# PTSD from Overseas Service in Afghanistan



## 54/102 CEF (8 Nov 2008)

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20081107/ptsd_Afghanistan_081108/20081108

Article mentions heavy drinking @ 17% of the troops - quelle horreur!

A bit of research suggests thats the number for heavy drinkers % from the general population ---- aka The Army REFLECTS society

See slide 28 here http://www.apolnet.ca/resources/education/presentations/ANOC5_Shows/Giesbrecht-ANOC5.pps

Screenshot attached


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## Shamrock (8 Nov 2008)

> "Personally, I wouldn't want to have a comrade working with me and to have to rely on someone with PTSD," Brunet said.



While I was unimpressed with the article in general, this quote disgusted me.


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## HollywoodHitman (8 Nov 2008)

Should be interesting to see how many people who may be suffering from PTSD will be willing to speak to Brunet after the comment Shamrock highlighted above becomes more widely known in our circles. With any luck, no-one speaks to him or assists in his research and he becomes irrelevant, dries up and goes away. 

Not impressed with the article either.


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## Scoobs (8 Nov 2008)

I agree, I read the article prior to coming onto the site today and was rather taken back from his comment.  Of all people who should know better, he should have not said that.  The whole point of indentifying that a person has PSTD is to help them.  How many CF pers that are now having trouble will feel comfortable coming forward to get the help that is necessary after reading this so called "Doctor's" comments?

Shame on this "Dr. Bruent" for his thoughtless comment.


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## the 48th regulator (8 Nov 2008)

It is actually a very good article.

His scentence actually referes to the previous paragraphs quoting him

_But significant barriers preventing PTSD diagnoses among soldiers remain, despite efforts made by the Canadian Armed Forces to educate soldiers about the disease. 

Having PTSD can be a career-ender for a soldier, Brunet said. 

A combination of this fear of dismissal from duty and the "macho culture" that permeates the force makes officers hesitate to disclose their problems, Brunet said. "We are sending mixed messages."  

The "hallmark" of PTSD is persistent nightmares, but symptoms can also include, flashbacks, gaps in memory, detachment from loved ones, little control over impulses, problems concentrating, anger and irritability. 

Although it's natural to experience any or all of these symptoms after witnessing a traumatic event, PTSD sufferers become incapacitated by their frequency and severity. 

"Personally, I wouldn't want to have a comrade working with me and to have to rely on someone with PTSD," Brunet said._

Due to the parts I have highlighted, many refuse to come forward.  This is what he was referring to.
And would you agree, that all of you would fear to be serving with someone, overseas, that was suffering an untreated OSI?

Again, a very good article, 

dileas

tess


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## HollywoodHitman (8 Nov 2008)

48th, generally speaking I did not think it was a good article. You highlight some good points, but in the end, the treatment of an OSI is up to the member and would normally not be able to be forced on someone. There are plenty of people who suffer from OSI's that function well, if not 100% and are still more than capable of doing their job. 

OSI's as many know, can surface after years of the person's seeming to be 'normal'..... 

You highlight good aspects of the article. However, I take issue with the Brunet's last statement - That won't help people come forward with their problems and work to deal with them, but will have the opposite effect.

My $.02


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## the 48th regulator (8 Nov 2008)

HollywoodHitman said:
			
		

> 48th, generally speaking I did not think it was a good article. You highlight some good points, but in the end, the treatment of an OSI is up to the member and would normally not be able to be forced on someone. There are plenty of people who suffer from OSI's that function well, if not 100% and are still more than capable of doing their job.



Is this based on your observation, or an actual study?  OSI's, if left untreated, becomes hard to manage for both the Sufferer and the clinician.  Although, it can not be forced, hiding the fact that it exists, or that it is something that does not need treatment, you are perpetuating the myth that he talks about.



			
				HollywoodHitman said:
			
		

> OSI's as many know, can surface after years of the person's seeming to be 'normal'.....



Yes, and it is also a known fact that people only come foward, after many years of suffering, due to the negative aspects that Brunett states in his study.



			
				HollywoodHitman said:
			
		

> You highlight good aspects of the article. However, I take issue with the Brunet's last statement - That won't help people come forward with their problems and work to deal with them, but will have the opposite effect.
> 
> My $.02



Because you are pulling out the last scentence and ignoring the whole article.  Anyone who works with an injury that they are hiding, whether Physical or Psychological, is a liabilty to the mission and his buddies.

