Stress follows some vets home
When Kyle Hlebinsky left Iraq in February 2005, he had no physical injuries to prevent him from getting back to life as usual.
Still, something wasn't right.
"I was feeling different, and not how I should feel," he said.
Unable to pinpoint a particular problem or reason for concern, the Ellwood City resident sought to move on with his life, securing a job and his own apartment.
It wasn't until two years later that Hlebinsky turned to the Butler Veterans Affairs Medical Center, where he is now receiving treatment for post-traumatic stress disorder.
According to the National Center for Post Traumatic Stress Disorder, an organization associated with the U.S. Department of Veterans Affairs, an estimated 12 percent to 20 percent of veterans who served in Operation Iraqi Freedom will deal with PTSD.
For military personnel serving in Afghanistan in Operation Enduring Freedom, the estimated rate of PTSD is 6 percent to 11 percent.
The center also estimates that 30 percent of Vietnam veterans and nearly 10 percent of Gulf War (Desert Storm) veterans suffer from PTSD.
Defined as an anxiety disorder, PTSD can be caused by experiencing or witnessing a traumatic event, such as life-threatening situations, or times when the victim feels he or she has no control.
Dr. Mary Jane Niebauer, a clinical psychologist at the Butler VA, specializes in treating patients with PTSD.Common symptoms of PTSD include re-experiencing things, which could include flashbacks, nightmares or persistent memories; avoidance behaviors, seen when a veteran distances him or herself from family, friends or any type of military association; and heightened arousal, which could include a quick temper, difficulty sleeping or nervousness."The majority of the people I see that went to Iraq come to therapy within two years of when they get back," Niebauer said.In most cases, PTSD patients are first seen in the VA's primary care area. At that time, every veteran is given screening questions that highlight symptoms of PTSD or depression.Other veterans seek out psychological services, citing lack of sleep, aggression or relationship problems.No matter what services they are seeking, each veteran entering the VAis paired with a social worker who helps guide the veteran through services and tracks the veteran's progress.For Hlebinsky, his pairing with social worker Tod Conner resulted in an instant rapport."I look at it like more of a friendship, but if I need something, he's there, it's his job,"Hlebinsky said.Part of that job often includes telling veterans they are displaying symptoms of PTSD and recommending they see a psychologist."Delivery of the message has to be sensitive if they test positive for trauma,"said Conner, who works within the VA's Operation Enduring Freedom/Operation Iraqi Freedom program.Bill Cress, who directs the OEF/OIF program, said for veterans unaware that their stress might be a problem, it is easier to bring up the topic casually.
"I put it in the form of a conversation," said Cress. "We may introduce it as 'It might just be nothing.'"According to Niebauer, by seeking help for PTSD, veterans often overcome a difficult hurdle."I think their initial tendency is to want to isolate,"she said. "The majority of (patients) realize that they can't go on the rest of their lives isolated in that way."Though care for each patient can be personalized, the VArecently began using a 12-session PTSD treatment program that takes veterans through a series of steps to accept and deal with their stress.Using a structured program, Niebauer can provide each patient with graphs that monitor how their symptoms change over time."Each time they come in, they take a questionnaire so you can see their progress over the course of the sessions."Though she said the program has been successful, sometimes, she chooses to interrupt the sessions for less structured therapy.For some, the 12-session program will be enough to help the veterans move on with their lives. For others, increased stress at different points in life can revive those symptoms, requiring additional visits to a psychologist.While many of the people she treats are veterans of more recent conflicts, Niebauer said about 20 percent of her case load consists of Vietnam veterans still dealing with the stresses of combat decades after returning home.For these veterans, however, problems associated with PTSD were never addressed at the onset."When the Vietnam veterans returned, (PTSD) wasn't even a diagnosis," Niebauer said.
Clearing new pathsChairman of the Mercer County Vietnam Era Veterans since the early 1980s, Wayne Stratos of Sharon has seen the needs of his fellow veterans and their struggle to readjust to everyday life.From the start, the Mercer County group sought local resources to provide psychological support and educational and career assistance for its members and all veterans."The larger veterans organizations didn't seem to address some of the issues the Vietnam veterans seemed to have," said Stratos."We formed to see if we could get answers for ourselves."He noted that upon their return to civilian life, Vietnam era veterans were expected to pick up with their jobs and lifestyles with little discussion about the challenges of transitioning.In addition to the sense of urgency and fear of danger that result from being in a war zone, Stratos said veterans faced fears in their own home, trying to reclaim their role in the family and reconnect with spouses and children who did not understand the trauma they endured."I don't care how many medals a guy or a woman has, these things scare them to death," he said.Working together, Stratos said, the Mercer County Vietnam Era Veterans were able to create a support network for themselves."I'd like to think that we had a lot to do with having a five-day-a-week clinic for all veterans up here in Mercer County," he said."In the beginning, we started utilizing our own community mental health clinics."Veterans who did not seek professional help often found their own ways of dealing with their thoughts and feelings.For some, divorce and broken families resulted. Some self-medicated with alcohol or drugs or by committing all their energy to their work.Though some of the stigma for seeking help for mental health issues has dissipated over time, Niebauer said it is still difficult to get veterans to let down their guard."You're dealing with the military population, a part of the way they are trained is to have a mental toughness. It's that kind of philosophy that doesn't lend itself to coming into therapy."Such was the case for Hlebinsky, whose mother mentioned the VA and offered phone numbers to call for months after his homecoming."My Mom always wanted me to come in,"he said.Believing time was the solution, he pushed her suggestions aside."I was kind of embarrassed to say something was wrong. I was hoping that it would take care of itself."Conner noted that it's difficult for many veterans to cease the defensive mindset of combat."Those skills they've been using, they no longer apply to day-to-day situations. It's not uncommon to see a soldier say he's only coming in because his wife made him."Now participating in the 12-session program offered by the VA, Hlebinsky sees that seeking help is important."It's nothing to be embarrassed about," he said.For patients like Hlebinsky, Niebauer hopes the message will reach them early on.She hopes to begin group sessions that allow veterans to come together and work through their stress."It's so important for us to be able to give these coping strategies to them at a young age," she said.
