Why Are Veterans with PTSD Still Struggling to Get the Help They Need?
For many veterans, the battle doesn’t end when they step off the battlefield. Instead, it follows them home, lurking in their minds, disrupting their lives, and making even the simplest tasks feel impossible. Post-Traumatic Stress Disorder (PTSD) is one of the most severe mental health challenges veterans face, yet the support they receive is often inconsistent, slow, or entirely absent.
Despite awareness campaigns and government initiatives, the system designed to help veterans with PTSD frequently falls short, leaving many to navigate their trauma alone. The consequences? High rates of veteran suicide, homelessness, and untreated mental health issues. But why is it so hard for veterans with PTSD to get the support they need, and what can be done to change that?
How Many Veterans Are There, and How Many Struggle with PTSD?
To understand the scale of the problem, let’s look at the numbers:
Yet, despite these numbers, many veterans do not receive proper treatment, often due to long VA wait times, lack of accessibility, or stigma around seeking help.
In Shadows of Tehran, Nick Berg’s story exposes the brutal cost of war—not just the physical wounds but the unseen scars left behind. His journey from special operations to civilian life reflects what thousands of veterans experience: the struggle to find purpose, the fight to regain control of their minds, and the painful reality that society often moves on while they remain trapped in a war that never truly ends.
Why Is PTSD So Hard to Treat in Veterans?
PTSD is more than just nightmares and flashbacks—it’s a full-body response to trauma that affects every aspect of a veteran’s life. It alters brain function, keeping individuals in a constant state of hyper-awareness, as if they were still in combat. This heightened state disrupts sleep, strains relationships, and makes even simple daily decisions overwhelming. Without the right therapy, support systems, and medical care, PTSD can spiral into chronic depression, substance abuse, and even homelessness.
The Veterans Health Administration (VHA) provides cognitive behavioral therapy (CBT), exposure therapy, and medication as standard treatments for PTSD. However, many veterans find these solutions ineffective, slow, or heavily reliant on pharmaceuticals. The backlog and bureaucratic red tape often leave veterans waiting months for mental health services, exacerbating their symptoms and reducing their likelihood of seeking help.
As a result, many veterans are turning to alternative therapies, such as MDMA-assisted therapy, service dogs, and outdoor rehabilitation programs. MDMA-assisted therapy, which was previously designated a “Breakthrough Therapy” by the FDA, showed promise in early trials. However, in 2024, an FDA advisory panel voted against its approval, citing research credibility concerns.
Meanwhile, service dogs have been shown to provide immense psychological relief by reducing anxiety and night terrors, but they are expensive and often not covered by traditional healthcare programs.
PTSD in Shadows of Tehran: A Glimpse into Reality
Is PTSD just a battle wound, or does it reshape a person’s entire existence?
For many veterans with PTSD, the war doesn’t end when the gunfire stops. It continues in their minds, in their daily lives, in the moments that should be peaceful but never are. The trauma lingers—through nightmares, sudden panic attacks, and the struggle to feel safe in a world that no longer feels familiar.
In Shadows of Tehran, Nick Berg’s journey is more than a war story—it’s a testament to the unrelenting psychological battles that follow combat. His life has been shaped by war in ways most people will never experience. Before he became a U.S. Special Operations soldier, he was already fighting for survival as a rebel in Iran, living through the chaos of the Iranian Revolution. He wasn’t just another soldier—he was enemy number one on Iran’s hit list, hunted, betrayed, and forced to navigate the brutal reality of war without a country to call home.
How Does Shadows of Tehran Reflect the PTSD Struggles of Veterans?
Nick Berg’s story mirrors the key struggles of veterans with PTSD, capturing the raw emotions and hidden battles they face:
- The Inescapable Past – Traumatic events don’t fade away. Flashbacks, nightmares, and intrusive thoughts bring the past crashing into the present. Veterans with PTSD often relive the worst moments of their lives over and over again, unable to turn them off.
- The Battle with Trust and Isolation – In war, trusting the wrong person can be deadly. That mindset doesn’t just disappear in civilian life. Many veterans with PTSD struggle to form relationships, feeling disconnected from friends, family, and a society that doesn’t understand them. Nick faces this same struggle—always looking over his shoulder, always questioning who he can trust.
- The Emotional Toll of War – Even the strongest warriors aren’t immune to trauma. PTSD doesn’t just affect the mind—it affects emotions, decision-making, and even the body. Veterans with PTSD often experience uncontrollable anger, sudden emotional detachment, and deep-seated guilt for surviving when others didn’t.
