SANDISFIELD, Mass.—Nightmares of a friend dying beside him in a bunker years ago now waken Donald Vitkus. “There is stuff that you carry from the war,” the 71-year-old Vietnam veteran said.
Mr. Vitkus spends his days in and out of therapy at a residential rehabilitation center filled with mostly older veterans, working on his memory while trying to gain control over disturbing recollections and the emotions they surface.
He is one of hundreds of thousands of aging Vietnam veterans who late in life are now seeking help for post-traumatic stress disorder—a mix of flashbacks, depression and sleeplessness springing from a war that ended four decades ago.
More than 530,000 veterans received treatment for PTSD from VA hospitals and clinics through March of this year, nearly double the total through 2006, according to the Veterans Administration. Iraq and Afghanistan veterans make up a large portion of the increase but account for slightly more than a quarter of PTSD patients; the rest served in earlier wars, mainly Vietnam.
Many of those Vietnam veterans threw themselves into family and work after the war, keeping busy to avoid thinking about what happened. Now, in their 60s and 70s, they have retired, their children grown, living without the distraction of workaday life. Some no longer have confidants—spouses, friends or siblings.
Edgardo Padin-Rivera, chief of Psychology Services at the Louis Stokes Cleveland VA Medical Center, said many returning Vietnam veterans didn’t seek treatment at the time because they were ashamed or felt they didn’t need it. Now, they make up the bulk of his patients, he said: “War memories are forever.”
Their experience suggests a long and costly journey ahead for men and women who served in Iraq and Afghanistan. “There is no doubt that we will see the re-occurring of these problems among younger veterans,” Dr. Padin-Rivera said. “They will be coming to us in 30, 40 years, having never been treated before and having never integrated what happened into their lives.”
The aging process itself can trigger PTSD or surface latent symptoms, doctors say, as veterans face serious health issues that force limits on driving, working and walking. Subsequent feelings of vulnerability and powerlessness can mimic feelings similar to those experienced by soldiers overwhelmed by war.
With age, too, comes introspection. “A lot of unfinished business clamors in our heads from the war,” said Dave McPeak, a 66-year-old Marine Corps Vietnam veteran and psychologist, who has worked predominantly with Vietnam veterans at the Vet Center in Pittsburgh, which is part of the Veterans Administration.
During his 35-year career, Mr. McPeak has seen three waves of veterans. Many in the first wave were drug addicts, he said, whose habits led to early death. Alcoholics, whose productive lives lasted slightly longer, followed.
A third wave of older veterans, plagued by nightmares and other symptoms, is now arriving. “They have more time on their hands,” Mr. McPeak said. “The war creeps back into their conscience.”
Experiencing PTSD late in life might also surface other health issues. “When you’re coping with severe traumatic memories for 45 years, certainly one could say it has an impact on your autoimmune system,” said Tom Berger, executive director of the Veterans Health Council at the Vietnam Veterans of America.
Some experts question the reported rise in PTSD cases. Christopher Frueh, a University of Hawaii psychologist and former clinician and director of a VA PTSD clinic, said the VA has relaxed criteria in determining PTSD—for example, not requiring documentation of exposure to a traumatic event—making it easier for veterans to misrepresent their combat experience.
The VA said there was the possibility of under- or over-diagnosis, as with any medical or psychiatric condition, and that it has enhanced training programs to provide more accurate assessments.
PTSD wasn’t identified as a medical disorder until 1980, after the emotional troubles of Vietnam veterans became too overwhelming to dismiss.
“Vietnam put a name on what we have,” said Ken Seybold, a heavy equipment operator during the Tet offensive in Vietnam. He believes he was the first in his hometown of Latrobe, Pa., to enlist and the first to return from the war. “There was no one to talk to about being in Vietnam,” he said. “If you tried, they would say ‘Get over it. That was yesterday.’ No one else could understand what I went through.”
At night, he walked the edges of his yard, sat in the garage or on his front porch, staying awake to see the sunrise. During the war, his best friend, struck in the chest by a mortar, crawled 75 feet to ask him to tell his wife he loved her. “I felt guilty that I made it back and he didn’t,” said Mr. Seybold, who later delivered the dying man’s message.
A neighbor eventually took Mr. Seybold to the VA and told the receptionist, “He never sleeps.” Mr. Seybold, 66 years old, began receiving partial disability benefits for PTSD in 2000, and he now attends monthly sessions with a dozen other veterans. “It felt so damn good to find out I wasn’t the only one,” he said.
Most veterans don’t get PTSD. Experts say those spared often have better coping skills or a stronger support system. Rank doesn’t matter. The disorder affects former captains, privates and cooks.
“I was not the type of person who would get PTSD,” said Herman Williams, three-time recipient of the Purple Heart and member of the celebrated Magnificent Bastards unit of the Marine Corps. He played football, ran track and was the 1966 class president at Liberty High School in the coal-mining town of Williamson, W.Va.
With all seven uncles in the military, there was little question Mr. Williams would enlist during the Vietnam War. “I was a patriot,” the 67-year-old veteran said from a table in his Cleveland home, his military commendations spread before him.
His distinguished career came at a price. While a teenager, he saw his battalion wiped out. For years, he blamed himself for the death of his best friend and a Vietnamese baby. “I felt responsible for everything bad that had happened even though I was just 18 years old,” Mr. Williams said.
He had a hard time settling down after the war, he said, but eventually married and raised a family, working as clerk at the Veterans Administration and repairing TVs part-time. Mr. Williams didn’t go to movies, grocery stores or family reunions. He said people stared. Short-tempered, he once shot a Rottweiler after its owners taunted him. “I had PTSD,” he said, “but I didn’t know it.”
