Invisible Wounds of War

Summary of Veterans Statistics for PTSD, TBI, Depression and Suicide.

  • There are over 2.3 million American veterans of the Iraq and Afghanistan wars (compared to 2.6 million Vietnam veterans who fought in Vietnam; there are 8.2 million “Vietnam Era Veterans” (personnel who served anywhere during any time of the Vietnam War)
  • At least 20% of Iraq and Afghanistan veterans have PTSD and/or Depression (military counselors I have interviewed state that, in their opinion, the percentage of veterans with PTSD is much higher; the number climbs higher when combined with TBI.
  • 50% of those with PTSD do not seek treatment
  • Out of the half that seek treatment, only half of them get “minimally adequate” treatment (RAND study)
  • Rates of post-traumatic stress are greater for these wars than prior conflicts
  • Recent statistical studies show that rates of veteran suicide are much higher than previously thought.
  • Major depression also a problem. “Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan.” Susan V. Eisen, PhD
  • More active duty personnel die by own hand than combat in 2012 (New York Times)

Post Traumatic Stress Disorder (PTSD)

thetear_jpgOne in five veterans of the Iraq and Afghanistan wars are diagnosed with post traumatic stress disorder (PTSD) – over 300,000 veterans by the end of 2012. The social and economic costs of PTSD are immense. First-year treatment alone costs the government $8,300 per person, or more than $2 billion so far. And suicides among active-duty military personnel averaged one per day in 2012. Veterans now account for 20 percent of suicides in the U.S., with the youngest (24 and under) taking their lives at four times the rate for other veteran age groups. –

Aggressive Behavior


According to research published in Neurology®, the medical journal of the American Academy of Neurology, the development of aggressive behavior after brain injury is linked to injury location and gene expression. The article, “Prefrontal cortex lesions and MAO-A modulate aggression in penetrating traumatic brain injury,” is authored by a group headed by Jordan Grafman, PhD, director of traumatic brain injury research at Kessler Foundation.

This is a follow-up study to the Vietnam Veterans Head Injury Project, which monitors long-term sequelae in more than 200 veterans with penetrating brain injury. Aggressive behavior develops in some individuals after traumatic brain injury–the signature wound of the wars in Iraq and Afghanistan. “Aggressive behavior not only hinders rehabilitation and recovery after brain injury, it’s devastating to families.…

The Signature Wound of War


Head injury has become known as the “signature injury” of the Iraq war. The Website of the Defense and Veterans Brain Injury Center (DVBIC), a congressionally funded research and outreach agency, cites a brain injury rate of 62% among troops returning from combat duty in Iraq. Blast-related TBI, an effect of the over-pressurized shock wave that ripples out from an explosion, is a particular concern in the current conflicts.

In the Walter Reed study, about half the soldiers reported having been exposed to at least one blast; 60% of these blast victims sustained a brain injury.  A study published by Army researchers January 31 in The New England Journal of Medicineii found that nearly 90% of troops had been exposed to two or more blasts from improvised explosive devices.…

Traumatic Brain Injuries (TBI -mTBI)


Blast injury to the human brain may cause the whole spectrum of TBI from mild TBI to severe brain injury with brain swelling, intracranial haemorrhage and penetrating injury.

The circumstances of the blast exposure and premorbid personality will determine the mix of psychological and physical injury.  It cannot be concluded that bomb blast causes PTSD and depression by psychogenic means alone.The emotional shock of the blast and the circumstances surrounding it may be enough in some cases to explain the PTSD and depression. However, there is emerging evidence that parts of the brain injured in blast TBI are concerned with regulation of emotions and judgement and this organic component of brain injury may contribute to the onset of PTSD and depression. There is still reluctance by military personnel to self-report mental health problems.

PTSDMental health professionals must continue to address this problem and reduce the stigma attached to mental health. This might occur by increased efforts to liaise with commanders who should be well briefed and supportive of mental health strategies. It is important that personnel understand that seeking treatment is confidential and that seeking help is a sign of interest in getting better, not a weakness and that treatment will minimize stress related conditions. There also needs to be a continued emphasis on the de-stigmatization of psychological conditions in military personnel returning from deployment.

Images from

US Copyright Title 17 U.S.C. Section 107


42 thoughts on “Invisible Wounds of War

  1. Thanks Victoria. One of my best friends has PTSD from multiple tours overseas with the military. I appreciate your studies and sharing.

