Sec. Gates with wounded warrior

A DOD analysis of the Post-Deployment Health Reassessment administered to service members returning from deployment reported that nearly 40 percent of active duty and almost 50% of Guard and Reserve troops manifested psychological symptoms of combat trauma, and that such symptoms increased significantly following multiple deployments.  Many troops, however, do not admit to psychological symptoms during the assessment for fear of jeopardizing their careers or delaying the reunion with their families. Moreover, only about half of those diagnosed with depression, Post Traumatic Stress Disorder (PTSD), or other psychological symptom follow through with treatment. Consensus is building that these statistics may be attributable to prolonged and repeated exposure to deadly combat.  It's estimated that during WWII, the average length of service was 33 months, of which the typical GI spent 16 months overseas, and perhaps 6 months in actual combat.  During the "war on terror," however, the average soldier has spent 4.5 years deployed, and 4 years in daily combat with the enemy. 

The most common weapon used the by the Taliban is the Improvised Explosive Device (IED), a bomb hidden alongside a road or other thoroughfare.  These weapons are designed and deployed to inflict maximum damage on vehicles or personnel, and despite advances in vehicle armor, personnel protective equipment, and detection capability, IED's remain the primary cause of death and injury for ISAF troops. IED survivors often experience Traumatic Brain Injury (TBI) from the force of the explosion, and PTSD from the horrific experience. TBI and PTSD are now considered the "signature wounds" of the war on terror, and IEDs are the primary cause. The Boston Globe recently reported that the ratio of wounded to killed in the war on terror is now 16 wounded for each fatality - in Vietnam, it was 1 wounded to every three fatalities.  Major advances in battle field medicine have made many catastrophic combat injuries survivable, but at the cost of extensive rehabilitation and major lifestyle changes for these wounded warriors and their families.  

PTSD and the other psychological symptoms of war are no longer limited to those actively engaged in combat.  The crews who operate unmanned aerial systems like the Predator from US locations, as well as the intelligence personnel who monitor and analyze their video feeds are beginning to manifest symptoms of combat trauma.  They spend their work days watching combat operations, but when they go home to their families at night, they can't discuss what they've seen because it's classified. As combat strategies against non-traditional enemies require greater dependence on such systems, the toll on human operators and their families may also rise.