TUESDAY, Nov. 11, 2003 (HealthDayNews) -- Kyle Jones was a U.S. Air Force navigator on his final mission during World War II when his plane was shot down over Germany.
He escaped with just one other man, free falling for 22,000 feet before he managed to open his defective parachute. After he landed, Jones was captured by the Germans and spent the next 18 months in a POW camp.
When he was finally released, Jones (not his real name) suffered from anxiety symptoms, including fear of fire and vivid memories of fighting and of being a prisoner. Eventually, though, the symptoms went away and Jones became a successful firefighter. Although he never married, he appeared to live a relatively "normal" life.
But 55 years after he was shot down, the haunting images of the crash and of combat intruded again into his life. Jones was 77 years old when he sought help at a New York City Veterans Administration Hospital.
He was not the only one. Charles Kaiman, a psychiatric nurse at the hospital, had noticed an influx of World War II and Korean veterans in the emergency room with symptoms of post-traumatic stress disorder (PTSD) as much as 60 years after having left combat.
Kaiman started a support group with two of these men. It eventually grew to about 30 men, ranging in age from 75 to 88. All the participants met the criteria for PTSD, even though many had not been in a combat zone for half a century or more. Some had had earlier symptoms that disappeared while others had never had symptoms until recently.
"It does show how pervasive and destructive PTSD can be. After the last shot is fired, it can still have tremendous effects on people," says Kaiman, who authored an article about his experiences with the support group in the November issue of the American Journal of Nursing.
Kaiman expects the trend will continue in coming years with Vietnam and Gulf War vets.
PTSD officially entered the Diagnostic and Statistical Manual of Mental Disorders-III in 1980 and was classified as one of the anxiety disorders. The syndrome is described as a response to disturbing, often life-threatening events such as combat. It is marked by memories and nightmares of the trauma, flashbacks, angry outbursts, poor concentration, insomnia, irritability and more.
Delayed onset or exacerbated PTSD is not widely recognized, but it's real.
Steven M. Herman is director of the Out-Patient PTSD Clinic at Richard L. Roudebush VA Medical Center in Indianapolis. He says PTSD "is probably more recognized in the medical field. The public is still in the process of coming to terms with PTSD in general."
Herman runs a group for World War II and Korean War veterans with PTSD, many of whom were able to keep their symptoms "under wraps" for years. Many were also told by medical professionals to "stop complaining and just get on with your life."
There are different theories as to why some people escape the ravages of PTSD for so many years or at least have extended relief from the symptoms. Some of the normal events of aging do seem to be involved.
"Many veterans are able to keep PTSD symptoms 'covered over' by 'excessive behaviors,' distracting themselves by overworking, alcohol, drugs, moving often, etcetera," Herman says. "As people age, they are less able to do these distracting behaviors."
"PTSD symptoms can often be aggravated by feelings of loss or especially vulnerability. As people age and start losing spouses, friends, their health, jobs, financial security, this makes them feel vulnerable, bringing back the PTSD symptoms," Herman explains.
A paradox of dementia is that people will often recall the past much more clearly than the present. "The past, including their traumas, becomes clearer, more vivid and more upsetting than it has been since the experiences first occurred," Herman says.
In the support group that Kaiman ran, veterans had a chance to talk about their experiences and to turn to one another for support. This setting in many ways mimicked the combat-era camaraderie that soldiers had experienced.
The men exchanged phone numbers and began interacting outside the group. Kaiman encouraged this by never arriving early for the group and always leaving immediately after so the men would forge bonds with each other. Basically, the men discovered they were not alone.
Part of the healing was coming to terms with survivor's guilt. While a member of the group, Jones was able to trace the family of the pilot who was killed in the explosion over Germany and eventually met the pilot's wife and his family who accepted and thanked him.
"The program was very successful. Most of them continued to have some degree of symptomology, but overall they experienced tremendous relief, a decrease in anxiety," Kaiman says. "Just anecdotally, a lot of folks that came in with heart conditions and had to have bypass operations have had no recurrence for about seven years."
Although Kaiman now works for the Albuquerque VA in New Mexico, the group in New York City is still going, with a new therapist.
"There was a somewhat difficult transitional period which I expected would happen, but they survived it," Kaiman says. "They're doing well."
More information
To learn more about PTSD, visit the International Society for Traumatic Stress Studies, the National Center for PTSD, or the Posttraumatic Stress Disorder Alliance.
