Veterans’ health care providers prepare for PTSD

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(Host) The Veterans’ Administration is alerting civilian health care providers to be on the lookout for signs of stress in returning combat veterans.

VPR’s Susan Keese has more.

(Keese) The Veterans’ Administration wants to avoid the errors of Vietnam and the first Gulf War. Veterans of those conflicts with unexplained symptoms often had to struggle to prove their illnesses were related to their military service.

This time around, the VA is offering two years’ free health care to returning combat zone veterans for any problem that might be service-related. The offer applies to most activated Reservists and National Guard troops. It also applies to people who may be showing early signs of post traumatic stress disorder, or PTSD.

(Andy Pomerantz) “We’re out there pounding the pavement in many ways looking for them. We’ve asked for help from primary care physicians around the state, community mental health centers, as well as within our own institutions, to help find these people when they start having problems.”

(Keese) Dr. Andy Pomerantz is chief of mental health and behavioral sciences at the VA Hospital in White River Junction. He’s spent the past 20 years working with veterans suffering from post traumatic stress disorder. He believes that catching the problems when they first develop is the surest way to the best possible results.

(Pomerantz) “One of the things that we know about all mental illnesses, including PTSD, is that over time the illness becomes hard-wired in. As one experiences more and more acute episodes the brain subtly changes, if you can think of it as simply favoring that pathway.”

(Keese) Warning signs for PTSD include what Pomerantz calls ‘intrusive memories.’ These may take the form of nightmares, or disruptive waking recollections. Sufferers may startle easily and be anxious or hyper-vigilant. They may seem detached or rely increasingly on alcohol or drugs to numb their feelings. Sometimes sufferers will complain of non-specific ailments, like headaches, upset stomach or fatigue.

(Pomerantz) “And it’s only with a little more discussion that you find out they’re drinking too much or having nightmares occasionally and just not talking about it.”

(Keese) Pomerantz says most returning soldiers will experience some symptoms early on. He says he’s never met anyone who’s been in combat who wasn’t changed by it. He says people spend their whole lives learning to behave in a certain way.

(Pomerantz) “And a great part of military training, unfortunately, is to take away those very strong beliefs. The rules are very different.”

(Keese) Pomerantz says most people manage to reconnect with their old lives after a few, often very difficult, weeks. If things are getting worse after three or four weeks, he says, it’s time to think about getting help.

He predicts that between 15 and 30 percent of returning combat vets will struggle with PTSD. No one knows why some people react this way. But Pomerantz says PTSD is a disease, not a character weakness. And the sooner it’s treated, the better off everyone will be.

For Vermont Public Radio, I’m Susan Keese.

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