#13 MARINES FIGHTING FOR YOUR DOM MANUAL#
10 The diagnosis of PTSD was not adopted until the late 1970s, and it became official in 1980 with inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. Over the next century of American warfare, PTSD would be described by many different names and diagnoses, including “shell shock” (World War I), “battle fatigue” (World War II), and “post-Vietnam syndrome.” An estimated 700,000 Vietnam veterans-almost 25% of those who served in the war-have required some form of psychological care for the delayed effects of combat exposure. Army, undertook research on “irritable heart” (neurocirculatory asthenia) in soldiers, and during the Civil War, this PTSD-like disorder was referred to as “Da Costa’s syndrome.” 9 Da Costa reported in the American Journal of Medical Science that the disorder, marked by shortness of breath, rapid pulse, and fatigue, is most commonly observed in soldiers during times of stress, especially when fear is involved. Jacob Mendez Da Costa (1833–1900), a cardiologist and assistant surgeon in the U.S. The Civil War also marked the start of formal medical attempts to address the psychological effects of combat on military veterans. 8 Often referred to as the country’s bloodiest conflict, the Civil War saw the first widespread use of rapid-fire rifles, telescopic sights, and other innovations in weaponry that greatly increased destructiveness in battle and left those who survived with a myriad of physical and psychological injuries. The symptoms and syndrome of PTSD became increasingly evident during the American Civil War (1861–1865). 6 Such accounts of psychological symptoms following military trauma are featured in the literature of many early cultures, and it is theorized that ancient soldiers experienced the stresses of war in much the same way as their modern-day counterparts. In writing about the Battle of Marathon in 490 b.c., Herodotus described an Athenian warrior who went permanently blind when the soldier standing next to him was killed, although the blinded soldier himself had not been wounded. The existence of war-induced psychological trauma likely goes back as far as warfare itself, with one of its first mentions by the Greek historian Herodotus.
4, 5 According to a study conducted by the RAND Center for Military Health Policy Research, less than half of returning veterans needing mental health services receive any treatment at all, and of those receiving treatment for PTSD and major depression, less than one-third are receiving evidence-based care. 4 These include the requirement that they have either an honorable or general discharge to access Department of Veterans Affairs (VA) medical benefits, long waiting lists at VA medical centers, and the social stigma associated with mental illness within military communities. Not only are recent veterans at higher risk of suffering from PTSD than those in the general population, 3 they also face unique barriers to accessing adequate treatment. While PTSD extends far beyond the military-affecting about eight million American adults in a given year 2-the problem is especially acute among war veterans. The last several years have seen a dramatic increase in the number of Iraq and Afghanistan war veterans seeking help for PTSD, 1 shining a spotlight on this debilitating condition and raising critical questions about appropriate treatment options and barriers to care. More than a decade of war in the Middle East has pushed post-traumatic stress disorder (PTSD) to the forefront of public health concerns.
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