HAVERHILLL, Mass. -- Before her life fell apart, before suicide began to sound like sweet release, Natasha Young was a tough and spirited and proud Marine.
Straight off the hardscrabble streets of Lawrence, Mass., a ruined mill town ravaged by poverty and drugs, she loved the Marine Corps' discipline, the hard work, the camaraderie, the honor of service to her country.
She went to war twice, the last time five years ago in western Iraq with a close-knit team of Marines who disabled IEDs, roadside bombs. It was nonstop work, dangerous, highly stressful and exhausting. Six of the Marines were killed in bomb blasts, each death a staggering gut-punch to the others. After they returned home the commander took his own life. Staff Sgt. Young broke down, too, spent physically, emotionally and mentally. Eventually, she was diagnosed with post traumatic stress disorder (PTSD) and, last October, was medically discharged from the Corps.
Having been a strong warrior, now she simply couldn't function. "I was ashamed of myself," she says in a whisper at her home in Haverhill, Mass.
Young is one of a generation of 2.4 million Americans who fought in Iraq or Afghanistan, many of whom are coming back profoundly changed by what combat veteran and author Karl Marlantes described as the "soul-battering experience" of war.
The shock of war, of course, is hardly new. But now the cascade of combat veterans from the Iraq and Afghanistan wars is forcing mental health practitioners to a new recognition: the effects of combat trauma extend far beyond the traditional and narrow clinical diagnoses of PTSD and traumatic brain injury (TBI). The current crop of veterans is at risk of a "downward spiral" that leads to depression, substance abuse and sometimes suicide, as Eric Shinseki, secretary of the Department of Veterans Affairs, said in a recent speech.
Almost a quarter million Iraq or Afghanistan vets have been diagnosed with mental health injuries from combat service. Many more are not diagnosed, yet go on with their lives while experiencing short-term memory loss, headaches, insomnia, anger or numbness -- conditions that can range from merely annoying to highly disruptive on the job and within the family. For some of them, hard work can temporarily mask these symptoms. But only temporarily.
"You can work through it [with therapy], or become a workaholic," says Tom Berger, who still suffers nightmares from his time as a medical corpsman with the 3rd Marine Division during bloody Vietnam fighting in the late 1960s. "Left untreated, you reinforce the trauma, so it makes sense to keep that loaded .357 [revolver] next to you on the car seat," adds Berger, who is a senior adviser on veterans health atVietnam Veterans of America.
Those who go to war, it turns out, carry the traumatic after-effects longer and deeper than previously recognized — perhaps for a lifetime.
At the Army medical center at Fort Gordon, Ga., Dr. John L. Rigg, director of the Traumatic Brain Injury Program, is treating active-duty soldiers complaining of headaches, mood swings, anger, insomnia, and memory loss as many as five years after they experienced concussive blasts in combat. They're still functioning, but they're struggling. "They're not getting better," says Rigg. "In fact, they may be getting worse."
With treatment, says Rigg, some can learn to manage.
"No one gets out unscathed," says Col. Katherine Platoni, a senior Army combat trauma psychologist with two battlefield tours in Iraq and Afghanistan who has seen and felt the deepening effects of combat trauma.
Large-scale U.S. military action is finished in Iraq and scheduled to wind down in Afghanistan. In those places, as President Obama has noted, "the tide of war is receding."
But at home, the tide of war is not receding for millions of veterans returning to a long, difficult and often dangerous transition back into civilian life, struggling to reconcile their searing combat experiences with a civilian society that largely disconnected itself from military service and now, according to polls, tired of war.
Like others leaving the ranks, Natasha Young's struggles with her psychological and emotional storms were compounded by the sudden decompression from the intensity of combat service. No one back home in the civilian world understood what she had gone through, or what she was going through.....
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