Soldiers’ mental traumas surfacing

WASHINGTON – Matt LaBranche got the tattoos at a seedy place down the street from the Army hospital here where he was a patient in the psychiatric ward.

The pain of the needle felt good to the former Army sergeant, 40, whose memories of his nine months as a machine gunner in Iraq had left him, he said, “feeling dead inside.” Drawn from his neck to the small of his back, the dark outline of a sword is emblazoned with the words LaBranche says encapsulate the war’s effect on him: “I’ve come to bring you hell.”

In soldiers such as LaBranche, their bodies whole but their psyches deeply wounded, mental health experts say a crisis is unfolding.

One of every six soldiers returning from Iraq is suffering the effects of post-traumatic stress – and as more come home, that number is expected to grow.

The Pentagon, which failed to anticipate the extent of the problem, is scrambling to find resources to address it.

A study by the Walter Reed Army Institute of Research found 15.6 percent of Marines and 17.1 percent of soldiers surveyed after they returned from Iraq suffered from major depression, generalized anxiety or post traumatic stress disorder – a debilitating, sometimes lifelong change in the brain’s chemistry that can include flashbacks, sleep disorders, panic attacks, violent outbursts, acute anxiety and emotional numbness.

Army and Veterans Affairs mental health experts say there is reason to believe the war’s ultimate psychological fallout will worsen. The Army survey of 6,200 soldiers and Marines included only troops willing to report their problems.

The study did not look at reservists, who tend to suffer higher rates of psychological injury than career Marines and soldiers. And the soldiers in the study served in the early months of the war, when tours were shorter and before the Iraqi insurgency took shape.

“The bad news is that the study underestimated the prevalence of what we are going to see down the road,” said Dr. Matthew Friedman, a professor of psychiatry and pharmacology at Dartmouth Medical School who is executive director of the VA’s National Center for Post Traumatic Stress Disorder.

Since the study was completed, Friedman said: “The complexion of the war has changed into a grueling counter insurgency. And that may be very important in terms of the potential toxicity of this combat experience.”

Initially, the Army sent far too few psychiatrists, psychologists and social workers to combat areas, an Army study released in the summer of 2003 found. Until this year, Congress had allocated no new funds to deal with the mental health effects of the war in Iraq. And when it did earmark money, the sum was minimal – $5 million over each of the next three years.

“We’re gearing ourselves up now and preparing ourselves to meet whatever the need is, but clearly this is something that could not be planned for,” said Dr. Alfonso Batres, a psychologist who heads the VA’s national office of readjustment counseling services.

Last year, 1,100 troops who had fought in Iraq or Afghanistan came to VA clinics seeking help for symptoms of depression or post-traumatic stress. This year, the number grew tenfold. In all, 23 percent of Iraq veterans treated at VA facilities have been diagnosed with post-traumatic stress disorder.

“And this is first year data,” Batres said. “Our experience is that over time that will increase.”

An Iraq veteran in treatment at Walter Reed Army Medical Center, Army 1st Lt. Jullian Philip Goodrum, drives most mornings to nearby Silver Spring, Md., seeking the solitude of movies and the solace of friends.

He leaves early to avoid traffic – the crush of cars makes him jumpy. On more than one occasion, he has imagined snipers with their sights on him in the streets. Diesel fumes cause flashbacks. He keeps a vial of medication in his pocket and pops a pill when he gets nervous.

“You question, outside of dealing with your psych injury, which will affect you from one degree or another throughout your life, you also question yourself,” Goodrum said. “I trained. I was an excellent soldier, a strong character. How could my mind dysfunction?”

When it began to become clear that the war transmuted into a drawn-out counter insurgency, the Army belatedly pushed to reach and treat distressed soldiers sooner.

The number of mental health professionals deployed near frontline positions in Iraq has been increased. Suicide prevention programs are given to soldiers in the field. According to the Pentagon, 31 U.S. troops have killed themselves while in Iraq.

At more than 200 storefront clinics known as Vet Centers – created in 1979 to reach out to Vietnam veterans – the VA has increased the number of group therapy sessions and staff. Three months ago the VA hired 50 Iraq war veterans to help serve as advocates at the clinics.

The Army and the VA are also trying to catalog and research the mental health effects of this war better than they have in the past.

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