Elusive threats boost PTSD risk in Afghanistan

Stefania Moretti, CTV.ca News

Canadian troops fighting in Afghanistan are up against two dangerous adversaries. The first, the elusive enemy; the second, the less-tangible threat of mental breakdown.

Indeed, new studies suggest soldiers deployed to Afghanistan are more likely to suffer from mental illness because of the high degree of uncertainty that characterizes the NATO-led mission.

Traditionally, wars have been fought on the front lines of the battlefield with an identifiable enemy in uniform. But in Afghanistan, the enemy is "elusive," said one mental health expert. Threat can come from anywhere.

Afghanistan has been described as a 360-degree war with virtually no safe zone. Suicide bombers dressed in civilian garb, improvised explosive devices strewn across the treacherous "Highway of Death" connecting Kabul and Kandahar and entire communities surrounded by deadly land mines means soldiers face around-the-clock danger.

As a result, Canadian soldiers in Afghanistan are likely at higher risk of developing post-traumatic disorder than their comrades serving in other missions, Dr. Alain Brunet, of the Douglas Research Centre and McGill University, recently told CTV.ca in a telephone interview from Montreal.

British troops sent to Afghanistan last year were nine times more likely to suffer from PTSD, according to that country's Ministry of Defence in a study released this month. Most British troops are stationed in Helmand province -- a less volatile region than Canadians stationed in the Taliban hotbed of Kandahar province.

Veterans Affairs Canada pegs the number of Canadian war vets who will experience PTSD as high as 10 per cent.

But the figure only represents former soldiers, and does not reflect soldiers currently on duty in Afghanistan, where the risk of PTSD is likely much different, Brunet said.

As many as 28 per cent of troops come back from armed combat with one or more mental health issues, according to data complied by the head of the Canadian military's deployment health section last year. Of those:

• seventeen per cent exhibited signs of high-risk drinking
• five per cent showed symptoms of PTSD
• five per cent had signs of serious depression

Since the mission in Afghanistan began in 2002, the number of Veterans Affairs members with a PTSD condition has more than tripled, up from roughly 1,800 to 6,500, according to a Veterans Affairs briefing note obtained by The Canadian Press in March. Veterans Affairs expect the numbers will continue to climb with troops scheduled to stay until at least 2011.

In 2007, the number of suicides among regular and reserve members of the Canadian Forces rose to 36, the highest in more than a decade, military police records from earlier this year show.

There is a sense that there has been a recent surge in PTSD, and it can be attributed to a number of factors, Brunet said.

The spike in military PTSD cases may also stem from fewer cases going unreported, thanks to education and screening programs implemented by the army in recent years.

Within two months of returning from a tour of duty in Afghanistan soldiers undergo a mandatory PTSD assessment followed by several weeks off and counseling.

Brunet, whose research focuses on the risk and remission factors associated with the disorder, said an officer with PTSD symptoms should not be re-deployed because the risks are "cumulative."

"The more you go (to Afghanistan) the more likely you are to develop the disease," he said, adding the diagnosis of PTSD in the army is "amazingly important."

Dozens of soldiers have already completed two tours of duty in Afghanistan, and some could face a third if the mission is extended.

But significant barriers preventing PTSD diagnoses among soldiers remain, despite efforts made by the Canadian Armed Forces to educate soldiers about the disease.

Having PTSD can be a career-ender for a soldier, Brunet said.

A combination of this fear of dismissal from duty and the "macho culture" that permeates the force makes officers hesitate to disclose their problems, Brunet said. "We are sending mixed messages."

The "hallmark" of PTSD is persistent nightmares, but symptoms can also include, flashbacks, gaps in memory, detachment from loved ones, little control over impulses, problems concentrating, anger and irritability.

Although it's natural to experience any or all of these symptoms after witnessing a traumatic event, PTSD sufferers become incapacitated by their frequency and severity.

"Personally, I wouldn't want to have a comrade working with me and to have to rely on someone with PTSD," Brunet said.