Post-Traumatic Stress Disorder (PTSD) From the Vietnam War

What You Need to Know About PTSD and the Vietnam War

Single long-stemmed red rose left atop names inscribed in Vietnam Veteran's Memorial, Washington DC, USA
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Our understanding of post-traumatic stress disorder (PTSD) has grown by leaps and bounds over the past few decades. Once referred to by terms such as "shell shock," the full impact of this diagnosis has become much more clear in the decades following the Vietnam war.

What do we know about PTSD and the Vietnam war as far as long term impact? What can veterans who continue to cope with this disorder many years later do, and can it make a difference?

If PTSD were not enough, we have learned as well how it is closely related to conditions such as heart disease and even pain, conditions which many Vietnam veterans are facing as they enter the '"golden years" today.

Following a congressional mandate in 1983, the National Vietnam Veterans Readjustment Study (NVVRS) was conducted by the U.S. government to better understand the development of PTSD from the Vietnam War, as well as other problems. In the past few years, many more studies have looked at the impact of the condition over time, with many important findings.

Incidence of PTSD in Vietnam Veterans

The findings from the study mandated by congress in 1983 were alarming. At the time of the study (middle- to late-1980s), among Vietnam veterans, approximately 15 percent of men and 9 percent of women were found to currently have PTSD. Approximately 30 percent of men and 27 percent of women had PTSD at some point in their life following Vietnam.

These findings, obtained approximately a decade after the end of the Vietnam War, found that for many veterans, their PTSD had become a chronic (that is, persistent and long-lasting) condition.

To examine the longer-term effects of chronic PTSD, researchers at the Harvard School of Public Health, Columbia University, The American Legion, and the State University of New York (SUNY) Downstate Medical Center surveyed 1,377 American Legionnaires who had served in Southeast Asia in the Vietnam War 14 years after their NVVRS interview in 1984.

Their study found that almost three decades after the Vietnam War, many veterans continued to experience problems with PTSD. At the initial interview, approximately 12 percent had PTSD. Fourteen years later, the rates of PTSD had dropped only slightly to approximately 11 percent. Those who had experienced high levels of combat exposure were most likely to have PTSD at both interviews.

Veterans who continued to have PTSD 14 years after their first interview were found to have considerably more psychological and social problems. They reported lower satisfaction with their marriage, sex life, and life in general. They also indicated having more parenting difficulties, higher divorce rates, lower happiness, and more physical health complaints, such as fatigue, aches, and colds. Veterans with chronic PTSD were also more likely to be smokers.

The Long-Term Impact of PTSD

Studies continue to find that PTSD in Vietnam war veterans remains a concern. A 2012 study looking at twins, found that 10 percent of "theater" veterans and 4.45 percent of "non-theater" veterans continued to cope with significant symptoms of PTSD. In many cases, the PTSD was categorized as "late onset." A different study found these numbers to be 22 percent for theater and 15.7 percent for "non-theater" Vietnam veterans.

It's clear that PTSD continues to affect the lives of many Vietnam war veterans today. More recent studies have dug deeper into the ripple effect of PTSD and it's role in many health conditions facing these veterans today.

PTSD's Role in Other Conditions

In addition to the symptoms of PTSD, veterans are now coping with many of the conditions that can go hand in hand. Some of these include:

  • PTSD and substance abuse - It's thought that substance abuse occurs in roughly a third of men with PTSD. It could be that "self-medicating" may underlie some of this propensity to become addicted to alcohol or drugs.
  • Connection between PTSD and pain - Whether related to injuries from the war or one of the painful conditions which arise with age, many Vietnam veterans face chronic pain, and this pain is tied closely with PTSD. The vicious cycle can continue further as the symptoms of PTSD such as muscle tension increase pain, which in turn aggravates the symptoms of PTSD and so on.  Finally, PTSD can increase the risk of depression and substance disorders, which in turn, increase pain.
  • PTSD and depression - PTSD and depression are closely related as well with nearly half of people with PTSD experiencing clinical depression at some point in time.
  • PTSD and heart disease - As with pain, many Vietnam veterans have reached an age when heart disease is very common, and some studies point at PTSD as a risk factor for heart disease in itself. In addition, people with PTSD have an increased rate of diabetes, and diabetes, as we know, is a significant risk factor for heart disease.