The sufferer is doing no service to his pals, or himself, by hiding it.  Therefore I agree with Brunette's statement.

dileas

tess


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## Eye In The Sky (8 Nov 2008)

the 48th regulator said:
			
		

> A combination of this fear of dismissal from duty and the "macho culture" that permeates the force makes officers  hesitate to disclose their problems, Brunet said. "We are sending mixed messages."



Perhaps the good Dr is a mental health professional.  However, as any one with a smick knows, you should "know your audience".

To him, maybe everyone in the CF is an Officer.  For us, we know the difference.  Maybe thats insignificant to some people.  Maybe, to an NCM who is secretyly suffering, this is just another kick in the groin by a 'system that has let him/her down'.

If you are going to apply your research to a group of people, it helps if you know something about the culture and the like of that group of people.


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## the 48th regulator (8 Nov 2008)

Eye In The Sky said:
			
		

> Perhaps the good Dr is a mental health professional.  However, as any one with a smick knows, you should "know your audience".
> 
> To him, maybe everyone in the CF is an Officer.  For us, we know the difference.  Maybe thats insignificant to some people.  Maybe, to an NCM who is secretyly suffering, this is just another kick in the groin by a 'system that has let him/her down'.
> 
> If you are going to apply your research to a group of people, it helps if you know something about the culture and the like of that group of people.



That is an excellent observation,

Now we have found two fly turds in the Pepper shaker.....

dileas

tess


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## Hot Lips (8 Nov 2008)

the 48th regulator said:
			
		

> It is actually a very good article.
> 
> His scentence actually referes to the previous paragraphs quoting him
> 
> ...


Well a good article maybe...lacking in empathy and loading up on stereotyping definitely...
I know of several members right now, on a personal level, not disclosing anything of a confidential nature here, that are on Permanent Categories right now because of PTSD and headed towards the ends of their careers as a result...

As for working with individuals who have PTSD...well in my former civilian life I have worked with firefighters, nurses, paramedics, police officers and so on who have PTSD...unfortunately this is not a disorder which solely effects military personnel...it effects many who work in areas with the potential to be effected by the nature of the work they do...
I have and would have no issue working with someone who has or has been treated for PTSD...

We still have a long way to go in the field of mental health when it comes to stereotyping those suffering with PTSD as well as addiction...often these two occur co-morbidly as do many illness...

HL


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## the 48th regulator (8 Nov 2008)

Hot Lips said:
			
		

> Well a good article maybe...lacking in empathy and loading up on stereotyping definitely...
> I know of several members right now, on a personal level, not disclosing anything of a confidential nature here, that are on Permanent Categories right now because of PTSD and headed towards the ends of their careers as a result...
> 
> As for working with individuals who have PTSD...well in my former civilian life I have worked with firefighters, nurses, paramedics, police officers and so on who have PTSD...unfortunately this is not a disorder which solely effects military personnel...it effects many who work in areas with the potential to be effected by the nature of the work they do...
> ...



Excellent post,

However, you are confusing what the Doctor is saying.  He is being blunt in the fact that people need to seek help, and not hide it.

You have no challenges working with someone, who is seeking help to manage PTSD, or any other OSI.  However would you feel comfortable knowing that someone is suffering mentally, and is doing nothing about it, and just carrying on?  Would you allow a person who has found an odd lump, that causes some pain, to ignore it and not seek help?  Would you allow someone with  swollen ankle, and blue toes, to not seek medical help and just hide the injury in their boot?

That is what Brunet is stating, that he would not want to work alongside someone who is suffering a Mental condition, and hiding it, while in an operational environment, such as combat.

Being in the medical field, you can offer some insight on that.

Everyone’s heart in the right place on this thread, however, people are misinterpreting what he is saying, based on one sentence, plucked out of an article that makes complete sense when the whole piece is read.   He is hitting the nail on the head that attitudes must change, for people to come forward.  Otherwise people will hide it, so they do not forsake their job.  Self medicate with Alcohol and Drugs, and then continue to work and possibly sent overseas again, which can exasperate the condition.

Did no one else read that from the article??

dileas

tess


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## Hot Lips (8 Nov 2008)

the 48th regulator said:
			
		

> Excellent post,
> 
> However, you are confusing what the Doctor is saying.  He is being blunt in the fact that people need to seek help, and not hide it.
> 
> ...


