Is PTSD Culprit in Ft. Hood Tragedy? Signs Point Both Ways

silhouette of a soldier

Army Spec. Ivan Lopez was under evaluation for PTSD but a diagnosis hadn't been made. PTSD suffers typically don't turn violent, but they often do commit suicide.

Much remains unraveled about the gunman who opened fire at the Fort Hood military base, slaying three and gravely wounding 16 others before killing himself. But when officials mentioned that Army Spec. Ivan Lopez might have post-traumatic stress disorder, concern erupted about stigmatizing the complex condition suffered by millions.

So little is understood about the mentality of Lopez, 34, who took his own life after shooting 19 people at the El Paso-based Army installation Wednesday. Lopez was being treated and medicated for depression, anxiety, insomnia and a brain injury he reported happening after his Iraq tour, military leaders disclosed. They said he was under evaluation for possibly suffering PTSD but that his most recent examination held no warning he’d be violent.

PTSD specialists swiftly expressed concern Thursday that such a link with violence miscasts PTSD.

“That is not what post-traumatic stress is or what it does,” Ingrid Herrera-Yee, a clinical psychologist in the Washington, D.C., area who treats veterans and their families diagnosed with PTSD and other mental health issues, told NBC News.  She’s married to Army National Guard Staff Sgt. Ian Yee, veteran of three combat deployments in Iraq and Afghanistan.

“Yes, there is anger and irritability (associated with PTSD), but it’s usually internalized. You’re more likely to see it as someone who is withdrawn, anxious and numb, who’s lost interest in life. Some veterans explain it to me this way: ‘The last thing you want is to go out and lash out,’ ” said Herrera-Yee, adding: “Just like any victims of a trauma –- rape or domestic violence -– they can become fearful of their surroundings, but they’re not going to react angrily toward their surroundings. For them, it’s all about avoidance.”

Also expressing the concerns of many vets and other trauma sufferers was Dr. Christine A. Courtois, a Washington, D.C.-based therapist.

“I do worry about PTSD being miscast as the cause,” said Courtois, a national trauma consultant for Elements Behavioral Health. “I think it is too early to assume anything and that a comprehensive review of this individual is in order.”

It is Lopez’s suicide — not his alleged murders — that most echoes PTSD, specialists said.

“PTSD causes someone to become more suicidal than homicidal,” David Maulsby, executive director at the Houston-based PTSD Foundation of America, told on the Foundation’s website. The PTSD sufferer, he said, feels “useless, of no value, they isolate and that’s when they start the downward spiral. And that’s when they take their own lives, not others’.”

Of Lopez — who attacked the same Army post where another military person committed a mass shooting in 2009 — Maulsby added: “It’s way too early to know exactly what he was dealing with and can they find out ahead of time. I don’t think there’s a way of knowing that right now.”

RELATED: PTSD and Long-Term Physical Health

PTSD is a psychological disorder that may be experienced by someone exposed to extreme trauma, and it was first recognized in military veterans. Among those who may experience the condition are child abuse victims, war victims, crime victims and children of those suffering from PTSD.

“Incidents like the one in Fort Hood are generally isolated occurances, and certainly not indicative of typical PTSD symptoms,” observed Christal Presley, author of Thirty Days With My Father: Finding Peace With Wartime PTSD, who, along with her Vietnam vet father, suffers from PTSD and founded the popular website United Children of

Symptoms of PTSD may include:

  • Re-experiencing original symptoms of the trauma
  • Extreme avoidance of anything that might trigger a memory of the trauma
  • Emotional numbness
  • Depression and withdrawal from normal activities
  • Hyper-alertness to surroundings (veterans have been known to hear a car backfire and react as if it were gunfire).

The VA spent almost $500 million in 2013 for PTSD treatments for veterans of just Iraq and Afghanistan, it reports. The PTSD Foundation of America estimated nearly 8 percent of Americans will suffer PTSD at some point, and fully 10 percent of women will. How common and who experiences PTSD?

