PTSD is a term used by laymen to explain aberrant behavior by individuals who served in combat. Is this a fair assessment or a misuse of a term that carries deadly consequences? What is this disorder and does PTSD have any correlation to suicide?

In the movie “Patton”, General Patton slapped a soldier who had “lost it” in battle and was recovering in the infirmary. He had battle fatigue or was shell shocked, according to the attending doctor. Of course, old “Blood and Guts” Patton couldn’t fathom why a soldier wouldn’t be honored to die on the battlefield in service to their country. Patton struck the young man and told him to get his sorry butt up and go back to his unit.

This scene was a real event, and the general had to apologize to the entire corps.

The U.S. medical profession and the Veterans Administration sat silently by while our soldiers fought the remainder of World War ll, the Korean War, the Vietnam War and still did not address this disorder with any degree of urgency. Not until 1980, when the disorder was finally included in the DSM-IV as Post-Traumatic Stress Disorder, would serious studies begin. Results from the litany of grant-funded research studies have been shocking.

The focus in the early years of research was from the large number of combat veterans from WWll, Korea, and Vietnam. The research pool consisted of over 20 million soldiers still alive in the 1980s. As data was being compiled and analyzed, one shocking fact arose, surprising the research teams. Once the surveys were expanded to include veterans not in-country, they discovered significant numbers of these veterans had high levels of symptoms of PTSD also.

This strange result was later explained because so many Vietnam-era veterans who didn’t have a combat tour on their DD-214 still served in hostile areas supporting the war. A good example that comes to mind were the B-52 crews who flew bombing missions over North Vietnam and weren’t based in Vietnam, but Columbus Air Force Base, Miss. The same was true of troops in Thailand, Guam, Cambodia and the many other locations that fueled the war effort.

Today’s special operators are based in CONUS but are deployed around the globe. The War on Terror is being fought disproportionately by this small segment of the military. The mental cost to this unsustainable pace will be paid sooner or later.

Today, with an entirely different generation of individuals, the numbers still are shocking. A study conducted in 2009 showed the rate of suicide was 38 per 100,000 males and 12 per 100,000 for females.

You have to ask yourself, why can’t we identify this vulnerable group before they commit this irreversible mortal sin? The progressive nature of this disorder, if internalized, will end in tragedy. The individual, if left on their own, sees an ever shrinking pool of options as the disorder progresses. If the individual is drinking to an excess, misusing prescription drugs or taking illegal drugs, at least that’s a sign they need help. The stoic, silent ones are the hardest to identify.

Family and friends are the front line of the recovery team. The VA can print pretty trifold brochures for waiting areas and spend millions on eye-popping websites, but sadly the results of their outreach are abysmal. It’s not the VA’s fault because, once a veteran has been identified, treatment is forthcoming. It is always the people closest to a soldier that needs to be on guard.

Be vigilant

What are the signs of PTSD? Let me state for the record, PTSD is a serious disorder which requires the help of trained, certified medical professionals. Those of us with friends and family returning from combat tours must remain vigilant and monitor them closely. Some signs to be on the lookout for in yourself are flashbacks, bad dreams, frightening thoughts and avoiding situations that are triggers.

Some behavior in your loved ones you monitor are if they are easily startled, if they appear tense or on edge, they mention they are having sleeping difficulties or any atypical behavior that coincides with their tour of duty.

Remember, it is better to err on the side of caution than to dismiss some of these signs thinking the veterans will “work it out” on their own. The phrase ‘hindsight is 20/20’ comes to mind and is a good rule to follow. Get your friend to a group or medical professional and do it sooner than later.

I pray none of you will find yourself in the situation after your friend has committed suicide saying, “I should have seen this coming,” because it will haunt you forever. I know this to be a fact.

To recap, PTSD doesn’t have to lead to suicide if properly treated. Not everyone in combat has PTSD. A servicemember doesn’t have to have a combat arms MOS to be vulnerable. A good case in point was the 7,500 female nurses that served in Vietnam. Most thought they were fine until their first trip to the wall of the Vietnam Memorial. For this author and Vietnam-era veteran, I can’t even think of the names on the wall without becoming emotional.

The following phone number is important for those of you with vulnerable veterans who are friends and family. The phone banks are manned 24/7 because PTSD and suicidal thoughts never come at a “convenient time.”

Your small gesture could be the difference between recovery and suicide. Veterans can call 1-800-273-8255 and Press 1, send a text message to 838255, or chat online to receive free, confidential support 24 hours a day, seven days a week, 365 days a year, even if they are not registered with VA or enrolled in VA health care. Do it and do it now.

Mike Dryden is a retired Army Major and current Older Persons Action Group, Inc. board member.