Thanks Tess...
Well unfortunately we do this type of thing a lot of the time in my experience...especially during basic trg and on crses and I have first hand knowledge of same...if you "tell" then you are recoursed or worse...whether it be a physical injury or mental/emotional one...
'We' as well need to be careful with the words we choose IMO when we make statements...I would never say I didn't want to work beside a member with a bum knee that they were putting off having treated for quite some time due to work related commitments...so I find it less than empathetic to even say that regardless of whether someone is being treated for a mental illness or not...but I manage my professional conduct to suit how I feel ethically about the people I care for...not saying everyone ought to be the same and I am quite aware that some are not...

I am a proponent of healthcare regardless of what type of injury a member is experiencing...however I am not naive in thinking mental health issues are treated in the same manner as physical injury or illness...this is just indicative of our populations continuation of stereotyping IMO...

HL


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## the 48th regulator (8 Nov 2008)

Hot Lips said:
			
		

> Thanks Tess...
> Well unfortunately we do this type of thing a lot of the time in my experience...especially during basic trg and on crses and I have first hand knowledge of same...if you "tell" then you are recoursed or worse...whether it be a physical injury or mental/emotional one...
> 'We' as well need to be careful with the words we choose IMO when we make statements...I would never say I didn't want to work beside a member with a bum knee that they were putting off having treated for quite some time due to work related commitments...so I find it less than empathetic to even say that regardless of whether someone is being treated for a mental illness or not...but I manage my professional conduct to suit how I feel ethically about the people I care for...not saying everyone ought to be the same and I am quite aware that some are not...
> 
> ...




Who's continuation of the  stereotyping?  The Doctor's?

The paragraphs above the sentence that is bringing everyone's vitriol, explains his view on why people do not want to come forward.  What he is saying, and I agree, that I would not want to work along someone that is hiding an OSI.  That someone is afraid of losing a position within the military, and becoming a pariah, and risk going overseas again with the illness.

He has stated he recognizes the challenges, that a soldier has in admitting that they are suffering an OSI, and he states that it is a barrier that must be broken. Otherwise you have people being deployed over and over again, creating various triggers that become "cumulative " in the soldier, that will take much more to treat and manage PTSD or any other form of OSI.  At that point, the soldier will be released, and with nothing but despair, what do you think will happen?

Once again, I commend Brunet, for stating exactly what he has found in his studies, and I hope this article will get the message out, that it is okay to seek the help.  It is better to manage it, and be able to continue soldiering, than compounding it and ultimately being released a mess.  Or even worse, being triggered at the wrong time, at a critical point in the mission, while overseas…


dileas

tess


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## 54/102 CEF (8 Nov 2008)

Career ender? Hmmmmmmmmm ----- probably - but not because they're weak - you may be able to put it out of your mind - but if you pass a point which varies for all - you may go "windy" to coin a WW1 term for exhibit the effects of operational stress.

When that happens should be a big pension attached to it ------ but its subjective --------- offer a big pension then suddenly everyone's flipped out ---- I've heard that when stress leave was put it - its claimed and awared far higher than one would expect.

In my WW1 studies I have seen references to our ability to handle operational stress as limited and not renewable. And its cumulative. However - all that said - I don't have references for you at present.

A google search for these key words ww1 battle fatigue limits to resilience follows
http://www.google.com/search?hl=en&rls=com.microsoft%3Aen-ca&rlz=1I7GPEA_enCA295&q=ww1+battle+fatigue+limits+to+resilience

In my opinion, if anyone says you can prevent it - they are probably a psychopath. I believe the effects vary for everyone.

A WW1 verse - note "the wind up" = scare him badly

It was a saucy sapper, who dug a merry mine 
To blow the Boche in Kttle bits. 
And ' put the wind up '  poor old Fritz, 
And so preserve the line. 

It was a luckless subaltern got orders from H.Q. 
To take a party standing by. 
And lead them forth to do or die, 
On the lip of that crater new. 

It was a luckless subaltern dashed out (on hands and knees) 
When a German flare as bright as day 
Shot up and showed him where he lay 
On a broken cheval-de-frise. 

It was the C.J. party which followed on behind. 
And the shovel clanged on the festive pick. 
And the sweat on the subaltern's brow lay thick. 
And the Boche, thank God, was blind. 

It was a Lewis gunner who got the notion queer. 
That the show would go with more of a whoop. 
If he planted an accurate 3-inch group 
By the cursing subaltern's ear. 

