The next time you're on the road, pay close attention to every pothole, piece of garbage and pile of dirt you come across. Imagine each one hides a bomb. The abandoned car on the side of the road also contains a bomb. Now, try to focus on driving.
This scenario simulates how some returning members of the U.S. military feel behind the wheel if they're suffering from post traumatic stress disorder (PTSD), which produces severe anxiety after exposure to extreme psychological trauma, such as military combat.
A review of driving records by USAA, an insurance company that caters to active-duty and retired members of the military, found that car accidents that were the fault of members of the military rose by 13 percent in the first six months after an overseas tour. The study was done before and after overseas deployments from 2007 to 2010.
The USAA study didn't identify the causes for the spike in auto accidents. However, USAA spokesman Roger Wildermuth, says: "Experts we’ve worked with explain this (increase in accidents) as a matter of learned driving behaviors that can save your life during deployment and can sometimes carry forward to civilian driving."
Not everyone with PTSD admits he has it or is even aware of it, says Marc Samuels, an occupational therapist and driving specialist who works with soldiers and veterans at the VA Palo Alto Health Care System in California.
"There's a stigma to PTSD," Samuels says. "In addition, it can often be initially misdiagnosed as road rage."
Which military branch is affected most?
The USAA report found that the jump in at-fault accidents was greatest for members of the Army, whose at-fault accidents rose by 23 percent. They were followed by Marines (12.5 percent), Navy (3 percent) and the Air Force (2 percent).
Other findings include:
• Drivers below age 22 experienced a 25 percent increase in at-fault accidents, compared with 7.5 percent for drivers older than 29.
• Accidents prompted by "objects in the road" increased more dramatically after deployment than any of the other 12 causes tracked in the study.
• Losing control of the vehicle was cited as the most frequent cause of accidents.
• Drivers at least three deployments experienced 36 percent more at-fault accidents, compared with 27 percent for two deployments and 12 percent for one deployment. Along with a higher number of deployments, longer deployments generally were linked to a spike in at-fault accidents.
Erica Stern, an associate professor of occupational therapy at the University of Minnesota, has studied this "carryover" behavior -- actions that were potentially lifesaving in deployment but unsafe on civilian roadways. For instance, a deployed soldier may swerve 10 feet to go around an object on the road -- an object that could be a bomb known as an IED, or improvised explosive device. This behavior can become automatic while a soldier is deployed, Stern says, but it's unsafe on a busy civilian road.
For every soldier who performs dangerous moves on the roads back home, many more are giving up driving altogether, Samuels says.
"Although the dramatic, dangerous driving stories make it more frequently in the news, many vets simply stop driving, isolate themselves or self-medicate with alcohol and drugs," Samuels says.
For more information about post-combat driving, visit www.amedd.army.mil/r2d/post_combat.html.
One tool being used to help combat behind-the-wheel demons is a smartphone app called PTSD Coach. Developed by the U.S. Department of Veterans Affairs and the U.S. Department of Defense, the app allows a soldier or veteran to identify conditions such as stress, sadness, anger and anxiety.
"We're working on additional features where people take the self-assessments from the app and bring it to their psychologist," Samuels says. "The self-assessment can help the therapist design an effective intervention program."
Driving simulators also work well, especially for those who have stopped driving. "It's a first step toward getting them back to driving," Samuels says.
Samuels says that around the country, 48 driver rehabilitation programs are available to returning soldiers and veterans. Not all of these programs are PTSD-specific.
"Going to work and picking up the kids are adult roles that hinge on driving," Stern says. "Soldiers who are discarding these roles do so at a loss to themselves."