Australia can expect an exponential increase in the number of cases of post-traumatic stress disorder (PTSD) among people who saw brutal sights in Afghanistan and some who didn't, retired Major General John Cantwell says.

Major General Cantwell, who revealed his struggle with PTSD in his book Exit Wounds, said the nation could expect a very large number of problems associated with PTSD out of the Afghanistan mission.

"The numbers will grow and grow exponentially. We have exposed thousands and thousands of young and old Australians to some pretty brutal experiences," he said.

"Even for those who aren't directly involved in combat there are ample number of vicarious exposures and experiences."

Major General Cantwell, the former commander of Australian forces in the Middle East, cited the case of the young female RAAF officer who managed the mortuary at the Australian base in the United Arab Emirates, which prepared the remains of soldiers killed in Afghanistan on their journey back to Australia.

"I am in touch with that young lady and she is deeply troubled about what she saw and the experiences she had. But she never went to Afghanistan," he said.

There would be hundreds like her.

"Add on to that all those who did have direct exposure," he said.

On some estimates, about one in eight of those exposed to traumatic events would suffer some profound and possibly lifelong experience.

"There is a large wave of sadness coming our way and the system, DVA (Department of Veterans Affairs) and Defence need to be ready for it and I wonder whether we are," he said.

Major General Cantwell developed PTSD after serving with the British military during the 1991 Kuwait War. He said he managed it by the unhealthy but effective technique of suppressing and denying its existence.

"The problem for me was when the pressure came off, when I was no longer in command, when all of those barriers that I had built up over so many years didn't need to be there any more, they just collapsed," he said.

Others in the services dealt with PTSD just as as he had, he said.

"They simply feel they cannot come forward with this, they feel ashamed, embarrassed, they are concerned about their prospects, what will it do for them in terms of their chances to get promotion, that good job, another deployment, all the things that go with having a successful career."


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