- Resilience in the Face of Trauma – In Shadows of Tehran, Nick fights not only his enemies but also the ghosts of his past. His resilience mirrors the reality of veterans who fight every day to reclaim their lives from PTSD. Recovery isn’t easy, but it’s possible.
PTSD Prevalence Among U.S. Veterans vs. General Population (Recent Findings)
PTSD Prevalence in U.S. Veterans (All Eras)
This is a large, nationally representative survey of 4,069 U.S. military veterans conducted online from November 2019 to March 2020. It used DSM-5 criteria (PTSD Checklist for DSM-5) to identify PTSD.
Key findings:
The weighted prevalence of lifetime PTSD among all U.S. veterans was about 9.4% (95% CI ~8.5–10.3%), and current PTSD (past-month) was 5.0%.
Female veterans had notably higher rates – roughly 11% current PTSD – compared to about 4% in male veterans.
This study also examined trauma exposure types, finding that direct traumatic experiences (combat, violence, etc.) were linked to higher PTSD risk, whereas indirect exposures were not.
The authors note these PTSD rates in veterans are slightly higher than those observed in the mid-2010s and indicate a significant mental health burden in the veteran population
Though a bit older, recent VA analyses cite this large epidemiological study of over 36,000 U.S. adults (including ~3,100 veterans) for baseline comparison. NESARC-III administered structured interviews using DSM-5 criteria.
Key findings:
Among U.S. veterans, the lifetime PTSD prevalence was about 7% overall.
Notably, female veterans had about 13% lifetime prevalence versus 6% in male veterans.
Younger veterans showed higher lifetime PTSD (e.g. ~15% among those age 18–29) compared to ~4% in veterans over 65, suggesting newer veteran cohorts have experienced PTSD at higher rates than older cohorts. The past-year PTSD prevalence in veterans was around 5% (with women ~11% vs men ~5%).
These NESARC-III findings reinforce that PTSD is a common diagnosis in the veteran community as a whole, even outside specific war zones.
To understand the scale of the problem, let’s look at the numbers:
Yet, despite these numbers, many veterans do not receive proper treatment, often due to long VA wait times, lack of accessibility, or stigma around seeking help.
In Shadows of Tehran, Nick Berg’s story exposes the brutal cost of war—not just the physical wounds but the unseen scars left behind. His journey from special operations to civilian life reflects what thousands of veterans experience: the struggle to find purpose, the fight to regain control of their minds, and the painful reality that society often moves on while they remain trapped in a war that never truly ends.
Why Is PTSD So Hard to Treat in Veterans?
PTSD is more than just nightmares and flashbacks—it’s a full-body response to trauma that affects every aspect of a veteran’s life. It alters brain function, keeping individuals in a constant state of hyper-awareness, as if they were still in combat. This heightened state disrupts sleep, strains relationships, and makes even simple daily decisions overwhelming. Without the right therapy, support systems, and medical care, PTSD can spiral into chronic depression, substance abuse, and even homelessness.
The Veterans Health Administration (VHA) provides cognitive behavioral therapy (CBT), exposure therapy, and medication as standard treatments for PTSD. However, many veterans find these solutions ineffective, slow, or heavily reliant on pharmaceuticals. The backlog and bureaucratic red tape often leave veterans waiting months for mental health services, exacerbating their symptoms and reducing their likelihood of seeking help.
As a result, many veterans are turning to alternative therapies, such as MDMA-assisted therapy, service dogs, and outdoor rehabilitation programs. MDMA-assisted therapy, which was previously designated a “Breakthrough Therapy” by the FDA, showed promise in early trials. However, in 2024, an FDA advisory panel voted against its approval, citing research credibility concerns.
Meanwhile, service dogs have been shown to provide immense psychological relief by reducing anxiety and night terrors, but they are expensive and often not covered by traditional healthcare programs.
How Does PTSD in Veterans Compare to the General U.S. Population?
While PTSD affects both military and civilian populations, veterans experience it at significantly higher rates due to the intensity of trauma they face in service.
- In the general U.S. population, about 6–7% of adults develop PTSD at some point in their lives, according to the National Epidemiologic Survey (NESARC-III) and the National Institute of Mental Health (NIMH)
- Each year, roughly 3.6% of U.S. adults suffer from PTSD symptoms, with women experiencing it at higher rates (5.2%) than men (1.8%)
By comparison, veterans have a much higher risk of PTSD:
This gap is largely due to the nature of military service, where exposure to combat, life-threatening situations, and traumatic events is far more common than in civilian life. Research confirms that veterans—particularly those who served in combat roles—are at an increased risk of developing PTSD compared to non-veterans.
