PTSD and Post Partum Depression: No Equal Defense before the Law?

The following a a guest column written by Bob Krause:

The Iowa Supreme Court's decision on the Heidi Anfinson case casts a new light into the shadows of mental illness and depression. The court ruled that the courts should have entertained evidence of depression and odd behavior that followed the birth of Anfinson's son. Anfinson allegedly drowned the child in Saylorville Lake a decade ago.

Although the tragic occurrence of the murder of Heidi's child by her was heinous, it has been recognized in medical circles and professional circles that an actual form of insanity sometimes occurs after child birth. It is called post-partum depression. The courts of Iowa will now allow evidence of the signs of it to be admitted in court during criminal proceedings.

But there are others in Iowa, some sitting in jail today without treatment, for an equally oppressive form of metal illness that they acquired often in the defense of America. That illness is Post Traumatic Stress Disorder (PTSD), and it deserves a like legal review to post-partum depression.

Today in Iowa, PTSD cannot be used as a defense in an insanity or diminished capacity plea before a jury. Not even military medical records diagnosing a soldier or veteran with PTSD can be entered in defense. It is only after conviction that the court can entertain PTSD records – not to prescribe treatment, but for consideration in sentencing.

PTSD does not have the same sympathetic ring as post-partum depression. But it is with us, and it is common. 480,000 of those returning from Vietnam (15.2% of men and 8.1% of women) had it. 168,000 of those Vietnam vets still have it. Of those, according to the National Vietnam Veterans Readjustment Study of 1988, ½ (around 240,000) were jailed at least once, 35% more than once, and 11.5% were convicted of felonies.

Today, some estimate that 20 percent of soldiers and 42 percent of reservists have returned from Iraq with some kind of psychological problem. Much of this is PTSD related. And the "canary in the coal mine" indicator of pervasive PTSD problems -- Army suicides -- more than doubled since 2001, hitting a 27-year high in 2007.

Many in my generation can relate to this as they saw friends and loved ones that served that bounced slowly down the razor-blade of life, not really quite fitting in after service. This generation will be "blessed" to see much of the same. And, with the high number of Guard and Reserve mobilizations in Iowa, the problem may be more significant.

I do not have Post Traumatic Stress Disorder (PTSD), but as a retired Army Reserve officer from the immediate post-Vietnam era, I have learned about it well over the course of a career.

My eyes first opened to the phenomena as a young captain in the 1133rd Transportation Company, Iowa Army National Guard in Mason City. One of my soldiers, Louis, a Vietnam veteran and a capable sergeant, disappeared early one morning.

Louis had been a tunnel rat in Vietnam. For those of this generation, a tunnel rat was a person that crawled into narrow enemy underground bunkers. It was a death-defying feat for the practitioners, and it had obviously had an impact on Louis.

That day, several years after the fact, Louis flashed back when he crawled under one of our trucks to change the oil. In his mind, he was back in a tunnel in Vietnam in a stand-off with a Viet Cong soldier. In this mental vise, he could not move forward, and he could not move backward. So he froze – for about six hours.

When we found Louis, he was embarrassed by what had occurred, but obviously changed and un-nerved. He quit the National Guard shortly after that, and I am embarrassed that at the time I did not know enough about PTSD to get him proper referrals. But, I was not alone in my lack of knowledge.

That evening, after the troops had left for the day, I asked my recruiting non-commissioned officer, also a Vietnam veteran, what he knew about Louis. Ron was also a Vietnam veteran and had his own little hell to live. Ron's was a traveling flash-back. Once a month or so as Ron was driving down the road, the windshield would suddenly become covered with gore and blood. He would stop the car, take a deep breath, and then start driving again. These episodes came from a mortar attack where the body of a soldier had been smeared across the windshield of the truck he was driving.

But these are just two old events of another generation. We have many good examples that we will be able to point to for this generation. I can assure you that many of these cases will wind up in the courts. Untreated, PTSD symptoms can become more severe. Drugs and alcohol are often part of escape from the pain and insomnia, and these in turn can trigger more grief. Jobs are lost; marriages are ruined, and fear-response mechanisms can breed violence. I have been involved in the periphery of a legal case in northern Iowa regarding such a young man of this generation. He was formally an upstanding businessman prior to a short notice mobilization with his Guard unit. Unfortunately he fell into calamity upon return, in part because of the consequences of the mobilization, and in major part because of his own personal reactions to his own PTSD.

Surely, he deserves the right to tell his case to the jury also, not just the judge, at sentencing.

Bob Krause is a retired lieutenant colonel in the US Army reserve. He is past state president of the Reserve Officers Association and past state chair of the Iowa Democratic Veterans' Caucus. He is currently roving ambassador for the Iowa Democratic Veterans' Caucus.