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Many Aging Vietnam War Vets Are Still Battling PTSD, Along With Chronic Illnesses, That Combat Exposure May Make More Likely, New Research Finds
Two groundbreaking studies shed light on combat's lasting physical and psychological damage more than 50 years on.
The toll of combat exposure and post-traumatic stress disorder (PTSD) is still disrupting the lives of soldiers who returned from Vietnam more than a half-century ago, according to two studies that followed and checked in with the same men — fewer than 0.4% of U.S. Military there were women — over 35 years.
Among the most striking findings: Soldiers who saw combat in the 1960s and '70s were nearly twice as likely to have a diagnosed heart condition in 2020 compared to vets in noncombat roles. And veterans with heart disease reported significantly more comorbid chronic illnesses like arthritis and respiratory conditions, including sleep apnea, emphysema and asthma.
Both trends were influenced by the extent of combat experience, with rates of heart disease and chronic illness highest among those who faced the most intense combat fighting. Chronic illnesses also were reported more often by men with PTSD.
Another eye-catching finding: Veterans with subthreshold PTSD – those whose symptoms indicate clear evidence of distress but don't meet the threshold for a diagnosis – were found to have worse physical and mental health outcomes compared with those who never experienced PTSD symptoms.
A quarter of participants reported having subthreshold PTSD in at least one of the three survey waves. The condition often is not sufficient to qualify for the VA's PTSD services.
Steven D. Stellman, Ph.D.
"Veterans with subthreshold PTSD suffer significant health burdens that are often overlooked," Steven D. Stellman, Ph.D., one of the authors and professor emeritus of epidemiology at Columbia Mailman School of Public Health in New York, said in a university news release, emphasizing that VA policies need to be updated to include them in care and treatment programs.
Jeanne Mager Stellman, Ph.D.
Steven Stellman and Jeanne Mager Stellman, Ph.D., a professor emerita of health policy and management at the school, were co-senior authors of both studies. The papers were produced by the same team of researchers, and other researchers were based at the Boston VA. The studies were published five weeks apart in the Journal of Occupational and Environmental Medicine.
Both studies used data from surveys mailed to a random sample of 12,400 war veterans in 1984 and 1998 and, in 2020, to a subset of 729 living veterans who had responded to both previous surveys, making this one of the longest studies of Vietnam veterans. The surveys asked about combat exposure, probable PTSD and history of diagnosed chronic illness.
The participants were, on average, 72.5 years old during the most recent wave of data collection five years ago.
The first study, posted online on Dec. 18, 2024, focused on the impact of persistent combat-related PTSD on heart disease and chronic disease comorbidity in aging Vietnam War veterans.
The second study, posted online Jan. 21, 2025, analyzed the persistence and patterns of combat-related PTSD, medical, and social dysfunction in male military veterans 50 years after deployment to Vietnam.
The social dysfunction study identified four distinct PTSD patterns over 35 years among male veterans who were 69- to 75-years-old in 2020. The majority (56%) were found to have never had PTSD. The second-largest group (25%) had subthreshold PTSD. Just under 10% had PTSD in the past but not currently. And 9% were found to currently have PTSD, rising to nearly 16% among those who were exposed to heavy combat. This was consistent with the strong combat-PTSD dose-response relationship that was found to persist over time.
Veterans with PTSD or subthreshold PTSD reported significantly worse life satisfaction, higher levels of depression and anxiety, and poorer overall health compared with those who'd never had the condition or had it in the past but not currently.
The findings underscore the importance of early and ongoing social and mental health support for veterans reintegrating into civilian life, Jeanne Stellman said: "Veterans who had fewer community social supports upon their return from Vietnam were more likely to develop PTSD."
Overall, she said, "This research reinforces how the trauma of war continues to affect veterans long after the war ends."
Trauma And PTSD Psychiatrists In Connecticut
Those needs range from mild to severe, and include: Anxiety, Depression, PTSD, Bipolar, Schizophrenia, Dissociation, OCD, in addition to many others.
Arthur "Eddie" Brouse is a board-certified, Advanced Practice Registered Nurse specializing in psychiatric mental health, at Advanced TelePsych. In his own words, "Mental illness is something that is extremely personal, yet often affects more than just one person. Worry, sadness, or feeling overwhelmed are only a few symptoms which cause difficulty for a person to function normally. Is there something that isn't quite right which causes you trouble? Have you noticed your mood or issues have been affecting not just you, but also those around you? Are you isolating, or feeling alone? Do you feel the roller coaster is out of control?"