These statistics highlight the urgent need for better mental health resources for veterans. Without proper treatment, PTSD can lead to long-term consequences, including depression, substance abuse, and an increased risk of homelessness or suicide.
PTSD: A War That Doesn’t End
Nick Berg’s story in Shadows of Tehran isn’t just fiction—it reflects the reality of thousands of veterans grappling with PTSD. Berg’s journey of survival, betrayal, and war trauma parallels the struggles real-life veterans face every day. His past as a hunted Iranian rebel and his later service as a U.S. Special Forces operator left him deeply scarred, much like many veterans who return from deployment and find that the battle isn’t over—it has only changed form.
For many veterans, PTSD follows them home in the form of nightmares, flashbacks, and emotional isolation. The struggle to find purpose, trust, and a way forward is an uphill battle. But despite these challenges, there are stories of resilience—veterans who have taken back control of their lives despite PTSD. Here are two powerful examples (for the full story, click here):
Andy Reynolds: Brewing a New Purpose
Andy Reynolds served as a Buffalo Commander in the Army, a high-risk role that involved leading convoys and identifying explosive threats. The stress and trauma of his service took a toll, and after returning home, he struggled with PTSD symptoms like anxiety, migraines, and sudden bursts of anger.
One of the things that helped him cope was brewing beer, a passion he discovered while deployed. After his service, he realized that brewing gave him a sense of peace and purpose—something the military had once provided. With help from the Wounded Warrior Project and the VA’s Vocational Rehabilitation program, Andy pursued formal training in brewing.
He eventually opened Alexandria Brewing Company in Kentucky, where he not only runs a successful business but also creates a space for other veterans to connect and heal. His story is proof that finding a new mission can help veterans regain control over their lives.
David Campos: Wrestling with Inner Demons
As an Army Combat Medic, David Campos witnessed firsthand the horrors of war. His job was to save lives under fire, but the trauma of those experiences never left him.
When he returned home, he found himself on edge, anxious, and overwhelmed by anger. Simple things—loud noises, crowded places, even certain smells—triggered painful memories.
For a long time, David avoided talking about his struggles, believing that admitting to PTSD was a sign of weakness. But eventually, he reached out for professional counseling and therapy, which changed his life. He learned that PTSD isn’t a personal failure—it’s a mental health condition that requires treatment, just like any physical injury.
David’s story highlights the power of seeking help and reminds other veterans that they don’t have to suffer in silence.
Veterans Finding Support Through Service Dogs
For many veterans, PTSD creates an invisible wall between them and the rest of the world. Everyday tasks become difficult, and feelings of isolation, hypervigilance, and anxiety take over. But for some, service dogs have become a lifeline—providing not just companionship, but also real, practical support for managing PTSD symptoms.
Veterans like Tarik Griggs and Dick St. Clair have shared how their service dogs help calm them during panic attacks, wake them from nightmares, and create a sense of safety in public spaces. These highly trained animals can recognize signs of anxiety, provide deep-pressure therapy, and even remind their handlers to take medication. For many veterans, service dogs have been the key to rebuilding their independence.
Despite their effectiveness, service dogs for PTSD are not always covered by traditional healthcare programs, making them financially out of reach for some veterans. Advocacy groups and nonprofit organizations continue to fight for greater access to these life-changing companions.
Why Is PTSD Among Veterans Still Overlooked?
The Hero vs. The Reality
Society often celebrates war heroes, yet struggles to confront the enduring psychological battles they face post-service. While books and movies frequently glorify combat, they seldom address the invisible wounds that linger long after the battlefield has been left behind. Shadows of Tehran breaks this mold by delving into the emotional scars that don’t heal easily, offering a more nuanced portrayal of a veteran’s journey.
The Stigma in Military and Civilian Life
The military instills values of strength and resilience, which can inadvertently make seeking help for mental health challenges like PTSD seem like a weakness. This cultural backdrop leads many veterans to feel they must handle PTSD alone—mirroring Nick Berg’s solitary struggle with his past in the narrative. However, seeking help is not a sign of weakness but a crucial component of resilience. The stigma surrounding mental health in both military and civilian spheres often prevents veterans from accessing necessary care, exacerbating their isolation.
A System That Fails Veterans
Many veterans encounter significant barriers when seeking treatment for PTSD, including long wait times and bureaucratic hurdles. This systemic failure forces individuals like Nick Berg, and many real-life veterans, to navigate their trauma with minimal structured support. The lack of public awareness and open discussion about PTSD contributes to insufficient funding and limited solutions, perpetuating a cycle where veterans’ needs remain unmet.
