Post-Traumatic Stress Disorder is often described as a mental illness, but I’d argue it’s more accurately a normal reaction to an abnormal event. There’s nothing normal about shooting at your fellow man and woman — or being shot at. There’s nothing normal about enduring repeated threats to your life or physical safety. When the human mind is forced into repeated exposure to trauma, it reacts — and that reaction, while painful and disruptive, is also profoundly human.
From 1993 until 2015, I had the privilege of serving in the United States Navy — the baddest Navy on the planet — and during those years I saw firsthand how service can shape, scar, and inspire. I began as a neuropsychiatric technician and spent 13 years in mental health, followed by three more on the med-surg side, preparing for a transition into critical care medicine. But strong leadership saw something in me — not just skill, but a calling — and they encouraged me to return to mental health, because our brothers and sisters in uniform needed people who understood what they had endured.
So I answered the call.
When I speak with veterans battling PTSD, I remind them of this reality. I remind them that their sacrifice meant something. My 18-year-old daughter is about to start college because of them. My 14-year-old son is preparing for high school football because of them. Their commitment protected not only the people they fought beside, but the lives and futures of millions of families back home. Including mine.
One of the greatest challenges I’ve seen — both as a provider and as a veteran — is that our leaders and politicians often do a terrible job explaining why we fight. When those planes struck the Twin Towers and the Pentagon on 9/11, we weren’t just caught off guard — we were attacked. That was a clear threat from a foreign enemy, and our response was both necessary and, to this day, effective. It has been nearly 24 years since that awful morning, and — knock on wood — we haven’t seen another attack of that scale on American soil.
This is why it’s especially frustrating — and, frankly, insulting — when our leaders, regardless of political affiliation, make careless or ignorant statements like not ruling out military force against Greenland. For those of us who served, who sacrificed, and who carry the invisible weight of those sacrifices every day, these kinds of flippant remarks aren’t just absurd — they cheapen the gravity of real conflict. They confuse the public, undermine the seriousness of military service, and do nothing to help those still struggling with the scars of war — both visible and unseen.
And how would you even begin to explain the necessity of such an act? What enemy were we defending ourselves from? Was Greenland launching missiles? Did they attack our homeland? Was there even the whisper of a threat against our people? Of course not. These kinds of offhand threats erode trust, distort the purpose of military force, and alienate the very people who’ve given everything to uphold the principles of honor, duty, and defense of our nation — not conquest, not chaos.
PTSD is more than just a buzzword or an emotional wound — it’s a diagnosable, treatable condition characterized by four primary symptom clusters:
Intrusive symptoms – Flashbacks, nightmares, and unwanted memories that feel as real as the original trauma.
Avoidance – Steering clear of reminders, people, or places that could trigger those memories.
Negative changes in mood or cognition – Persistent guilt, shame, distorted beliefs, and detachment.
Hyperarousal – Being on edge, irritable, hypervigilant, or easily startled.
Fortunately, we have tools in this fight. Evidence-based therapies like Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and EMDR (Eye Movement Desensitization and Reprocessing) have helped countless individuals regain a sense of control and peace. On the medication front, SSRIs like sertraline and paroxetine are FDA-approved, though often imperfect. We also use adjunctive treatments including prazosin for nightmares, and atypical antipsychotics or mood stabilizers in more complex cases.
But make no mistake — we are far from done.
One of the most promising advances we’ve seen in recent years came from the Multidisciplinary Association for Psychedelic Studies (MAPS), which completed Phase 3 trials of MDMA-assisted psychotherapy for PTSD. The results? Nothing short of remarkable. Participants experienced significant, lasting reductions in symptoms — with many no longer even meeting the criteria for PTSD after treatment.
So what happened?
The FDA rejected it.
Despite years of preparation, rigorous data, and unprecedented efficacy, the treatment was denied approval. Why? That’s the question. Science is not about opinion or political optics — it’s about outcomes, evidence, and facts. If the goal is truly to help those who’ve borne the burden of service, then bureaucracy cannot be allowed to stand in the way of healing.
To the FDA and the government more broadly: get it together. Veterans don’t have the luxury of delay. Every day matters when someone is trapped in a mental warzone long after the physical one has ended.
Unfortunately, the MAPS trial isn’t the only example.
Rexulti (brexpiprazole) has shown encouraging signs as an adjunctive treatment for PTSD, but its FDA review has been pushed back repeatedly. The most recent reason? “Employee shortages.” Right — because we laid off a whole bunch of people, and now we’re shocked that no one’s around to do the work. It’s self-sabotage in slow motion, and the cost isn’t measured in profit margins — it’s measured in human lives, in suffering, in the delay of healing for people who’ve waited long enough.
Meanwhile, Methylone, a structurally unique cousin of MDMA, is now in Phase 3 trials for PTSD. Early data looks promising — not just in dulling symptoms, but in potentially rewiring the trauma response. These agents may work through entirely different mechanisms than traditional SSRIs, offering quicker and more robust outcomes for those suffering with severe trauma.
We’re also entering a new frontier of glutamatergic agents, BDNF-mTOR targeting therapies, and neuroplasticity enhancers that are changing how we think about mental illness altogether. These aren't band-aid solutions — they're regenerative, restorative approaches aimed at healing the brain, not just sedating it.
And here’s where I want to speak directly to the pharmaceutical leaders shaping this landscape:
Janssen. Axsome. Are you listening?
You’ve changed the game for depression — I’ve seen it firsthand. Spravato and Auvelity have brought people back from the brink. Clients who were suicidal and broken are living again. If these agents can do that for MDD, I implore you — start trials for PTSD. The pathophysiology overlaps. The mechanisms are relevant. And the need is overwhelming.
This is your moment. Step up.
The science is ready. The tools are developing. What’s missing is the will. The urgency. The humanity.
And that’s where we come in.
Even though I no longer wear the uniform, I haven’t stopped fighting. At South Chesapeake Psychiatry and TRIP, we are still in the trenches. Every single day. Fighting for the people the system seems to forget. Fighting to give our veterans what they were promised — a shot at a life after war. A real one.
If the government can’t move fast enough, we will.
If pharmaceutical companies stall, we won’t.
If no one else will carry the weight, we will.
Because we owe them more than just thanks. We owe them action. We owe them progress. And we owe them healing.
We’re still in the fight. Always.
— Justin Ray
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