This Monday at 2 PM Baghdad time, a US soldier gunned down five fellow soldiers at a stress-counseling center at a US base in Baghdad. Adm. Mike Mullen, the chairman of the US military's Joint Chiefs of Staff, told reporters at a news conference at the Pentagon that the shootings occurred in a place where "individuals were seeking help." Admiral Mullen added, "It does speak to me, though, about the need for us to redouble our efforts, the concern in terms of dealing with the stress.... It also speaks to the issue of multiple deployments."

    Commenting on the incident in nearly parallel terms, US Secretary of Defense Robert Gates said that the Pentagon needs to redouble its efforts to relieve stress caused by repeated deployments in war zones that is further exacerbated by limited time at home in between deployments.

    The condition described by Mullen and Gates is what veteran health experts often refer to as PTSD (post-traumatic stress disorder).

    While soldiers returning home are routinely involved in shootings, suicide, and other forms of self-destructive violent behaviors as a direct result of their experiences in Iraq, we have yet to see an event of this magnitude in Iraq.

    The last reported incident of this kind happened in 2005 when an Army captain and lieutenant were killed when an anti-personnel mine detonated in the window of their room at a US base in Tikrit. In that case, National Guard Staff Sgt. Alberto Martinez was acquitted.

    The shocking story of a soldier killing five of his comrades does not come as a surprise when we consider that the military has, for years now, been sending troops with untreated PTSD back into the US occupation of Iraq.

    Last summer I spoke with Bryan Casler, a Marine who had served in both Iraq and Afghanistan. Casler suffered from chronic PTSD, continued to have nightmares and was grinding his teeth so badly that he had dislocated his jaw.

    "I'm still on edge 24/7," Casler explained, "I have trouble being in social environments. I never thought of myself as suicidal, and I still don't, but for the past few months there have been points where I was driving and I would close my eyes for 15 seconds and just think about what it would be like to crash my car into a concrete barrier. That's not me. I never had these thoughts until after I got out [of the military]. I just don't feel like myself. I was always a hopeless romantic and now I have relationship problems. The greatest girlfriend in the world and I know it's not her fault. I just have personal problems I have to work out. There are just so many issues. I'm not at rest. And there are these regrets. I think about the Iraq war way too much. I wish I could think about my family more than I think about Iraq. And it's draining me. I can't focus in class. I can't focus at a job. I was working for a union, and I was picketing for the union, and all I could think of was how to end this war. I cannot attend to things that are outside the realm of ending this war."

    War is an atrocity. War is bilateral psychosis. War brings nothing but destruction and suffering to everyone involved in it, whether they be Iraqi civilians or US soldiers occupying Iraq.

    "I saw so many things happening and I knew they were wrong," Casler added, "I can't speak for everybody, but I think a lot of people have PTSD from regrets, about something they did earlier that they now have a problem with. It is immaterial whether you thought it was right or wrong when you did it. All that matters is that now you have a problem with your actions and there's this inner turmoil. I have this inner turmoil every day. I was indoctrinated into the military spirit and the perpetuation of lies."

    Complicating things is that the US military has been medicating soldiers before they are redeployed to Iraq, in order to keep enough boots on the ground. An anonymous survey of US troops taken during Fall 2007, used as part of the data in the Army's fifth Mental Health Advisory Team report, found that 12 percent of combat troops in Iraq and 17 percent in Afghanistan were on prescription drugs that were mostly antidepressants or sleeping pills.

    Sgt. Christopher LeJeune has first-hand experience of this "treatment." He was diagnosed with depression and the military doctor he consulted sent him back into the field with the antidepressant Zoloft and an antianxiety drug called Clonazepam. He feels, "For a variety of reasons it is not easy for soldiers to admit the problems that they're having and if they do admit it, the only solution they are offered is pills."

    Two out of five suicide victims among troops in Iraq and Afghanistan have been found to be on antidepressants.

    Consecutive deployment with little recovery time in the interim, like what Casler experienced and what both Mullen and Gates commented about, has also affected veterans' mental health adversely.

    It is common for soldiers to have only two weeks off between postings to Iraq and Afghanistan by rotation. Indiscriminate use of the "stop-loss" policy and widespread incidence of extension of deployments have aggravated an already critical situation.

    On May 9, 2008, The Los Angeles Times reported that the number of soldiers held in the Army under the stop-loss program in March 2005, reached a high of 15,758. In August 2008, the House Appropriations Defense Subcommittee approved a $500 monthly payment for soldiers whose separations or retirements had been delayed by stop-loss orders since October 2001. The promised incentive has failed to boost morale.

    Pentagon records expose one conspicuous result of the Army's frantic stop-loss policy since 2003. As Gregg Zorova reported for USA Today on May 8, 2008, over 43,000 troops declared medically unfit for combat in weeks prior to their scheduled departure to Iraq or Afghanistan were redeployed anyway.

    Army psychiatrist Col. Charles Hoge told Congress in March 2008, that nearly 30 percent of troops on their third deployment are mental wrecks. Recent research has proved that the year's break that soldiers are currently permitted between combat tours "is insufficient time" for them "to reset" and recover from stress before proceeding back into combat.

