By: Desarée Rosskopf
In 2003, a generation of young Canadians born and raised in an era of peace entered a modern war of insurgents without territorial boundaries. The Canadian Armed Forces’s (CAF) subsequent eleven-year deployment to Afghanistan was a primary battleground against terrorist organizations like al Qaeda and the Taliban. The new war challenged traditional military doctrine, but a historic enemy followed soldiers home plaguing them with nightmares and panic attacks—the internal struggle of Post-Traumatic Stress Disorder.
By 2014 Canada deployed more than 40,000 military personnel in support of its combat and support mission in Afghanistan. Some like sniper Jody Mitic, who has written about his experiences in the CAF and Afghanistan, returned home with physical injuries; but 13.5% of those deployed between 2001-2008 came back with “invisible” injuries. Colonel John Conrad describes these veterans as “the walking wounded,” people who returned from the “kill theatre” alongside their “doppelganger.” A kill theatre refers to the main area of combat. Conrad uses Sigmund Freud’s doppelganger theory to explain his experiences with PTSD. And his first experience was in the kill theatre during a conversation with an officer who had recently arrived in Afghanistan. In the midst of the conversation, the officer made a comment about the conflict and Conrad, feeling disconnected from himself, reacted angrily to the comment drawing nervous stares from his friends. Looking back, he acknowledges that his response did not require the venom it harboured but he could not stop the words.
According to the fifth edition of the Diagnostic Symptoms Manuel (DSM-5) exposure to an extremely threatening or horrific event(s) can trigger PTSD but the symptoms might take time to emerge. This was the case for Colonel Conrad who writes that while he did not dream in Kandahar but “since my return to Canada in the fall of 2006, I dream all the time. My mind is alive with them.” His reoccurring nightmare is the bombing of his convoy but the most specific detail he remembers is a female medic he calls an “angel” because of her professional but kind treatment of the casualties. Conrad was diagnosed with PTSD in 2011, five years after coming home. “For the longest time after Kandahar, I could not accept that I was unwell. Part of it was embarrassment and part of it was denial,” he writes in his 2017 memoir Among the Walking Wounded: Soldiers, Survival, and PTSD.
These delays in diagnoses caused by embarrassment, denial, and bureaucratic process have disastrous consequences for sufferers like Warrant Officer Michael McNeil who committed suicide in 2013 after completing two tours in Afghanistan. “Basically, he didn’t get the help he needed, or he would still be there,” said his uncle Frank McNeil who believes PTSD was the cause of his nephew’s suicide. “[He] did commit suicide. He hung himself. But the thing is, where did that come from? From being overseas, from seeing what he’d seen. He’s not going to be recognized because he committed suicide but, as far as I am concerned, he’s a hero. He’s done his thing.” However, even if PTSD soldiers are encouraged to pursue treatment measures, it does not guarantee recovery.
Joshua Wood was organized, efficient, and dedicated, the type of soldier who never missed an exercise and was professional to his core. However, after returning from Afghanistan, his family noticed changes in his personality and his officer Andy Singh—a fellow sufferer of PTSD—recognized the behaviour and thought he could help “his brother”. But on a Friday afternoon, Wood committed suicide by stepping in front of a Toronto train. Singh carries the guilt of Wood’s suicide even though he did everything within his power to help the young soldier.
Despite its historic presence, societies continue to struggle with treating and identifying PTSD sufferers. Recent efforts to remove the stigma linked to mental illness are challenging incorrect assumptions about those struggling with anxiety, depression, etc. but have done little to remove the negative opinions attached to PTSD. This stigma is particularly prevalent in the military culture who label those claiming to struggle with the mental illness as “malingerers”, and those diagnosed undergo a lengthy waiting process to receive assistance from Veterans Affairs or their requests for assistance is denied. This was the experience of Colonel Conrad who requested compensation for back pain and therapy but was denied it. In another event, Conrad asked to meet a friend who was also his career manager in the CAF at the Pilot’s Bar but, after waiting for over an hour, he stumbled home and broke down crying.