About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event (60.7% of men and 51.2% of women reported at least one traumatic event).

The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.

About 30 percent of men and women with experience in war zones have had PTSD. An additional 20 percent to 25 percent have had partial PTSD.

More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced “clinically serious stress reaction symptoms,” the PTSD Foundation says.

About 10% of Gulf War veterans suffer from PTSD. An estimated 6 percent to 11 percent of veterans of the war in Afghanistan are afflicted. Estimates vary from 12 percent to 20 percent for Iraq War military personnel.

Thirty percent of children of veterans with PTSD struggle with it themselves, a USC professor told CBS News. And his research found one in four California high school age children of a veteran with PTSD consider suicide.

“Clean Record”

Lopez was rapidly identified by officials as the gunman. He “had a clean record” with no major misconduct yet surfacing, Secretary of the Army John M. McHugh said in an appearance before the Senate Armed Services Committee on Thursday.

What else is known about Lopez: He was married, had served two deployments, one of them in Iraq from August to December 2011; and during his deployments he did not have direct involvement in combat. When he returned to the states, he was stationed at another Texas Army post, Fort Bliss. He arrived at Fort Hood in February for training as a truck driver.

“He was undergoing a variety of treatment and diagnoses for mental health conditions ranging from depression to anxiety to some sleep disturbance,” McHugh said. McHugh told the Senate Armed Services Committee on Thursday that Lopez was prescribed drugs including Ambien and was fully examined last month by a psychiatrist. There was no record or sign that Lopez might harm someone or himself “so the plan [going] forward was just to continue to monitor and treat him as deemed appropriate,” he said.

Lopez Had Reported Traumatic Brain Injury

The Associated Press in Houston reported that Ivan Lopez and his wife came from Puerto Rico, where he served in the military reserves. He had other relatives in the states and lived in an off-post apartment in the Fort Hood area and was assigned to the 13th Sustainment Command (Expeditionary) at Fort Hood, which is a logistics and support unit. Officials did not release his rank but said he was not in the process of departing the Army.

— Army Secretary John McHugh said Lopez did not see combat in Iraq. He was not wounded in action while serving overseas, but self-reported a traumatic brain injury upon his return to the U.S. Fort Hood’s senior officer, Lt. Gen. Mark Milley, told the media that Lopez “was not wounded in action, to our records, no Purple Heart, not wounded in action in that regard.”

— Lopez had several mental health issues. He was taking medication and receiving psychiatric help for depression and anxiety, and was undergoing a process to determine whether he had post-traumatic stress disorder. “We do not know a motive,” Milley said. “We do know that this soldier had behavioral health and mental health issues, and was being treated for that.”

— Lopez had one weapon, a .45-caliber Smith & Wesson handgun, that wasn’t registered with post authorities as required. The amount of ammunition he carried has not been announced.

—   Lopez died from a self-inflicted gunshot in a parking lot at the post’s transportation brigade administration building, after he was confronted by a military police officer.

The VA, which is entrusted with caring for the health and well-being of America’s veterans, has been criticized for inadequately doing the job. The same day of the Fort Hood shooting, the Center for Investigative Reporting, a national nonprofit news organization, won a Peabody Award for its story on the VA overprescribing opiates in place of therapy and other treatments; the result, CIR reported based on Freedom of Information Act documents, is a large population of veterans becoming addicts.

As younger veterans of two wars since 9/11 increasingly seek care for PTSD, some veterans say they still feel what NBC News called “an unspoken social scar.”

“This is very taboo and many vets feel more [like] outcasts when something like this happens,” Iowa Marine veteran Logan Edwards, 26, told NBC News. After serving eight months in Iraq, he was diagnosed with PTSD. Fellow veterans suffering with the disorder, he said, feel suspect “because they have weapons [and] they have PTSD, and they aren’t going to go shoot anyone.”

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