    Sergio Kochergin, back home from his second deployment in Iraq, held a gun in his mouth, trying to muster the courage to pull the trigger. Untreated PTSD and accompanying nightmares and insomnia, heavy substance abuse and several failed attempts at self-medication had taken their toll on him. He was in an apartment he shared with a friend in Texarkana, Texas. He had spent the past few months with his parents, where he "was drinking too much and causing too much trouble, breaking things, flipping out every day, and cursing at them." The decision to end his life came in early 2007, from a desperate need for relief and to avoid deployment back to Iraq. Although Kochergin's contract had expired, it would have taken more than six months for him to be medically discharged from the military, in which period he was sure to be redeployed.

    A year later, describing his aborted attempt to me, Kochergin said, "I had a 40-caliber in my mouth for a long time, trying to figure out the right thing to do. Should I put an end to this suffering or should I allow it to continue to torment me? Fortunately, I fell asleep and woke up the next morning. My roommate came in and fucking flipped out on me and took the gun away to his parent's house. I stepped out, and with a deep breath of air I was like, 'Man, this is way too good to just throw away.' After that, I decided I had to do something. That's when it sunk in that there's no point running away. I must start dealing with it and do something and that kind of pushed me up."

    But many vets in that situation do not make that decision.

    Dr. Evan Kanter, the president elect of Physicians for Social Responsibility, is a psychiatrist who specializes in treating vets with PTSD. I was fortunate enough to hear him speak at a conference held at Seattle Town Hall in June 2008.

    "Panelists have mentioned that the most severely affected of our veterans are unable to participate in an event like this," the doctor said, "One of the reasons that I'm here is to speak on behalf of those that I treat. Not only are they not able to come up here and speak publicly, many of them would be unable to tolerate being in a room with a crowd of this size. Their grievous condition is part of the true costs of the occupation, a very large proportion of which fall in the area of health care. As a doctor I want to talk about these hidden wounds and hidden costs, many of which are intentionally hidden because if people knew the extent of the costs, maybe they would be less prepared to go to war.

    "We know that the death tally in combat is more than 4,000, represented by the headstones we see around this hall. What we do not know is that these do not include suicides or post evacuation deaths induced by lethal wounds received in combat, nor even the deaths of over 1,000 private contractors. If we include all the wounded, the injured and the medically ill, we have a total of over 70,000, but the military intentionally camouflages and segregates the numbers in three categories that are extremely difficult to access. The ratio of wounded to killed in Iraq is much higher than in previous conflicts, and is a far more accurate measure of the scale of violence in the country than the tally of combat deaths. In Iraq the ratio is 8 to 1, compared to Vietnam, where it was 3 to 1, or World War II, where it was 2 to 1. The reasons for this are the twofold advance in body armor and in battlefield medicine. Today we can stabilize and airlift people to Landstuhl Air Force Base in Germany within 24 hours, whereas in Vietnam it would have taken weeks for those treated in the field to be taken out for proper medical care. As a consequence, we now have service members with dreadful injuries who would never have survived similar conditions in an earlier battle. We as a society will be bearing the cost of caring for these grievously injured veterans for the rest of their lives."

    Expounding further on this issue, Dr. Kanter added, "In addition ... a new phenomenon we are witnessing but do not yet know how to deal with is the TBI or traumatic brain injury. These are injuries brought on by atmospheric pressure caused by the great blasts. We do not know much about its pathology or its long-term impact. It's a new hidden wound that can be placed alongside post-traumatic stress disorder as one of the hidden wounds of war. Now if you think about the fact that we've deployed over 1,600,000 personnel so far [it is now well over 1,800,000], looking at the PTSD and major depression cases alone will give you three to four hundred thousand psychiatric casualties."

    The huge and growing number of cases of PTSD and major depression among returning soldiers has a direct link with the high suicide rates in the military, Kanter explained. "PTSD is no less a war wound than a shrapnel injury. It can be tremendously debilitating. Symptoms include nightmares and flashbacks, triggered physiological and psychological stress, social withdrawal, isolation, avoidance of any kind of reminders of the trauma, emotional numbing, uncontrolled outbursts of anger or rage, difficulty concentrating and focusing and a state of hyper vigilance, which the military calls the 'battle mind.' All these are symptoms that would make it impossible for a vet with severe PTSD to be in the room with us today."

    Studies that go back to World War II have found that combat veterans are twice as likely to commit suicide as people in the general population. Other lesser known distressing facts are that nine percent of all unemployment in the United States is attributed to combat exposure, as is 8 percent of all divorce or separation and 21 percent of all spousal or partner abuse. The impact of all this extends to behavioral problems in children, child abuse, drug and alcohol addiction, incarceration, and homelessness, all of which have implication that go well beyond the individual and reverberate across generations.

    As both occupations continue into the indefinite future, we should not be surprised when we hear of more atrocities like what happened Monday in Baghdad, whether they occur in Iraq or in the United States.