海角大神

An Iraq War veteran drove his vehicle into a group of pedestrians two weeks ago believing his intended victims were Muslim. A former Marine who served in Afghanistan fatally shot 13 patrons at a country music bar in November. Last spring, an Army veteran who deployed to Afghanistan shot and killed three mental health clinicians at a residential treatment program for former service members.

All three incidents occurred in California, and in each instance, news coverage emphasized that the veteran involved had struggled with post-traumatic stress disorder after returning from war.

The reports hewed to a 鈥渢roubled veteran鈥� narrative at once familiar and frustrating to Dan Klutenkamper, who has been diagnosed with post-traumatic stress disorder linked to his three Army tours in Iraq and Afghanistan. The former sergeant subdues his condition with counseling, exercise, and pet therapy. He has harmed neither himself nor others since his honorable discharge in 2011.

His quiet recovery makes him one of the hundreds of thousands of Iraq and Afghanistan war veterans who cope with PTSD while leading the kind of ordinary life that seldom attracts public notice. They inhabit an obvious yet unseen demographic that, by news standards, draws as much interest as motorists whose daily commute passes without calamity.

鈥淟ook at how many combat veterans have come back and haven鈥檛 hurt anyone, who have jobs and families, who are doing good,鈥� says Mr. Klutenkamper, who works for a veterans service organization in Washington. 鈥淏ut that鈥檚 not the story that gets the headlines, and that鈥檚 not the story most people know.鈥�

An estimated 10% to 20% of the 2.77 million men and women who deployed to Iraq or Afghanistan have been diagnosed with PTSD related to their service. Dropping that statistic into reports about isolated acts of violence committed by former service members can distort perceptions, implying that as many as one-fifth of them pose a lethal threat.

Craig Bryan, executive director of the National Center for Veterans Studies at the University of Utah, suggests that reframing the same statistic could alter the image of the veteran as a ticking time bomb. Viewed from another perspective, he explains, 80% to 90% of Iraq and Afghanistan war veterans returned home without PTSD. He adds that the majority of those diagnosed with the condition either recover from or learn to manage their symptoms.

鈥淧eople have a more general awareness of PTSD than they did a decade ago,鈥� says Dr. Bryan, who deployed to Iraq with the Air Force in 2009. 鈥淏ut there鈥檚 this idea that anyone who has the diagnosis is broken. That isn鈥檛 the case.鈥�

鈥楢 big disconnect鈥�

The unease clutched Jason Roncoroni as he drove along a rural road in Pennsylvania in 2011 soon after his third tour to Afghanistan with the Army. The severity of his panic attack forced him to pull over, and as he tried to tame his anxiety in the ensuing weeks and months, a sense of failure shadowed him.

鈥淚 thought I was falling apart, that I had a character flaw. It was beyond crushing,鈥� says Mr. Roncoroni, who retired from the Army in 2015 at the rank of lieutenant colonel. He draws on that feeling of despair and his recovery in his work as a mental health advocate and life coach for veterans, whose homeland can resemble a foreign country once they hang up their uniforms.

鈥淭here鈥檚 a big disconnect between what veterans experienced and what civilians know about that experience,鈥� he says. 鈥淕oing to war changes everyone, but it doesn鈥檛 break most of them. It usually makes them stronger. But civilians somehow see combat veterans as damaged goods. They think 鈥榲eteran鈥� means 鈥楶TSD.鈥欌��

The country鈥檚 18.2 million former service members make up less than 6% of its population, and less than 1% of American adults serve in the military. Their small numbers reduce them to an afterthought in the daily life of most civilians even as veterans occupy a place of veneration in the national culture, celebrated at sporting events and in political campaigns, given priority at restaurants and airports, and lionized in movies and TV shows.

The lack of deeper understanding about veterans and PTSD provides space for stereotypes to flourish. One study found that a majority of employers, while proclaiming a desire to hire veterans, regard them with concern because of doubts about their mental health.

鈥淲hether you see veterans as damaged or heroic, what that does is effectively keep them at arm鈥檚 length and makes their individual experience invisible,鈥� says Dr. Shauna Springer. The senior director of suicide prevention with the Tragedy Assistance Program for Survivors, a national nonprofit that aids families of deceased service members, she has counseled hundreds of veterans with combat trauma over the past decade.

鈥淲e have this practice of singling out veterans, but that pulls them out of their tribe,鈥� she says. 鈥淚t gives them no way to navigate being human and find their way forward.鈥�

The latest mission

An average of 20 veterans die by suicide each day. Army Master Sgt. Tom Cruz found himself at the precipice in 2010 after three deployments to Iraq. Following an argument with his fianc茅e, he threatened to end her life and his own, his thoughts knotted by anger and depression.

She stayed composed during the ordeal, talking through his emotions and attempting to calm him. He emerged from his mental haze seven hours later, and in the aftermath, he agreed to receive a psychiatric evaluation and attend counseling. The couple later married, and they since have shared their story with service members, veterans, and civilians across the country.

鈥淭here鈥檚 a gap between the military and civilian populations in general and on the subject of PTSD in particular,鈥� Sergeant Cruz says. 鈥淭he only way to make that gap smaller is for us to talk about our experiences and try to help people understand. They need to hear our stories and realize that PTSD is treatable.鈥�

Research shows that the rate of lethal violence remains low among former service members who deployed to war zones. Yet they can struggle with erratic behavior and aggression that contribute to veterans committing a higher rate of violent offenses compared with civilians.

News coverage of combat trauma over the course of the Iraq and Afghanistan wars has broadened awareness of the psychological burdens that troops carry home.

At the same time, resistance to the idea that PTSD can be overcome still exists, including among clinicians.

鈥淚 have heard mental health professionals say there are no treatments that work and you can鈥檛 get better,鈥� Dr. Bryan says. 鈥淭hat鈥檚 just not true. It takes a lot of work in some cases, but most people do recover or keep their symptoms under control.鈥�

Veterans diagnosed with PTSD, if wishing that civilians held a more nuanced view of their condition, assert that the greater onus falls on former service members to confront their trauma. Sergeant Cruz chides veterans who stop receiving treatment after one or two therapy sessions.

鈥淵ou have to go into counseling kind of like it鈥檚 dating,鈥� he says. 鈥淚f you don鈥檛 like one therapist, go find another one. It isn鈥檛 always easy to do that, and it鈥檚 natural to get frustrated sometimes. But the alternative is not treating your condition, which isn鈥檛 really an alternative.鈥�

Mr. Klutenkamper, the former Army sergeant, approaches his ongoing recovery from PTSD as his latest mission, one undertaken as much for himself as for his cohorts, the country鈥檚 new generation of veterans. He believes that, as in Iraq and Afghanistan, lives hang in the balance.

鈥淲hen there鈥檚 a situation where a veteran does something bad and it ends up in the news, it casts a stigma over anyone who has PTSD,鈥� he says. 鈥淰ietnam veterans went through that, and you can see some of that happening now with us. We have to do better 鈥� and that means both veterans and civilians.鈥