The American Enterprise Institute (AEI) hosted a conference on September 25th on the mental health of soldiers, specifically the issue of post-traumatic stress disorder (PTSD). A physiological condition that is a manifestation of extreme stress, PTSD is a struggle for 10-20% of combat-exposed soldiers, said Dr. Charles Hoge. Science Daily reported on September 15th that PTSD for Iraq veterans could reach as high as 35%. Yet, there are ways to cope and turn it into post-traumatic growth, argued speakers at AEI.

Nate Self, former Army Ranger and father of four, detailed the struggles he faced both in the military and once he left. Despite the pains and difficulties, he admitted: “I miss the army dearly every day.”

Mr. Self served in Kosovo as a platoon leader and said of his experience there, that he “did not expect to see the level of violence, the level of hate,” adding how he had carried the bodies of men who had been executed.

After returning home, Mr. Self served as a platoon leader for the Army Rangers and witnessed his fellow Rangers’ “desire and eagerness to go to war,” and “their desire to be shot at,” although almost none of them had been in combat before.

After the tragic events of September 11, 2001, Mr. Self admitted that he, too, felt an eagerness to deploy. At the end of 2001, soon after the birth of his first child, Mr. Self was sent to Afghanistan. “Our mission was to kill or capture Osama bin Laden,” he said, adding that he and those deployed “really thought we were going to catch someone important.”

After telling a vivid story about a rescue mission, full of death and injury, he recounted the difficulties of reintegrating into civilian life, a sharp contrast to the battlefield. When Mr. Self came back home, he did not want to talk with his family about what he had seen. His wife and sister would make comments that he had changed, that he was not as funny as he used to be. Mr. Self said that he would often overhear people talking about something trivial and he would think, “I’ve got friends deployed that I am worried about.” He admitted that he fantasized about death all the time.

Mr. Self discussed the army stigma surrounding mental issues-the kind that led him to have suicidal thoughts-saying that these stigmas exist because many in the army view mental illness as a weakness. Yet, Mr. Self said that these mental issues are not uncommon and should be addressed, claiming that “this happens at every level of every armed service that we have.”

Brig. Gen. Colleen L. McGuire, director of the suicide prevention task force at the U.S. Army, addressed the suicide rates among soldiers and veterans, as well as what she called “the spiritual and mental health of our soldiers.” She, like Nate Self, spoke of the common stigma in the army associated with mental illness, claiming that “stigma is just ignorance.” McGuire compared the stigma with divorce, another type of traumatic event; the stigma attached to divorce has decreased drastically and she said she hopes this will also happen with the stigma attached to mental health in the army.

Colonel Charles Hoge is running a research program on PTSD and related mental-health issues at the Walter Reed Army Institute of Research. Researchers conducted surveys and focus groups in Iraq, identifying some of the mental health needs of soldiers. The Institute’s research discovered a linear increase in mental health problems like PTSD directly related to the number of deployments. The overriding factor in PTSD likelihood, said Hoge, “is the frequency and intensity of combat,” especially if it is personal. He pointed to a story Nate Self said told about having to climb over his fellow soldiers in the heat of combat as an example.

There has been a concerted effort on the part of the leadership to address mental health issues, said Hoge, adding that “What we have seen, despite all of these efforts, is rising suicide rates, now above the civilian level for the first time since Vietnam.”

Hoge outlined some factors that help a soldier be resilient, defining resilience as “the belief in yourself and your value,” bolstered by a connection to loved ones. Referring to a confession by Nate Self, Hoge asked rhetorically if there is going to be anyone there to help, “when someone is sitting there with a [gun] in their lap.”

Nate Self’s chosen form of therapy, suggested to him by members of his church, was to write about his experiences, because talking about post-traumatic stress disorder (PTSD) helps others’ awareness of the issue. His writings have been turned into a book, Two Wars, which, according to his website, is “a rare look into a Soldier’s soul.”

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