In a recent Chieftain column ("The Nature of Things," April 6), the subject of Post traumatic Stress Disorder (PTSD) was brought up and briefly discussed from one perspective. The Wallowa Valley Center for Wellness has an alternative view that we would like to present.

According to the Diagnostic and Statistical Manual for Mental Disorders, PTSD is a very real condition. In order to receive the diagnosis, a person must meet the following criteria:

Criterion A: You have experienced, witnessed or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and your response involved intense fear, helplessness or horror.

Criterion B: You re-experience the trauma in the form of dreams, flashbacks, intrusive memories, or unrest at being in situations that remind you of the original trauma.

Criterion C: You show evidence of avoidance behavior, which is a numbing of emotions and reduced interest in others and the outside world.

Criterion D: You experience physiological hyper arousal, as evidenced by insomnia, agitation, irritability or outbursts of rage.

Criterion E: Your symptoms persist for at least one month.

Some examples of events that could bring on Post traumatic Stress Disorder include, but are not limited to, military combat, sexual assault, being kidnapped, physical attacks, the sudden death of a loved one, severe automobile accidents or being diagnosed with a life threatening illness. The disorder may be especially severe or long lasting when the stressor is of human design (e.g. rape, torture). It can occur at any age, including childhood.

Acute Post traumatic Stress Disorder occurs immediately or within six months after a traumatic event. PTSD can also have a delayed-onset that can come on several years after the trauma. PTSD is no different than any other medical or psychiatric disorder in that its severity may vary from mild to severe.

Just like diabetes or heart disease or depression, there is a continuum for this illness. Some people have no diabetes, some have a mild form of the disease, and others become so ill that they are at risk of dying. Today, PTSD is considered a significant public health problem in all cultures, and research indicates that 8 percent of Americans will develop PTSD at some point in their lives.

There are no certain predictors for who is at risk for developing the disorder. What we do know is that 40 percent of those who develop PTSD will likely not recover, whether or not they have ever received treatment. For example, research from the Veteran's Administration with World War II veterans and Nazi Holocaust survivors show that PTSD can persist for over 50 years or for a lifetime (Chronic PTSD). Unhealed PTSD can devastate a life - ironically making one who wanted to be a soldier for his or her country unable to participate effectively as a citizen upon return from combat.

It is true that Post traumatic Stress Disorder is most commonly associated with Vietnam veterans. Yet PTSD or PTSD-like symptoms have been experienced by soldiers throughout the ages. In fact, war-related PTSD has been documented by historians, dramatists, military officials and others at least as far back as the ancient Greeks and Romans. War-related PTSD was noted in England and France during the Middle Ages, in the Civil War in this country, and in the first and second World Wars, the Korean War and other wars of this century. What used to be referred to as shell shock, war neurosis or battle fatigue is now known as Post traumatic Stress Disorder.

After World War II, military experts concluded that the trauma of war was often enough to impair even the "strongest" and "toughest" of men (Goodwin; Grinker and Spiegel 1983). However, most World War I and II veterans who suffered from PTSD kept their problems to themselves or drowned them in alcohol. If it is not considered manly to admit inner turmoil today, it was even less so in the past. As a result, numerous World War II, Korean War, Vietnam veterans and the new Iraqi war returnees still suffer from nightmares and other symptoms of PTSD because they view their symptoms as a "weakness" and feel ashamed.

There is a very clear reason why we use the phrase "suffer from PTSD." The men and women who have developed the disorder do not want it. It is extremely painful to be haunted by traumatic memories. It is terrifying to have a car backfire and automatically be thrown into a flashback of being in a fire fight. PTSD victims often hate themselves for raging behaviors towards others, or the excessive alcohol and drug abuse they use to suppress traumatic symptoms. Many war veterans have committed suicide in order to free themselves from their "memory prisons."

Those combat veterans who did not develop PTSD are the fortunate ones. And thankfully, their numbers are greater than those with PTSD. At least those that don't have to suffer from Post traumatic Stress Disorder had only the original (though we're sure horrific) battles to fight. Instead, sometimes for the rest of their lives, PTSD victims have to deal with the original battles, and then the reoccurring battle traumas in their heads.

If we're going to truly "support our troops," let's caution ourselves before judging others who had no idea they could or would develop Post traumatic Stress Disorder. For help with the pain and suffering connected with PTSD, the Wallowa Valley Center for Wellness offers individual assessments and therapy, group therapy, family counseling and group therapy for combat veterans twice a month on Mondays at 3 p.m., facilitated by Cynthia Maguire, Psy.D., 426-4524, psychiatric consultations and possible mediation management. If needed, alcohol and drug treatment is also available at Wallowa Valley Center for Wellness.

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