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NEAL CONAN, host:

This is TALK OF THE NATION. I'm Neal Conan, broadcasting today from the studios of Texas Public Radio in San Antonio.

Shellshock, soldiers' heart, combat fatigue, combat neurosis - names used since the Civil War to describe the varied miseries that too many veterans bring home from war.

Today we use a more clinical term: post-traumatic stress disorder, PTSD for short. We know symptoms include sleeplessness, anger and anxiety, and those can lead to depression and even suicide; that the systems we've set up to treat both active and retired military are overwhelmed; and that stigma still prevents many from seeking help.

We're in San Antonio today, home to two Air Force bases, Fort Sam Houston, the San Antonio Military Medical Center, and one of the largest populations of veterans in the nation.

Mental health providers here are working to find ways to treat and even prevent PTSD. If you have experience with PTSD as a patient, a family member, a caregiver, give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. Go to npr.org. Click on TALK OF THE NATION.

Later in the program, the ethics of medical research on our closest relatives, chimpanzees. But first, PTSD. Dexter Pitts was 19 years old when he deployed to Iraq in 2004 with the U.S. Army. Less than a year later, he was seriously injured by a bomb while driving a Humvee in Baghdad. He was later diagnosed with PTSD.

Dexter Pitts is now a police officer with the Louisville Metropolitan Police Department, and he joins from member station WFPL in Louisville, Kentucky, and thanks very much for being with us today.

Mr. DEXTER PITTS (Police Officer): Thank you for having me, sir.

CONAN: And I know you suffered some serious physical injuries in that blast as well. How are you doing now?

Mr. PITTS: Well, I'm doing - actually, I'm doing rather well. It's been a long, long journey, but you know, I've been coming along, and I'm very, very happy with where I'm at now.

CONAN: I know you spent six months at Walter Reed recovering from an injury that almost cost you your arm. But when did you realize you needed help with something other than physical injuries?

Mr. PITTS: I believe it was soon after I got back. I remember I was laying in my room, my mom had adopted my little cousin, I believe he was nine at the time. He kept coming to my room, and he kept bothering me, and I was like, Zach, leave me alone. Just leave me alone.

And he wouldn't leave me alone. I yelled him. The next thing you know, he got mad at me, came in the room, and he hit my injured arm. And at that point I just lost it. I blacked out. I chased him down the hallway, grabbed him by his shirt, picked him up and punched him in his chest as hard as I could.

And my mom was like: What are you doing? And I just had this blank stare on my face. And that's when my mother was like: Baby, you need some help. And at that point, that's when I realized that, you know what, maybe I really do need some help.

CONAN: And once you realized you needed help, did you recognize some other symptoms?

Mr. PITTS: I had already recognized symptoms, you know, but it's -nobody really wants to admit to it, especially being in the military and being in the infantry, all units.

I knew the symptoms - when I was in Walter Reed, they were kind of getting us, taking us through the PTSD courses and such, but I really avoided it. I didn't really want to accept it, that there was nothing wrong with me, that nothing had changed.

CONAN: Nothing wrong with you that needed to change, yeah, especially when you're a strong young man.

Mr. PITTS: Oh, very much. That's what they - you know, the military boot camp and infantry, that's what they build you up to be, this big larger-than-life - almost like a superhero. You feel like you're Superman.

You know, you walk around, you carry a gun, you give commands, and if you're anything other than that, you're weak-minded, and nobody wants to be looked as weak-minded.

CONAN: You're Superman, but all of a sudden you realize you're afraid to drive.

Mr. PITTS: Yeah, afraid to drive, afraid to just go out and talk to people, afraid to talk to people you've known your whole life because you don't want people to look at you like: Hey, you're different, and you've changed. You don't want to hear that because in your mind you're still thinking, I'm still the same person, but you're really not.

When you go overseas and you get hurt, or just going overseas and even surviving the tour, you leave a piece of yourself over there. You don't come back the same person. It's just not possible.

CONAN: And do you ever get that piece back?

Mr. PITTS: You know, I think a piece of me will always be gone, but it's - I feel like I've pieced myself together slowly, slowly, you know, slowly, month by month, day by day and just by the years. It's been some years since I've been back.

And I feel I'm closer to being who I once was, although I feel like I'll never truly be able to be that person once again because of the things I saw and the things I did. I don't think it's possible for me to truly be that person again.

