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The Ravages of War Related PTSD Spread to Partners and Children of US Soldiers

The heartbreaking story of a family's secondary trauma.

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BY THIS POINT, YOU MIGHT BE wondering, and possibly feeling guilty about wondering, why Brannan doesn't just get divorced. And she would tell you openly that she's thought about it. "Everyone has thought about it," she says. And a lot of people do it. In the wake of Vietnam,  38 percent of marriages failed within the first six months of a veteran's return stateside; the divorce rate was twice as high for vets with PTSD as for those without. Vietnam vets with severe PTSD are  69 percent more likely to have their marriages fail than other vets. Army records also show that 65 percent of active-duty suicides, which  now outpace combat deaths, are  precipitated by broken relationships. And veterans, well, one of them dies by suicide  every 80 minutes. But even ignoring that though vets make up 7 percent of the United States, they account for  20 percent of its suicides—or that children and teenagers of a parent who's committed suicide are  three times more likely to kill themselves, too—or a whole bunch of equally grim statistics, Brannan's got her reasons for sticking it out with Caleb.

"I love him," she says.

Brannan fully supports any wife—who feels that she or her children are in danger, or in an untenable mental-health environment, or for whatever reason—who decides to leave. She's here, through Family of a Vet, to help those people. But she's also there for those FOV users who, like her, have decided to stay. "I have enormous respect for Caleb," she explains if you ask her why. "He has never stopped fighting for this family. Now, we've had little breaks from therapy, but he never stopped going to therapy. I love him," she repeats, defensively at times.

He is her friend, and her first love, and her rock, and her lifeline, her blossoming young daughter's father, her ally, and her hero, she tells Caleb when he asks. Because the person who most often asks Brannan why she stays with her husband is her husband.

The amount of progress in Caleb's six years of therapy has been frustrating for everyone. But ultimately, says Alain Brunet, vice president of the  International Society for Traumatic Stress Studies and director of the  Traumatic Stress Laboratory at McGill University in Canada, "we have reason to be reasonably optimistic. Psychotherapy does work for typical PTSD." The VA tends to favor cognitive-behavioral therapy and exposure therapy—whereby traumatic events are hashed out and rehashed until they become, theoretically, less consuming. Some state VA offices also offer group therapy. For severe cases, the agency offers inpatient programs, one of which Caleb resided in for three months in 2010. The VA also endorses  eye movement desensitization and reprocessing therapy (EMDR), which is based on the theory that memories of traumatic events are, in effect,  improperly stored, and tries to refile them by discussing those memories while providing visual or auditory stimulus. "There's a fairly strong consensus around CBT and EMDR," Brunet says. While veterans are waiting for those to work, they're often prescribed complicated antidepressant-based pharmacological cocktails.

To stay up to date on the latest advances in PTSD treatment, the VA collaborates with outside entities through its Intramural Research Program. Currently, the agency is funding 130 PTSD-related studies, from testing whether hypertension drugs might help to examining the effectiveness of meditation therapy, or providing veterans with trauma-sensitive service dogs, like Caleb's. The Mental Health Research Portfolio manager says the organization is "highly concerned and highly supportive" of PTSD research.

But a lot of FOV members and users are impatient with the progress. Up until 2006, the VA was spending  $9.9 million, just 2.5 percent of its medical and prosthetic research budget, on PTSD studies. In 2009, funding was upped to  $24.5 million. But studies take a long time, and any resulting new directives take even longer to be implemented.

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