Echoing Michael Savage, GOP presidential nominee Donald Trump said on October 3 2016 that troops who suffer from PTSD are not “strong.” Trump has previously appeared on Savage's show and even floated Savage for the head of the National Institutes of Health (NIH) if Trump is elected. Savage has also described himself as “the architect of Trump's messaging.”

Last week, Michael Savage leveled his latest in a long string of attacks on Americans with mental illness and the medical community that works to help them. After a veteran caller with Posttraumatic Stress Disorder (PTSD) expressed support for the city of San Francisco naming a bridge after the late Robin Williams, the right-wing radio host announced that he is “so sick and tired of everyone with their complaints about PTSD, depression,” asserting that it's a sign of a “weak, sick, broken nation.”

According to the Department of Veterans Affairs (VA), approximately 5.2 million adults have PTSD within a given year. As of 2012, mental illness was the leading reason for active-duty hospitalizations in the military, and the VA estimates that up to 20 percent of veterans who served in the Iraq and Afghanistan wars since 2001 suffer from PTSD. For veterans who left the military between October 2002 and July 2011, nearly 200,000 had a provisional diagnosis for PTSD, not including those who went undiagnosed or misdiagnosed. And the Institute of Medicine reported in June that “PTSD is the third most common major service-connected disability after hearing loss and ringing of the ears.”

PTSD isn't just a combat-related injury. It can result from various traumatic incidents, ranging from child abuse to car accidents to muggings to sexual assault. A fight-or-flight response can be triggered by things that remind the survivor of her trauma, or things that catch the person off-guard, like bright lights or loud noises. Often those with PTSD experience flashbacks, where memories and feelings associated with past trauma come rushing back as if the trauma was happening all over again.

The Painful Reality Of PTSD

Michael Savage suggested that younger military members think they are “the only generation that had PTSD.” Contrary to Savage's straw man argument, it's been widely reported that an estimated 12 percent of Gulf War veterans have PTSD in a given year, and 30 percent of Vietnam veterans live with this condition at some point in their lives. Additionally, since the disorder wasn't officially recognized by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1980, it took time for the medical community to recognize the illness and adequately diagnose it.

Savage also recommended that people who suffer from PTSD should simply focus on “the good things in your life.” But PTSD isn't just a sad feeling, and it certainly isn't a choice. It permanently affects people's lives, sometimes to point of debilitation. Trauma survivors don't choose to have night terrors, severe depression, eating disorders, or the plethora of physical symptoms that can result from the illness.

Savage's suggestion that PTSD is a choice is further undermined by the reality that traumatic stress can severely affect brain function . Using MRI scans, medical studies have shown that acute stress affects three different parts of the brain: the hippocampus (which plays a crucial role in storing memories), the amygdala (which is important for processing emotions, such as fear and anxiety), and the prefrontal cortex (which is involved with decision-making, problem-solving, and social behavior). Additionally, it alters the regulation of cortisol, a hormone that is released in response to stress in order to alert the body to prepare to respond to a threat, as well as norepinephrine, a stress hormone that also plays a large part in the fight-or-flight response. High levels of cortisol can have significant physiological effects as it helps regulate blood sugar, metabolism, immune system, and can affect the hippocampus, where memories are encoded.

Image via National Institutes of Health

The Severe Consequences Of Untreated PTSD

Perhaps one of the most disturbing parts of Savage's rant was his claim that with so many troops being treated for PTSD, “no wonder ISIS can defeat our military.” But this right-wing radio host ignores the consequences of untreated PTSD, particularly with the cumulative effects of multiple deployments. Colonel Elspeth C. Ritchie, consultant to the U.S. Army Surgeon General, reported that the rates of anxiety and depression drastically increase with more deployments, “ranging from 21% with [the] first deployment to 27% with [the] third deployment.”

And as highlighted by Iraq and Afghanistan Veterans of America, service members may turn to drugs or alcohol to self-medicate as a replacement for professional medical treatment. Additionally, “personal and economic consequences of untreated PTSD [include] social isolation and violent behavior, [which] increase the risk of homelessness.” Dr. Michele Spoont, a psychologist at the Minneapolis VA Health Care System, observes that “about 30 percent of Veterans with untreated PTSD” are more likely to “to have failed marriages, be indigent, and have a number of medical problems. It's one of those things that cascades over time. You lose your job. Your marriage falls apart, and it just accumulates.”