Mr. Williams had four 12-week therapy sessions but still couldn’t visit stores or crowded places. While driving, a landscape of trees could unexpectedly place him in another time and place, making his head hurt and his heart race.
Three years ago, Mr. Williams began an intensive program and regained memories that helped him realize he wasn’t responsible for his friend’s death: “It all came back to me. I thought I shot him,” he said. Mr. Williams recalled how, instead, his friend had held a grenade that detonated in his hands.
Therapy was difficult, he said, but he began going to grocery stores, starting with five-minute visits. Mr. Williams said he tells other struggling veterans, “You don’t cure PTSD. You learn to manage it.”
There remains one memory he has yet to escape. His unit had set fire to a village, and a woman fled her hut screaming about a baby. Mr. Williams found a badly charred baby inside and carried it out. He said he still washes his hands compulsively with hot water, trying to get the feel of the dead infant off his hands. “It’s like my hands sunk into this baby,” he said.
Traumas from abusive childhoods, assaults or accidents also can compound war-related PTSD, making symptoms worse and treatment more difficult. Over a lifetime, “You can’t determine how much PTSD is from this event and that event,” Dr. Padin-Rivera said.
Mr. Vitkus is one of those veterans who may never untangle his childhood traumas from those of war. Abandoned as an infant by his teenage mother, he was placed in foster care before being sent in 1949 to Belchertown State School in Massachusetts, an institution for people with developmental disabilities. He was wrongly labeled mentally retarded.
Every Sunday as a child, Mr. Vitkus said, he would watch the cars of arriving visitors, hoping his mother would come to retrieve him. He worked in the printing press and bakery, and helped care for others. He finished 4th grade.
His life changed, Mr. Vitkus said, seeing the Rev. Martin Luther King Jr. talk about freedom and civil rights during a speech broadcast on a TV kept in a locked cage in a community room. Rebelling against his own lack of freedom, he grew aggressive, challenging workers who beat disabled residents, and ran away, using a crude key he fashioned from a hangar. A staffer finally petitioned for Mr. Vitkus’ release, saying he was too intelligent to live there.
Once out, he got a job washing dishes at a Catholic orphanage and then at a veterans home before joining the military. “I wanted to go,” he said, and adjusted easily to Army life, already accustomed to wearing commissioned clothes, eating institutional food and taking orders.
Trained as a cook, Mr. Vitkus served food and saw limited combat. But during one nighttime advance, his friend died next to him in a foxhole, which Mr. Vitkus didn’t realize until dawn. He blames himself, saying he should have sought a medic that night. “I was a coward,” he said.
When he returned home, Mr. Vitkus married and had two children. He took night classes through the GI Bill to complete high school and worked 60 to 70 hours a week at an envelope factory. “I wanted to keep busy and not think about anything,” he said.
After three decades, he was laid off, and at age 60 he began college, using training funds from the North American Free Trade Agreement. He obtained an associate degree in human services and worked with people with developmental disabilities. Co-workers and families credit him for helping his clients make great strides.
“I worked hard because I know what it’s like not to be cared for,” said Mr. Vitkus, who became vice president of a statewide advocacy group in Massachusetts. He would begin speeches saying, “I am Donald Vitkus and I am a former moron.”
In 2008, he started having seizures and memory loss. Doctors discovered a nonmalignant brain tumor. Forced to quit working and driving, Mr. Vitkus felt powerless. “Being unable to work was difficult for him,” his son, David, said.
Mr. Vitkus grew frustrated, angry and depressed. His wife, Pat, and his son persuaded him to seek help from the VA. “It’s hard for me to ask for help,” he said. “I fought so long to be independent.”
During an interview with a psychologist, Mr. Vitkus revealed memories he had never shared. He talked about his friend’s battlefield death and a recurring nightmare of being court-martialed for not saving him. “I wake when they put the handcuffs on,” he said. He still struggles with guilt. “I should have been the one hit because I didn’t have anyone,” he said.
In June 2013, Mr. Vitkus was awarded 100% disability for his PTSD and heart disease. The diagnosis helped explain his anger and depression, his wife said: “The war bothered him a whole lot more than he let on.”
Since December, Mr. Vitkus has lived at the Berkshire Rehabilitation & Skilled Care Center, a single-story building in the Berkshire Mountains of Massachusetts. Banners from all branches of the armed services hang above the entrance.
Walking through the corridors, Mr. Vitkus shakes hands with other veterans. He plays bingo and cards to improve his memory, and logs his medications on his iPhone. “I realize that I’m in better shape than anyone here,” he said.
But the war is never far off. When he sleeps, he faces the wall and wears eye coverings, ear plugs and a sweatshirt zipped up over his head. “It makes me feel safe,” he said. “In Nam, there were flashes of lights, the missiles and jets and rounds fired.”
He recently dreamed of children, 2 and 3 years old, lining a road, he said. Some were walking, others dead. He was on patrol and people were yelling to kill the children because they were diseased.
Through therapy, he said, “They’re helping me realize what is going on inside, what is real and what isn’t.”
Mr. Vitkus gets frustrated that he again lives in an institution that he can’t leave without permission. But he tries to keep his good humor, joking about bingo winnings, and keeping a focus on his accomplishments.
“My kids and grandkids tell me I should be proud of my life and what I have done and how I made it,” he said.
David Vitkus said his father doesn’t take freedom for granted. “He’s fought for it in pretty much every way possible. He still is.”