CONAN: What about the men you served with, your mates in the 10th Mountain?

Mr. PITTS: I haven't - thanks to things like Facebook and Twitter, you know, I still talk to many of them, a lot of them. Some of them I lost contact with. One of my good friends, my roommate, my battle buddy, Joshua Cox(ph), if he's out there listening, I haven't talked to him in forever. Last I heard, he was not doing well. He was suicidal, and he lives in Texas.

And I have not heard from him in forever. I have been trying to get in contact with him, check on him, see how he's doing. And I heard he wasn't doing well at all.

Other than that, most of the guys I served with, they're actually still in. Some of them, they're on their fourth or fifth combat tours.

CONAN: Some people might wonder about your choice of career. Police officer might be a little challenging for somebody who's got PTSD.

(Soundbite of laughter)

Mr. PITTS: Yeah, that was a big thing for me. When I was going through the process, the selection process, I kept thinking when I got to the psychological part of the police department for the hiring process -there's no way they're going to hire me. I have PTSD. There's just no way I'm going to get this job.

And I told them everything I went through. I went to counseling and took medications, and they actually took me. And my family, when I told them I was going to be a police officer, they looked at me like: What is wrong with you, Dexter? You barely made it out of Iraq, and now you want to go be a police officer and work the late shift in the worst part of town.

(Soundbite of laughter)

CONAN: And how's it going?

Mr. PITTS: I love my job. I love the department I work for. I love the people I serve. And I love this city. There's - I have 24 years to retire, and I'm not counting. I love what I do. I was born to serve.

CONAN: I understand you improve with PTSD. I don't think you ever, from what I've read, I don't think you ever completely get over it. Do you worry sometimes that that same anger that caused you to hit your little cousin is going to strike you when you're on the job?

Mr. PITTS: No, actually, no, I don't, because I've gotten to the point where I've dealt with it so much and I know myself, you know, and I know when I'm getting to that point to where, hey: You know what, Dexter? You need to walk away, and you need to calm down.

I've been in therapy - I have two therapists now, actually. I go to the VA, and I actually have a professional civilian doctor I see here. So I'm actually pretty good with keeping myself under control because I know that it's not just me.

My actions will represent my police department, and I don't want to disrespect or degrade my police department's name at all. So I think about my actions before I do anything.

And plus, I know the last thing - a lot of police officers worry about getting killed. A lot of people - me, that's not - I'm not worried about that. I worry more so about my name and my reputation.

And my reputation is - when I'm done with the police department here, I want to be known as one of the most friendliest cops anybody's ever met.

CONAN: Dexter Pitts, please pull me over.

(Soundbite of laughter)

CONAN: Thank you very much for your time today, and continued good luck to you.

Mr. PITTS: Thank you very much for having me, I appreciate it.

CONAN: Dexter Pitts, a former U.S. Army private, now a police officer with the Louisville Metropolitan Police Department in Louisville, Kentucky, joined us today from member station WFPL there in Louisville, Kentucky.

And it's a great story. Dexter Pitts' story, though, mirrors the experience of many other combat vets. Medical anthropologist Erin Finley interviewed more than 60 for her book "Fields of Combat: Understanding PTSD Among Veterans of Iraq and Afghanistan." She's now a health research scientist with the South Texas Veterans Health Care System, and she's with us here at Texas Public Radio. And nice to have you on TALK OF THE NATION today.

And as you listen to Dexter's story, there was a lot that you were nodding your head at, and at one point when he said, you know, I love my job, you gave a cheer.

CONAN: Oh, I'm sorry, we're having a little difficulty with your microphone. So we'll get you on in just a moment. Yeah, it's not you, it's a small technical problem. We'll get it worked out in just a moment.

We're talking with Erin Finley, who's a medical anthropologist, and, well, she's talking about the general problem of PTSD and talking about PTSD as, well, not - as a problem of growth and seeing it as something that can be improved. And we're just talking to some engineers and maybe see if we can move her over to another microphone here and see if we can get her on mic.

Bear with us. We're at a studio here, and they're of course doing very well there, but let's see if we can hear from Erin Finley. Erin, can you say something?

Ms. ERIN FINLEY (South Texas Veterans Health Care System): How's this?

CONAN: How's that? No? Well, we're still having technical difficulties. Okay. Erin, why don't you come over here, and you sit in my chair. Live radio, folks. So as - just getting back to the question, we wanted to find out more about Dexter and what it was you were cheering about when you were hearing Dexter Pitts talk.