    • Sigh, I am sorry to read that one of your best friends has PTSD. Doing multiple tours is what sets these recent wars apart from the rest. The duration. I hope your friend is getting the necessary assistance he/she needs. Sometimes people have to be their own advocate, and that can be hard.

      Christy, I hope this last day of July finds you well. ☼ It’s been feeling like me on a good day.

      • She did several tours, in a fairly short amount of time. I never really thought about brain injury though, she doesn’t talk much about it, but that would make a lot of sense.

        She’s retiring very soon, which I think will be good. I don’t think she got assistance bc she was worried about losing her security clearance. So maybe she’ll get the help she needs now. It actually kind of drive us apart… sad.

        Maybe we can talk about it off-line sometime if you’d like. I do appreciate you sharing, it matters.

        And yes, it was a good day. I have a good day every now and then…

  2. Finally, I can comment! Was having tech difficulties. :\

    Great article, V. Heartbreaking to be sure, but still a good share.

    I don’t know many military people, but I wanted to add (and hopefully this is “adding” something relevant and not “taking away” ) domestic violence can be another cause of PTSD or C-PTSD.

    Most associate this disorder strictly with military personnel, but it is becoming clearer that all types of abuse are another risk for developing it as it is another type of war or combat where stress hormones are overstimulated and can change the brain structure. You know what happens from there.

    I hope this finds you well. x

    • Hi Jenn, thanks so much for stopping by and commenting. What a nice surprise. Sorry to read that you ran into technical difficulties. I appreciate you bringing up the fact that PTSD is not limited to war vets.

      The PTSD Alliance states that PTSD can be found in anyone “who has been victimized or has witnessed a violent act,” which includes those that had experienced either domestic or war-related violence (“Hope for Recovery,”

      I thought I posted this to add to your your comment about victims of domestic abuse and PTSD:

      Recent studies have discovered that PTSD can be found in victims of domestic violence, as well as in children that have been exposed to household violence.

      Another issue I read about a few years back was that domestic abuse is a common cause of traumatic brain injuries in woman.

      Hope you had a nice weekend, and I also hope you will pop in more often. I’ve kinda been busy on my other blog lately.

  3. Coming from such a military family — father was USMC — I have a sacred place in my heart and soul for combat veterans. I totally understand them and their “Band of Brothers.” That life, the hyper-sensitized and overused ‘fight or flight’ mode bonds those men closer than blood brothers. When you’re forced to trust the soldier next to you with your life, and do it in return, day-in and day-out…hell, no wonder they find it so hard to fit back in to this trivial, go-through-the-motions of “What shopping mall will I go to?” or “When will I arrive at the pro ball-game stadium to watch my team?”

    And when our politicians think of them or use them as if they are toy soldiers, who act like “if we have them then why don’t we use them”…mentality, they actually send them off to possible death one way or the other: short/KIA or this, your post, long-term PTSD, TBI, depression and suicide. I often ask, what’s the difference?

    Aside from finding all means possible to avoid armed conflict, we must then NEVER stop to find ways of healing our sons and daughters-of-combat from their long-term wounds…or living-death.

    Great post Victoria! Thank you.

    • Professor, ugh, I’m sorry I haven’t responded to this sooner. October was a world-wind month for me in the bloggingsphere, and I lost track of the notifications. My reply is timely with today being Veteran’s Day. I couldn’t agree more that aside from finding all means possible to avoid armed conflict, we must ever stop to find ways of healing our veterans and their long-term wounds. We both grew up “military brats”, and we are fully aware of the untold sacrifices that our parents made for our country. It grieves me deeply when I read the statistics on this senseless war, as well as the Vietnam war.

      Thank you for your compassion. Thank you for caring.

    • Afracooking, my apologies for not responding sooner. Your comment notification got lost in a sea of several hundred notifications (likes, followings and comments) after an article on my 2nd blog was Freshly Pressed. I really appreciate that you took the time to read, and for your thoughtful comment. ღ


  4. My friend’s son was with Marines 1/5 for the fall of Baghdad. When I asked him what his experience over there was, the first words out of his mouth were, “We killed people for no reason.” He went on to relate how their checkpoints would regularly open up on approaching vehicles that often were full of nothing but women and children because maybe they didn’t slow down enough or heed hand signals properly. He also had to render aid to these same occupants with wounded children screaming in anguish and terror next to their dead or dying mothers, aunts, and/or sisters. He told of a six year old girl with the back of her skull blown off by a rifle round stumbling about unaware of anything but her dead mother on the ground.

