Lisa Lauria

Those reading the story of Richard Owsley in the January 7, 2009 New York Times would probably agree that he is still suffering from the effects of war even though he is home and safe now. Owsley is 47 and served in the National Guard as a gunner in 2004. He is now unable to hold a job, is supporting his family on disability checks, and is being treated for post-traumatic stress disorder and traumatic brain injury. He has had suicidal thoughts and says that he relives the sights, sounds, and smells of death and war every day and night. After all of this suffering, an aggravated Owsley was recently told that he will not be decorated by the U.S. Government with a Purple Heart.

There has been much recent debate addressing the question of whether or not to award a Purple Heart to soldiers who suffer from post-traumatic stress disorder. According to the United States Army Regulations, the criteria for a Purple Heart include injury to the body from an enemy. This injury can be inflicted in many different ways, including bullets, shrapnel, chemicals, vehicles or explosives. However, the Pentagon reached a final decision in January 2009, that soldiers suffering from PTSD are not eligible for a Purple Heart, citing the facts that this injury is not intentionally caused by an enemy and is difficult to diagnose and quantify. However, some would argue that the “wounds” caused by PTSD are just as painful as bloody battle wounds.

PTSD is a type of anxiety disorder that is triggered by a traumatic event. According to the Anxiety Disorders Association of America (ADAA), PTSD is characterized by four main criteria. First, one must experience a trauma that is life-threatening or causes intense fear, helplessness or horror. Many people associate PTSD with war and veterans, but causes can also include rape, sexual abuse, a terrorist attack, a natural disaster, witnessing a murder or death, childhood neglect or abuse, a physical attack, a car accident, or a robbery. Although the experience of trauma is by far the most significant factor, other contributing factors include inherited predisposition, life experiences, how many traumatic events one has experienced, and personality. Second, someone suffering from PTSD persistently re-experiences the trauma. This can be characterized by intense, intrusive flashbacks, nightmares, or unrelenting memories and recollections. Third, victims of PTSD will persistently avoid things associated with the trauma. They may avoid the place where the trauma occurred, people who were present, or situations similar to the traumatic event. They may also avoid conversations about the trauma, or forget specific details about the trauma. Also, those suffering from PTSD often feel numb, disconnected or hopeless. Lastly, sufferers of PTSD will experience increased arousal. This can manifest in the form of jumpiness, anger, irritability, a heightened startle response, lack of concentration, or sleep problems. All of these symptoms must be present for at least one month, but can show up months, or even years, after the trauma occurs.

Although PTSD can result from any number of different traumas, symptoms generally present in the same ways for almost all victims. It is unknown why some people who experience the same trauma will suffer from PTSD and others will not, however, the more traumatic the event the more likely it is for someone to develop PTSD. According to the ADAA, approximately 7.7 million Americans over age 18 suffer from PTSD, while 7%-8% of Americans will develop it in their lifetime. Of those who experience high trauma events, such as combat or rape, 10%-30% will develop PTSD.

According to the National Center for PTSD, the most effective treatment for PTSD is Cognitive Behavioral Therapy. Other types of therapy proven effective include exposure therapy, group therapy, family therapy, and brief psychodynamic psychotherapy. Medications have also been proven effective in treating PTSD, typically those classified as antidepressants, including SSRIs, (most common for PTSD) tricyclic antidepressants, and MAOIs.

Reading all of the definitions, symptoms and treatment possibilities that are available on PTSD still cannot begin to make one understand the pain that a soldier experiences and re-experiences as a result of war and its associated traumas. Lawrence Winters, a Vietnam veteran and author, stated in his article from the publication “Mental Health News,” that, “When declaring PTSD an illness and listing it in the mental health manual for the treatment of individuals, we effectively isolated the problem into the category of mental illness… [But] all of this misses the point that war wounds the soul, and soul wounds are not listed in the DSM.” Winters makes his opinion clear, explaining that although Americans recognize PTSD as a real disease, civilians may not be able to grasp the magnitude of the “wounds” that many soldiers are still trying to heal, a lifetime later.

Leaders at the Pentagon defended their decision, claiming that they did not want to “belittle” the Purple Heart by awarding it to just anyone, specifically those who did not shed blood for their country. The conclusion was based on logic, save the Purple Heart for those with severe, visible injuries only. However, this theory leaves out those veterans who can no longer function normally in society, putting working or caring for their families second only to their disease, their flashbacks, nightmares and hopelessness. PTSD sufferers may not have a broken leg or a gunshot wound, but they do have serious symptoms that may never go away.

*Lisa Lauria is an undergraduate intern from Pace University