SAN ANTONIO — The day after the Fort Hood shootings, officials said the gunman, Iraq war vet Spc. Ivan Lopez, was to undergo analysis for post-traumatic stress disorder, or PTSD.
Once called “shell shock” or “combat fatigue,” PTSD is estimated to affect up to 20 percent of Iraq and Afghanistan war veterans, studies show. It can arise when someone experiences a life-threatening trauma or witnesses those around him undergoing such a threat, experts said.
While symptoms of PTSD can include thoughts of harming oneself or others, the diagnosis doesn’t automatically imply the sufferer is prone to violence, said Dr. Emma Mata-Galan, program manager of mental health outpatient services at the South Texas Veterans Health Care System
“When we speak of PTSD, we have to be sure not to make general assumptions,” she said. “PTSD does not automatically equate to violence. Anyone can have the disorder — children, women, the elderly.”
Other symptoms of PTSD include recurring nightmares, flashbacks, anxiety, depression, insomnia and “hyper-arousal,” such as feeling constantly on edge. The condition is diagnosed by assessing a veteran’s exposure to trauma and his or her symptoms, Mata-Galan said.
“They would have to persist over three months for a diagnosis of PTSD,” she said. “It’s not difficult to detect with the tools we have today.”
In the wake of the Fort Hood tragedy, critics are pointing fingers at what they contend is a negligent mental health care system at the post. They say soldiers with PTSD and other medical issues are routinely redeployed against doctors’ orders.
Lopez was being evaluated for PTSD at the time of the shooting, but no diagnosis had been made, Army officials said. He wasn’t wounded during his four-month deployment to Iraq, but “self-reported” a traumatic brain injury when he returned, they said.
Within the past month, Lopez had been examined by a psychiatrist, who determined he showed no signs of becoming violent. The plan was to “continue monitoring” him, officials said.
At the time of the shooting, Lopez had been prescribed Ambien, a sleep aid, and medications for anxiety and depression.
People suffering with PTSD may self-medicate with drugs or alcohol, experts said. They may withdraw from family and friends and avoid situations or places that remind them of the earlier trauma.
A rise in PTSD diagnoses in recent years could be the result of the nature of the wars in Iraq and Afghanistan, or it could be that doctors now have better tools to detect it, Mata-Galan said.
Prior exposure to trauma, such as child abuse, can increase a person’s chances of developing PTSD, she added.
PTSD is not limited to those on the battle field: Each year, around 7 percent to 8 percent of the general population will be diagnosed with the disorder, studies show.
Locally, the military has enabled veterans to get help for PTSD and other emotional or behavioral issues earlier by blending mental health care into the primary care system, such as placing psychologists’ offices next to primary care doctors, Mata-Galan said.
At the Frank M. Tejeda VA Outpatient Clinic, as well as at clinics around the city, cutting edge treatment, such as cognitive behavioral therapy and prolonged exposure therapy is helping veterans overcome PTSD.
“We’re finding very good results,” she said.