Ms. FINLEY: One of the things that has so struck me in working with the veterans that I have worked with has been how many of the folks who are really most successful in reintegrating and going on to live a really wonderful, satisfying life, is that they have been focused on serving others, whether that's serving their community as a police officer or serving their family by having a career and taking care of them.

And that's such a common theme among the veterans that I have worked with. It's just a delight to hear from Mr. Pitts that he has made this his calling and is doing what sounds like such a wonderful job with is.

CONAN: Serving others in the same way sort of reinforces the ethos that they grew up with in the military culture, where you work so closely with every - with your buddies.

Ms. FINLEY: Absolutely, and I think that can be a real strength, particularly when it comes to identifying a problem such as PTSD and seeking out care.

Many of the veterans I know who ended up in care and had a very positive experience with treatment were those who sought care because they saw the impact PTSD was having on others around them, for example like Mr. Pitts and his nephew. And it really became a catalyst for very positive change in their own lives.

CONAN: Obviously Dexter Pitts got the help he needed and is doing well. That is not always the case, however. Recently the Ninth Circuit Court of Appeals issued a scathing ruling against the Department of Veterans Affairs for how it has handled mental health care for veterans.

The ruling cited what it called unchecked incompetence, unchallengeable and interminable delays. And when we come back after a short break, we're going to be talking about how we turn that around and get the new system up and running and working for people in addition to people like Dexter Pitts. So stay with us. I'm Neal Conan. You're listening to TALK OF THE NATION from Texas Public Radio, from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. I'm Neal Conan broadcasting today from the studios of Texas Public Radio in San Antonio.

About a 20-minute drive from here, you'll find Fort Sam Houston and the Brooke Army Medical Center. One of the things researchers and doctors there continue to work on is PTSD, its treatment diagnosis and prevention.

The U.S. military has been criticized over the years for not recognizing and treating the disorder. Military medicine has made progress in recent years as more veterans return from the tours in Iraq and Afghanistan with tell-tale signs of post-traumatic stress. It's been described as an epidemic.

If you have experience with PTSD as a patient, a family member or caregiver, give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. Go to npr.org. Click on TALK OF THE NATION.

Our guest is Erin Finley. He works as a health research scientist with the South Texas Veterans Health Care System and wrote a book on the subject, "Fields of Combat: Understanding PTSD Among Veterans of Iraq and Afghanistan."

And Erin, we hope your mic is working now.

Ms. FINLEY: How are we doing?

CONAN: I think we're doing a little bit better. And I wanted to ask you about those scathing words from the Ninth Circuit Court of Appeals. How are we going to turn this around? Is this simply a factor of the system being overwhelmed?

Ms. FINLEY: You know, I think we're really at a point - what I understand from the Ninth Circuit Court of Appeals Ruling was that was really focused on disability claims related to PTSD, rather than providing treatment itself.

Now obviously, making sure that every veteran has the resources that he or she needs to get through life in terms of whether those might be disability payments, et cetera, are very important.

However, my work has really been much more on the treatment side of things, and there we're really seeing a very exciting revolution in PTSD care.

And the VA is really, at this point, making some great strides in what is available and what we can offer in terms of effective treatments for veterans.

CONAN: One of the things the Ninth Circuit Court of Appeals decision did talk about was unconscionable delays in getting treatment, that it is only 40 to 50 percent of the time that somebody will be seen on the same day as entering a complaint, seen by a therapist, and that an appointment can take weeks. And we've heard these conversations from our callers.

Ms. FINLEY: You know, that's certainly a concern always, and there is great variability around the country. Some VAs are very good about getting folks in quickly. Other VAs have struggled with this. But it has been something that leadership has paid a lot of attention to, and certainly we have made enormous gains over the last few years.

Nonetheless, it is always important to continually push to get it better.

CONAN: One part of the solution may be to prevent PTSD in the first place and find ways to better integrate the clinical world of mental health with the warrior culture of the patients.

Clinical psychologist Craig Bryan served as director of the Traumatic Brain Injury Clinic at the Air Force Theater Hospital in Iraq. He now researches suicide prevention and psychological resiliency, and he's also with us here at the studios at Texas Public Radio. Nice to have you with us today.

Dr. CRAIG BRYAN (Clinical Psychologist): Thank you for having me.

