The headlines from Iraq are filled almost daily with stories of average people caught in the crossfire between insurgents and coalition forces. The stress of living in a war zone takes an emotional toll. But so do other life-threatening experiences: living through a natural disaster, being the victim of a crime or even sustaining injury in a serious accident.
Today, doctors describe this condition as Post-traumatic Stress Disorder and as VOA's Melinda Smith explains, it can happen to anyone, anywhere.
Soldiers know this condition all too well. In earlier wars, it was called "Shell Shock" or "Combat Fatigue." The term "Post-traumatic Stress Disorder" was used to describe the psychological effects on Vietnam veterans after they came home.
Since the 1980s it has been more widely defined to include reaction to other disasters. Listen to the symptoms expressed by this New York City resident after the terrorist attacks of September 11, 2001:
"I'm having a fear of going into any tunnel right now … 'cause I'm thinking it's gonna explode. I've been having nightmares," said one fearful woman of her difficulties.
Because of violence in Israel and the Palestinian territories, young people there commonly suffer from post-traumatic stress.
Tanya Weiz was wounded during a suicide-bombing of a Tel Aviv nightclub:
"It's the hardest thing for me and it's been a year, but I still look back at it. I still think about it every day. There isn't one second that goes by that I don't think about it."
Ten years after the sarin gas terrorist attack in a Tokyo subway, this man still carries psychological scars: "I have been diagnosed with what my doctor calls an anniversary syndrome. Every year at this time of year I start having various symptoms."
Dr. Robert Ursano heads the psychiatry department of the medical school which trains U.S military and public health doctors.
He says there's a difference between the war-time experience of a soldier or hostage versus that of a civilian in a natural disaster like Hurricane Katrina.
"If you've been exposed to a life-threatening event at any time in your life, you may well develop post-traumatic disorder. Most people recover from it. But some will not.
Soldiers, whether they're at the front line or back line, are exposed to ongoing threat ... ongoing experiences of worrying about their life and the lives of friends," he continued. "Remember that post-traumatic stress disorder is only one problem and not the most important one for Katrina. Probably issues of depression because of the degree of loss that people experienced ... Stay alert to issues of substance abuse ... alcohol withdrawal, substance withdrawal for those who may have been using substances before and might not now be able to have those."
Reestablishing a sense of community and making sure children are back in school are also important. Refugees -- especially women -- are particularly vulnerable to post-traumatic stress. Studies have shown that women are twice as likely to suffer than men.
In Sudan's western Darfur region, one woman describes how the Janjaweed militia stole her cattle, murdered her husband and brother: “I just escaped with the clothes on my back."
Large populations are displaced by natural disasters. Here are three dramatic examples:
- Hurricane Katrina along the American Gulf coast in August 2005
- The tsunami that swept thousands out to sea along the Indonesian coast
- The earthquake in Pakistan on October 8, 2005 which killed 87,000 people and left millions without homes.
It could be days or weeks before relief workers can address post-traumatic stress. Dr. Ursano says elected officials can help in the healing by recognizing when its time to give up looking for survivors and begin to mourn the dead.
"That's a critical decision to be made by leadership," he says. "It really leads the community to a very different way of thinking about what's occurred."
There are common symptoms that can be recognized even without a professional diagnosis:
Psychiatrists describe "intrusive thoughts" … that is, being mentally being led back to the traumatic event even when you don't want to think about it … feeling jumpy … or having difficulty sleeping. If these symptoms persist over a period of time, it could be post-traumatic stress.