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By William M. Welch, USA TODAY
MORGANTOWN, W.Va. — Jeremy Harrison sees the warning signs in the Iraq war veterans who walk through his office door every day — flashbacks, inability to relax or relate, restless nights and more.
He recognizes them as symptoms of combat stress because he's trained to, as a counselor at the small storefront Vet Center here run by the U.S. Department of Veterans Affairs. He recognizes them as well because he, too, has faced readjustment in the year since he returned from Iraq, where he served as a sergeant in an engineering company that helped capture Baghdad in 2003.
"Sometimes these sessions are helpful to me," Harrison says, taking a break from counseling some of the nation's newest combat veterans. "Because I deal with a lot of the same problems."
As the United States nears the two-year mark in its military presence in Iraq still fighting a violent insurgency, it is also coming to grips with one of the products of war at home: a new generation of veterans, some of them scarred in ways seen and unseen. While military hospitals mend the physical wounds, the VA is attempting to focus its massive health and benefits bureaucracy on the long-term needs of combat veterans after they leave military service. Some suffer from wounds of flesh and bone, others of emotions and psyche.
These injured and disabled men and women represent the most grievously wounded group of returning combat veterans since the Vietnam War, which officially ended in 1975. Of more than 5 million veterans treated at VA facilities last year, from counseling centers like this one to big hospitals, 48,733 were from the fighting in Iraq and Afghanistan. [...]
Post-traumatic stress was defined in 1980, partly based on the experiences of soldiers and victims of war. It produces a wide range of symptoms in men and women who have experienced a traumatic event that provoked intense fear, helplessness or horror. (Related story: Iraq injuries differ from past wars)
The events are sometimes re-experienced later through intrusive memories, nightmares, hallucinations or flashbacks, usually triggered by anything that symbolizes or resembles the trauma. Troubled sleep, irritability, anger, poor concentration, hypervigilance and exaggerated responses are often symptoms.
Individuals may feel depression, detachment or estrangement, guilt, intense anxiety and panic, and other negative emotions. They often feel they have little in common with civilian peers; issues that concern friends and family seem trivial after combat. [...]
A recent Defense Department study of combat troops returning from Iraq found that soldiers and Marines who need counseling the most are least likely to seek it because of the stigma of mental health care in the military.
One in six troops questioned in the study admitted to symptoms of severe depression, PTSD or other problems. Of those, six in 10 felt their commanders would treat them differently and fellow troops would lose confidence if they acknowledged their problems.
A report this month by the Government Accountability Office said the VA "is a world leader in PTSD treatment." But it said the department "does not have sufficient capacity to meet the needs of new combat veterans while still providing for veterans of past wars." It said the department hasn't met its own goals for PTSD clinical care and education, even as it anticipates "greater numbers of veterans with PTSD seeking VA services." [...]
In all cases, the veteran has to be the one who wants to talk before counselors can help. "Once they come through the door, they usually come back," Harrison says. "For them, this is the only chance to talk to somebody, because their families don't understand, their friends don't understand. That's the big thing. They can't talk to anyone. They can't relate to anyone."