ANNAPOLIS – David Greenberg has a very difficult time watching war movies. During 1998’s “Saving Private Ryan,” he felt his body beginning to shake and had to leave the theatre.
Seven years after he served in the Persian Gulf War, the movie resurrected images that he thought were left on the battlefield, images that “are not part of a normal environment.”
Many soldiers returning from war develop symptoms of Post-Traumatic Stress Disorder, a consequence of being exposed to life-and-death situations, such as war, rape, or terrorism.
The current war with Iraq has created two situations involving PTSD: a possibility of new sufferers returning from the war and the opening of old wounds for veterans of previous wars.
While Greenberg said he doesn’t have any severe lasting psychological effects from the war, he understands how other veterans can have problems.
“I’m pretty well-adjusted, it only bothers me during things like that, it comes back to you, subconsciously,” said Greenberg, a retired army captain and Annapolis resident.
PTSD can be triggered even years after the initial event. The sound of helicopters overhead or watching unrelenting war coverage on television can provoke memories in war veterans.
Since the U.S. attacked Iraq March 19, there has been a noticeable increase in phone calls from veterans who thought their feelings were resolved, but the images of war on the news “seem to be affecting guys,” said Dr. Raymond Wilson, a clinical psychologist at Baltimore’s Veterans Affairs Medical Center.
Even the war demonstrations revived bad memories and angry feelings, especially for Vietnam veterans, said Wilson, a former Marine who served in Vietnam in 1968 and 1969.
Returning from war requires a lot of adapting, which at times can be compounded by symptoms of PTSD, said Dave Clark, chief of Veterans Claims for Maryland’s Veterans Affairs.
“It’s rough for the kids today. Veterans come back home and have to deal with people on the home front who don’t understand war. It keeps the stressors alive within the veteran,” said Clark, who was a staff sergeant in Vietnam from 1967 to 1968.
“It’s a big adjustment, it’s like learning to walk all over again,” Clark added.
Soldiers in the current war could learn much from the experiences of veterans in past wars, especially about the after effects of battle.
Some percentage of troops involved in war experience Post-Traumatic Stress Disorder. About 30 percent of Vietnam veterans developed PTSD, with estimates as high as 8 percent for Persian Gulf veterans, according to the National Institute of Mental Health.
PTSD involves re-experiencing the traumatic event in a distressing way, such as through nightmares and flashback experiences, according to Terence M. Keane, director of the National Center for PTSD at VA Boston and Boston University.
At times, something as mundane as watching a movie can trigger “haunting memories” of the event.
The stress of reliving the event can be “very disabling.” The individual can suffer from a preoccupation with trauma memories and an inability to eat, sleep and concentrate, Keane added.
PTSD is often associated with war because “war is a constellation of traumatic events that occur in a particularly malevolent environment,” Keane said.
Wars are unpredictable and uncontrollable, and soldiers are constantly confronting things they hadn’t anticipated, he added.
This war has its own set of stresses. The potential for a large number of civilian casualties and the lack of humanitarian aid for civilians “could leave a soldier at risk for psychological reactions of guilt and the like,” Keane said.
Worry, guilt and lack of control, plus the unrelieved nature of war, is a recipe for PTSD.
“There’s a feeling of uncertainty on a daily basis,” said Wilson.
American troops in Iraq, almost daily, deal with the uncertainty of a possible chemical weapons attack, suicide bombings, civilian attacks, and worries about possible terrorist threats on the home front.
In this war, there’s a dreadful feeling that no place is safe. “If you have a safe place, then you can get some relief,” Wilson added.
If a buddy is wounded or killed, Wilson explained, you can’t stop and grieve, you might have to keep fighting to save your own life, so you suppress your feelings and go on with the mission.
“Survival behavior is very effective and adaptive in combat situations but loses its effectiveness when you get home,” he said.
Military training attempts to prepare troops, but there is nothing that can adequately prepare someone for battle, said Wilson.
The military also provides “debriefing,” an attempt to talk about the trauma after it has occurred, however, he said, “the jury is still out on its effectiveness.”
The lasting effects of PTSD can be crippling.
The experience of reliving a traumatic event can be so awful that it leads a person to avoid whatever triggered the memories. The individual will avoid people and ultimately shut down emotionally, said Wilson.
“It’s like walking through life rather than experiencing it,” he added.
PTSD is often associated with depression and self-medication, either with alcohol or drugs. There’s an aggregation that occurs over time of many different types of problems, including trouble holding jobs, and marital difficulties, said Keane.
Treatment, which can include psychoanalysis or antidepressants, tries to restore stability and order in the individual’s life, added Keane.
David Greenberg said in his case, the most effective treatment was just slowing down and talking about the war experience with other people.