0:00:01.759,0:00:05.112
I worked as a war reporter for 15 years

0:00:05.136,0:00:08.601
before I realized[br]that I really had a problem.

0:00:09.101,0:00:11.207
There was something really wrong with me.

0:00:11.231,0:00:14.569
This was about a year before 9/11,[br]and America wasn't at war yet.

0:00:15.432,0:00:17.824
We weren't talking about PTSD.

0:00:17.848,0:00:22.044
We were not yet talking[br]about the effect of trauma and war

0:00:22.068,0:00:23.852
on the human psyche.

0:00:24.706,0:00:26.956
I'd been in Afghanistan[br]for a couple of months

0:00:26.980,0:00:29.988
with the Northern Alliance[br]as they were fighting the Taliban.

0:00:30.012,0:00:33.269
And at that point the Taliban[br]had an air force,

0:00:33.293,0:00:36.522
they had fighter planes,[br]they had tanks, they had artillery,

0:00:36.546,0:00:39.837
and we really got hammered[br]pretty badly a couple of times.

0:00:39.861,0:00:41.827
We saw some very ugly things.

0:00:43.104,0:00:45.074
But I didn't really think it affected me.

0:00:45.098,0:00:46.626
I didn't think much about it.

0:00:46.650,0:00:48.601
I came home to New York, where I live.

0:00:49.141,0:00:51.506
Then one day I went down into the subway,

0:00:52.490,0:00:54.941
and for the first time in my life,

0:00:54.965,0:00:56.799
I knew real fear.

0:00:56.823,0:00:59.162
I had a massive panic attack.

0:01:00.058,0:01:02.937
I was way more scared[br]than I had ever been in Afghanistan.

0:01:04.093,0:01:07.493
Everything I was looking at seemed like[br]it was going to kill me,

0:01:07.517,0:01:09.810
but I couldn't explain why.

0:01:10.121,0:01:12.095
The trains were going too fast.

0:01:12.119,0:01:13.473
There were too many people.

0:01:13.497,0:01:15.285
The lights were too bright.

0:01:15.309,0:01:18.108
Everything was too loud,[br]everything was moving too quickly.

0:01:18.132,0:01:21.460
I backed up against a support column[br]and just waited for it.

0:01:23.115,0:01:26.311
When I couldn't take it any longer,[br]I ran out of the subway station

0:01:26.335,0:01:28.064
and walked wherever I was going.

0:01:29.648,0:01:33.827
Later, I found out that what I had[br]was short-term PTSD:

0:01:33.851,0:01:35.754
post-traumatic stress disorder.

0:01:36.993,0:01:40.221
We evolved as animals, as primates,[br]to survive periods of danger,

0:01:40.245,0:01:43.166
and if your life has been in danger,

0:01:43.190,0:01:45.831
you want to react to unfamiliar noises.

0:01:47.352,0:01:49.607
You want to sleep lightly, wake up easily.

0:01:49.631,0:01:51.825
You want to have nightmares and flashbacks

0:01:51.849,0:01:53.658
of the thing that could kill you.

0:01:54.756,0:01:57.813
You want to be angry because it makes you[br]predisposed to fight,

0:01:57.837,0:02:01.210
or depressed, because it keeps you out[br]of circulation a little bit.

0:02:01.591,0:02:02.922
Keeps you safe.

0:02:03.580,0:02:06.458
It's not very pleasant,[br]but it's better than getting eaten.

0:02:08.469,0:02:10.923
Most people recover[br]from that pretty quickly.

0:02:10.947,0:02:13.037
It takes a few weeks, a few months.

0:02:13.061,0:02:16.176
I kept having panic attacks,[br]but they eventually went away.

0:02:16.200,0:02:18.850
I had no idea it was connected[br]to the war that I'd seen.

0:02:18.874,0:02:20.470
I just thought I was going crazy,

0:02:20.494,0:02:23.628
and then I thought, well,[br]now I'm not going crazy anymore.

0:02:25.197,0:02:27.827
About 20 percent of people, however,

0:02:27.851,0:02:31.142
wind up with chronic, long-term PTSD.

0:02:31.166,0:02:33.560
They are not adapted to temporary danger.

0:02:33.584,0:02:36.345
They are maladapted for everyday life,

0:02:36.369,0:02:37.547
unless they get help.

0:02:37.994,0:02:41.533
We know that the people[br]who are vulnerable to long-term PTSD

0:02:41.557,0:02:44.273
are people who were abused as children,

0:02:44.297,0:02:46.028
who suffered trauma as children,

0:02:46.052,0:02:48.670
people who have low education levels,

0:02:48.694,0:02:51.252
people who have psychiatric[br]disorders in their family.