These interconnected factors highlight the urgent need for cultural and systemic changes to better support veterans dealing with PTSD.
The Path to Resilience: How Veterans Overcome PTSD
Finding Purpose After Combat
Nick Berg’s fight for survival didn’t end when the bullets stopped flying—it continued as he sought meaning beyond war. Many veterans find purpose through leadership, storytelling, and advocacy, much like Berg’s story now serves as a voice for others.
Alternative Healing and Recovery
In Shadows of Tehran, Berg pushes through mental battles with the same determination he applied to physical ones—a trait seen in many resilient veterans.
Real-life veterans utilize various therapies, service dogs, and even psychedelic-assisted treatments to manage PTSD. For instance, recent studies have explored the potential of MDMA-assisted therapy for PTSD, offering hope to those who haven’t found relief through traditional methods.
Additionally, some veterans have participated in psilocybin retreats, reporting significant improvements in their mental health.
Brotherhood and Community
Berg’s bond with fellow soldiers mirrors the real-world power of veteran support groups. Recovery is rarely a solo fight—veterans who lean on mentors, communities, and peers often find the strength to move forward.
Organizations like The Mission Continues empower veterans to continue serving in their communities, fostering camaraderie and a renewed sense of purpose. Similarly, initiatives like WeServed, co-founded by SAS hero Andy McNab, provide platforms for veterans to access vital support and reconnect with comradeship.
These avenues—finding new purpose, exploring alternative therapies, and embracing community—highlight the resilience veterans embody as they navigate life after combat.
What Needs to Change? A New Approach to PTSD Awareness, Treatment, and Support
Despite the progress made in PTSD research and treatment, many veterans with PTSD still struggle to access the care and support they need. From public misconceptions to systemic failures in mental health services, several key changes must happen to ensure that veterans receive timely, effective, and stigma-free PTSD treatment.
Public Awareness and Education: Changing the Narrative on PTSD
Many people associate PTSD with Hollywood portrayals of unstable, violent soldiers—a damaging stereotype that prevents veterans from receiving the empathy and support they deserve. In reality, PTSD is a complex, treatable condition, but misconceptions contribute to stigma and policy inaction.
A 2022 study published in the Journal of Anxiety Disorders found that while 76–94% of U.S. adults support increased funding for PTSD treatment, the general public lacks knowledge about PTSD therapies. This knowledge gap means that veterans may not receive the societal pressure needed to push for better mental health policies.
Furthermore, a 2022 study in Frontiers in Psychology found that stigma around trauma survivors leads to discrimination in employment, healthcare, and social relationships. Public education campaigns are crucial to dismantling these harmful stereotypes and creating an environment where veterans feel comfortable seeking help.
One of the most effective public awareness tools has been the VA’s AboutFace program, which features veterans openly discussing PTSD and treatment. Veterans who watched these peer videos were significantly more likely to seek mental health treatment. Expanding initiatives like this can increase PTSD awareness and help-seeking behaviors among veterans.
Expanding Mental Health Support for Veterans: Fixing the System
The Effectiveness—and Shortcomings—of VA PTSD Treatment
The VA provides some of the most effective, evidence-based PTSD treatments, but many veterans do not receive them due to access issues. Research shows that:
- 53% of veterans who complete trauma-focused therapy recover from PTSD, compared to 42% who rely on medication alone
- However, only 9% of veterans in the VA system receive a full course of PTSD therapy, meaning most veterans never complete treatment
- 30–40% of veterans drop out of PTSD treatment prematurely, highlighting the need for better engagement strategies
While the VA has implemented telehealth and community-based mental health services to improve access, wait times remain an issue. A 2024 systematic review in Military Medicine found that while telehealth increased attendance in PTSD treatment, VA outreach efforts had mixed success in reducing wait times (source).
To improve mental health support for veterans, the VA must ensure that more veterans complete therapy by reducing administrative barriers and expanding alternative treatment options.
A System That Fails Veterans
Many veterans encounter significant barriers when seeking treatment for PTSD, including long wait times and bureaucratic hurdles. This systemic failure forces individuals like Nick Berg, and many real-life veterans, to navigate their trauma with minimal structured support. The lack of public awareness and open discussion about PTSD contributes to insufficient funding and limited solutions, perpetuating a cycle where veterans’ needs remain unmet.
These interconnected factors highlight the urgent need for cultural and systemic changes to better support veterans dealing with PTSD.