How Businesses Should Support Employees At Risk Of Post-Traumatic Stress Disorder (PTSD)
New data* highlights the proactive and essential role businesses must play in protecting their employees' mental health following a traumatic event. This is to ensure quicker recovery for the patient as well as business continuity. With the modern workforce increasingly required to travel and face unpredictable risks, such as natural disasters, armed conflict, or personal emergencies, the need for comprehensive mental health support has never been more critical to avoid longer term psychiatric problems.
The Psychological Impact of Trauma on Employees
Unfortunately, at some point in our lives many of us will be exposed to terrifying or extremely stressful events. These can clearly have huge effects on our wellbeing and mental health. The immediate aftermath often involves an acute stress response, but without timely and appropriate support, this can develop into a chronic and serious condition called Post-Traumatic Stress Disorder (PTSD).
PTSD was first identified in young soldiers returning from war, often referred to as "shell shock". The symptoms of PTSD usually develop quite soon after being exposed to a significantly traumatic event. They include intrusive memories of the incident, distressing flashbacks and severe emotional distress when recalling or being reminded of the trauma. As a result, individuals often avoid people, places, or activities that might trigger these painful memories, leading to isolation and a withdrawal from support networks. When left untreated, it is common to develop feelings of shame and guilt around the event and to develop symptoms of severe depression and anxiety alongside the PTSD.
In some cases, PTSD can come to the surface more than six-months after a trauma. This is known as delayed PTSD. Another form of PTSD, which is being increasingly discussed in media and in general, is complex PTSD. This is when PTSD symptoms are caused by a more prolonged traumatic experience – such as living with an abuser or being exposed to a trauma over a long period of time.
All types of PTSD are regarded as quite severe mental health diagnoses, and they can be challenging to treat and manage. The ripple effects of PTSD extend beyond the individual, and in a business might impact team dynamics, productivity, and organisational culture. It is essential to act early to reduce the opportunity for PTSD to develop.
Case Studies: The Cost of Delayed Intervention
Having worked directly with people suffering from PTSD for various reasons, Healix has witnessed the cost of delayed intervention, as outlined below.
Case Study 1: Sexual Assault in the Workplace: Anna, a marketing executive, endured harassment in her workplace, which was met with dismissiveness from her management. The absence of support mechanisms resulted in untreated PTSD, compounding her stress and leading to chronic physical health issues such as fibromyalgia. Years of therapy and medical treatment were required to address the long-term damage. This underscores the critical importance of immediate validation, trauma-focused therapy, and workplace adjustments.
Case Study 2: Armed Robbery at Work: James, a retail manager, experienced an armed robbery during his shift. Although his employer provided financial support, the lack of mental health resources led to delayed-onset PTSD symptoms, including panic attacks and a prolonged recovery process. Early psychoeducation and intervention could have significantly reduced the long-term impact on his mental health and career.
Case Study 3: Road Traffic Collision on a Business Trip: Michael, a senior executive, survived a road traffic collision during a business trip that tragically claimed the life of his colleague. His employer's proactive approach, including access to trauma-focused therapy within 48 hours, time off work, and a structured return-to-work plan, allowed him to recover fully within a year. This case illustrates the effectiveness of immediate and sustained mental health support in preventing PTSD.
The Evidence for Early Intervention
Healix works with Mind Right to help people access timely mental health support. New data from a recent review of Mind Right PTSD cases reinforces the importance of early intervention:
This data underscores that prompt access to trauma-focused interventions not only accelerates recovery but also enhances the overall effectiveness of treatment.
Practical Recommendations for Employers
Conclusion
It's a fact of life that trauma can occur at any time, profoundly affecting employees and organisations alike. By prioritising early intervention, leveraging evidence-based therapies, and fostering supportive workplace cultures, businesses can play a pivotal role in mitigating the impact of trauma. As the cases of Anna, James, and Michael illustrate, timely and proactive measures can prevent long-term mental health challenges and enable employees to rebuild their lives and careers with resilience.
*Data from Healix Health's partner, psychological services provider, Mind Right
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