Bomber Command, suffered the same effects as their infantry comrades. In the Royal Air Force, these men were judged to be “lacking in moral fibre” and were quickly shipped off to coal mines or to the docks. The Royal Canadian Air Force, to its great credit, objected strenuously to Canadian airmen being treated in this fashion, preferring treatment or transfer to non-flying duties.

In all these wars and in the wars that followed (Korea, Afghanistan) and in peacekeeping missions in places such as the Congo, Cyprus and the Balkans, PTSD was generally recognized as a problem requiring immediate attention.

But the sad fact is that no one knows what the suicide rates were among veterans of all of those wars.

What was not realized until the U.S. involvement in the Vietnam War – and in Canada, not until the civil war in the Balkans in the 1990s – is that PTSD is not easily treated. In many cases, it takes years of counselling, family care and proper medical attention to cure, or even simply to keep it under control.

With Canada’s military mission ended in Afghanistan, it is unlikely that Canadian soldiers will soon experience combat again. But they will go on missions of great danger, or see countless civilians slaughtered in so-called peacekeeping missions, or see mass starvation or countless deaths from natural disasters.

Those men and women deserve everything we can do for them, for as long as it takes, to return them to a semblance of normalcy.


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