Rambam: Soldiers and Veterans with PTSD Have Worsening Symptoms with Approach of Anniversaries of Lebanon and Gaza Wars

During the months of June-August, there is a noticeable increase in the appeals of soldiers and veterans who suffer from PTSD due to worsening symptoms, according to the patients at the Medical Unit of the psychiatric division at Rambam Hospital in northern Israel.  The trigger at this time of year, according to the clinic’s experts, is the anniversary of the Second Lebanon War and Operation “Tzuk Eitan,” the more recent Gaza War, which took place during these months and raises traumatic experiences from previous years.

About 720 people have been treated at Rambam’s clinic, a 75 percent increase over the past decade, with half of them diagnosed with PTSD, mostly by former combat veterans.  Among the patients are fighters from all of Israel’s wars – those who were injured in the battles of attrition, the Six Day War, and Yom Kippur, through patients who were wounded in the first Lebanon war, the years of fighting in southern Lebanon, the first and second Intifadas, and the Second Lebanon War.

“Among the strongest triggers for worsening post-traumatic symptoms is the anniversary of the traumatic events, Memorial Day of course, and periods in which there is a sense of higher alertness on the part of the defense establishment,” explains Yael Caspi, a clinical psychologist, “For example, new patients arrived at the clinic following the Second Lebanon War, as the threat to the homeland experienced by the residents of the north caused them traumatic experiences from previous combat events in which they had participated in the past. In tense times, such as when the “knife intifada” began in September 2015, and in times when Air Force planes are often heard at different times of the day, there is a wave of visits to the clinic from longstanding and relatively stable patients, due to heightened anxiety, difficulties with sleep, and the penetrating memories of past events disrupting daily functioning.

“In recent times, and directly connected with the security events in the south and north, there has been an increase in calls to the clinic outside the pre-determined lines.  To address these needs, we maintain an emergency clinic every day until noon, which is run by a psychiatric nurse who provides care for these patients without a queue while the work is ongoing.  This helps the applicants cope with their distress until they see the doctor. ”

Post-Traumatic Stress Disorder – A Cross-Sectoral Problem

The medical clinic at the Rambam Medical Center has been in existence for nearly 30 years.  Appointments to the clinic are made only through the Rehabilitation Branch of the Ministry of Defense, Northern District, and include members of the former security forces – the IDF, the police and prison service.  The clinic staff consists of psychiatrists, social workers, and psychologists, and includes students and interns. With an average annual growth of 50-60 new patients whose age range ranges from early 20’s to 80+, a representative sample of Israeli society.

“We deal with people who are in the process of claiming a mental health disability, or those who are already recognized with a disability due to mental impairment,” notes Dr. Eyal Fruchter, director of the psychiatric branch at Rambam and former head of the medical corps’ mental health department. “The vast majority of the patients are men, with a representation similar to that of the general population of Arabs in the general population – especially Druze who are forced to enlist and the Bedouin who volunteer to serve.” There are, of course, SLA members from the Christian community in Lebanon who came to Israel after the army withdrew in 2000, Christian and Muslim Arab volunteers who view the recruitment of the security forces as a civic duty. Some women have also been treated with us, both because of events they experienced during their service or because they were combatants. ”

PTSD is a very serious disorder of the brain, body, mind, and spirit, with very extensive consequences and injury to all areas of life, including the high probability of accompanying physical diseases. Psychiatric drugs do not usually help. Experience and research indicate that many in the general population deal with post-traumatic symptoms without reaching diagnosis and medical recognition.

“Coping with chronic PTSD involves a long process of rehabilitation, including the rebuilding of skills that were standard in the past and have now collapsed,” concludes Dr. Caspi. “There is a need to re-conceptualize self-image and interpersonal relationships.  We find that the only way to ‘beat’ PTSD is to rebuild, together with the patients, the personal competence that gives them the ability to be the boss of their lives.”

“Rambam’s unique expertise in understanding and treating PTSD in all its forms is fundamental to ensuring the well-being of Israeli society.  The highest level of care and support is assured to those who have bravely defended Israel through their national service.  In this regard, Rambam is Israel’s equivalent of Walter Reed Medical Center in the U.S.,” added Richard S. Hirschhaut, National Director of the American Friends of Rambam Medical Center.