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Shooting Of 'American Sniper' Raises Questions About PTSD Treatment

Police in Texas have charged Eddie Ray Routh, a 25-year-old U.S. Marine reservist, with capital murder. Arrest records indicate that Routh had been twice taken to a mental hospital in recent months, and had told police he was suffering from post-traumatic stress disorder.

It's not clear whether a doctor had diagnosed Routh with the disorder before he allegedly murdered Chris Kyle and his friend Chad Littlefield. Kyle, a retired Navy SEAL and author of the book American Sniper, had taken Routh to a shooting range apparently as a form of therapy.

A few hours later, Routh's sister Laura Blevins called 911. In a recording of that call, she said: "My brother just came by here ... He told me that he just committed a murder."

She then put her husband, Gaines Blevins, on the line.

"He said he killed two guys at a shooting range," he said. "But he's recently diagnosed with PTSD, and he's been acting real weird."

Police later apprehended Routh driving Kyle's pickup truck.

Working With Troubled Veterans

Todd Vance, who is also an Iraq War vet, coaches a mixed martial arts group for veterans in San Diego. He says many veterans see hiking, hunting or shooting as a way to re-create their military experience, but without the danger. Vance, who's getting a degree in social work, has also received treatment for PTSD. Now, he says fighting in the gym helps him.

"Everybody deals with it differently," he says. "Somebody could look at me and say, 'You get punched in the face seven days a week — that seems like pretty risky behavior, as well.' But in reality, it's keeping me out of trouble."

Vance says what he does is a perfectly normal activity, and that it could even be used as a form of exposure therapy, one of the cognitive therapies known to help with PTSD. The idea is to help a patient remember traumatic events without re-experiencing the trauma.

It's not clear that's what Kyle was trying to do by taking a fellow veteran to the shooting range — and any sort of therapy is meant to be done with a doctor's supervision.

Cognitive therapies and a limited number of drugs are the only treatments for PTSD backed by empirical studies. But with hundreds of thousands of veterans suffering, there are a lot of experimental methods out there.

"The big challenges here ... [are] what we know that works doesn't work for everyone," says Dr. Farris Tuma, with the National Institutes of Health. "And there's limited availability of the things we know do work. "

Treatments include everything from virtual reality to yoga, and even spending time with dogs or horses. Doctors sometimes try other drugs, from antipsychotics to the recreational drug Ecstasy. Tuma just wishes he had evidence to say what helps and what hurts.

Many suffering from PTSD are "essentially using their own experience and maybe something they've read about," says Tuma. "But the bottom line is ... we don't have good guidance for them."

The Pentagon has financed a major study, due out next year, to assess all these treatments. Sandro Galea, the head of the epidemiology department at Columbia University, is leading the effort, and he says there's new funding, new understanding of PTSD, and new research on how the brain works.

"So there is a lot going on, and it is that depth of activity that makes me say I'm optimistic," Galea says. "There's a lot of effort invested by practitioners of all stripes to deliver PTSD care to those who need it."

Galea says he hopes the public will soon see PTSD as an injury — like a broken arm — that can be treated. But destigmatizing PTSD has already had another effect: A lot more people are seeking treatment.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

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