SPRINGFIELD, Ill. - For most of the 33rd Infantry Brigade Combat Team, the battle ended a year and a half ago when they returned home from Afghanistan in the fall of 2009. For some, the battle is still going today.
Several Soldiers were wounded in the Illinois National Guard's largest deployment since World War II, and though the physical scars eventually fade, the invisible injuries linger.
Post traumatic stress disorder has become a more recognized issue among deployed service members, said Juliann Steinbeigle, the Illinois National Guard's director of psychological health.
The issue of PTSD has two major aspects. The first is due to the current overseas operations, which brings with it unique dynamics that constitutes trauma and contributes to the risk factors associated with PTSD, said Steinbeigle. The other aspect is the increased capacity by the military mental health professionals to recognize and address symptoms that attribute to the diagnoses of PTSD.
PTSD can consist of several symptoms such as difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hyper vigilance and exaggerated startle responses, she said.
"This can affect every aspect of an individual's life from work to individual self-care to relationships. Feelings of inadequacy can develop and increase the symptomatology creating isolation, self medication through substance or prescription abuse, violence or suicidal tendencies."
Steinbeigle said 20 percent, 1 in 5, more than 300,000 service members returning from Middle East deployments reported symptoms of PTSD and/or major depression, yet only 53 percent of these troops sought treatment according to the National Center for Post-Traumatic Stress Disorder, Rand Center for Military Health Policy Research, U.S. Department of Defense in 2008.
PTSD is not limited to a certain military branch or component. It is an issue than can occur to anyone who has experienced a traumatic event, said Steinbeigle.
Army Staff Sgt. Mike Brown, a cannon crew member with Battery B, 2nd Battalion, 122nd Field Artillery Regiment, was driving a Humvee Sept. 24, 2008, less than a month into his tour, when an improvised explosive device buried in the gravel road detonated under his vehicle.
Brown sustained numerous injuries to his right arm and lower back and was knocked unconscious from the explosion.
Though his physical injuries were quickly recognized, it was months before Brown was diagnosed with PTSD.
"At first I didn't want to talk about it," said Brown. "I tried to put it on the back burner."
Though Brown tried to put on a strong face, his family saw right through it.
"My mother recognized me going through a change."
Brown said he avoided his problem by isolating himself from others and shopping to distract him from what he had been through.
Eventually Brown grew tired of hiding what was going on, and sought assistance through the Department of Veterans Affairs. He attended biweekly meetings with a psychologist and in the summer of 2010 he traveled to an inpatient facility in Florida.
"That really helped me focus on, and deal with, the PTSD," said Brown. "I was in the room with other veterans going through the same problems."
In addition to group counseling, Brown had plenty of one-on-one time with a therapist and said she helped him accept his diagnosis by constantly talking and writing about his experiences.
For another Soldier in the 33rd, the most effective PTSD treatment has been local and less formal.
"My wife has been the most supportive through the whole thing, [staying] up with me at night when I have nightmares," said Army Cpl. Mitch Chapman, an infantryman with the Company B, 2nd Battalion, 130th Infantry Regiment.
Chapman deployed with a police mentor team, training Afghan police until Oct.13, 2008, when his vehicle was struck by an IED. He suffered a broken back, lacerations, hearing loss and a mild traumatic brain injury. Another Soldier in the vehicle did not survive.
"What made it worse is the guilt of feeling that it was my fault that my friend was killed and that I shouldn't have hit the IED," Chapman said.
Chapman was treated for his physical injuries at Walter Reed Medical Center when he was diagnosed with PTSD, but said the diagnosis did not sink in right away because of the pain medication. His main symptoms are the nightmares and the guilt of surviving.
Back in Illinois the Community Based Warrior Transition Unit at Rock Island Arsenal Garrison and the VA provided Chapman with a local counselor to help him deal with the PTSD.
Chapman said he felt a stigma regarding PTSD when talking to some civilians about it, but has received plenty of support from his family and his fellow Soldiers, which has improved his outlook on the future.
Steinbeigel said the Illinois National Guard along with the entire U.S. military, has made advancements in treating PTSD for its service members to help improve their quality of life.
"The Illinois National Guard has and continues to explore, develop and institute effective education, assessment and treatment to all of its Guard members and their families that are struggling with the affects of [post traumatic stress]," she said.
Due to the complex nature of PTSD and the individual needs of those affected by it, several agencies play a role in its treatment, Steinbeigel said.
"Because the affects of PTS stream across so many avenues of life, it is difficult to identify just one or a couple agencies that have played a major part in helping service members and veterans," Steinbeigel said. "Providing care as a team approach, including both military and civilian agencies and addressing all concerns of the service member, is the only way that help can be effective."
Despite the proactive stance the military is taking to expand the psychological health of its troops, instilled cultural barriers will take time to overcome, she said. Help is available. It just comes down to the matter of stepping forward and seeking it.
"There are many forms of treatment available to combat the symptoms of PTSD ranging from medication management to cognitive-behavioral therapies. The goal of treatment is to alleviate the distress symptoms associated with PTSD to create a better quality of living for the service member. For some service members it will improve their quality of life and with others it will save their life."
Chapman is in the process of re-classing to become a logistics specialist and said he looks forward to advancing his military career.
Brown said he is looking forward to retiring from the military and is focusing on his recovery. Physically, he still has his limitations. He will be on blood thinners for the rest of his life, and has difficulty using his right hand, but is learning to use his left hand dominantly.Emotionally, he's progressing as well.
"I'm not 100 percent satisfied and I probably never will be," Brown said, "but it's getting better."