CONAN: And is it really possible to prevent PTSD?

Dr. BRYAN: We certainly think so. And there is some good evidence, particularly when you look at the research on one particular type of preventive approach, which is called stress inoculation training.

And what stress inoculation training is, if you kind of think of the notion of inoculation against illness or disease in general, it's sort of the theory that underlies vaccination, as well. Is - you introduce the service member to increasingly stressful situations that mirror the traumatic event as much as possible, and over time, they learn to habituate, and they become more immune to the effects of the stressful situation.

CONAN: More immune to the effects. You can't eliminate it completely, I assume.

Dr. BRYAN: I don't think we'll ever get to the point where we will be able to completely eliminate traumatic responses. There's too much individual variability amongst, you know, unique service members.

CONAN: Well, let's see if we can get a caller in on the conversation. Again, our number is 800-989-8255. Email talk@npr.org. And Mark(ph) is on the line, Mark with us from Boynton Beach in Florida. You're on the air. Go ahead, please.

MARK (Caller): Yeah, I recently spoke to a friend of mine that has served a couple of tours in Iraq, and he's actually now in Africa. And we were talking, and he was telling me how hard it is for him to - and his buddies - when they come over to the actual civilian world, to adjust, and then take everything as natural as we see it every day. Obviously, because of the environment where they've been for the last years, it's very hard for them to relate and take a normal...

One thing that I've seen, and everyone should take an hour and take a look at it, is a documentary called "Beyond Treason." And you look at that, and the reason why I'm telling you, because before we totally send people to war, we should take it to the last possible option before we go into war.

These people that experience these traumatic things, it's very hard to ask them to erase these experiences or take medications to erase the experiences. You know, it's not that easy. So...

CONAN: Erin Finley, it's not really a question of asking them to erase it. It's a question of teaching them how to cope with it.

Dr. FINLEY: I think that's exactly--

MARK: Yeah, it's just that the things that you see and experience are things that are out of the ordinary. I don't think a human being can prepare... and I don't think any type of medication can help, really. It may help you to get over it, momentarily, but I think - I mean, people that went to Vietnam are still having nightmares after 30 years of...

CONAN: No, I think World War II, people are still having nightmares, so...

MARK: Oh, yeah, that's why before we go to war, you know, we should really - I don't think it's ever an option. It's that simple. It's like asking what's the solution to the problems that we're having in the Gulf with drilling. Well, don't look for the solution after you've done the drilling. You look for the solution of not drilling. You don't drill, and then you don't have those problems. It's kind of like that.

CONAN: Thanks very much for the call, we appreciate that. And that goes, Craig Bryan, a little bit more to your work and interestingly that Erin Finley was talking about looking at an opportunity to grow with this disorder, understanding you've got it, understanding its effects.

It was interesting, you were involved in a project called the Defender's Edge Program, and I found that really interesting to read about, in part because you accepted: Yes, combat can lead to PTSD and a lot of debilitating things, but part of the problem for a mental health provider is to understand it can lead to some positive things, too.

Dr. BRYAN: Right, yeah. It's - you know, one of the most interesting things about working with service members is that, you know, situations like combat, a lot of us have started to look at them more as akin to athletic events.

And when you think about what service members do when they deploy, you know, these men and women, they're the best of the best. They're very elite. They're in shape. They have very high physical conditioning and mental conditioning.

They're asked to carry over 100 pounds of gear every single day in 100-plus-degree weather while they're dehydrated and sleep-deprived and to continue to do those for months on end. They are athletes.

And so what we've started to do with these service members is get them to start looking at these experiences not as necessarily something that's going to bring them down and cause problems in life but how to look at it as a way to grow and to become a better person.

And the reality is that all of us become better people through hardship and through adversity and through rising up and overcoming. And without hardship and challenge, we never learn anything in life.

CONAN: We never learn anything. Interesting, too, that the Defender's Edge Program involved putting mental health experts in the field with the troops and then trying to use their terminology - the soldiers' terminology - and not the clinicians' terminology.

Dr. BRYAN: Right, yeah. So, you know, we all talk extensively about, you know, mental health stigma and how service members aren't going to come into mental health because they're afraid of coming in and talking to doctors.

And what we did within this program is we say: Well, instead of trying to convince the warrior to change their mind about who they are and to violate their rules about talking to a mental health provider, what if we change the mental health provider, and we alter the way that they provide services.