It was a weary party crawled in at break of day 
And the Boches smiled when the Boches woke. 
And the mortar popped and the rum jar spoke. 
And the trench did melt away. 
Ref http://www.archive.org/stream/onfourfrontswith00sparrich/onfourfrontswith00sparrich_djvu.txt

Another use

We camped in the narrow neck on a sandy bay by the 
river, rock shooting up sheer from the back of the tents, 
the horses hidden under the trees. The Colonel's com- 
mand consisted of one 6o-pounder — brought round by 
sea and thrown into the shallows by the Navy, who said 
to us, " Here you are, George. She's on terra firma. 
It's up to you now " — two naval 6-inch, one eighteen- 
pounder battery, " Don," one 4.5 howitzer battery, and 
a mountain battery, whose commander rode about on a 
beautiful white mule with a tail trimmed like an hotel 
bell pull. *' AC " battery of ours came along a day or 
two later to join the merry party, because, to use the 
vulgar but expressive phrase, the Staff " got the wind 
up'  and saw Bulgars behind every tree. 
ref http://www.archive.org/stream/greywave00gibbrich/greywave00gibbrich_djvu.txt

A Scottish Soldier speaks on war with the Germans


"Sir-r," he said, "the habits of the Hoon, or Gairman, ha'e been ma life study. Often in the nicht when ye gentlemen at the mess are smokin' bad seegairs an' playin' the gamblin' game o' bridge-whist, Tam o' the Scoots is workin' oot problems in Gairman psych—I forget the bonnie waird. There he sits, the wee man wi'oot so much as a seegair to keep him company—thank ye, sir-r, A'll not smoke it the noo, but 'twill be welcomed by one of the sufferin' mechanics—there sits Tam, gettin' into the mind, or substitute, of the Hoon."

"But do you seriously believe that you have scared him?"

Tam's eyes twinkled.

"Mr. Craig, sir-r, what do ye fear wairst in the world?"

Craig thought a moment.

"Snakes," he said.

"An' if ye wanted to strafe a feller as bad as ye could, would ye put him amongst snakes?"

"I can't imagine anything more horrible," shuddered Craig.

"'Tis the same with the Hoon. He goes in for frichtfulness because he's afraid of frichtfulness. He bombs little toons because he's scairt of his ain little toons bein' bombed. He believes we get the wind up  because he'd be silly wi' terror if we did the same thing to him. Ye can always scare a Hoon—that's ma theery, sir-r."

ref - http://www.gutenberg.org/files/25038/25038-h/25038-h.htm


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## Armymedic (8 Nov 2008)

My issue with the article is the same as was highlighted earlier in this thread:


> As many as 28 per cent of troops come back from armed combat with one or more mental health issues, according to data complied by the head of the Canadian military's deployment health section last year. Of those:
> 
> * seventeen per cent exhibited signs of high-risk drinking
> * five per cent showed symptoms of PTSD
> * five per cent had signs of serious depression



So this is exceptional from normal Cdn population statistics in what way? The only thing exceptional is that more people are being exposed to combat (abnormal situation which causes stress) so there for the total numbers are getting larger.

Common sense says if there is a 5% prevalence of a disease, then when you increase the numbers of those exposed to the situations that can cause it....more people will get it.


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## 54/102 CEF (8 Nov 2008)

I think that % will stay the same even if you deploy more


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## Armymedic (8 Nov 2008)

Add to above,

I would like to see numbers per captia comparing Rwanda vets and those from the first couple Bosnia/Croatia tours to the numbers in Afghanistan....

I would bet the per capita number now is much lower


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## Armymedic (8 Nov 2008)

54/102 CEF said:
			
		

> I think that % will stay the same even if you deploy more


thats my point... 

prevalence is the % of population expose who will contract the disease.


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## the 48th regulator (8 Nov 2008)

Prairie Dog said:
			
		

> My issue with the article is the same as was highlighted earlier in this thread:
> So this is exceptional from normal Cdn population statistics in what way? The only thing exceptional is that more people are being exposed to combat (abnormal situation which causes stress) so there for the total numbers are getting larger.
> 
> Common sense says if there is a 5% prevalence of a disease, then when you increase the numbers of those exposed to the situations that can cause it....more people will get it.



I do not understnad what your issue is, sorry, I may be reading it wrong.

