March 23, 2010: As expected the U.S. Army is beginning to see more widespread effects from PTSD (post-traumatic stress disorder). There are two main indicators. The suicide rate, which has gone from 9 per 100,000 troops in 2001, to 23 last year, gets most of the media attention. The less noticed indicator, which impacts a lot more people, is the use of anti-stress medications. These have gone up 76 percent since 2001. About 17 percent of all troops now take these drugs, including six percent of those in combat zones. In 2001, the troops used these drugs to about the same degree as the civilian population (ten percent.) The impact of these drugs, especially in combination, can be unpredictable. The army is still waiting to see how this increased use of anti-stress medications will play out. This is all unknown territory.

The losses to stress are growing. For example, for every soldier killed, one is sent back home for treatment of acute stress. For every one of those cases, there are several less serious ones that are treated in the combat zone.

Many of these stressed troops are no longer able to perform all their duties. This is sometimes the case with troops taking anti-stress drugs. Some of these medications slow you down, which can be fatal if you find yourself in combat, or an emergency situation. Many troops on these medications are no longer sent overseas. They can perform well back in the United States, but this complicates the job of finding enough troops to go to combat zones.

All this was seen as an inevitable result of so many NCOs and officers doing their third or fourth combat tours (in Iraq or Afghanistan). Thus a PTSD epidemic has been created by the unprecedented exposure of so many troops, to so much combat, in so short a time. Once a soldier has PTSD, they are often no longer fit for combat, and many troops headed for Afghanistan are falling into this category. PTSD makes it difficult for people to function, or get along with others. With treatment (medication, and therapy), you can recover from PTSD. But this can take months or years.

Nearly a century of energetic effort to diagnose and treat PTSD (including much recent attention to civilian victims, via accidents or criminal assault), had made it clear that most troops eventually got PTSD if they were in combat long enough. During World War II, it was found that, on average, 200 days of combat would bring on a case of PTSD for American troops. After World War II, methods were found to delay the onset of PTSD (more breaks from combat, better living conditions in the combat zone, prompt treatment when PTSD was detected). That's why combat troops in Iraq and Afghanistan often sleep in air conditioned quarters, have Internet access, lots of amenities, and a two week vacation (anywhere) in the middle of their combat tour. This has extended their useful time in combat, before PTSD sets in. No one is yet sure what the new combat days average is, and new screening methods are an attempt to find out. But more troops appear to be hitting, or approaching, the limits.

What the army does know is that a large percentage of its combat troops have over 200 days of combat. Some have three or four times that. A major reason for army generals talking about the army "needing a break" (from combat) is the growing loss of many combat experienced troops and leaders (especially NCOs) to PTSD. The army won't give out exact figures, partly because they don't have much in the way of exact figures. But over the next decade, the army will get a clearer picture of how well they have coped with PTSD, among troops who have, individually, seen far more combat than their predecessors in Vietnam, Korea or World War II.

The army is dealing with PTSD head on, believing that a lot of troops have experienced a lot of combat stress. Experience so far has shown that PTSD can be delayed, perhaps for a long time. When a soldier does come down with it, PTSD can often be treated, and its effects reversed. This has large ramifications for non-military medicine, for many civilians suffer from PTSD. That's why military recruits are screened for their ability to handle stress and resist PTSD. In the civilian community, there are far more people who can acquire PTSD after exposure to much less stress.