The Wages of War: The Unpaid Debt Owed to Our Veterans

This Memorial Day in particular has me feeling some kind of way; not just because I am keenly aware of those lives lost to ensure my freedom, but also because I am acutely aware of those lives indelibly changed as a result of their service to this great country.  My own service in Afghanistan as a civilian has given me an entirely different perspective on the combat experience. On what it means to be prepared for war; and what it means to go to war unprepared (like so many of our young men during Vietnam). I understand just a bit more about their sacrifice. I know what it is to go to bed with one eye open, with your weapons and ammo and boots near you. To be ever vigilant, never at ease, and always on the ready.  To have your heart pound almost out of your chest and fight to keep your wits about you the very first time you feel the impact of an IED blast. To be separated from your loved ones for a really long time.  But I don’t know what it’s like to have to fight for your life. Or to kill to protect your life.  Or to see the gory horrors of war.

And so because of my experience, I have a newfound respect for all combat veterans; but especially those who continue to fight the silent war.  The silent war is the war inside their minds. It is a war waged largely against their own thoughts, memories, feelings.  It is a war against habits and behaviors that many implement to numb the pain. It is the isolation that they enact because they feel that no one understands, or that they cannot be totally open and honest and trusting of anyone, and because they just don’t want anyone to know the depths of their pain. They don’t want to deal with the stigma. The stigma is real. For a soldier even more so.

As much as we say we honor them, we dishonor them and their sacrifices. We turn our heads when we see a homeless guy with a nappy hat, and a tattered jacket, and a dirty sign saying, “Hungry veteran. Please help me eat.”  We cross to the other side of the street when we see the woman mumbling to herself.  We forget that it was war that contributed to this social problem. And we forget that our brothers and sisters who were prepared to lay down their lives, they are our problem.

No veteran should struggle with mental illness, addiction, unemployment, homelessness, or hunger following his or her service. So many of them have been adversely impacted by their combat experiences. We still don’t really know how many Vietnam-era vets struggle with PTSD, but certainly our best guess pales in comparison to the true numbers. Four decades later, we now know that a large majority (THE vast majority) of Vietnam vets struggle(d) with chronic PTSD symptoms. Four out of five Vietnam veterans reported active PTSD symptoms when interviewed 20 to 25 years after that war. Indeed, I recently interviewed a Vietnam-era vet who sobbed as he recounted story after story of his war experience in vivid detail just like it was yesterday. He had never spoken of his experiences in theatre. They rarely if ever do.

Why do I do what I do? Why is it so important to shed light on the issues facing our veterans? Because the rates of suicide amongst veterans are astounding; in one year it was 2 times the number of suicides in the US population writ large.  In 2014, 20 veterans per day committed suicide. I do what I do because:

  • 50% of those with PTSD do not seek treatment.
  • Rates of post-traumatic stress are greater for the Iraq and Afghanistan wars than for prior conflicts
  • 19% of veterans may have a traumatic brain injury (TBI); and 7% may have PTSD and TBI
  • More active duty personnel die by their own hand than from combat.
  • It is estimated that 20% of Iraq and Afghanistan combat veterans have PTSD and/or depression.

There is a consequence to waging war, and it is a costly one. You cannot place a price on mental health, or psychological wholeness. Nevertheless, we owe this debt and it must be paid in full. How can we ensure that we do right by the men and women who have valiantly served?  We must demand that Congress allocate the funds to providing state of the art services, to hiring the best and brightest clinicians and researchers, and to creating the infrastructure to properly and adequately care for our wounded warriors.

To do your part — to truly thank them for their sacrifice, and to honor those lives lost for your freedom and mine, contact your state representatives to Congress via letter or phone, and demand that this be a priority.

We owe it to those who laid their lives down for us — to take care of their brothers and sisters-in-arms who are still fighting a war alone.

Be well,

The Good Dr. Nik


Dr. Nicole Alford is a DMV-based clinical psychologist, writer and prolific blogger, teacher, media commentator and compassionate activist working to raise mental health awareness and end stigma. For more information on her professional services, view her website at, and follow her @TheGoodDrNik on all social media platforms.