War follows too many vets home.

• Position: PTSD

American soldiers are bringing the war home: 22 veterans and one active duty soldier are said to commit suicide every day. Some estimate that more than 30 lives are lost every day, points out Jane M. Orient, executive director of the Association of American Physicians and Surgeons, Tucson, Ariz. According to Stop Soldier Suicide, veterans commit suicide at a rate two to three times higher than civilians.

Post-traumatic stress disorder (PTSD) is diagnosed in about 15% of soldiers, and may drive them to end their lives, says Orient, adding that many more probably suffer from PTSD in silence, fearing that the stigma may end their career or keep them from finding any gainful employment.

"What a tragedy and scandal it is for America to send its strongest, bravest and most dedicated and capable young people off to war-- and then abandon them when they come home," laments Orient. "How many spend years alone in a dark room, or wander homeless, or become addicted to drugs or alcohol? Maybe they don't commit suicide--but their lives as a member of their family and society may be over or blighted.

"Since World War I, there has been a perception that PTSD--'shell shock' as it was known then--is a sign of mental weakness, or of not having the 'right stuff.' The manifestations resemble psychiatric illness: sleeplessness, nightmares, flashbacks, irritability, and inability to concentrate and control impulses. Veterans may get little sympathy--they have not lost a limb; they may have no visible scars; they may not even have had a concussion or loss of consciousness. Their brain CT scan or MRI may be completely normal."

If they are able to get into a Veterans Administration treatment program, they probably will receive drugs: anti-depressants, anti-psychotics, perhaps opioids. While there is little to no evidence that this treatment helps, it does generally carry a Federal Drug Administration "black box" warning--of increased risk of suicide, indicates Orient.

"What can we do? We could start by making the right diagnosis. Many of these veterans have an...