Listen to the article
When the last American combat troops left Vietnam in January 1973, over 700,000 veterans needed psychological treatment for what no one knew how to diagnose. The VA couldn’t help them because officially, their condition didn’t exist.
Nightmares, flashbacks, rage, emotional numbness. Veterans knew something was wrong. VA psychiatrists called it depression or schizophrenia. Treatment rarely worked because doctors were treating the wrong things.
The psychiatric establishment had a term for combat trauma as early as 1952, when “gross stress reaction” appeared in the first Diagnostic and Statistical Manual of Mental Disorders. By 1968, when the DSM was revised during peak Vietnam combat operations, that diagnosis vanished without explanation. Veterans coming home had nowhere to turn.
Veterans Built Their Own System
Without official recognition or treatment, Vietnam veterans created their own support networks. Groups such as Twice-Born Men formed for veterans leaving prison. Others met informally, what psychiatrist Robert Lifton called “street corner psychiatry.” Veterans helped veterans because no one else would.
They demanded answers. Why were so many veterans homeless, unemployed or addicted? Why did symptoms that started in Vietnam follow them for years? The VA denied disability claims for psychological conditions because no combat-related diagnosis existed in the manual.
Advocates pushed back. Veterans testified before Congress. Researchers studied returning soldiers. Psychiatrists who worked with survivors of the Holocaust, rape victims and combat veterans saw the same patterns. Trauma didn’t discriminate by source.
The pressure mounted through the 1970s. Veterans organizations lobbied the American Psychiatric Association. Clinicians like Chaim Shatan wrote about “post-Vietnam syndrome” in The New York Times. The psychiatric community couldn’t ignore 2.7 million veterans anymore.
Read More: EMDR: The PTSD Treatment Many Veterans Don’t Know the VA Offers
In 1980, Changed Everything
Five years after the war ended, the American Psychiatric Association added post-traumatic stress disorder to DSM-III. The diagnosis finally gave veterans’ suffering a name and treatment pathway. More importantly, it shifted blame from individual weakness to external trauma.
PTSD was the first psychiatric diagnosis to identify the cause as outside the person rather than an inherent flaw. That distinction mattered. Veterans weren’t broken. They’d experienced events outside normal human experience and reacted normally to abnormal circumstances.
Congress ordered the VA to study PTSD prevalence in 1983. The National Vietnam Veterans Readjustment Study found that 15% of Vietnam veterans had PTSD. A follow-up study decades later showed 11% of male theater veterans and 7% of female theater veterans still struggled with PTSD 40 years after the war.
The PTSD diagnosis opened doors. The VA developed specialized treatment programs. Research into trauma-focused therapies began. Veterans could file disability claims for a condition the VA finally recognized. But recognition came too late for thousands who’d suffered without help for years.
Read More: December 1944: The Medics Who Saved Thousands at the Battle of the Bulge
The Legacy Lives On
Modern VA mental health treatment exists because Vietnam veterans refused to accept that their symptoms weren’t real. They organized, testified, demanded research and forced the psychiatric establishment to acknowledge combat trauma.
Today’s veterans benefit from that fight. PTSD treatment protocols, specialized VA programs, disability compensation for mental health conditions. None of it existed before Vietnam veterans created it.
The VA now offers evidence-based PTSD treatments such as cognitive processing therapy, prolonged exposure and EMDR. Vet Centers provide readjustment counseling. The Veterans Crisis Line operates 24/7. Mental health care is integrated into primary care.
But gaps remain. Veterans still wait weeks for mental health appointments. Some VA facilities lack trained PTSD specialists. The stigma around mental health persists in military culture.
Vietnam veterans fought a second war at home to get recognition and treatment. That fight created the modern VA mental health system. Every veteran who gets PTSD treatment today owes them a debt.
Stay on Top of Your Veteran Benefits
Military benefits are always changing. Keep up with everything from pay to health care by subscribing to Military.com, and get access to up-to-date pay charts and more with all latest benefits delivered straight to your inbox.
Story Continues
Read the full article here
17 Comments
Considering that 2.7 million veterans were affected and the pressure mounted through the 1970s for the recognition of PTSD, it’s clear that collective action and lobbying by veterans organizations played a critical role in achieving this essential diagnosis.
The transformation in the approach to treating veterans with PTSD, from blaming individual weakness to recognizing external trauma, is a model for how our understanding and treatment of mental health can evolve with advocacy and research.
The work of advocates, including clinicians like Chaim Shatan who wrote about ‘post-Vietnam syndrome’, was instrumental in pushing for the recognition of PTSD and highlights the importance of persistent advocacy for veterans’ rights.
The American Psychiatric Association’s addition of post-traumatic stress disorder to the DSM-III in 1980 was a crucial step forward, as it finally gave veterans’ suffering a name and a treatment pathway, shifting the blame from individual weakness to external trauma.
The removal of ‘gross stress reaction’ from the DSM in 1968 and its consequences for Vietnam veterans raises questions about the process of diagnosing and treating mental health conditions, particularly in relation to trauma and stress reactions.
It’s heartening to see that the PTSD diagnosis has led to the development of specialized treatment programs by the VA and research into trauma-focused therapies, offering hope for improved care for veterans struggling with PTSD.
However, more work needs to be done to ensure that all veterans have access to these resources and that the stigma surrounding mental health issues is addressed.
The creation of support networks by Vietnam veterans themselves, such as Twice-Born Men, demonstrates the resourcefulness and resilience of those affected by the lack of official recognition and treatment for their conditions.
The statistic that 15% of Vietnam veterans had PTSD, as found by the National Vietnam Veterans Readjustment Study in 1983, highlights the severity of the issue and the need for better support systems for veterans.
This number is even more striking when considering that a follow-up study decades later showed that 11% of male theater veterans and 7% of female theater veterans still struggled with PTSD 40 years after the war.
It’s disturbing to learn that the diagnosis of ‘gross stress reaction’ was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1968 without explanation, leaving veterans without a legitimate way to seek help for their combat trauma.
The personal stories of veterans who struggled to find help and support due to the lack of a recognized diagnosis for their conditions serve as a poignant reminder of the human cost of delayed recognition and action on mental health issues.
These stories also emphasize the importance of listening to and believing veterans when they share their experiences, rather than dismissing their symptoms as individual weaknesses.
Learning about the ‘street corner psychiatry’ and informal support groups formed by veterans to help each other cope with their experiences underscores the urgent need for formal, comprehensive mental health support systems for veterans.
The fact that PTSD was the first psychiatric diagnosis to identify the cause as outside the person, rather than an inherent flaw, marked a significant shift in understanding mental health and should inform how we approach mental health issues today.
Understanding the history of how PTSD came to be recognized as a legitimate diagnosis can provide valuable insights into the challenges of addressing mental health issues among veterans and the importance of continued research and advocacy.
The fact that the VA couldn’t help Vietnam veterans because their condition didn’t officially exist is shocking, especially considering that over 700,000 veterans needed psychological treatment after the war.