Over her 28-year Army career, Brogan Farren worked as a helicopter pilot and military planner. She deployed to combat zones and flew peacekeeping missions. And when she retired three years ago, Farren found that when people in the civilian world met her, they sometimes had four very specific letters on their mind: PTSD.
“They all want to thank you for your service,” she said. “But then the next [unasked] question is, ‘Are you OK?’ Can I talk to you without you, you know, getting mad?’”
Farren gets it. Since 9/11, both the military and civilian world have made progress when it comes to understanding and treating post-traumatic stress disorder. But confusion lingers.
A survey commissioned by Cohen Veterans Network found most Americans greatly overestimate how many veterans have PTSD. Two-thirds of respondents believe it’s more than half. According to experts, the real number is fewer than one in five.
“I'm not surprised that there's misinformation,” said Tracy Neil-Walden, a clinical psychologist and chief clinical officer at Cohen Veterans Network.
“But the percentage of [respondents] who believe this was extremely surprising and really disheartening.”
Estimates on the actual prevalence of PTSD among veterans from the Gulf War and the post 9/11 era run between 12 and 20 percent, Neil-Walden said.
Those misperceptions have real-world consequences.
Many patients describe awkward questions about combat, Neil-Walden said. And when people find out she deployed overseas with the Air Force, Neil-Walden gets asked the same thing.
“There's always an assumption that you've seen or done something horrific,” she said.
Farren pins some responsibility for the misperception on portrayals in movies and television, which may depict veterans as homeless or suffering from severe PTSD.
“I know that you're trying to make the public aware that we have our challenges and that PTSD is real - and it is - but I think it's so overdramatized in one direction,” she said.
“I don't think they show enough of the middle of the road or the well-treated PTSD," Farren said. "And I'm concerned in the long-term that will hurt the working prospect of veterans.”
Neil-Walden said PTSD comes in many degrees of severity. It’s easier to identify people with severe symptoms because they may engage in disruptive behavior or be unable to do their jobs. But it’s much harder to spot people who seek and receive proper treatment.
Another problem with misperceptions about PTSD is that they may exacerbate the divide between the military and civilian worlds.
“There’s still a massive and extreme stigma” associated with veterans and mental health, said Hannah Sinoway, a professional counselor and executive vice president with Iraq and Afghanistan Veterans of America.
IAVA runs a 24-hour hotline for veterans who need mental health care. Calls during the last two weeks of August were up 70 percent, Sinoway said.
“The vast majority of those folks were calling as a direct result of what was happening in Afghanistan,” she said.
Many veterans were feeling “stress, sorrow, and confusion,” she said, as the country they fought in descended so quickly into chaos as U.S. forces pulled out.
The stigma veterans may feel “creates difficulties and barriers for the individuals who are struggling,” she said. “Do you feel comfortable talking about this with your friends and family, and your community? Sometimes not, and there’s a real disconnect.”
While the volume of hotline calls is disheartening, Sinoway said there’s a silver lining in the fact that so many people are willing to reach out when they need help. Some veterans might be wary of walking into a doctors office to talk about mental health, so if the first step is a phone call or text message, that’s okay.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.Funding comes from the Corporation for Public Broadcasting.
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