If every mental illness has a face, then these are the ones of PTSD, individuals fighting similar battles through different methods leading to recovery, further trauma, or death. Psychological and pharmacologic therapies are highly effective in treating PTSD patients. Cognitive Behavioural Therapy is one of the leading psychological treatments that revisits distressing elements of the traumatic events because of the common avoidance symptom of the condition. Specific protocols of this therapy include gradual exposure—where the patient revisits aspects of the traumatic event in a safe environment and are taught self-regulating methods—and processing therapy that explores dysfunctional beliefs. Although responses to treatment differ and risk of exposing a patient to the trauma too quickly can cause further damage, it is currently the most effective treatment. Yet, veterans are reluctant to seek this treatment because of stigma, cost, and current military policy.
Military and societal stigma regarding PTSD make individuals hesitant to report their symptoms or acknowledge the diagnosis. This is the first area of fundamental national change required to serve returning soldiers better through counteracting erroneous ideas about those combating the mental illness. Journalists can either help or hinder this like Margaret Wente who in a 2006 article commented on the rising number of soldiers diagnosed with PTSD wrote, “As the claims mount up, perhaps we should consider that not every soldier with a problem is Romeo Dallaire. And when stress is mowing down far more troops than the Taliban, maybe something’s out of whack.” Wente’s comment suggests that there is a level of soldier creditability and that it is stress affecting the soldiers. While it is called Post-Traumatic Stress Disorder, it is not stress as understood by the general population but a physiological response akin to anxiety disorders that can feel like one is experiencing a heart attack and a reliving of the combat experience.
Some novelists like Eric Walters have attempted to discuss the realities of PTSD for soldiers and their families through fiction. His novel Wounded is told from the perspective of a career military family’s son who is waiting for his father to return from Afghanistan. He notices that his father is not the same man who left and seeks to help him before he loses his father forever. Dreamwork Pictures have also used media to discuss the issue and released the film Thank you for your service in 2017. The $20 million budget biographical war film follows the decorated combat veteran Adam Schumann’s return from Iraq and his battle with PTSD. Despite the impressive budget and talented cast, the film itself only grossed $9.5 million at the Box Office suggesting the lack of knowledge about the realities of the illness.
If the soldiers brave the stigma, then the CAF policy that states that individuals suffering from mental illnesses like PTSD are discharged from service after two years might deter them from seeking treatment. It is important to remember that most CAF members consider their colleagues family and do not want to leave the military. While this policy is responsible because of the risks posed by aggravating existing mental illness in combat zones, it can also become a deterrent for those concerned about not recovering within the timeframe.
The CAF is improving its handling of PTSD, but Veterans Affairs and the Canadian Government are struggling to handle the deluge of cases. As a result, eligible soldiers and veterans are not receiving the financial, emotional, and psychological support they deserve. More needs to be done to rectify the current system’s failings when responding to PTSD cases. These soldiers gave Canada their blood, sweat, sometimes limbs, mental health, and lives. It is the least a nation can do to stand alongside them when they returned because the walking wounded are not maligners, but heroes.
 Mark Zamorski, Corneliu Rusu, and Bryan Garber, “prevalence and correlates of mental health problems in Canadian Forces Personnel Who Deployed Support of the mission in Afghanistan,” The Canadian Journal of Psychiatry 59, No. 6 (June 2014): 320.
 Ibid., 21.
 John Conrad, Among the Walking Wounded: Soldiers, Survival, and PTSD (Toronto: Dundurn Press, 2017), 3.
 Conrad, Among the Walking Wounded, 4.
 Ibid., 8.
 Gloria Galloway, “Trio of suicides puts focus on military culture,” The Globe and Mail (Toronto, ON) November 30, 2013, A8.
 Conrad, Among the Walking Wounded, 337.
 Ibid., 128.
 Arieh Shalev, Israel Liberzon, and Charles Marmar, “Post-Traumatic Stress Disorder,” The New England Journal of Medicine 376, no. 25, June 22, 2014, 2459.
 Margaret Wente, “Post-Traumatic Stress is Felling More Troops than the Enemy,” The Globe and Mail (Toronto, ON) July 6, 2006, A15.