    He said he learned first hand just how much we were all lied to about Iraq. His attitude was, “Support the troops, but not the mission” (this sentiment gets regularly mocked on right wing sites). Several of his friends I met at his homecoming never came back from their next tour of duty.

    This former Marine is now suffering from PTSD. I asked his father if the VA covered his treatment. He said he gets ZERO help/treatment from the VA because they arbitrarily designate a % of level of affliction and his % (60%?) is below the threshold for treatment.

    • Lance, your post grieves me — and is added to the multiple stories I’ve read about the longest war in American history, well, besides the war against the indigenous peoples of North America. The war started by G.W. Bush and Company, a senseless war about power and greed, has clearly demonstrated how our veterans have been ‘thrown away’, yet again. Dehumanized.

      The National Coalition for the Homeless states that between 130,000 and 200,000 veterans are homeless on any given night. Many of them have mental illness and/or TBI caused by the war. Three times that many veterans are struggling with excessive rent burdens and thus at increased risk of homelessness. I can’t wrap my brain around the inhumanity towards our veterans, betrayed by the very country they served.

      Thank you for sharing.

      • from:

        The trick of declaring war against the armed resistance and then attacking the resisters’ unarmed kin as well as the sur­rounding population with the most gruesome products of Death-Science — this trick is not new. American Pioneers were pioneers in this too; they made it standard practice to declare war on indigenous warriors and then to murder and burn villages with only women and children in them. This is already modern war, what we know as war against civilian populations; it has also been called, more candidly, mass murder or genocide.

        Maybe I shouldn’t be surprised that the perpetrators of a Pogrom portray themselves as the victims, in the present case as victims of the Holocaust.

        Herman Melville noticed over a century ago, in his analysis of the metaphysics of Indian-hating, that those who made a full-time profession of hunting and murdering indigenous people of this continent always made themselves appear, even in their own eyes, as the victims of manhunts.

        The use the Nazis made of the International Jewish Conspiracy is better known: during all the years of atrocities defying belief, the Nazis considered themselves the victimized.

        It’s as if the experience of being a victim gave exemption from human solidarity, as if it gave special powers, as if it gave a license to kill.

        ~ Fredy Perlman

  5. Here in Canada, if a veteran seeks treatment and is diagnosed with PTSD, then they are not ‘fit’ to redeploy back to combat duties. Being unfit is cause for dismissal, and so we find men and women who are discharged as unfit shortly before achieving a pensionable time of service.

    I don’t know why so many countries have veteran services that are adversarial to the best interests of veterans. This reason alone is suggested here in Canada for the steep rise in PTSD suicides. Fortunately for other soldiers (but unfortunately for the person) retired General and Senator Romeo Dellaire also continues to suffer from the effects of PTSD and so has been instrumental in gaining some small measure of improvement to mental health services for returning veterans and their families but the task remains largely undone when government departments work so diligently and with such dedication to undermine having to take any financial responsibility or commitment to these injured soldiers. Such official ‘treatment’ is unconscionable in the eyes of the public yet remains a permanent fixture of so many governments. I would like to blame Veteran’s Affairs here in Canada and its political overseers but I recognize the same malaise active for decades in the both the US and Britain. Why, I wonder, when public support for the veterans receiving long term and effective treatment and financial security for them and their families is so high?

    • Tildeb, it’s great to see you here. I grew up a ‘military brat’, as they call kids here in the U.S. whose parents make/made careers in the military. My father was in the Air Force, and my step-dad was in the Navy. Both are retired now. But neither one of them were ever on the front-lines during wartime. Nevertheless, I had friends whose father’s had been, and I witnessed the dysfunction in their families.

      I have also been personally affected (identity theft for over 1 million dollars) by a veteran who was diagnosed with PTSD and experienced blast-related TBI. It devastated my life and my well being. I lost my business, had to file bankruptcy, and I’m still dealing with the repercussions over a decade later. He had been honorably discharged after combat duty in the Gulf War. Rather than giving him the necessary rehabilitation, they pretty much left him to manage it on his own. The result was drug abuse followed by criminal activity against me and my banking institution which landed him in prison for 12 years. To make matters worse, he lost any benefits he had, and was not given the necessary meds or psychotherapy while incarcerated. The fault was placed on him, solely.

      I listened to an interesting interview on NPR (National Public Radio). The program highlighted the fact that you don’t see the real cost in human terms until 20 to 30 years after the conflict has ended. This is not only detrimental to the veterans and their families but to communities and my country as a whole. Most of the time, connection is never made to their service in combat.