Traditional vs. Alternative PTSD Treatments: Expanding Treatment Options
Traditional PTSD treatments—Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and SSRIs—are clinically effective but do not work for everyone. Alternative treatments, such as MDMA-assisted therapy, service dogs, and virtual reality exposure therapy, are showing promising results and must be considered as part of the VA’s approach to PTSD care.
Finding Purpose After Combat
A 2023 Phase 3 clinical trial in Nature Medicine found that 71.2% of veterans receiving MDMA-assisted therapy no longer had PTSD after 18 weeks, compared to 47.6% in the placebo group.
The FDA is reviewing MDMA-assisted therapy for approval, which could offer a powerful alternative for treatment-resistant PTSD.
A 2024 JAMA Network Open study found that veterans with trained service dogs had significantly lower PTSD symptoms and better overall well-being than those in standard PTSD care.
Despite this, service dogs are not covered under VA healthcare, making them inaccessible for many veterans. Expanding funding for service dogs could provide a life-changing solution for veterans who do not respond to traditional therapy.
A 2023 randomized trial in Translational Psychiatry found that Virtual Reality Exposure Therapy (VRET) was just as effective as traditional exposure therapy for PTSD, but veterans with comorbid depression responded better to VR-based therapy.
Integrating VR therapy into VA PTSD clinics could improve treatment outcomes for specific veteran populations.
Veterans often hesitate to share their struggles due to military culture and societal stigma. However, research shows that when veterans openly discuss their PTSD, it can inspire others to seek treatment.
A 2023 pilot study in Internet Interventions found that veterans who watched peer videos discussing PTSD were 62% more likely to start treatment within a month.
The VA’s AboutFace program, which features veterans discussing PTSD recovery, led to a significant increase in help-seeking behaviors.
Research in JAMA Psychiatry (2024) suggests that public testimony from veterans about PTSD helps shift public perception and reduces stigma.
Veterans like Nick Berg in Shadows of Tehran serve as powerful examples of resilience, demonstrating that PTSD is not the end of the road, but rather a challenge that can be faced head-on.
By sharing their experiences, veterans can help dismantle stigma, encourage others to seek help, and push for stronger mental health policies.
Conclusion: A Call for Action
To truly support veterans with PTSD, we must:
- Expand public awareness campaigns to reduce stigma and build support for better policies.
- Improve access to VA mental health services, ensuring more veterans complete PTSD therapy.
- Integrate alternative treatments, such as MDMA-assisted therapy, service dogs, and VR therapy, into mainstream PTSD care.
- Encourage veterans to speak out, using their stories to inspire change and combat stigma.
With public awareness, policy action, and medical innovation, we can create a system where veterans no longer suffer in silence, but receive the support they deserve.
Conclusion: The Real Battle Never Ends
Shadows of Tehran isn’t just a war story—it’s a glimpse into the reality of what happens when war follows you home. The battlefield may be thousands of miles away, but for veterans with PTSD, the fight never truly ends.
Nick Berg’s story embodies the resilience veterans must summon every single day. From his time as a hunted rebel in Iran to becoming a U.S. Special Operations soldier, Berg’s life has been a constant battle for survival—one that didn’t end when the fighting stopped. Like many real-life veterans, he had to learn how to fight an invisible war against trauma, isolation, and a system that often fails to provide adequate support.
But resilience alone isn’t enough. Veterans shouldn’t have to fight for proper mental health care. They shouldn’t have to battle stigma or navigate a broken system just to get the help they deserve.
It’s up to society as a whole to step up—to ensure that veterans aren’t left behind, struggling with PTSD in silence.
How Can You Help?
You don’t have to be a veteran to make a difference. Here’s what you can do to support those who’ve served:
- Read and share veteran stories. The more we talk about PTSD, the less power the stigma holds. Listen to veterans. Read books like Shadows of Tehran, which shed light on what happens after combat.
- Support organizations helping veterans with PTSD. Groups like the Wounded Warrior Project, Soldiers’ Angels, and the National Center for PTSD provide critical services. Consider donating, volunteering, or spreading the word.
- Challenge the silence around mental health struggles. If you know a veteran struggling with PTSD, encourage them to seek help. Advocate for better mental health resources and policies that prioritize veteran care.
PTSD doesn’t just affect veterans—it affects families, communities, and the entire nation. By taking action, we can change the narrative, improve access to care, and ensure that no veteran has to face PTSD alone.
The battle doesn’t end when the war is over. But with awareness, support, and real change, we can make sure that every veteran has the opportunity to heal, recover, and move forward.
