Iraq Stress Hits Veterans of Past Wars: Most PTSD Cases Locally Are Triggered By Stories, Images of Current Conflict.

By Denny Boyles, The Fresno Bee, Calif.

Sep. 24–The war in Iraq has caused an increase in the number of local veterans with post-traumatic stress disorder, an anxiety illness that can make it difficult — or even impossible — to lead a normal life.

But relatively few of those seeking treatment fought in Iraq. Instead, the televised images of war — and daily news of bombings and deaths — have caused the disorder to surface in Vietnam and Korean war veterans who have been off the battlefield for decades.

At Fresno’s VA hospital, 190 new patients are referred for treatment of PTSD each month.

Up to 80% are older veterans who served in Vietnam and Korea and suffer from anxiety, anger or depression.

They did not seek treatment before because they didn’t know they had the disorder or they didn’t want to ask for help, say VA officials.

They believe the trend is seen elsewhere as well, and will continue as the war in Iraq progresses.

Dr. Cara Zuccarelli Miller, a clinical psychologist at the Fresno VA, said many older veterans only become aware that they have PTSD because they recognize their symptoms in those returning from Iraq who have been diagnosed.

“They often tell me that for the past 30 years, they felt they were the only ones experiencing these things and are glad to know they aren’t alone and that there is treatment,” Miller said.

“The VA has committed tremendous resources to apply research and treatment knowledge to veterans coming back from Iraq and Afghanistan, and veterans from the Vietnam War and other conflicts are becoming aware of the new programs.”

For many, it’s their first experience with the VA medical system.

“Some of these veterans never even made it into the VA system when they came home,” said Dr. Nestor Manzano, chief of mental health services at the Fresno VA Hospital.

“They may have had PTSD symptoms when they came home, but instead of seeking treatment, they tried to deal with it their own way. They became workaholics, or self-medicated with drugs or alcohol.”

As it works to treat veterans nationwide, the VA has come under fire for staffing and funding shortfalls in its mental health units and for wide differences in how much it spends on such treatment at its medical centers.

The agency maintains that it delivers consistently high-quality treatment.

“The best measurement of success, and what really counts, is how well we are doing in improving our patients’ health,” the agency’s top medical official, Michael Kussman, said in a statement to McClatchy Newspapers earlier this year. “Our results are uniformly positive.”

The VA has 153 medical centers nationwide, and one of the reports lists 103 centers with the special PTSD clinical units at the end of fiscal 2006. The VA has added such units rapidly in the past year, and by the end of this year, about 120 centers will have them, according to a May statement by the department.

In Fresno, treatment of patients with PTSD is constantly evolving as new techniques are developed, officials said. Since 2004, the hospital has treated 2,954 patients for symptoms related to the disorder, at a cost of more than $10 million.

Local VA officials say they’ve worked to improve their care for PTSD patients. They’ve expanded programs, added new staff and formed new support groups. They’ve also formed a specialized PTSD clinical team that will coordinate care for veterans suffering from the disorder.

Because many PTSD patients never are truly cured, the group also focuses efforts on helping patients make meaningful changes in their lives.

“What we want to do is bring out the resiliency of these individuals so they don’t rely on us,” Manzano said. “We compare it to hypertension or diabetes, neither of which can be cured. But they can be managed. This disorder can be managed as well.”

One veteran of Vietnam praised the care he has received from the Fresno VA. But to help everyone, the hospital will need more space, more staff members and — most importantly — more money, said Army veteran Brian Ross, 62, of Fresno.

“Our government says ‘we need more soldiers, we need more Marines’ and we answer,” said Ross, who served as an enlisted combat infantryman. “They promised they would take care of us, but to do that, the system needs a lot of help.”

Forty years after he left Vietnam, Ross continues to struggle with what he saw and was asked to do for his country.

Unlike many who were drafted, Ross volunteered to fight. He remains proud of his service, even though the trauma he suffered in the war has cost him a wife, many jobs and eventually the ability to work at all.

Though he won’t speak about his experiences in Vietnam, Ross willingly talks about how he still suffers from PTSD and how it has ravaged his life. His hope, Ross said, is that his story will help other veterans seek the help they will surely need.

“The last thing we want to do, as young men, is say there’s something wrong with me mentally,” Ross said. “We just wanted to get the heck out [of the Army]. So instead of being treated, our problems just festered. It festers, then it comes out horribly.”

The National Center for Posttraumatic Stress Disorder describes PTSD as an anxiety disorder that can occur after a traumatic event. It isn’t necessary to be involved in an event to wind up with the disorder, Manzano said.

“You just have to be traumatized by it,” Manzano said. “Sometimes just witnessing something traumatic, such as watching the World Trade Center collapse on television, can cause PTSD symptoms.”

For Ross, the symptoms that had grown inside him became too strong to ignore in the mid-1980s. He had moved to Fresno after being laid off from a police department in Washington state, and was volunteering as a driver at the local VA hospital. There was no specific event that triggered what he calls his “PTSD hit” — including outbursts of uncontrollable anger — but one day he no longer could function, and he sought help from VA officials.

“I think the head wound I suffered in Vietnam made it take a long time for some of the stuff to catch up with me,” Ross said. “Eventually it was just there, and even the little things of everyday life became too much.”

Ross was screened by mental health workers and assigned to a support group with other Vietnam veterans experiencing similar problems. He still meets with that group weekly, and credits his fellow veterans and the group leader for saving his life.

“If it wasn’t for that group, I would probably be divorced again, or would have killed someone with road rage, or be dead myself,” Ross said.

“My goal when I started was just to help myself, to find out what was wrong with me. I wanted to be a better husband, a better neighbor and just a better person.”

McClatchy Newspapers contributed to this report. The reporter can be reached at dboyles@fresnobee.com or(559) 441-6659.

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