"The troops are not being prescreened," says Lese. "They are not being given the medication guide that was required to be given with any medication in 2003 or the handy wallet card that says, 'If you have any symptoms, you are supposed to consult a doctor immediately and leave the area.' It's pretty crazy to think that someone in combat can say, 'Oh, no, I'm having hallucinations — I think I should go home.' "
Back to the frontAccording to veterans and health experts interviewed by the Phoenix, increasing occurrences of PTSD can be blamed at least in part on yet another factor: multiple deployments. The DoD is in tacit agreement, as it acknowledged in the Army's mental-health report that 11.9 percent of troops deployed to Iraq for the first time say they experience mental-health issues. The ranks swell to 18.5 percent reporting problems during their second deployment, and 27.2 percent during their third.
THE WAR, ON DRUGS: To fight PTSD, US troops are being prescribed a staggering battery of pharmaceuticals, including Xanax, Ativan, Klonopin, Valium, morphine, Ambien, and Zoloft.
In Afghanistan, the number of troops raising mental-health concerns rises from 9.8 percent on the first tour to 14.2 during the second tour or beyond.
"If you're exposed to one gruesome and horrible episode, like your buddy getting blown up beside you, you'll get some sort of Post-Traumatic Stress Disorder," says Arthur S. Blank, a psychiatrist and former head of the Department of Veterans Affairs Vet Centers, who actually helped define the diagnosis for PTSD after the Vietnam War. "If that happens five, 10, 20, or 30 times because of multiple tours, your chances of getting PTSD go up considerably."
As of mid-2007 — when such figures were last available — the military said 525,000 of nearly 1.6 million personnel who had been deployed to either Iraq and Afghanistan had been deployed more than once. Almost two years later, with the number of personnel that have served in the two theaters reaching nearly 1.8 million, critics estimate that one-third have served multiple deployments.
Many of these multiple-deployed personnel are going back to battle voluntarily — despite either suffering from, or putting themselves at increased risk for suffering from, PTSD.
The Army's mental-health team also reports that 21.8 percent of troops in Iraq and 33 percent in Afghanistan feel their leaders discourage mental-health treatment. While doctors, veterans advocates, and the Army acknowledge the stigma felt by troops who feel they look weak in front of comrades by seeking treatment, they also recognize that it's become easier for people with said problems to enlist and re-enlist.
Medics and vets who spoke with the Phoenix note that the military is often a crutch for troubled recruits, providing them with needed structure, and empowers soldiers by helping them survive traumatic experiences. The unforeseen consequence, however, is war as therapy and an endless cycle of long deployments.
"Lots of soldiers that know better look at deployment as a form of treatment," says one medic. "No soldier wants to say, 'I'm a coward. I want to quit.' "
The war at home
Hardly all soldiers with PTSD want to go back to a war zone. But some are finding themselves on the frontlines anyway, because of the utter lack of communication between the VA and the DoD, which often results in a veteran with PTSD being returned to active duty.