Rethinking how we treat the invisible scars of war
The hidden burden of service
There is a great deal of misunderstanding around post-traumatic stress disorder (PTSD).
All too often, perfectly natural reactions to traumatic stress exposure are labelled as a “disorder”, while at the same time many veterans carry deeply entrenched and debilitating symptoms that remain undiagnosed – rooted in the cumulative impact of sustained physical, psychological and operational pressure over prolonged periods.
The human brain, particularly in those selected, trained and deployed on high-tempo operations, becomes wired to an “always on” setting. In time this leads to overload, then to progressive shutdown. Their bodies suffer equally from the excessive loads that are placed upon them. The result is a complex constellation of symptoms that conventional diagnostic frameworks frequently fail to capture.
In the course of my own service and the years that have followed, including eight of them in Iraq, I have lost more friends and colleagues to suicide than to any other single cause of death. Not once did our peer group see it coming. That fact alone should give us pause, as should the shocking number of 17 veteran suicides a day in this country. There is also growing evidence that, for some veterans with PTSD, the treatments intended to help them can themselves carry significant risks.
There is a widespread and deeply troubling tendency to pathologize perfectly natural human responses to trauma, prolonged stress and the accumulated burdens of service. What begins as sleeplessness, hyper-vigilance or a temporary collapse under extreme pressure is too readily labelled a disorder requiring chemical intervention.
Once the first prescription is written, a predictable cascade often follows: one drug produces side-effects that are then treated with another, and another, until the individual is left dependent upon a toxic cocktail that dulls the senses, clouds judgement and steadily erodes the capacity to function as a human being. In far too many cases the original injury of the mind is compounded by the very treatments intended to relieve it, leaving men and women who once stood ready to face any threat barely able to face ordinary life.
When treatment becomes part of the problem
My own experience began with difficulty sleeping. That was medicated. The ensuing anxiety was medicated in turn. Depression followed, and that too was medicated.
For every side-effect, another drug was added, each compounding the problem rather than addressing what sat beneath it.
In my case, things deteriorated to the point where I began systematically putting my affairs in order, ensuring my family would be able to function without me.
It was my wife who recognised what was happening and immediately knew that something was seriously wrong.
That experience has shaped the way I think about veteran mental health and why I believe we need to keep looking for better ways to treat the effects of trauma.
Exploring a different approach
This is why the work Aspen Medical is supporting in Ukraine matters so much to me.
Aspen Medical is working alongside healthcare professionals and researchers in Lviv to advance our understanding of emerging treatments for PTSD and other trauma-related conditions affecting military personnel and veterans.
The collaboration is exploring the use of Stellate Ganglion Block (SGB) combined with Ketamine therapy as a potential treatment pathway for people experiencing the effects of combat-related trauma.
Ukraine provides an extraordinarily challenging environment in which to undertake this work. Military personnel have been exposed to sustained and extreme combat conditions, making the need to better understand effective approaches to trauma treatment particularly urgent.
The aim is to generate clinically rigorous, actionable evidence that can help determine the efficacy and safety of these approaches and, ultimately, inform how treatments might be made more widely available.
This work also builds on Aspen Medical's broader involvement in Ukraine since 2022, which has included combat casualty care research, advanced trauma surgery training, prosthetics and rehabilitation support, and pain management initiatives.
An obligation to the next generation
We owe this to those who have already served. We owe it even more to the generation that will follow. The military remains, in many respects, an enduring caste within this nation. Over 80% of whom serve today come from families with prior service, often a parent or close relative, despite the fact that less than one per cent of the population ever answers the call. My niece is a straight-A student and cheerleader at the University of Texas at Austin, where she is studying on a Reserve Officers' Training Corps (ROTC) scholarship. My son, about to begin high school, already has his sights set on Division I lacrosse and ROTC as a path to commissioning.
These are young people with their futures ahead of them who are prepared to commit to a life of service that may one day require them to willingly step into harm's way.
Warfare itself is changing, and with it, our understanding of what prolonged exposure to combat does to the human brain and body must continue to evolve. So too must our understanding of how best to help people recover when they return.
We owe that to those who have already served, but we also owe it to the generations that follow them.
My hope is that the work underway today contributes to a future in which veterans experiencing the invisible effects of war have ready access to treatments supported by strong clinical evidence – and that seeking effective treatment becomes as routine as treating any physical wound sustained in service.
There can be few greater obligations than ensuring that those we ask to serve are given every possible opportunity to return not simply alive, but able to live full and meaningful lives.
Author: Ethan Bond is President of Aspen Medical in the USA. Before his civilian career, Ethan served as a commissioned officer in the Life Guards, the senior regiment of the British Army. He completed both peacekeeping and combat tours in the Balkans and Iraq, gaining firsthand experience in crisis management and complex international operations.