And instead of talking like doctors, why don't we talk like warriors and get us to help them to understand basic psychological principles as job skills and as occupational performance enhancement.

CONAN: So this is a way to do your job better, as opposed to a way to be forced to leave your unit in the field to go make an appointment at the base, and everybody knows what you're doing.

Dr. BRYAN: Yeah, exactly. And, you know, most warriors, they are trained how to manage stress. I mean, they have a stressful job, and that's all basic training and, you know, specialty career field training does is teach them how to handle stress.

And so what we started doing was saying: Look, this is what you've learned in your work as a service member and as a warrior. Now here's how you can apply those same skills to help improve your sleep, to help, you know, calm yourself down after having an argument with a spouse, to keep yourself focused and on track and respond to stressful situations.

CONAN: Erin Finley, let me turn back to you. Then we'll get back to the phones. And so many of the men you interviewed said it was, in a way, a lot easier to be in the field under all that stress than to come back home. Had they - had this had this kind of help then, do you think it might have been easier?

Dr. FINLEY: I think it may well have been easier if they had had this kind of skills training. I think some of the work that Dr. Bryan and his colleagues have been doing is really tremendously exciting in terms of helping our service members make the transition home in a smoother way. But, certainly, if you live in that environment and that is the environment that you are trained for, for a long period of time, it can begin to feel more comfortable than what we think of as normal civilian life after a time.

CONAN: Let's get Roy(ph) on the line. Roy with us from Wilmington in North Carolina.

ROY (Caller): Yes. I'm a Vietnam veteran, and I suffer from PTSD. And I agree with, well, a lot of what those folks are saying, and it's something you don't talk about, but it's also something you never forget - those experiences and those trials and tribulations that you went through once you came back home, especially the way a lot of us came back home to demonstrations and people yelling baby killer and slogans such as that.

And I've been into treatment with the VA for a number of years, and the treatment and the medications don't seem to help. It's just a - it's an ongoing thing, and it's very frustrating. And you just don't know what to do. So now, I'm pretty isolated. I'm in a tent off the coast of North Carolina, and I don't deal with - I don't see many people at all, and it - I don't know. It's just - it's not a good life.

CONAN: I'm so sorry for your experiences, Roy. It's got to be difficult to do that. When did you come to realize that you needed to - it might be better for you to live by yourself in a tent?

ROY: Well, I've been doing it on and off for a period of time, probably 1987, '88, somewhere in there, and, you know, on and off. I might go be as a roommate and get tired of that, mainly because of all the drama that goes along with that with a lot of people. And it's something I can't handle, and I can't handle large crowds.

I have an inability to look at people in authority and see how things can be done so much easier, and they don't want to listen to you or they don't want to maybe change some of the processes they go through to do what they do. And it becomes - it comes to a point where you just say: Forget it. I'm just not going to deal with any of it anymore and...

CONAN: Roy, we wish you the best of luck. Thank you very much for sharing your story.

ROY: You're welcome. Thank you. Bye now.

CONAN: We're talking about PTSD with Erin Finley and with Craig Bryan. You're listening to TALK OF THE NATION from NPR News.

And, Erin Finley, I know you wanted to respond to what Roy was just telling us.

Dr. FINLEY: Well, I wanted to thank Roy for calling in. Sir, you've done something very wonderful by reminding us of just how high the stakes are in terms of getting treatment out to folks.

One thing that has been very exciting in the last few years is that the VA has been able to make what we call evidence-based treatments available to our veterans, and not just to our veterans of Iraq and Afghanistan. We are seeing veterans - Vietnam veterans now coming in.

And within a period of months, maybe they have been in treatment for decades without much success, but now, with the new treatment, within a period of months, they can see their whole lives absolutely turned around.

I heard a story from a clinician recently who had a Vietnam veteran patient who had not really been able to have a relationship with his children when they were young because his need for isolation was so great. At the close of treatment, which was very successful for him, he brought a picture of himself with his grandson in to the clinician and said I can have a relationship now with my grandchildren that I couldn't have with my children and thank you for that.

So I would really encourage you to go back and try again, if at all possible, because we have so much more to offer now.

CONAN: Craig Bryan?