0:02:51.276,0:02:52.554
If you served in Vietnam

0:02:52.578,0:02:55.272
and your brother is schizophrenic,

0:02:55.296,0:02:59.412
you're way more likely to get[br]long-term PTSD from Vietnam.

0:03:00.571,0:03:03.199
So I started to study this[br]as a journalist,

0:03:03.868,0:03:07.391
and I realized that there was something[br]really strange going on.

0:03:07.415,0:03:10.158
The numbers seemed to be going[br]in the wrong direction.

0:03:10.597,0:03:12.969
Every war that we have[br]fought as a country,

0:03:12.993,0:03:14.967
starting with the Civil War,

0:03:14.991,0:03:18.047
the intensity of the combat has gone down.

0:03:18.878,0:03:22.258
As a result, the casualty rates[br]have gone down.

0:03:22.707,0:03:24.662
But disability rates have gone up.

0:03:24.686,0:03:26.888
They should be going[br]in the same direction,

0:03:27.702,0:03:29.951
but they're going in different directions.

0:03:32.124,0:03:36.713
The recent wars in Iraq and Afghanistan[br]have produced, thank God,

0:03:36.737,0:03:42.081
a casualty rate about one third[br]of what it was in Vietnam.

0:03:44.129,0:03:46.089
But they've also created --

0:03:46.678,0:03:50.024
they've also produced[br]three times the disability rates.

0:03:51.526,0:03:57.499
Around 10 percent of the US military[br]is actively engaged in combat,

0:03:58.439,0:03:59.777
10 percent or under.

0:03:59.801,0:04:02.075
They're shooting at people,[br]killing people,

0:04:02.099,0:04:04.437
getting shot at,[br]seeing their friends get killed.

0:04:04.461,0:04:06.014
It's incredibly traumatic.

0:04:06.038,0:04:08.848
But it's only about 10 percent[br]of our military.

0:04:08.872,0:04:11.105
But about half of our military has filed

0:04:11.129,0:04:15.351
for some kind of PTSD compensation[br]from the government.

0:04:16.922,0:04:21.617
And suicide doesn't even fit into this[br]in a very logical way.

0:04:22.173,0:04:27.959
We've all heard the tragic statistic[br]of 22 vets a day, on average,

0:04:27.983,0:04:30.590
in this country, killing themselves.

0:04:31.564,0:04:33.054
Most people don't realize

0:04:33.078,0:04:38.715
that the majority of those suicides[br]are veterans of the Vietnam War,

0:04:38.739,0:04:40.617
that generation,

0:04:40.641,0:04:45.139
and their decision to take their own lives[br]actually might not be related

0:04:45.163,0:04:47.861
to the war they fought 50 years earlier.

0:04:49.122,0:04:52.814
In fact, there's no statistical connection[br]between combat and suicide.

0:04:52.838,0:04:55.905
If you're in the military[br]and you're in a lot of combat,

0:04:55.929,0:04:58.939
you're no more likely to kill yourself[br]than if you weren't.

0:04:59.614,0:05:00.940
In fact, one study found

0:05:00.964,0:05:02.988
that if you deploy to Iraq or Afghanistan,

0:05:03.012,0:05:06.432
you're actually slightly less likely[br]to commit suicide later.

0:05:08.626,0:05:10.896
I studied anthropology in college.

0:05:10.920,0:05:13.939
I did my fieldwork[br]on the Navajo reservation.

0:05:13.963,0:05:17.358
I wrote a thesis on Navajo[br]long-distance runners.

0:05:18.473,0:05:22.477
And recently, while[br]I was researching PTSD,

0:05:23.501,0:05:25.606
I had this thought.

0:05:26.325,0:05:29.404
I thought back to the work[br]I did when I was young,

0:05:29.428,0:05:33.497
and I thought, I bet the Navajo,[br]the Apache, the Comanche --

0:05:33.521,0:05:36.085
I mean, these are very warlike nations --

0:05:36.109,0:05:39.891
I bet they weren't getting[br]PTSD like we do.

0:05:40.814,0:05:43.806
When their warriors came back[br]from fighting the US military

0:05:43.830,0:05:45.438
or fighting each other,

0:05:46.241,0:05:50.184
I bet they pretty much just slipped[br]right back into tribal life.

0:05:51.635,0:05:53.889
And maybe what determines

0:05:53.913,0:05:56.607
the rate of long-term PTSD

0:05:56.631,0:05:58.619
isn't what happened out there,

0:05:59.942,0:06:02.347
but the kind of society you come back to.

0:06:03.107,0:06:08.061
And maybe if you come back[br]to a close, cohesive, tribal society,

0:06:08.823,0:06:11.148
you can get over trauma pretty quickly.

0:06:11.830,0:06:16.176
And if you come back[br]to an alienating, modern society,

0:06:16.719,0:06:20.224
you might remain traumatized[br]your entire life.

