Editor's note: Click here for updated information on Rick Duncan, who was interviewed for the story below.
The most exciting news in recent months about treating post-traumatic stress disorder involves MDMA. Otherwise known as Ecstasy.
Michael Mithoefer, a South Carolina psychiatrist, has researched the effects of giving the drug to help patients confront their traumatic pasts. He's nonchalant when asked if it actually worked.
"It did," he says, explaining the drug seemed to enable a large majority of subjects to "change their relationship to their trauma."
Excitement about Mithoefer's work sent ripples across the media landscape, with the results described in The Economist magazine and trumpeted on CNN by none other than Dr. Sanjay Gupta, President Barack Obama's nominee to become surgeon general.
But at Fort Carson, where PTSD has become part of the military vernacular, a question about MDMA's potential is met with decidedly less ... enthusiasm.
"If someone is so emotionally numb that they can't affectively connect, that would be an interesting place to ask that question," Col. George Brandt says quietly as a couple onlookers chuckle in an Evans Army Community Hospital meeting room. Then he adds for clarity: "We're not doing that here."
A wider net
That's not to say they're doing nothing. Fort Carson and the Army took fire in 2006 and 2007 after combat veterans started talking about being ignored, ridiculed or even kicked out of the Army for reporting the nightmares, sleeplessness or anxiety that can accompany PTSD. Screens to find soldiers who've experienced these symptoms have increased, and Army has announced efforts to make soldiers more comfortable admitting to having them.
Brandt, a psychiatrist and the hospital's chief of behavioral health, talks in general about one brigade with about 4,000 soldiers that was given a total of around 9,000 screens. About 650 soldiers screened positive for possible behavioral health problems and were sent on to be evaluated by social workers.
In the end, Brandt says, about 160 were sent for further evaluations to see if they had PTSD, depression or another disorder.
"I'm screening more people positive than actually get referred for care, but that's the way I want it to be," Brandt explains. "That's the way a screening procedure should work the goal is to go fishing, to identify cases, pull people in, and refer them accordingly."
The numbers bear that out, at least partially. According to Fort Carson statistics, 547 PTSD cases were identified in 2005 and 535 in 2006. With all the attention devoted to PTSD, diagnoses climbed to 750 in 2007.
They dropped again in 2008 to 450. Brandt couldn't be reached for follow-up after Fort Carson released the PTSD numbers, but the drop could be related to a lull in soldiers returning from combat or a reduction in the severity of fighting.
Embedded distrust
When Brandt came to Fort Carson in August, there were fewer than 50 psychologists, psychiatrists and social workers handling mental health care at Evans.
"Now we're well over 60, on our way to 70," he says.
"We have many open hiring agreements out there, looking for psychiatrists and psychologists," notes Lt. Col. Nicholas Piantanida, deputy commander for clinical services at Evans. "My guidance is that we will continue to hire these individuals."
After reports of untreated PTSD cases circulated, congressional pressure built to change procedures and attitudes so soldiers can get help. In August 2006, then-Sen. Ken Salazar called for a hearing on the subject, and legislation was eventually passed giving some protection to veterans discharged for mental health reasons or injuries.
Salazar, now Barack Obama's secretary of the Interior, could not be reached to comment on how the Army is now handling PTSD cases. Newly sworn-in Sen. Mark Udall, in an e-mail, offered only: "It is important for the Army to identify and treat soldiers with Post Traumatic Stress Disorder (PTSD) cases as soon as possible."
Rick Duncan, with the Colorado Veterans Alliance, says programs now are in place. But there's still what Duncan calls a "structural" problem, with soldiers facing skeptical colleagues once a mental-health problem rears up.
Duncan describes the experiences of a soldier he knows who is now in Fort Carson's Warrior Transition Unit, a special unit for wounded troops. The soldier, he says, was involved in an incident during which Iraqi civilians were killed in 2006, and he started having sleeplessness, nightmares and other symptoms of PTSD when he returned to combat in 2008. Even if he makes a full recovery from PTSD, Duncan says, this combat veteran will have to worry, "Are soldiers going to trust me?"
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I am a mental health professional and the techniques I know are great for alleviating PTSD. I wish the military would use the latest techniques but the military is shy about anything new. I actually volunteered my services at the VA in my city and they said they would not allow any mental health volunteers, only the full time staff could help. So if you are concerned about your soldiers(my daughter and nephew are soldiers, both have been to Iraq) get them professional help on your own. Look for EMDR, and RRT(rapid resolution therapy by John Connoly) trained therapists. Don't let your kids suffer when there is help.
Laurie, I can only pray that the WTU at Ft Carson is doing a better job than it was when I was there. I was hospitalized once while I was still in the WTU, and twice since I retired because I'm still dealing with PTSD and suicidal thoughts. I've been told that it can't be cured, only managed, and after two years of struggling with it I can't help but believe that. I'm glad that I finally got retired out after spending a year in the MEB process, because I've gotten better care from the VA in Kansas than I did from the Army in the end. And once you get out, it's up to you to reach out for help, but there are many excellent programs as well as great mental health professionals that want to give you that help. At least that has been my experience in Topeka. For any vets that happen to read this and want help, check out the SDTP (Stress Disorder Treatment Program) at the Topeka VA and I promise that if you are willing to work on your problems, the staff in the program are as wonderful and compassionate as anyone could ask for.
I don't think the soldiers are capable to cope in the state of mind they come back in. that is the real problem. I have a son who went to Iraq and came back a totally different person. He is in a constant state of "numbness". Has no feelings for anything, or anyone...not even me (I was his "best friend", "mother", and one person he "loved the most" in the world) It is like he is "GONE". He is in the process of going through the medical eval and if they let him out to survive on his own, he will never make it. I am sure I will get a call from the police telling me he committed suicide. He is telling them the medications and counseling is not working...but they say there is nothing they can do.... what can he do now? Does he have any options? Are they going to just let him out? from a very concerned parent of a soldier in PTSD Unit.Ft. Carson, CO
Good story, Anthony, and befitting the leadership Col. Brandt's brought. Most of the chaplains I'm interviewing, interestingly, suggest there really isn't a cure for PTSD; it is a condition people learn to cope with well, at best. I wonder what others think?
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