The PTSD Merry-Go-Round Continues to Spin

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Colonel Dallas Homas

Colonel Dallas Homas has been reinstated as commander at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state. That is great news.

What troubles me is that there remains a widespread belief that there was malfeasance at Madigan — an attempt by Army doctors to screw Soldiers out of benefits to “save the Army money.”

I do not know what actually happened. To the best of my knowledge there are four different Army investigations that are seeking to understand what went on there. I am not privy to those investigations.

But there has been a rush to judgment among the media and general public, who do not seem to have read the investigations either.

The diagnosis of PTSD, as it is currently made, requires certain criteria be met. Many of these are subjective, relying on the patient’s self-reporting. One of them is that people must experience a traumatic event, with extreme hopelessness, fear and horror (the so-called criteria A-2).

Our Soldiers are well-trained, and may not experience fear, hopelessness and horror.

They still may experience the other symptoms of PTSD, to include flashbacks, numbness, and a startle response. More troubling — and not included in the criteria — is anger, irritability, and the inability to re-integrate with family and friends.

But symptoms wax and wane, respond to treatment, and what may look like depression one day, looks like PTSD the next.

I have always believed in erring on the side of the Soldier. If Soldiers says they have had a traumatic event while in the theater of war, and have the related symptoms, they should get the diagnosis and appropriate treatment, and if needed, compensation.

The policy letter published by the Army Surgeon General’s office in April of this year, reiterated that theme.

The American Psychiatric Association is also re-looking at the criteria for PTSD.

Academic researchers and advocates alike are also saying that it should not be named as a disorder, but as an injury. I am sympathetic to that argument.

Bottom line is that our Soldiers and service members need to be cared for, whatever the psychological reactions to war are labeled as. We should be striving to do that as a nation.