      In the interview, Paul Rieckhoff of the Iraq and Afghanistan Veterans of America says that is not surprising.

      “Now, any vet asking for help is supposed to be evaluated within 24 hours and start treatment within two weeks. The VA has claimed that happens in the vast majority of cases, but a new investigation by the agency’s inspector general says the VA statistics are skewed to make wait times appear shorter.

      Paul Rieckhoff:

      “It illustrates, in incredible clarity, how dysfunctional the VA system is right now for thousands of veterans around the country,” he says.”

      The inspector general pointed out that similar problems have been ongoing for at least seven years. The VA released a statement saying it endorses the inspector general’s findings.

      Also in the NPR program, Attorney Dan Brier is suing the VA on behalf of Stanley Laskowski, an Iraq vet diagnosed with PTSD in 2007.

      “Brier says that even though his client was diagnosed and was in the VA system, he never got the help he needed.

      It grieves me to know that our veterans, who were willing to give their life for their country, are devalued — and dehumanized. It’s nothing short of disgraceful, and makes me disgusted when I see institutions like the VA trying to minimize the problem.

      Thanks for your comment. If we don’t keep making the public aware of this problem, it will continue to be swept under the rug by those who should be taking the full blame for the enormous harm and dysfunction of individuals, families, communities and the country.

      • Life goes on and that’s the important thing to take from this situation. We have the opportunity to do good with our lives. We can’t change the past, but we can learn from it and try to make the future better. All very corny, but true.

          • I mentioned Romeo Dellaire but forgot to offer a link. This is his site and he is now working closely with the Governor-General (our military head of State) to try to produce better recognition that this is a real injury, make appropriate policy changes, and establish additional treatment for vets back on civvy street where support and understanding is supposed to materialize as if by magic. With four suicides in the past ten days by afflicted vets, the issue is a problem that just keeps on costing us all.

            Like you, Neuro, I think lasting and meaningful solutions will eventually come from better understanding brain processes and how to alter them into healthier expressions. When someone like a Dellaire – a highly decorated and seasoned veteran with demonstrated command abilities in combat missions – is frozen in fear when an injured grandchild asks to be picked up and comforted today, we know that it takes a lot of brain training to short circuit the unthinking care response and rewire it to a paralytic fear response based on exposure to hundreds and hundreds of suffering, often mutilated, children from decades earlier (Rwanda).

            Those of us who do not suffer directly from brain trauma have a very difficult time appreciating the challenges these folk face but we are first in line to be adversely affected by them. For example, my brother suffered such an injury at a young age and it has been such a relief to me to know that his roller-coaster bizarre and sometimes violent behaviour (he’s also one of the funniest people I have ever known) is not part of his character but an expression of an illness in action. In the same way I do not blame (and take as a personal insult) an amputee’s stumbling and bumping into me, I can now stop this same blame response with him and be a much better brother with with a better understanding of why he does what he does and a firmer grasp of how I must respond to it. More knowledge, not anger, is a much better investment and one that actually pays dividends. When this can be extended into the military response and rehab, we’ll start to head in the right direction. I would like to see the same kind of response offered to families who will be on the front lines with the vet and need better training and equipment than some legal relationship.

            • “For example, my brother suffered such an injury at a young age and it has been such a relief to me to know that his roller-coaster bizarre and sometimes violent behaviour (he’s also one of the funniest people I have ever known) is not part of his character but an expression of an illness in action.

              Exactly. Humans have made assumptions about ‘human nature’ and character for far too long, and it’s gotten us no where. Today, we have the knowledge (though still limited), and the technology to make dramatic changes in well being as well as implement preventative measures. I am hopeful.

              Thanks for the link. That’s very encouraging what’s happening in your country.

  6. Such sobering statistics. It’s easy to feel at a loss for what to do in the face of such staggering odds. I’m grateful you’ve chosen to share the information here. Awareness is one step closer to finding an answer…and a reminder for the rest of us to treat our soldiers with kindness. We never know the suffering and wounds they may carry under the skin. I’m glad Professor Taboo chose to promote your blog on mine today.

  7. Wow. What a heavy post. Excellent, but seriously heavy.
    Maybe its about time societies started looking toward the Avoidable War rather than continually justifying getting involved?