If Savage is truly concerned about the mission effectiveness of our military, then he would address the fact that active duty suicides hit a record high in 2012, with almost one active duty suicide per day, exceeding the number of active duty personnel killed in combat. Think Progress also highlighted the drastic increase in young veteran suicides reported earlier this year, revealing that “at least 22 veterans commit suicide every day and young male veterans under the age of 30 are three times more likely to commit suicide when compared to civilian males in the same age bracket."

Meanwhile, Savage says he has “no sympathy for suicides,” and labels them “an act of cowardliness” and “aggression.” If he hates suicides so much, why does he attack troops who seek help, when treatment can be one of the most important factors in preventing a military member with PTSD from killing herself?

Military Members' Past Struggles With Reporting Mental Illness

A recent study found that despite the prevalence of PTSD in those who served in the wars in Iraq and Afghanistan, only about half received “the recommended treatment in 2013.” So what factors play into the significant disparity between people who have it and people who get treated? On top of the existing stigma toward mental illness, historically there has been a deep-seated military culture that discourages troops from obtaining help for mental health.

Barbara Van Dahlen, the president of a non-profit that helps connect service members to free mental health services, explains that the military teaches people to be “reliant on self, focused on the other, mission first, stop whining, suck it up.” Policy researcher Carrie Farmer of the RAND corporation notes “military personnel face unique barriers to seeking mental health treatment, including worries about how seeking treatment will affect their military career, concerns about losing security clearance, and the stigma of appearing 'weak' to fellow service members.”

Michael Savage only reinforces this outdated and dangerous mindset by calling veterans who seek help “weak” and “narcissistic.” In a 2012 survey by Iraq and Afghanistan Veterans of America, 76 percent of veteran respondents who said they didn't seek care for a mental health injury either did so because they thought it could hurt their career or because they didn't want their peers to look down on them. This can be particularly true for service members who are afraid they could lose their security clearances. The Department of Defense claims that in recent years it has taken steps to ensure that “negative inferences will not be made on the basis of getting treatment or counseling for a psychological health issue,” but it's still unclear how many service members applying for access to clearances are aware of these changes.

Another troubling trend has permeated the military health care system and severely inhibited troops with PTSD from receiving adequate treatment. Since 2001, at least 31,000 service members have been released from service based on personality disorder diagnoses. According to The New York Times, veterans' advocates have evidence showing that some commanders “pressure[d] clinicians to issue unwarranted psychiatric diagnoses,” such as personality or adjustment disorders that service members did not have, “to get rid of troops.” Since the VA doesn't regard personality disorders as a compensatable mental illness, these troops lost access to post-service disability coverage. Even worse, these misdiagnoses were reportedly frequently used to handle sexual assault reports, which could be related to the significantly higher rate of women being discharged from the military for personality disorders than men. Fortunately, the 2014 National Defense Authorization Act (NDAA) ordered an investigation into those who have been wrongly discharged from the military under the auspice of personality or adjustment disorders.

In an interview with CNN, former U.S. Navy Seal Brandon Webb said that he had observed significant improvements in the way PTSD is reported and discussed within the military, but pointed out an even larger challenge that veterans face:

WEBB: Most of the veterans and active duty folks I speak to, actually their biggest fear is that this stigma is created in the media and elsewhere that these veterans, as they're transitioning from active duty to civilian life, that there's this stigma that they're damaged goods.

Webb also pointed out the positive qualities that veterans, even those with PTSD, can bring to the civilian working world that are often overlooked by the media: “They're leaders, they can think on their feet, and make incredibly tough decisions under extreme amounts of pressure.”

Savage's History of Smearing Mental Health And People With Mental Illness

Of course, Michael Savage's attacks on those with mental illness and the mental health medical community, as well as his attempts to distort what really causes mental illness, are nothing new. Sounding eerily similar to Fox News' Dr. Keith Ablow, Savage wrote a book called Liberalism is a Mental Disorder. His toxic tirades have reached extreme lows, from calling Robin Williams a “depressed clown,” to labeling a psychiatrist who appeared on CNN a “pill-pushing prostitute with a medical degree,” to claiming that “children's minds are being raped by the homosexual mafia.” Savage also called autism a “fraud, a racket,” and suggested that flu shots could give people Alzheimer's or MS. He's also ordered parents to attack overweight children with derogatory names like “fatty,” based on his belief that self esteem is “a product of idiocy put out by the government and wack jobs in the psychological world.”