Dr. BRYAN: I agree with that a hundred percent. I think one of the most important advances within the mental health field over the past several decades, since the time of Vietnam, is in our treatment of PTSD. And now, we have treatments, you know, in particular prolonged exposure and cognitive processing therapy. These are the gold standards, and I don't think these were really available, you know, 30, 40 years ago. And they absolutely work.

I've used the treatments myself with service members. Interestingly enough, I actually treated a Vietnam vet while I was deployed in Iraq. He was there as a civilian contractor and had been living with PTSD very similar to Roy for many, many years and underwent cognitive processing therapy with me in a combat zone in Iraq. And we saw some very significant gains after, you know, decades of living this way.

CONAN: I wanted to ask you - the Defender's Edge program requires change, yeah, from the troops but also primarily from mental health providers to change their culture to adapt to the people they're going to serve. Are you going to get many clinicians to sign up for the Special Forces, do you think?

(Soundbite of laughter)

Dr. BRYAN: No, I don't anticipate there to be a significant increase in recruitment for military psychologist or psychiatrist positions. So, and interestingly enough, that's been my experience. You know, there's a core of us who've been kind of doing this type of work and programming, and we've found that one of the biggest challenges is trying to convince the mental health system itself to take this new approach.

And really, it's just a cultural competency approach, and all of us have, you know, ethical mandates to appreciate and understand the cultural background of the patients that we work with. And we really need to recognize the military as a distinct subculture within the United States.

CONAN: And, Erin Finley, you obviously work with people here in San Antonio. It's a different environment. But adapting to their culture, this is something we all need to learn from, isn't it?

Dr. FINLEY: I think absolutely so, and I think clinicians will do what they see working. So that's something that will take us a long way.

CONAN: We're going to talk more with Erin Finley and Craig Bryan in a moment. If you have experience with PTSD as a patient, a family member or caregiver, give us a call. 800-989-8255. Email, talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: Right now, we're talking about PTSD and what we've learned about the experience, treatment and prevention of a disorder that the military says affects some 10 to 18 percent of veterans returning from Iraq and Afghanistan.

Our guests here in the studios at Texas Public Radio in San Antonio, Erin Finley, a medical anthropologist and a health research scientist with the South Texas Veterans Health Care System in San Antonio, and Craig Bryan, clinical psychologist who directed the traumatic brain injury clinic at the Air Force theater hospital in Iraq in 2009, now consults with the Air Force and Marine Corps on issues related to psychological health and suicide prevention in the military.

Let's see if we can get another caller on the line. And let's go to Jack(ph), and Jack is with us from Bellevue.

JACK (Caller): Yeah. I should mention I'm a veteran, and my father was a World War II combat veteran with PTSD, which is how I became interested in this subject. And the Veterans Administration actually invented a treatment in the late '80s, early '90s based on brainwave biofeedback. It's called the Peniston Protocol. And a friend of mine who runs a Wounded Warrior clinic at Fort Hood is one of only two locations, to the best of my knowledge, in the U.S. currently using this protocol. When it was...

CONAN: And...

JACK: ...published, it showed an 85 percent success rate with curing PTSD, and I use the word curing specifically because the soldiers and sailors that went through this treatment essentially were able to return to a normal life after this treatment. So I would just like to commend to your other participants that they might want to look into this particular treatment because it's been largely ignored in the current VA.

CONAN: Craig Bryan, are you familiar with this?

Dr. BRYAN: I've not heard of that treatment specifically, but I've certainly heard of many different proposed treatments for PTSD. This particular treatment certainly is not vetted and well-known within the scientific community, so it's hard to say that it's effective. I mean, sometimes, you get a lot of promising results from early, you know, pilot trials, but until we do more rigorous evaluations, it's not really safe to say that a treatment is fully effective.

CONAN: So it's - Erin, I wonder - I don't mean to - I know nothing about this particular procedure, and it may work. But panacea treatments that seem to be - promise great cures - maybe the reporter in me, I'm just skeptical.

Dr. FINLEY: You know, I think one of the things that's really exciting about what our caller said was we really can talk about curing PTSD now in a way we certainly never have been able to do so before.

One of the other things, though, is the treatments that we have been -that both DOD and VA have been recommending are treatments that we have decades of multiple studies conducted with thousands of individuals to show that they work. So I expect we will see a growing number of treatments that serve maybe different subpopulations of our veterans and service members better than others, but we must take the time to accumulate the evidence to make sure that they work.

