War's Heart of Darkness

From: "Bruce K. Melson" <doc32751@cookeville.com>
 Rice at VETS4EVER@aol.com wrote:


War's Heart of Darkness

By Bill Brewster
Nov. 10 - Thursday is Veterans' Day, the day Americans remember their
country's wars, and the men and women who fought in them.
Some remember heroism and sacrifice; some remember horror and senseless
death. Some swell with pride; some recoil in shame. But everyone remembers
For many former U.S. military personnel who fought in Vietnam in the 1960s
and '70s, the much-reported truth is that they remember all too much.
Thousands experienced something so awful in Vietnam that they developed
post-traumatic stress disorder, an often-debilitating psychological condition
that never lets them forget what they saw and felt.
In this month's issue of Annals of Behavioral Medicine, researchers Joseph
Boscarino and Jeani Chang establish a direct link between PTSD and coronary
heart disease. The news is especially crucial because as Vietnam veterans
age, their doctors have an increasing need to know and address their
principal disease risks.
Heart Risk Doubles

To be sure, PTSD did not begin in Vietnam. Boscarino, the chief researcher of
this study, notes that its symptoms have long been recognized in military
hospitals. He says journal entries indicate that the symptoms of PTSD were
widespread as far back as the U.S. Civil War.
PTSD sufferers include those who witness, or are victims of, violent crime;
workers in high-risk occupations such as inner-city police or metropolitan
firefighters; victims of sexual abuse or domestic battery; victims of natural
disasters, and people involved in motor vehicle or airplane accidents.
But only in the past 20 years has PTSD commanded the attention of psychiatric
researchers. And only among war veterans can they find a large group of
people approximately the same age, suffering PTSD from a kind of communal
experience that is perfect for studying.
Boscarino looked at more than 4,000 male U.S. Army vets' electrocardiograms,
which were collected by the Centers for Disease Control in the mid-1980s -
about 20 years after most of the men had served.
Boscarino found that while 14.5 percent of the study population had
abnormalities in their resting ECG test - that is, they were at serious risk
of heart disease or had already suffered a cardiac event - the rate nearly
doubled for those currently being treated for PTSD.

Rough Idle
Charles Figley, a Florida State University professor who studies PTSD, says
its overarching problem is that "it increases the body's idle point" because
it consumes extra energy and attention. That "takes away from the good things
that enable our body and mind to spring back," says Figley, things such as
strengthening the immune system and having pleasant dreams.
Boscarino says his study is a breakthrough because it presents one of few
proven links between PTSD and other diseases as determined by an objective
medical test not just by "self-reporting" of symptoms by the study
population. He characterizes the ECG tests as "the gold standard for
diagnosis of heart disease."
He says the study shows that doctors need to consider history of PTSD as an
additional risk factor for heart disease. Most researchers agree that this
conclusion is intuitive and not surprising, but they also agree that
Boscarino's study delivers the proof.
Paula Schnurr, a psychiatry professor at Dartmouth Medical School and a
researcher at the National Center for PTSD, says she hopes that this week's
results will encourage further research to look for links between PTSD and
other illnesses, including gastrointestinal complaints, cancer, stroke,
immune problems and a host of other diseases.

Multiple Pathways
Schnurr emphasizes the distinction between stress, which has been
well-studied and linked to many illnesses, and PTSD, which has not. While no
one denies the weighty impact of events like divorce or job loss that lead to
stress, something about suffering a trauma is different.
She says that while nearly everyone who suffers trauma shows some symptoms
like those described below, most do not develop PTSD, which is defined as
suffering from such symptoms for more than a month. And it's the onset of
PTSD, not the trauma itself, that is linked with increased disease risk.
Those who develop PTSD are more likely to use alcohol more, smoke more, use
legal and illegal drugs regularly, exercise less, and engage in other
health-compromising behavior. That might mean that there are many pathways by
which trauma turns into PTSD for some, or several reasons why PTSD sufferers
develop serious diseases more often.
Whatever the case, spare a thought on this week's day of remembrance for
those who are getting sick from memories they cannot escape.