Harry Truman founded the National Institute for Mental Health in 1946 to provide services to soldiers returning from WWII with “combat neurosis.” Less than a century before, Civil War veterans suffered from, “soldier's heart” and in WWI, “combat fatigue.”

It has been called “shell shock” and post-Vietnam syndrome. Today, it is known as post-traumatic stress disorder or PTSD.

By whatever name, the symptoms have been chronicled throughout the history of war. It is epidemic among soldiers returning from Iraq and Afghanistan. It is thought that the soldier shooter at Fort Hood this month, Spc. Ivan Lopez, was being treated for PTSD.

Post-traumatic stress disorder and our soldiers, what do you know? T or F?

1. It is the most common mental health diagnosis.

2. Symptoms are immediately apparent after trauma.

3. Treatment is generally not effective.

In 1946 the U.S. Army produced a film “Let There Be Light,” directed by the legendary John Huston. This World War II documentary is about soldiers returning home with “psychoneurotic symptoms” or PTSD. The Army refused to release it citing invasion of privacy of the 75 soldiers whose in-hospital treatment and recovery were featured in the film.

This was a smokescreen. All of the soldiers had signed releases. It was well known that the Army did not want the film released because of the potential for negative publicity and adverse impact on recruiting. It was not available for public viewing until 1980. It has been restored by film archivists and you can learn more about it at www.filmpreservation.org.

A 1973 “M*A*S*H “ episode, Deal Me Out, featured John Ritter as a shell-shocked soldier cared for by psychiatrist Dr. Sidney Freedman.

PTSD is an anxiety disorder that manifests after a traumatic event. Bodily injury is a major risk factor for PTSD. The perceived threat at the time of the injury is often a greater factor than the actual extent of injuries sustained. Although most traumas cause some degree of anxiety and related symptoms, in PTSD, symptoms linger and if not treated may continue unabated leading to severe debility.

Common symptoms of PTSD are sleep disturbances, anxiety, mood changes, depression and anger. Those with PTSD may repeatedly re-live the trauma, exhibit hypersensitivity to perceived danger, avoid situations that remind them of the trauma or withdraw socially to suppress the trauma.

Soldiers are screened for PTSD and other mental illness periodically and at discharge. They are often hesitant to acknowledge symptoms of mental illness fearing social stigma. Further, symptoms may not be readily apparent to the soldier. Cognitive behavioral, related therapies and medications are often used for treatment with good results. And, slowly, soldiers are reaching out for help.

More than 1.6 million U.S. soldiers have been deployed to Iraq and Afghanistan and returned home to join the ranks of veterans. About 54 percent of them seek care through Veteran's Administration facilities, over half of those for mental health care. More than 400,000 have been diagnosed with PTSD, depression or both. Spc. Lopez had served in Iraq and was being treated for undisclosed mental illness.

The Veterans Administration operates the National Center for PTSD, www.ptsd.va.gov/index.asp. It is a resource for soldiers, their families and healthcare providers. The Army is conducting research to improve understanding of PTSD. At www.armystarrs.org, servicemen and women can participate in a study about mental health and soldiers.

Retired Vice Chief of Staff of the Army Gen. Peter Chiarelli, who worked to eliminate the stigma of mental illness in the military stated, "I'm trying to get Soldiers to realize that the wounds you can't see are just as serious as the ones you can." Harry understood that 68 years ago.

Answers: 1. T; 2. F; 3. F.

Dr. Lori Boyajian-O’Neill can be contacted at lori.boyajian-oneill@hcahealthcare.com.