How long did the PTSD last

Everything was different after Afghanistan

When the soldier Johannes Clair returned home from Afghanistan, the relationship with his girlfriend broke up. Nightmares, depression, aggression - that was too much for the young woman. In the classroom with all the students he got scared.

Johannes Clair dropped out of the social economy studies in the first semester. "Visibility is a huge problem," he says today. Veterans with an amputated arm do not have to constantly justify themselves.

In the past, the Bundeswehr mission was considered to be over with the return. Today the troop doctors know about possible long-term consequences, says Clair. The Bundeswehr registered the first cases of post-traumatic stress disorder (PTSD) after its deployment in Kosovo from 1999.

There were fewer battles there than in Afghanistan, but the soldiers were traumatized by the confrontation with mine victims and war graves. In 2010 Clair was a co-founder of the Association of Mission Veterans. He estimates that around 2,000 former soldiers are affected by PTSD, "plus relatives".

Strong man reaches his limits

"The support at the federal government is good when you are there," says Johannes Clair - and emphasizes the "if", because it was not only with him that it took a long time before there was willingness to seek help.

Clair left the company in 2011. He started therapy two and a half years later. He says: "It was really tough - from the strong man in action to the person who admits his limits."

Today the 31-year-old lives in a former army barracks in Hamburg with officer candidates. He has many appearances in the Bundeswehr, mostly in civilian clothes: lectures at the Bundeswehr universities and discussions with comrades.

Therapy with the eyes

Clair was hired again as a soldier by the German Armed Forces at the beginning of 2014, due to a law from 2007, which stipulates this for the duration of the therapy.

About his experiences Johannes Clair wrote a book.

The title "Four days in November" refers to those four days that have not let go of him to this day: a mission in a village with wounded comrades, civilians between the fronts and his own inability to "function".

The book stood for 37 weeks on the "Spiegel" bestseller list. As a result, Clair was a guest on numerous talk shows and gave many interviews.

Johannes Clair: "Four days in November. My combat mission in Afghanistan". Ullstein-Verlag, 413 pages, 9.99 euros, ISBN: 978-3548375212

He now has weekly conversation and trauma therapy with a private therapist in Hamburg. He also expects a lot from EMDR (Eye Movement Desensitization and Reprocessing), a desensitization and processing through eye movements.

Clair is cared for by the Bundeswehr Hospital in Hamburg, but also needs time off in Bad Waldsee - "as far away from home as possible". Last summer he was in the Urbachtal acute clinic there for twelve weeks, then another eight weeks around the turn of the year.

The clinic, a house with 60 beds, was "just the right size"; says Clair; big enough for many therapy offers and small enough for a personal relationship with the doctors. "The beautiful landscape in Upper Swabia is the icing on the cake."

Soldiers, train drivers, teachers

The acute clinic only treats private patients and self-payers, especially people with depression. As a further focus, Dr. Volker Reinken the treatment of trauma patients: soldiers, police officers, train drivers, but also more and more teachers. The psychiatrist is the medical director and chief physician.

There are always two trauma groups with eight places each, separate for women and men. The relatives are not treated, but are invited to interviews so that their understanding of the disease grows.

Volker Reinken describes the settlement with the Bundeswehr and the coffers as bureaucratic, but problem-free. The house is "very well utilized". The destigmatization of mental illnesses contributes to this.

"It takes a lot of courage to fight as a soldier," says Reinken. "It is just as brave to face possible psychological consequences." This is what general practitioners should convey to those affected, he advises.

Diffuse symptoms

According to current guidelines, the prevalence of PTSD in Germany is 1.5 to two percent, but 50 percent of victims of war, displacement and torture develop PTSD. Often the patients come to the doctor with diffuse symptoms, such as sleep disorders, stress or gastrointestinal problems.

"The resident colleagues should pay attention to the police or soldiers and consider PTSD," recommends Reinken. But suicides on railroad tracks or events in everyday school life can also have long-term consequences. The acute clinic offers schools in the region training courses on how to deal with conflicts.

And what are the prospects for Johannes Clair? Dr. Volker Reinken attests to a typical healing process. "He started late but is making good progress." Clair is still fighting with the triggers, i.e. sensory stimuli that bring back what has happened with all their might.

He himself believes that he will come to Bad Waldsee a few more times because interval therapy has been recommended to him. He wants to go back to college and find a new steadfast girlfriend.

Further information is available on the Bundeswehr hotline on PTSD: 08 00-5 88 79 57 and on the websites