0:06:20.248,0:06:23.359
In other words, maybe the problem[br]isn't them, the vets;

0:06:23.383,0:06:25.147
maybe the problem is us.

0:06:27.325,0:06:31.768
Certainly, modern society[br]is hard on the human psyche

0:06:32.649,0:06:34.563
by every metric that we have.

0:06:37.043,0:06:39.404
As wealth goes up in a society,

0:06:41.523,0:06:45.094
the suicide rate goes up instead of down.

0:06:46.066,0:06:48.156
If you live in modern society,

0:06:48.180,0:06:50.316
you're up to eight times more likely

0:06:52.379,0:06:54.700
to suffer from depression in your lifetime

0:06:54.724,0:06:57.612
than if you live in a poor,[br]agrarian society.

0:06:58.915,0:07:02.514
Modern society has probably produced[br]the highest rates of suicide

0:07:02.538,0:07:05.792
and depression and anxiety[br]and loneliness and child abuse

0:07:05.816,0:07:07.561
ever in human history.

0:07:08.695,0:07:10.268
I saw one study

0:07:10.292,0:07:13.334
that compared women in Nigeria,

0:07:13.358,0:07:15.855
one of the most chaotic[br]and violent and corrupt

0:07:16.627,0:07:18.833
and poorest countries in Africa,

0:07:19.358,0:07:20.649
to women in North America.

0:07:20.673,0:07:25.863
And the highest rates of depression[br]were urban women in North America.

0:07:25.887,0:07:27.882
That was also the wealthiest group.

0:07:28.637,0:07:32.486
So let's go back to the US military.

0:07:33.096,0:07:35.614
Ten percent are in combat.

0:07:35.638,0:07:40.377
Around 50 percent have filed[br]for PTSD compensation.

0:07:41.602,0:07:46.704
So about 40 percent of veterans[br]really were not traumatized overseas

0:07:47.734,0:07:52.040
but have come home to discover[br]they are dangerously alienated

0:07:52.563,0:07:53.889
and depressed.

0:07:56.341,0:07:59.278
So what is happening with them?

0:07:59.302,0:08:01.119
What's going on with those people,

0:08:02.051,0:08:06.786
the phantom 40 percent that are troubled[br]but don't understand why?

0:08:06.810,0:08:08.134
Maybe it's this:

0:08:08.158,0:08:12.802
maybe they had an experience[br]of sort of tribal closeness

0:08:12.826,0:08:15.056
in their unit when they were overseas.

0:08:16.075,0:08:18.708
They were eating together,[br]sleeping together,

0:08:18.732,0:08:21.031
doing tasks and missions together.

0:08:21.055,0:08:23.594
They were trusting each other[br]with their lives.

0:08:25.160,0:08:26.833
And then they come home

0:08:26.857,0:08:28.857
and they have to give all that up

0:08:29.851,0:08:33.590
and they're coming back[br]to a society, a modern society,

0:08:33.614,0:08:37.147
which is hard on people[br]who weren't even in the military.

0:08:37.171,0:08:38.796
It's just hard on everybody.

0:08:39.494,0:08:43.417
And we keep focusing on trauma, PTSD.

0:08:44.685,0:08:46.377
But for a lot of these people,

0:08:47.340,0:08:48.537
maybe it's not trauma.

0:08:48.561,0:08:51.116
I mean, certainly,[br]soldiers are traumatized

0:08:51.140,0:08:53.509
and the ones who are[br]have to be treated for that.

0:08:53.533,0:08:54.727
But a lot of them --

0:08:54.751,0:08:57.981
maybe what's bothering them[br]is actually a kind of alienation.

0:08:58.321,0:09:01.091
I mean, maybe we just have[br]the wrong word for some of it,

0:09:01.115,0:09:03.504
and just changing our language,[br]our understanding,

0:09:03.528,0:09:04.702
would help a little bit.

0:09:04.726,0:09:07.438
"Post-deployment alienation disorder."

0:09:07.462,0:09:10.340
Maybe even just calling it that[br]for some of these people

0:09:11.634,0:09:14.212
would allow them to stop imagining

0:09:14.236,0:09:17.002
trying to imagine a trauma[br]that didn't really happen

0:09:17.707,0:09:20.478
in order to explain a feeling[br]that really is happening.

0:09:20.502,0:09:23.019
And in fact, it's an extremely[br]dangerous feeling.

0:09:23.043,0:09:25.783
That alienation and depression[br]can lead to suicide.

0:09:25.807,0:09:27.804
These people are in danger.

0:09:27.828,0:09:29.950
It's very important to understand why.

0:09:31.167,0:09:35.441
The Israeli military has a PTSD rate[br]of around one percent.

0:09:35.650,0:09:41.249
The theory is that everyone in Israel[br]is supposed to serve in the military.

