The Politics of PTSD

In World War II, PTSD was called Combat Fatigue and dealt with differently in different armies. Among the Allies, you got R&R leave behind the lines. If you were a Russian soldier who said he had Combat Fatigue, you were shot. Amazingly, there weren't nearly as many cases of Combat Fatigue in the Russian Army (from James Dunnigan's book How to Make War (Fourth Edition) : A Comprehensive Guide to Modern Warfare in the Twenty-first Century). We no longer deal with PTSD in such a severe way, but is going to the opposite extreme where veterans are told they will never get better the answer?

The Washington Post has an article today on Post-Traumatic Stress Disorder (PTSD)--hat tip to immodestproposals' blog for pointing out the article. Basically, criteria for PTSD are that a person has been exposed to a traumatic event, and has recurrent nightmares, hypervigilance etc. as a result of the trauma. See here for a description of PTSD. While I do believe that some people can experience PTSD, my concern is the growing political debate over soldiers who may or may not have the condition. Here is an excerpt from the Post article that clearly shows the politics involved in the diagnosis of PTSD:

The growing national debate over the Iraq war has changed the nature of the discussion over PTSD, some participants said. "It has become a pro-war-versus-antiwar issue," said one VA official who spoke on the condition of anonymity because politics is not supposed to enter the debate. "If we show that PTSD is prevalent and severe, that becomes one more little reason we should stop waging war. If, on the other hand, PTSD rates are low . . . that is convenient for the Bush administration."

This professor is correct about his assertion that soldiers will remain sick if they are told they will never recover by the PC crowd:

"We have young men and women coming back from Iraq who are having PTSD and getting the message that this is a disorder they can't be treated for, and they will have to be on disability for the rest of their lives," said Frueh, a professor of public psychiatry at the Medical University of South Carolina. "My concern about the policies is that they create perverse incentives to stay ill. It is very tough to get better when you are trying to demonstrate how ill you are."

There are some soldiers who truly suffer from PTSD, but many of these can be treated, if they seek help or believe that they have the chance to get better. But as long as these soldiers can be exploited for the political cause of the moment, their working lives will be tragically cut short and they will suffer for that, regardless of the size of their disability check. Or vice versa, those who need help will not get it because of the stigma. Whenever diagnoses are politicized, it is bad for the people involved. Those who have PTSD may not go for help and those who are malingerers have the incentive to rip off the system.

Update: Medpundit has more thoughts on PTSD.