  8. Great and informative post! It’s work that you have done and compiled to make everyone aware just how devastating that PTSD is on service men and women- but in general. This hits home for me in many respects as well and as I have told you I am so grateful that someone is bringing attention to these issues as they are devastating. I have PTSD from being married to a service member who inflicted abuse on me. My sister is currently married to a service member who is “agressive” as was described in your post and he definitely has demonstrated abusive behavior. He has been to Iraq 4 times. My current husband’s very good friend has PTSD and his is so severe he is “disabled.” I was happy that they are taking care of him- but it took him almost losing his leg (getting hit with IED) and shrapnel hit his face and he had to have surgery to fix leg and face. He can’t walk the same and definitely can’t run. He also gained a significant amount of weight 😞 People throw around the term PTSD but don’t realize how serious it is- and it’s information like this that everyone should be made aware of- because it’s real- and really scary for all those involved. 😔

    • Hey Linden, thank you for taking the time to read and for your thoughtful comment. I’m sadden to read about your hardships and that of friends and family. I have read quite extensively about how war traumas not only impact the individuals who served their country but also their families and the community. Domestic abuse is high among veterans who have experienced mental/brain trauma. Criminal behavior also increased. I don’t share this to demonize veterans, not at all. The system is broken and our veterans have been sorely neglected.

      Reuters reports (1/19/2012):

      “Violent sex crimes committed by active U.S. Army soldiers have almost doubled over the past five years, due in part to the trauma of war, according to an Army report released on Thursday.

      Reported violent sex crimes increased by 90 percent over the five-year period from 2006 to 2011. Most were committed in the United States.

      One violent sex crime was committed by a soldier every six hours and 40 minutes in 2011, the Army said, serving as the main driver for an overall increase in violent felony crimes. Soldiers suffering from issues such as Post-Traumatic Stress Disorder (PTSD), traumatic brain injury, and depression have been shown to have higher incidences of partner abuse, according to the report.”

      I had a very negative experience myself around 15 years ago from a Gulf War veteran who had sustained a TBI and was on disability for PTSD. He committed identity theft/cyber fraud against me, and it was a huge sum of money. I lost my business, had to file bankruptcy, and start all over again from scratch. He was convicted and sentence to 12 years in prison. The fact that he was a disabled veteran had no bearing on the courts decision.

      I later learned that the TBI affected his prefrontal cortex. Neurological studies show that individuals with adult-acquired damage to the pre-frontal cortex are usually aware of proper social and moral conduct, but are unable to apply such behaviors. Our court system is way behind the brain research which is why over 60 percent of people in the prison system have mental illness and/or TBI.

      At the time this happened to me there were no support systems in place for people who had experienced cyber fraud (like identity theft insurance). I wasn’t always this understanding, and I was really angry at this guy who pretty much ruined my life. I was devastated that this happened to me but at the time had no idea how damage to the brain could impact behavior. Research helped me understand and expedited my recovery from this profoundly negative experience.

      I read this article today and was encouraged. The Army (finally) is doing an overhaul of their broken system and are implementing plans to help veterans with mental trauma.

      “Mental trauma counts among the top issues affecting members of the Armed Forces. Last July, a national survey of more than 2,000 members of Iraq and Afghanistan Veterans of America — which includes members of the Army, Marines, Air Force, and Navy — found that more than 60 percent of respondents said they have been diagnosed with PTSD or traumatic brain injuries. More than 30 percent of respondents also said they have thought about taking their own lives since joining the military.

      Now, Army officials want to be more proactive in addressing mental ailments, meeting soldiers in the very environment where anxiety festers.”

      • I am beyond sorry that happened to you! You really are a strong person to have survived the things you have been through! And you have such compassion and forgiveness for those that have hurt you it is incredible and I admire you so much for that! 😊You take an awesome approach and the high road- and the research you’re doing in this regard is more than a contribution it is remarkable!
        I hope the military keeps making progress and takes the research folks like you do and take it into serious speculation and consideration!

        • Again, thank you so much for your kind words. I think you are strong as well even though I don’t think you see what I and others see in you. 🙂

          Anyways, you have probably figured out by now why I am so passionate with regard to advocacy and bringing awareness about these and other issues. We live in societies with systems that create the very problems — dysfunctions and then blame it on a mythological scapegoat and “original sin”. Don’t even get me started, heh. 😉

          Hope you have a nice weekend. *hug*

  9. Excellent post, sobering and heart-breaking. Used and then thrown out to the four winds to fly or fall. No longer valued after going through such harrowing experiences. Well said Victoria.

    – esme upon the Cloud

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