And Savage harbors a particularly strong hatred for the DSM, the psychiatric document in which PTSD was first officially recognized in 1980. He's asserted that it was “put out by the psychotic liberal psychiatric establishment,” reads like something “out of the Soviet Union,” and “will become a weapon in the arsenal of the new so-called liberal repressive state” to be used against those who oppose the Obama administration.

So Where Does He Get This Stuff?

To add a unique layer to Michael Savage's attacks on the medical community, he holds a Ph.D. in nutritional ethnomedicine from UC Berkeley. In a 2003 Salon article titled “Michael Savage's Long Strange Trip,” David Gilson details “Michael Weiner's” post-degree romp with alternative medicine:

Throughout the late 1960s and early 1970s, he traveled to Tonga, Fiji and other South Pacific island nations to study traditional herbal medicine ... and he became passionately convinced that their expertise could be used to cure modern ailments. Thus began a quest to salvage -- not savage -- this 'ethnic wisdom' before Western influences destroyed it.

Savage's travels led him to release more than a dozen books on alternative medicine, some of which illustrated a growing hostility toward western medicine. In Maximum Immunity, a book that claimed to give instruction on how to “fortify your natural defenses against cancer, AIDS, arthritis, allergies” and the common cold, he accused the American medical community of being “in passive connivance with the homosexual lobby.”

Gilson notes that “Weiner did have a knack for combining the promise of herbal medicine with good old-fashioned hucksterism. From his home, he started vanity projects such as the Fund for Ethnic Medicine and the Alzheimer's Research Institute.” Savage once advised that cocaine addicts kick the habit by “ingesting a daily cocktail of Sudafed, vitamins C and E, and amino acids” and self-administered coffee enemas using “good quality coffee,” “not decaffeinated or instant.”

So Michael Savage's disdain for the medical community comes as no surprise, particularly in light of how he's managed his own emotional struggles:

Fearing a “nervous collapse,” Weiner traded his running shoes for a bike and soothed his jangled nerves by curling up on the sofa with a mug of passionflower herbal tea and ingesting “megadoses” of vitamins. Feeling much better, he concluded: “I learned to calm the inner debate that had threatened to drown me in madness!”

In last week's rant, Savage recommended that instead of seeking treatment for mental illness, first people try “massive doses” of vitamins like niacin and ascorbic acid, “walking around the block,” or visiting a leukemia patient who is “much worse off than you are.” In reality, therapy and medicine have the greatest empirical support to treat PTSD. While exercise can be a fantastic tool for prevention and aiding in recovery from psychiatric illness, walking your dog should supplement -- not replace -- talking to a trained therapist who can assist in processing past trauma. And vitamins won't have the same effect as medication created specifically to help balance chemicals in a person's brain after it's been directly impacted by acute stress.

The Trouble With Michael Savage's Toxicity

As Michael Savage's distaste for Western medicine has evolved into angry, incoherent rants aimed at combat veterans suffering from PTSD, he has no excuse for contributing to a right-wing spectacle that regularly interferes with Americans citizens' understanding of basic health and science, most notably when it comes to high rates of misinformation and misunderstanding with topics like climate change, childhood obesity, women's health, and most recently, the Ebola virus.

Savage's actively discouraging military members from seeking help for mental illness is an outdated mindset that has already led to the loss of too many troops. He's simply parroting the same misinformed arguments that have been historically used as an excuse to deny help to people with psychiatric conditions, which can be just as debilitating as any other medical injury. The disturbing part is that Michael Savage's radio show still reportedly enjoys an audience of at least 5 million, ranking fifth in talk radio overall.

Fortunately, a vast majority of our medical community and a growing number of Americans have progressed past this grave misunderstanding of mental health issues, and there are an increasing number of resources to help military members recognize and address trauma-related and other psychological conditions. Additionally, as more friends and family members learn how to support loved ones who are trauma survivors, as well as maintain their own sanity while doing so, the future looks bright -- as long as those friends and family members don't take advice from Michael Savage.

Lisa L. Reed is the Social Media Director for MMFA and is also a U.S. Air Force veteran.