Wednesday, December 08, 2010

PTSD Isn't Just for Americans

Given the fact that I'm now working as a prosecutor within Travis County's brand new veterans court, over the last year or so I've been reading up quite a bit about post-traumatic stress disorder- primarily, of course, the incidence of the disorder amongst our returning troops and the effects that the disorder is having upon the returning soldiers. (I've done some reading on the subject myself, and I've also had a number of interested people forward me informative articles and reading on the condition).
PTSD can be extremely debilitating and difficult to live with. Triggered by the experience of some traumatic event (such as the violence of combat, for instance), PTSD is an extreme anxiety disorder which produces symptoms such as depression, anxiety, flashbacks, nightmares, anger, and hypervigilance. People suffering from the condition are often found to report problems with concentration, difficulty in maintaining normal relationships, and have an increased likelihood of drug or alcohol dependence as a result of a tendency toward self medication.
Within our troops returning from Iraq and Afghanistan, I've read estimates saying that as many as 30% (occasionally I've read as high as 40%) of our veterans may be suffering from various levels of PTSD, putting the number of stateside veterans who are dealing with PTSD well in excess of 300,000.
So I know something about this problem. I've read about PTSD and I've been thinking about its effect on our veterans for at least a couple of years now. I've even worked on criminal cases, ranging from drug possession cases to strange, unprovoked assaults, where I really had virtually no doubt that the root cause of the behavior was related to PTSD. Getting treatment for the veterans who are dealing with these issues is a large part of what our new veterans court is all about.

So PTSD is undoubtedly a very bad thing, and both the Veterans Administration and the civilian population here in the U.S. are beginning to take significant strides in trying to recognize the problem and address it when it comes to our returning troops (we could always do more, but I really do think that legitimate, substantial strides have been taken in recent years).

But, in all of the time that I'd been reading about PTSD I had never really given much thought to its incidence or effect within the population of a country where a war is actually, actively being fought.
There is an interesting article this week by Ron Moreau this week in Newsweek which examined the mental health impact of the war in Afghanistan upon both the country's civilian population and enemy combatants (namely, the Taliban). While it's pretty hard to work up a tremendous amount of sympathy for Taliban combatants (we went to war with the Taliban because they provided a safe haven for Al Qaeda during the planning of the 9/11 operation, and, in the end, don't we want them to just quit fighting?), it's nonetheless strange to wonder and think about what sort of impact the war is having upon our enemies.
With PTSD rates among U.S. forces rising as high as 30%, one might expect that rates among the Taliban (who have limited medical care, less training, and face a vastly superior enemy in terms of firepower and technological advantage) might be much, much higher. Also, while U.S. soldiers can at least hold out the realistic hope of eventually returning to a safe, secure environment back home, the home of Taliban soldiers is actually their battlefield, with their possible outcomes mostly limited to victory, surrender, or death.
The Newsweek article discusses a couple of cases of Taliban soldiers who are suffering with apparent combat related mental illness, citing their delusions, flashbacks, and violent outbursts as anecdotal evidence of PTSD within the Taliban ranks.
More troubling for most Americans would probably be the effects of PTSD upon Afghanistan's civilian population. Having lived for many years within a war stricken, impoverished nation (with very little health care of any kind- let alone mental health treatment), experts are beginning to suspect that the incidence of PTSD and other combat-related mental illness within Afghanistan's civilian population may be as high as 60%. The ongoing stress of living within a country where death is an ongoing, constant possibility (from both U.S. and Taliban forces) has begun to create a civilian population where mental illness is not only prevalent, but extremely commonplace.
The whole thing makes me wonder what sort of place Afghanistan is going to be by the time this war finally winds down (yes, yes- assuming it ever does wind down. I'm aware that the U.S. is now considering the option of leaving a number of permanent bases in Afghanistan in order to provide a continuing military presence). I mean, I know that other parts of the world have suffered horribly traumatic wartime events as well (WWII England, Japan, and Germany all come to mind), but those wounds essentially took a generation to heal, and I'm sure that plenty of the people who lived through those events went to their graves still suffering from periodic nightmares and anxiety from things that happened decades previously.

Annnyway, I guess I didn't really have any grand point to make with this post other than the usual "war is really bad- and we continue to find out on a regular basis that it's bad in new and surprising ways that we hadn't even thought about before!"
In addition to waging a war that's physically destroying a country, it appears that we might be wrecking the place from a psychological standpoint as well. Sure would be awesome if we could find a way to wrap the whole Afghanistan thing up!

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