Study Shows Very High Rate of PTSD Among Veterans

– Posted in: PTSD – Post Traumatic Stress Disorder

Almost 40 percent of Iraq and Afghanistan veterans receiving health care from VA hospitals have one or more mental disorders.

A new study, published in the July 16 online edition of the American Journal of Public Health, reported this and other shocking news about the mental health of our veterans of the Middle East wars.

The study’s principal author, Dr. Karen H. Seal, an assistant professor of medicine and psychiatry at the University of California, San Francisco, had even more distressing news. She said:

When the definition is expanded to include diagnoses of mental health disorders or psychosocial behavioral problems such as homelessness, or both, 43 percent of these veterans received these diagnoses.

If previous history with Vietnam-era veterans is any guide, the burden of mental illness will follow these veterans for many years to come. The research reported on in this post seems to back this idea up.

The findings of the study and its implications are detailed under the following headings:

  • How the study was conducted?
  • What were the findings of the study?
  • The incidence of mental illness among veterans is accelerating
  • It can take years for Anxiety Disorders such as PTSD to develop
  • What are the implications of the study?

How the study was conducted?

The health records of 289,328 Iraq and Afghanistan veterans entering Veterans Affairs (VA) health care from April 1, 2002 to April 1, 2008 were studied by researchers at the San Francisco Veterans Administration (VA) Medical Center and the University of California, San Francisco. This number accounts for about 40 percent of returning veterans.

Mark Kaplan, a professor of community health at the School of Community Health at Portland State University in Oregon, noted that the study only covers veterans who have received care at the VA, but there are many more with serious mental health problems that are either seeking care privately or not at all. He said,

This study adds to what we know about this population, however, that’s the veterans who seek care at the VA system. But if you look at the total population of veterans from all wars, there are one-third of all veterans who have these problems.

What were the findings of the study?

Well over a third of the returning veterans, 37 percent, received a diagnosis of having a mental disorder. Of these, the largest groups of diagnoses were:

Many veterans had several mental health problems. In fact, 29 percent of veterans with mental health issues were diagnosed with two different conditions, and 33 percent were diagnosed with three or more. Women were at higher risk for depression than were men, but men had over twice the risk for drug use disorders.

Active duty veterans younger than 25 years had higher rates of PTSD and alcohol and drug use disorder diagnoses compared with active duty veterans older than 40 years. Greater combat exposure was associated with higher risk for PTSD.

Veterans older than 40 with the National Guard or the Reserves were more likely to develop PTSD and substance abuse disorders than those under 25. Dr. Seal said a possible reason is that older reservists go to war from established civilian lives, with families and full-time jobs, making combat trauma potentially more difficult to absorb. She continued:

It’s the disparity between their lives at home, which they are settled in, and suddenly, without much training, being dropped into this situation.

The incidence of mental illness among veterans is accelerating

Dr. Seal states that, “What’s really striking is the dramatic acceleration in mental health diagnoses, particularly PTSD, after the beginning of the conflict in Iraq,”

The increase in mental illness diagnoses accelerated after the invasion of Iraq in 2003, the researchers found, increasing 4 to 7 times. Among the group of veterans who enrolled in veterans health services during the first three months of 2004, 15 percent received mental health diagnoses after one year. But after four years, the number had nearly doubled, to 27.5 percent.

Dr. Seal attributed the rising number of diagnoses to several factors: repeat deployments; the perilous and confusing nature of war in Iraq and Afghanistan, where there are no defined front lines; growing public awareness of PTSD; unsteady public support for the wars; and reduced troop morale. She said that “waning public support and lower morale among troops may predispose returning veterans to mental health problems, as occurred during the Vietnam era.”

It can take years for Anxiety Disorders such as PTSD to develop

Dr. Seal said often it takes more than a year for symptoms of PTSD to appear and diagnosis to be made. She said,

The longer we can work with a veteran in the system, the more likely there will be more diagnoses over time. It sometimes takes time, given the stigma associated with mental illness, before we are able to break through the barriers and have patients tell us what is happening.

