During the Civil War it was called “soldier’s heart” or “nostalgia.” During the wars of the 20th century from World War I through Vietnam it was called “shell shock.”

It wasn’t until 1980 that “post-traumatic stress disorder” (PTSD) became a diagnostic term.

According to the American Psychiatric Assn., PTSD can occur in people who have experienced or witnessed life-threatening events. People who suffer from PTSD often relive the experience through flashbacks or nightmares. They have difficulty sleeping and coping with everyday life. It can happen to civilians as well as military personnel.

Nearly 40 years after Artie Ramirez fought as a Marine in South Vietnam, the 57-year-old Lawrence resident still has occasional nightmares. He received treatment for PTSD after leaving the Marines in the mid-1970s. There are times even now when he wakes up in a sweat with his heart pounding.

“You know it was just a flashback and that your brain had gone back to 1968,” Ramirez said. “You never know how your brain is going to work. Sometimes those old doors up there open up.”

At Colmery-O’Neil Veterans Affairs Medical Center in Topeka, there are 24 beds in the stress disorder treatment program headed by Dr. Jonathan Farrell-Higgins. It is where the most serious cases of PTSD are treated, and usually the unit is nearly full.

“Every week we’ll graduate a few veterans and then bring in maybe three more,” Farrell-Higgins said.

About a third of the patients in the seven-week primary treatment program are veterans of the Iraq war, he said. The number of Iraq war veterans in the program has increased over the past few months, he said.

There have been few comprehensive studies so far about the mental health effects of the Iraq and Afghanistan wars. A 2004 study by the Army published in the New England Journal of Medicine found that one in six soldiers in Iraq experienced depression, anxiety or post-traumatic stress disorder. That study, however, was done early in the war, which began in March 2003.

A 2005 study by the Department of Veterans Affairs found that out of nearly 170,000 Iraq veterans about 34,000 were diagnosed with psychological disorders. Those suffering from PTSD were 1,641.

“The good news today is that we are able to diagnose a lot more effectively than ever before,” Farrell-Higgins said.

But it is unclear what the long-term effect will be as far as how many soldiers might become PTSD victims.

“The picture five years and 10 years from now will be very interesting to discover, and right now we’re kind of looking ahead wondering what that picture will look like,” Farrell-Higgins said.

There are a lot of war events that can lead to PTSD, Farrell-Higgins said. The most publicized is the roadside bomb, or improvised explosive device. But he thinks one cause also is the cumulative effects of war.

“I think it’s the daily grind of war; the combat mission that these guys are involved in even if there is not an IED,” he said. “Certainly it is the battles and firefights and the constant threats in war.”

The length of time it takes to recover from PTSD varies from person to person. Much of it depends on good social support from family and friends as well as inpatient and outpatient treatment, Farrell-Higgins said. Most who receive support go on to lead productive lives, he said.