Are you saying, that the observations are moot, due to the fact we are war and OSI's naturally increase?

dileas

tess


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## the 48th regulator (8 Nov 2008)

Prairie Dog said:
			
		

> Add to above,
> 
> I would like to see numbers per captia comparing Rwanda vets and those from the first couple Bosnia/Croatia tours to the numbers in Afghanistan....
> 
> I would bet the per capita number now is much lower



What??


Per capita compared to the Military population at the time of Rawanda, or the Balkans to those of todays War.

Or do you mean compared to the civillian population?

dileas

tess


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## Armymedic (8 Nov 2008)

the 48th regulator said:
			
		

> Are you saying, that the observations are moot, due to the fact we are war and OSI's naturally increase?


I am saying that there is an increase because we are sending more people into situations where the conditions are right for people to get PTSD, and not an increase in prevalence or % in persons getting it.

Second post,

yes, military, % of those who went to those deployments compared to the 5% who get it now.


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## the 48th regulator (8 Nov 2008)

54/102 CEF said:
			
		

> I think that % will stay the same even if you deploy more





			
				Prairie Dog said:
			
		

> I am saying that there is an increase because we are sending more people into situations where the conditions are right for people to get PTSD, and not an increase in prevalence or % in persons getting it.
> 
> Second post,
> 
> yes, military, % of those who went to those deployments compared to the 5% who get it now.



Stress cases climb sharply among Afghan mission vets  

Minister of Veterans Affairs presents 2006-07 Departmental Performance Reports  

Due to the increased operational tempo, psychological and psychiatric-related conditions are on the rise among Veterans, still-serving CF members and RCMP. The increase is particularly noticeable among VAC clients suffering from Post-Traumatic Stress Disorder (PTSD). Over the past five years the number of clients with a PTSD-condition has more than tripled, increasing to 6,504. As of March 31, 2007, a total of 10,525 clients are in receipt of a pension for a psychiatric condition. Our younger clients with service in Regular Force, Special Duty Area or RCMP represent 69 per cent of those pensioned for a psychiatric condition. Our traditional war service Veterans make up the remaining 31 per cent.

The only challenge is this; Does the tripling of cases mean a higher tempo in operations.  Does it mean the message is getting out, and the Military is more aware in understanding OSI's, allowing more members to come forward than in the past?

That would be a statistic that would  useful in determining what would benefit the soldier.

As for the article, again, it was bang on in the observations presented.

dileas

tess


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## Armymedic (8 Nov 2008)

There are some significant stats and details missing from all these reports.

One big question I have; are all the new cases of PTSD Afghan veterans who suffered their "stress" during their last Afghan tour, or are they/ is there: a. people being treated now for previous tour PTS that has been intensified by their recent tour, or b.people now "educated" and coming forth with previously hidden illness?


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## the 48th regulator (8 Nov 2008)

Prairie Dog said:
			
		

> There are some significant stats and details missing from all these reports.
> 
> One big question I have; are all the new cases of PTSD Afghan veterans who suffered their "stress" during their last Afghan tour, or are they/ is there: a. people being treated now for previous tour PTS that has been intensified by their recent tour, or b.people now "educated" and coming forth with previously hidden illness?



That is a very good statement, and question.

It has been noted, within groups like OSISS, that the average time that a person comes forward for help is 7-10 years.

Are there more services for OSI's?  Are the Troops now more aware of the services provided to them?

These are stats which would be good to have.  However, we can agree that statistics like that can take much time to aquire.

dileas

tess


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## Franko (8 Nov 2008)

Prairie Dog said:
			
		

> There are some significant stats and details missing from all these reports.
> 
> One big question I have; are all the new cases of PTSD Afghan veterans who suffered their "stress" during their last Afghan tour, or are they/ is there: a. people being treated now for previous tour PTS that has been intensified by their recent tour, or b.people now "educated" and coming forth with previously hidden illness?



I'm thinking that it's a bit of both.

Regards


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## KingKikapu (8 Nov 2008)

I'm with 48 on this one.  Quotations must always be taken in context, and I think this is a perfect example of why.


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## PAT-Platoon (10 Nov 2008)

KingKikapu said:
			
		

> I'm with 48 on this one.  Quotations must always be taken in context, and I think this is a perfect example of why.



Thirded. This is a very good article, and 48th regulator hit the nail on the head in his previous posts.

-C/D


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