CONAN: And as you look towards the future, I know you're seeing a lot of promise in the treatments that are being offered now and even systems that are overwhelmed as these systems are, have been by the sheer volume of people who need the help. Do you look forward to - with optimism to the - we're seeing, you know, so many people suffering from this, 18 percent, as much as that, so many suicides. It seems that we're just struggling to begin to catch up.

Dr. FINLEY: I think the difference is really being able to say for the first time we have so much to offer in a way that we simply haven't had as much to offer in the past. So does that mean the work is done? No. This means the work starts now. We have to make sure that every individual service member and veteran is getting his or her needs met. However, now we can say we have a solid grasp of the knowledge we need to make that possible.

CONAN: Let's get another caller on the line. And I'm sorry. This is line two. We're having a little difficulty with our phoner system, too. I apologize for that. Hi, you're on the air. Can you tell us who you are, please?

JOHN (Caller): Hello?

CONAN: Hi, you're on the air. Can you tell us who you are, please?

JOHN: My name is John. Can you hear me?

CONAN: Yes. You're on the air. Go ahead, please.

JOHN: Yes. About 11 days ago - well, exactly 11 days ago, my nephew who was diagnosed with PTSD took his life. One of many reactions that I had was that he seemed so high-functioning. He had gotten out of the service and finished his college degree and took on a very challenging job and seemed to - where some people seemed to have a difficult time, perhaps, getting up off the sofa. I mean, I don't mean that to judge them, but it's - he seemed to be in some ways very driven to and looking forward to life.

CONAN: And what job was he doing?

JOHN: Well, he went on to train Green Berets as a civilian, and so he would take these guys out to the field for two or three weeks at a time. And we think that maybe that, perhaps, gave it a great deal of stress to his life and that, you know, they do survival training and sort of things like this. And coming back, he'd have these long periods of inactivity because they're not out in the field all the time. And so could that have contributed to his, you know, maybe lack of sleep or poor diet or what-have-you that can add layers to stress to your lives? But...

CONAN: Did he leave a note?

JOHN: No, he did not. No.

CONAN: I'm so sorry for your loss.

JOHN: Yes.

CONAN: I know it's going to be difficult to deal with and it's not going to get easier, I don't think.

JOHN: Yes. It's - well, thank you very much. Like I said, that some people seemed to be sort of moving forward better than others and yet, this happened to him. And like I said, that's one of my - one of many reactions to the...

CONAN: Yeah. Thank you very much for the call and for sharing your story.

JOHN: Yes. Thank you. Bye-bye.

CONAN: Craig Bryan?

Dr. BRYAN: Yeah. I think this is, this is the tragedy of psychiatric illness in general. And I think what most people in our society don't really understand is that suicide is a fatal outcome of psychiatric illness. And, unfortunately, when it comes to something like suicide, you know, sometimes we don't necessarily see it coming in advance, even though there are plenty of warning signs and risk factors.

And usually, it's after the fact that we kind of Monday morning quarterback and say, oh, now, I can see the indicators and it's just a tragedy. And this is something that we're working on. We're actively -we have several research studies under way right now trying to identify, how do you know when someone is at increased risk for suicide in the short term, and how do you prevent that from happening?

CONAN: Yet, the number of suicides we're seeing every day; this is a terrible, terrible problem. This is an epidemic.

Dr. BRYAN: Yeah. The suicide rates have definitely increased steadily since about 2004, 2005. And we've been very aggressive in trying to address the problem. Interestingly enough, I think, you know, the Department of Defense and the VA have spent more money researching and preventing suicide in the past several years than probably the entire world, has spent up, you know, in history, up until this point. And unfortunately, as fast as many of us are working, we can never get the answers fast enough to, you know, save as many lives as we would like to. But we're doing everything we can to bring out this knowledge as quickly as possible.

CONAN: Craig Bryan, thank you very much for your time today. Craig Bryan is a clinical psychologist and assistant professor at the Department of Psychiatry at the University of Texas Health Science Center and served as director of the Traumatic Brain Injury Clinic at the Air Force Theater Hospital in Iraq back in 2009. He joined us here at the studios of Texas Public Radio.

Our thanks as well to Erin Finley, a medical anthropologist, a health research scientist with the South Texas Veterans Health Care System here in San Antonio, and the author of "Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan."

When we come back in just a few seconds, we'll be talking about testing on animals, indeed, testing on chimpanzees.

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