An ocean and three decades now separate Johnny Lê and Peter Nguy?n from the horrible days they spent in Vietnamese labor camps after the 1975 fall of Sài Gòn, but they still can’t bear to talk about the details. The two former South Vietnamese army officers still are as close as a vivid flashback away from their tormentors and the inhumane treatment to which they were subjected.

Lê, 79, and Nguy?n, 66, are among untold numbers of former South Vietnamese soldiers forced to live in the Communist reeducation camps who now suffer from post-traumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to a terrifying event or ordeal that involves a severe trauma in which grave physical harm occurred or was threatened.

The flashbacks to their days of starvation, hard labor, countless beatings and living in constant fear for their lives as they saw others around them being killed unmercifully are just some of what PTSD victims endure, both experts on the condition and sufferers interviewed said.

In Southern California, where the greatest number of Vietnamese live outside of the country itself, Phi H?ng Nguy?n Voss has worked with PTSD sufferers from her homeland for 17 years. In addition to former labor camp sufferers, she works with many of their wives, who also were traumatized while their husbands were imprisoned, she said.

Symptoms of PTSD including fear, anxiety, irritability, insomnia, nightmares, stomach problems, headaches and loss of appetite make it very difficult for many sufferers to live normal lives, Voss said. In extreme cases, victims may suffer from psychotic episodes, hearing voices or seeing people who are not there.

The flashbacks, in which sufferers vividly recall the horrors of their traumas, can occur at any time and with no warning.

"A noise or smell could bring them back. In very severe case, (they) feel numb and go back to what they experienced," she said.

While for Lê and Nguy?n it was their labor camp experiences that led to their PTSD, others from their country endured other traumas as well, including women, who were subjected to violent acts themselves, said J. David Kinzie, who has worked for 30 years with people suffering from the disorder at the Oregon Health and Science University Intercultural Psychiatric Program in Portland.

Those who made it to the refugee camps found themselves lacking, or being deprived of, food and water; being exposed to various infectious diseases and other ailments for which they had no treatments; living in overcrowded and unsanitary conditions, and experiencing physical assaults and/or deaths of family members, Kinzie and other experts said.

The traumas continued for most Vietnamese when, upon their arrivals in the United States, they found themselves facing language and cultural barriers, as well as isolation, hostility and even racism.

Even though it has been around for years, PTSD entered wide public consciousness after the Vietnam War, when American veterans suffering from the syndrome had difficulties receiving veterans’ disability benefits because the condition had no psychiatric diagnosis.

The disorder affects about 7.7 million Americans, according to the National Institute of Mental Health (NIMH), but specific numbers for Vietnamese American PTSD sufferers are not available.

Roughly 30 percent of Vietnam veterans developed PTSD, and the disorder has been detected in as many as 8 percent of Gulf War veterans, according to psychologytoday.com and the NIHM, which has few statistics on the disorder, a spokesperson said.

PTSD can affect all aspects of a sufferer’s life, starting with detrimentally affecting their interpersonal relationships and jeopardizing their jobs, Voss said.

Even though the Vietnam War ended more than 30 years ago, Voss still meets new patients whose PTSD began as a result of that conflict, she said. These patients generally "are 50 or 60 years old (and) should have come 10 years ago, but didn’t know. (Often it) is children urging parents to go get help. Most of them are referred by medical doctors," she said.

For those with PTSD who endured time in the labor camps, group therapy sometimes is the best way to approach the problem, she said. In her experience, one-on-one meetings with therapists may not always be the best treatment for them because such meetings can elicit flashbacks to their face-to-face interrogations and/or torture at the hands of the Communist jailers, she said. Meeting as a group and sharing their stories makes them feel less alone, Voss said.

Group sessions are the primary way that St. Anselm’s Cross-Cultural Community Center in Garden Grove, Calif., helps those with PTSD feel less alone, said Nguy?n, of Anaheim, Calif.

A program for torture survivors that has since lost its funding led to a support group that continues today; it is led by Nguy?n, who is a program manager at St. Anselm’s. The center provides services for refugees from all countries, and the support group includes natives of not only Vietnam, but also Afghanistan, the Middle East, and East Africa.

The Vietnamese American members of his PTSD group consist primarily of labor camp torture survivors, many of whom have or have had difficulties forming or maintaining relationships, even with loved ones because of feelings of shame, guilt, distrust and fear, Nguy?n said.

It is the support that the PTSD survivors get from others who endured similar traumas that plays an important role in breaking through the personal and social isolation they feel, he said.

In the months preceding the fall of Sài Gòn, many in South Vietnam had believed that when the Communists took over their country, they would kill them, "but they did not do so. They let us live painfully and killed us slowly for disease, for starving and most of all they wanted us suffering," Nguy?n said.

As with many others in the St. Anselm’s PTSD Support Group, Nguy?n started having PTSD-related difficulties soon after his release from imprisonment, and also like his peers, he had no idea what was causing those problems, he said. His symptoms included flashbacks, insomnia and nightmares, on those rare occasions when he was able to sleep, he said.

Getting help when he moved to the U.S. in 1996 was not so easy for Lê, who first settled in North Carolina, where programs for PTSD sufferers who speak only Vietnamese were nonexistent, he said through an interpreter.

A few years later, after he moved to Southern California, friends suggested he seek help from St. Anselm’s, which has staff bilingual in Vietnamese and other foreign languages, and soon he joined the support group, sharing his story with others and slowly gaining an improved quality of life, he said through the interpreter.

Lê, Nguy?n would not recount specifics of their trauma.

With many of the PTSD sufferers with whom he works, Nguy?n said he must earn their trust slowly. Eventually, they become more willing to share their stories with him and with other members of the group, he said.

While the support group and his strong faith in God seem to be enough treatment for Nguy?n to maintain a good quality of life, he said, others require professional counseling or intervention by psychiatrists. For this reason, he regularly refers some clients for mental health evaluations and treatment, Nguy?n said.

What is PTSD?
Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. During this type of event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening. Anyone who has gone through a life-threatening event can develop PTSD. These events can include:
-Combat or military exposure
-Child sexual or physical abuse
-Terrorist attacks
-Sexual or physical assault
-Serious accidents
-Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake

After the event, you may feel scared, confused, and angry. If these feelings don’t go away or they get worse, you may have PTSD.

How does PTSD develop?
All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

Many people who go through a traumatic event don’t get PTSD. It isn’t clear why some people develop PTSD and others don’t. How likely you are to get PTSD depends on many things. These include:
-How intense the trauma was
-If you lost a loved one or were hurt
-How close you were to the event
-How strong your reaction was
-How much you felt in control of events
-How much help and support you got after the event

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. Between 40 percent and 60 percent of people who develop PTSD get better at some time. But about one out of three people who develop PTSD always will have some symptoms.

What are the symptoms of PTSD?
Symptoms of PTSD can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms may come and go over many years. If the symptoms last longer than four weeks, cause you great distress or interfere with your work or home life, you probably have PTSD.

What are other common problems?
People with PTSD may also have other problems. These include:
-Drinking or drug problems
-Feelings of hopelessness, shame, or despair
-Employment problems
-Relationships problems including divorce and violence
-Physical symptoms

What treatments are available?
Today, there are good treatments available for PTSD. When you have PTSD dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But talking with a therapist can help you get better.

Cognitive-behavioral therapy is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. There is also a similar kind of therapy called eye movement desensitization and reprocessing that is used for PTSD. Medications have also been shown to be effective, as well.

Source: National Center for Posttraumatic Stress Disorder