0:09:41.273,0:09:43.383
When soldiers come back[br]from the front line,

0:09:43.407,0:09:47.845
they're not going from a military[br]environment to a civilian environment.

0:09:48.741,0:09:52.448
They're coming back to a community[br]where everyone understands

0:09:53.698,0:09:54.853
about the military.

0:09:54.877,0:09:57.032
Everyone's been in it[br]or is going to be in it.

0:09:57.056,0:09:59.412
Everyone understands[br]the situation they're all in.

0:09:59.436,0:10:01.705
It's as if they're all in one big tribe.

0:10:02.282,0:10:04.316
We know that if you take a lab rat

0:10:04.340,0:10:08.012
and traumatize it and put it[br]in a cage by itself,

0:10:08.036,0:10:11.193
you can maintain its trauma symptoms[br]almost indefinitely.

0:10:11.717,0:10:16.804
And if you take that same lab rat[br]and put it in a cage with other rats,

0:10:18.018,0:10:21.374
after a couple of weeks,[br]it's pretty much OK.

0:10:23.509,0:10:24.771
After 9/11,

0:10:26.549,0:10:29.842
the murder rate in New York City[br]went down by 40 percent.

0:10:29.866,0:10:31.688
The suicide rate went down.

0:10:32.756,0:10:37.260
The violent crime rate in New York[br]went down after 9/11.

0:10:37.284,0:10:42.603
Even combat veterans of previous wars[br]who suffered from PTSD

0:10:42.627,0:10:47.124
said that their symptoms went down[br]after 9/11 happened.

0:10:47.148,0:10:50.584
The reason is that if you traumatize[br]an entire society,

0:10:52.450,0:10:55.669
we don't fall apart[br]and turn on one another.

0:10:55.693,0:10:57.807
We come together. We unify.

0:10:57.831,0:10:59.878
Basically, we tribalize,

0:10:59.902,0:11:05.455
and that process of unifying[br]feels so good and is so good for us,

0:11:05.479,0:11:06.896
that it even helps people

0:11:06.920,0:11:10.214
who are struggling[br]with mental health issues.

0:11:10.238,0:11:12.003
During the blitz in London,

0:11:12.027,0:11:17.040
admissions to psychiatric wards[br]went down during the bombings.

0:11:18.606,0:11:21.828
For a while, that was the kind of country

0:11:21.852,0:11:25.723
that American soldiers came[br]back to -- a unified country.

0:11:26.288,0:11:27.559
We were sticking together.

0:11:27.583,0:11:30.194
We were trying to understand[br]the threat against us.

0:11:30.218,0:11:34.297
We were trying to help[br]ourselves and the world.

0:11:35.521,0:11:37.122
But that's changed.

0:11:38.392,0:11:40.738
Now, American soldiers,

0:11:40.762,0:11:44.582
American veterans are coming back[br]to a country that is so bitterly divided

0:11:45.716,0:11:49.138
that the two political parties[br]are literally accusing each other

0:11:50.670,0:11:53.510
of treason, of being[br]an enemy of the state,

0:11:54.265,0:11:59.025
of trying to undermine the security[br]and the welfare of their own country.

0:11:59.049,0:12:03.182
The gap between rich and poor[br]is the biggest it's ever been.

0:12:03.206,0:12:04.391
It's just getting worse.

0:12:04.415,0:12:06.823
Race relations are terrible.

0:12:06.847,0:12:09.703
There are demonstrations[br]and even riots in the streets

0:12:09.727,0:12:11.706
because of racial injustice.

0:12:12.727,0:12:16.988
And veterans know that any tribe[br]that treated itself that way -- in fact,

0:12:17.012,0:12:21.942
any platoon that treated itself[br]that way -- would never survive.

0:12:23.068,0:12:24.959
We've gotten used to it.

0:12:24.983,0:12:28.836
Veterans have gone away[br]and are coming back

0:12:28.860,0:12:33.301
and seeing their own country[br]with fresh eyes.

0:12:33.325,0:12:34.982
And they see what's going on.

0:12:35.738,0:12:37.593
This is the country they fought for.

0:12:38.433,0:12:40.111
No wonder they're depressed.

0:12:40.135,0:12:41.709
No wonder they're scared.

0:12:43.371,0:12:47.248
Sometimes, we ask ourselves[br]if we can save the vets.

0:12:48.248,0:12:51.418
I think the real question[br]is if we can save ourselves.

0:12:51.905,0:12:53.595
If we can,

0:12:53.619,0:12:55.593
I think the vets are going to be fine.

0:12:56.697,0:12:59.834
It's time for this country to unite,

0:13:01.818,0:13:06.610
if only to help the men and women[br]who fought to protect us.

0:13:07.182,0:13:08.413
Thank you very much.

0:13:08.437,0:13:15.103
(Applause)