TAMPA — It took nearly 30 years before Gerard Abbett could bring himself to enter the VA hospital's mental health clinic, to walk past the discreet little sign that says PTSD (for post-traumatic stress disorder) and sit patiently in a chair beneath the sign that reads: "It takes the courage and strength of a soldier to ask for help."
The men in the clinic are not damaged young warriors just back from Afghanistan and Iraq. They are graying. They are balding and bespectacled. And like Abbett, 59, they have only recently begun to deal with the psychological wounds that they sustained in Vietnam.
Since 1999, the number of American veterans receiving PTSD treatment has more than doubled. About 60 percent of the 400,000 veterans seeking PTSD treatment from the Department of Veterans Affairs are Vietnam veterans, according to figures from the VA. Locally, experts estimate that Vietnam veterans account for 70 percent of cases.
There are several reasons for this surge, experts say.
Many Vietnam veterans are retiring, giving them more time alone with their memories. As they age, a lot of veterans have quit drinking and using drugs, which they had used to cope.
Some veterans are dealing with family issues — like the death of a spouse or birth of a grandchild — that prompt them to re-evaluate their lives. Others have succumbed to a barrage of graphic images of wars in Afghanistan and Iraq.
"Whatever mechanisms they've used over the past 40 years, they aren't working anymore," said Tom Berger, chairman of the National PTSD and Substance Abuse Committee for Vietnam Veterans of America. "You can only drink so much."
All bottled up
Abbett graduated from high school in Massachusetts in 1967 and quickly signed up for the Army, figuring he was going to get drafted to fight in Vietnam anyway. The guys in his unit used to call him "Boston," partly because of his New England accent.
He just wanted to put in his two years in the service and get out. He returned to the United States in 1968, but he didn't really leave Vietnam.
"Living that life and then coming back to the world, people expect you to be the same person that left," he said. "But you're different."
His dad, a Navy pharmacist, saw the difference. Abbett got into fights. He got irritated easily.
"You're shell-shocked," Abbett's father said. He wasn't sympathetic.
Abbett knew he had problems, but he wouldn't seek help. What would his dad think?
He married, but his wife left him after a few years.
He drank and smoked marijuana. "Self-medication," as he calls it.
"Back then it was like, '… I'll just have a beer,' " he said.
All of these behaviors were classic symptoms of post-traumatic stress disorder, a condition that has tormented returning soldiers and other victims of traumatic ordeals long before it became an officially recognized medical diagnosis in 1980.
But even after doctors began to treat PTSD, veterans like Abbett preferred to gut it out on their own.
When it rained at night, Abbett often sat awake at home in Brandon, thinking about the first time he saw a friend killed.
He hadn't been in Vietnam a month on the rainy night his unit was hit in a grenade attack. A piece of shrapnel tore into Abbett's left arm. His friend had a gaping head wound.
"He started moaning and groaning," Abbett said. "Then he howled. I never heard a sound like that.
"Then," he said, "it stopped."
Scenes of warfare on television could trigger flashbacks, but so could something innocuous glimpsed out the car window. Like a palm tree.
He smiles when he thinks about the seemingly illogical decision to move from Massachusetts to a state that so resembles Vietnam.
"Sometimes you look at something," he said, "and it instantly brings you back there."
Abbett could have gone on this way indefinitely. Then one morning a co-worker at the trucking company where he was a dispatcher told him to turn on the television. He watched as the second plane hit the World Trade Center.
For years, the enemy that haunted Abbett lived across the Pacific Ocean. Now, a new enemy had reached America.
Coping with a crisis
Within weeks, Abbett quit his job after an argument with his boss. His anger, depression and anxiety consumed him.
"I was always able to cope," he said, "but this was beyond coping. I think I hid everything I could away."
This time he no longer had his old coping mechanism; he had quit drinking and smoking marijuana in 1999. He was at the point of desperation. He worried that he would hurt himself or others, and that's when he decided to seek the help he had so long avoided.
Turns out he was part of a wave of men reaching their breaking points.
Michael Taylor, 59, of Valrico started seeking treatment in 2000, shortly after he retired from the Philadelphia Navy Yard. He had always dealt with nightmares and flashbacks, but after the Persian Gulf War in the early 1990s, the symptoms worsened.
"Those things never leave you," he said.
Jim Murphy, 58, of Inverness had nightmares off and on ever since he returned from Vietnam. In 2004, the retired Marine said they became unbearable.
"They were things I thought I had forgotten, but I guess not," Murphy said.
'It haunts me'
His primary care physician suggested he get professional help. Twice a month he drives to Ocala for counseling.
The clinic's waiting room is quiet except for the TV and Abbett's occasional small talk about his beloved Red Sox. The men all know why they're here, but they prefer not to talk about it publicly.
In private they will tell their stories because they believe it could help others seek treatment — not just fellow Vietnam veterans, but also soldiers returning from Afghanistan and Iraq.
"I feel bad for these kids coming home today," Taylor said, "because it haunts me, and I know it will haunt them, too."
The VA system is in much better shape now to handle returning troops.
The number of mental health providers employed through the James A. Haley VA Medical Center in Tampa has grown in recent years from 80 to 250, said Dr. Carri-Ann Gibson, Gerard Abbett's counselor and director of Haley's PTSD and Trauma Recovery program. In June, Florida lawmakers approved a $17.4-million expansion at Bay Pines VA Medical Center in St. Petersburg to enhance mental health care.
But troops returning from Afghanistan and Iraq still have a hard time admitting they have a problem.
A recent study published in the New England Journal of Medicine found that less than half of returning troops who met criteria for a mental disorder actually seek treatment. The biggest barrier is still the stigma. About 65 percent of those returning troops say they don't want treatment because "I would be seen as weak," the study reported.
That's just wrong, says Chuck Luster, 59, who waited until he had a stroke in 2005 to deal with his chronic symptoms.
"You certainly wouldn't say that a person who lost his leg in Afghanistan or Iraq was weak for receiving a prosthetic leg," Luster said.
He only wishes it hadn't taken him 30 years to figure that out.
Times researcher Shirl Kennedy contributed to this report. Contact Michael Sanserino at firstname.lastname@example.org or (352) 848-1430.