Importance of Recognizing PTSD

Understanding how common PTSD is in Vietnam veterans, and the complications of the condition, it's clear why it is so important that the condition is recognized. Studies have found several types of treatment to be helpful, but in order to seek treatment, veterans need to be aware that what they are experiencing is something that can improve with treatment. If you are uncertain whether or not you may have PTSD, look at these requirements for a PTSD diagnosis and make an appointment with your doctor to talk about your concerns.

Getting Help for Chronic PTSD

People exposed to severe traumatic events (such as combat exposure) are clearly at risk for PTSD, and it goes without saying that persistent or chronic PTSD can have a tremendous negative effect on a person's daily life as well as physical health.

Yet even in cases of chronic PTSD, recovery can still occur.

Whether you have bee suffering from PTSD for many years, or recently developed the disorder (which, as noted, is still possible in Vietnam veterans) it is important to seek out treatment.

The Anxiety Disorder Association of America provides links to people who treat in your area. You can also get specific information on PTSD and its treatment for veterans from the National Center for PTSD.

The treatment of PTSD usually includes a combination of therapies. Check out this overview of treatment options for PTSD. As noted, there is a multitude of different approaches so that you and your doctor can find the methods which work best for you.

Physical Health and PTSD

PTSD affects physical health as well. It's important to note that any treatment plan for PTSD in Vietnam veterans should take account of not just the psychological impact, but the physical aspect of the disorder. Physical conditions which are more common in those living with PTSD include:

  • Heart disease
  • Arthritis
  • Chronic pain
  • Respiratory-related disorders such as emphysema
  • Digestive tract disorders such as GERD and peptic ulcer disease
  • Diabetes

Secondary Traumatization

Those with PTSD do not live in a bubble, and partners and children are also affected by the disorder. Demoralization in partners has been well reported. Although the disorder has been found to affect both sons and daughters of Vietnam veterans in a number of ways—previous studies have found increased violence and hostility in children—it’s thought that the children of Vietnam veterans are at least as healthy emotionally as their counterparts in the general population.

Bottom Line on PTSD in Vietnam War Veterans

Now that we recognize PTSD as being common in military veterans, we are learning that those who were involved in the Vietnam war often cope with continued symptoms and that these symptoms may even begin late in life. Thankfully there are now many effective treatment approaches available to help those who realize that, for many people, the war is not yet over, but healing is still occurring every day for many of these heroes.

Sources:

Dennis, P., Dennis, N., Van Voorhees, E., Calhoun, P., Dennis, M., and J. Beckham. Moral Trangression During the Vietnam War: A Path Analysis of the Psychological Impact of Veterans’ Involvement in Wartime Atrocities. Anxiety, Stress, and Coping. 2016 Sep 19. (Epub ahead of print).

Goldberg, J., Magruder, K., Forsberg, C. et al. Prevalence of Post-Traumatic Stress Disorder in Aging Vietnam-Era Veterans: Veterans Administration Cooperative Study 569: Course and Consequences of Post-Traumatic Stress Disorder in Vietnam-Era Veteran Twins. American Journal of Geriatric Psychiatry. 2016. 24(3):181-91.

Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B. K., Marmar, C.R., & Weiss, D.S. (1990). Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.

Magruder, K., Goldberg, J., Forsberg, C. et al. Long-Term Trajectories of PTSD in Vietnam-Era Veterans: The Course and Consequences of PTSD in Twins. Journal of Trauma and Stress. 2016. 29(1):5-16.

Murdock, M., Spoont, M., Kehle-Forbes, S., Harwood, E., Sayer, N., Clothier, B., and A. Bangerter. Persistent Serious Mental Illness Among Former Applicants for VA PTS Disability Benefits and Long-Term Outcomes: Symptoms, Functioning, and Employment. Journal of Trauma and Stress. 2017 Jan 8. (Epub ahead of print).

Yager, T., Gerszberg, N., and B. Dohrenwend. Secondary Traumatization in Vietnam Veterans’ Families. Journal of Trauma and Stress. 2016. 29(4):349-55.

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