This finding supports the recent move to extend VA benefits to five years of free health care, which allows VA doctors the time to detect and treat more mental illness in returning combat veterans, the researchers said.

Kaplan noted that it is not uncommon for problems such as PTSD to arise years, even decades, after service. “We don’t know the full emotional toll of the wars in Iraq and Afghanistan,” he said.

What are the implications of the study?

Dr. Seal believes that more resources are needed to deal with the problem of mental illness among returning veterans. She states that:

After the start of the Iraq War, there is a growing burden of mental illness, particularly post-traumatic stress disorder (PTSD), that will require increased allocation of resources for better detection and early intervention to prevent chronic mental illness, which threatens individual veterans, their families and communities.

Simon A. Rego, associate director of psychology training at Montefiore Medical Center in New York City, says,

An important and often overlooked finding here was that a lack of social support — being separated, divorced, widowed, etc.– may pose a serious risk for new post-deployment mental health problems.

Rego emphasizes that this underscores the need for social support services for returning veterans who are unmarried and/or without social support. He continues:

All too often we focus on treating the symptoms but fail to address the individual’s social context. Based on the data here, a failure to do so could lead to increased risk in developing new mental health problems.

What do you think?

I live in the city that is host to Fort Benning, one of the largest army installations in the world. There is a continual flow of new recruits coming in for training, combat-ready soldiers being deployed to Iraq and Afghanistan, and veterans returning from the wars. The health and well-being of these troops is a matter of no small concern to not only the Army, but to the entire community.

The results of the study reported on in this article are distressing to me for two reasons: I am shocked how many veterans are returning home, burdened by a load of mental woe and illness that will follow them the rest of their lives; and I cannot help but think of the millions of veterans of former wars whose mental disorders went undiagnosed, and whose lives were lived out in pain and frustration.

  • Do you think that the dramatic rise in diagnoses of mental illness in veterans is due to better diagnostic techniques, or the increasing difficulties of the wars?
  • Congress has increased the length of time a veteran can be treated by the VA to 5 years. Do you think it should be longer still given the long gestation of PTSD?

©2009 Michael L Nichols. All rights reserved.

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Resources Used in This Post
Chong, Jia-Rui. (2009, July 16). Percentage of veterans with mental health problems jumps dramatically. Retrieved July 21, 2009 from Los Angeles Times web site:
Dao, James. (2009, July 16). Vets’ Mental Health Diagnoses Rising. Retrieved July 21, 2009 from The New York Times web site:
Grohol, John. (2009, July 18). Veterans’ Mental Health Concerns Rising. Retrieved July 21, 2009 from PsychCentral web site:
Reinberg]]Reinberg, Steven. (2009, July 16). Many Veterans Need Mental Health Care. Retrieved July 21, 2009 from HealthScout web site:
Seal, Karen; Metzler, Thomas; Gima, Kristian; Bertenthal, Daniel; Maguen, Shira; Marmar, Charles. (2009, July 16). Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002-2008. Retrieved July 21, 2009 from American Journal of Public Health web site:

13 comments… add one
Brittany at Mommy Words July 23, 2009, 10:07 am

Mike, you have been helping me on my Thesis site, so THANK YOU! My brother has PTSD (along with a host of other problems) after serving 1 tour in Kosovo (then being moved to Afghanistan) 2 tours in Iraq and 1 in North Korea which he did not complete because he was Medivacced to Water Reed. He struggles with life every day and oddly enough, after being medically discharged from the Army, he now wants to go back because he does not know what else to call his family. He was stationed at Fort Benning for the little time he actually spent in the states at all other than some time out west in some training camps and then ranger school.
Yes, I think that veterans should be treated with medical and emotional care for their ENTIRE lives. If anyone deserves the congressional health plan – it is these guys. I believed this before my brother enlisted and even more so now.

Also, I think that we are diagnosing more but also seeing more because of a host of factors, including the two that you mentioned but also – significantly – because the world today does not always have a place for men and women who have served their country and been educated by the armed forces and do not have a degree from a college and so when they get out of a place where they could earn promotions and where they could earn respect and be a part of a community, many find themselves unable to find even the simplest job without that degree. The stress of losing one’s place in the world is immense and because there are not a lot of opportunities for some of these vets, they cannot handle or work through the trauma they have experienced. This is just my 2 cents.
.-= Brittany at Mommy Words´s last blog ..When One is Pregnant =-.

Hua July 28, 2009, 4:53 pm

Hi Mike,

I really enjoyed reading this post, you have so much detailed information. I had no idea that over a third of the returning veterans, received a diagnosis of having a mental disorder. I’m Hua, the director of Wellsphere’s HealthBlogger Network, a network of over 2,000 of the best health writers on the web (including doctors, nurses, healthy living professionals, and expert patients). I think your blog would be a great addition to the Network, and I’d like to invite you to learn more about it and apply to join at Once approved by our Chief Medical Officer, your posts will be republished on Wellsphere where they will be available to over 5 million monthly visitors who come to the site looking for health information and support. There’s no cost and no extra work for you! The HealthBlogger page ( provides details about participation, but if you have any questions please feel free to email me at


Patricia August 2, 2009, 1:42 pm

I found your site while browsing for some information on anxiety attacks. You have a plethora of information here and a very beautifully designed site.

Term Life Quotes September 12, 2010, 10:02 pm

I agree with the fact that it takes a while to PTSD to surface. While I definitely was not at war, my anxiety and panic symptoms didn’t surface until about 5 years after I almost died in a car wreck, which is where my Psych told me it stemmed from………I am hoping that there continues to be progress in this area from a medical perspective.
.-= Term Life Quotes´s last blog ..The Minnesota Life Insurance Company =-.

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Anunturi imobiliare proprietari May 17, 2011, 7:30 pm

I am unable to thank you enough for the discussions on your web page. I know you put a lot of time and effort into all of them and really hope you know how considerably I enjoy it. I hope I’ll do exactly the same person sooner or later.

amar July 22, 2011, 4:06 am

I do agreed with the statement; “we should be showing love to our “enemies.” Perhaps we can stop copying the Romans who “make a wasteland and call it peace.”

Dr Yassiri says..”There are efforts to organise research looking at mental health services, what would be feasible economically and culturally,” he says.”There are a lot of things happening. But it will take years.” If someone had flashbacks, nightmares, nerves, there would be nowhere for them to seek help.. “Youssef”, Basra doctor.

On Thursday, BBC News talks to UK veterans.Friday, 12 August, 2005, 16:55 GMT 17:55 UK

The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.


I am truly sorry on what had happened to the armies which been reported mental health. Therefore, as a human being I am trying help your organization which also required your assistance.. A few steps that needs to consideration before pursue this steps:
1- the patience must free from drug (sober)
2- close the patience’s eyes with their own hands..then
3- rubs/a little moves on their own eyes with hands gently until he/she saw images like glittering stars (one spot of light)
4- stay focus on the image/glittering spot until it appears look alike an it for a couple of minutes.
5- after the patience saw image of the eyes,he/she should feel much better.. ( do exercise this frequently )

IF the patience do not recovered, they must been entered the Holy Place accidentally. Advisable to arrange a meeting with a Muslim community

6- refer to a Muslim what is the content of this recite chapter : Al Mu’minun:98 and al Kahfi:102
7- the images of eyes is the devil, so required a guidance from a Muslim.


muoi November 10, 2011, 8:20 pm
Kevin Michael April 13, 2012, 9:09 am

This doubling is due to the time lag between the PTSD-generating event and the onset of symptoms and to the fact that many surveyed troops will do subsequent deployments. annuities rate

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