Larry Syverson

A WHITE HOUSE security officer and his dog walk behind Larry Syverson, whose son, Army Staff Sgt. Bryce Syverson, was redeployed to Kuwait despite being diagnosed with post-traumatic stress disorder. Larry Syverson went to Washington on May 1, the third anniversary of President Bush's announcement that major combat had ended in Iraq. (MARK MIRKO / May 2, 2006)

Eight months ago, Staff Sgt. Bryce Syverson was damaged goods, so unsteady that doctors at Walter Reed Army Medical Center wouldn't let him wear socks or a belt.

Syverson, 27, had landed in the psychiatric unit at Walter Reed after a breakdown that doctors traced to his 15-month tour in Iraq as a gunner on a Bradley tank. He was diagnosed with post-traumatic stress disorder and depression, and was put on a suicide watch and antidepressants, according to his family.

Today, Syverson is back in the combat zone, part of a quick-reaction force in Kuwait that could be summoned to Iraq at any time.

He got his deployment orders after being told he wasn't fit for duty.

He got his gun back after being told he was too unstable to carry a weapon.

But he hasn't quite managed to get his bearings.

"Nearly died on a PT test out here on a nice and really mild night because of the medication that I am taking,'' he wrote in a recent e-mail to his parents and brothers. "Head about to explode from the blood swelling inside, the [lightning] storm that happened in my head, the blurred vision, confusion, dizziness and a whole lot more. Not the best feeling in the entire world to have after being here for two days ...

"And I ask myself what the F*** am I doing here?''

Syverson is among a growing number of troops who are being recycled into combat after being diagnosed with PTSD or other combat-related mental disorders -- a new phenomenon that has their families worried and some mental health experts alarmed. The practice, which a top military mental health official concedes is driven partly by pressure to maintain troop levels, runs counter to accepted medical doctrine and research, which cautions that re-exposure to trauma increases the risk of serious psychiatric problems.

"I'm concerned that people who are symptomatic are being sent back, which is potentially very bad for them. That has not happened before in our country,'' said Dr. Arthur S. Blank Jr., a Yale-trained psychiatrist who helped to get PTSD recognized as a diagnosis after the Vietnam War.

"If people have received treatment for a year or two or three and the condition is completely stabilized, I could see it,'' said Blank, who was formerly director of the Department of Veterans Affairs' counseling centers. "[But] there's no study that says it's beneficial to send people back. Being re-exposed to the trauma can just intensify the symptoms.''

Although Department of Defense medical standards for enlistment into the armed forces disqualify those who have suffered from PTSD or acute reactions to stress, including combat fatigue, military officials acknowledge that they are not exempting service members who meet those criteria from going to war. Many of those who are being sent back with such symptoms, such as Syverson, are being redeployed on psychiatric medications known as SSRIs.

Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, acknowledged that the decision to send back soldiers with symptoms or a diagnosis of PTSD was "something that we wrestle with,'' and partly driven by the military's need to retain troops because of recruiting shortfalls.

"Historically, we have not wanted to send soldiers or anybody with post-traumatic stress disorder back into what traumatized them,'' she said. "The challenge for us ... is that the Army has a mission to fight.''

Ritchie said the military looks closely at the "impairment'' level of individual service members and their response to medication before deciding whom to redeploy, and would not put any soldier at risk.

"If they're simply -- and I don't mean to minimize it -- but if they're simply having nightmares, for example, but they can do their job, then most likely they're going to deploy back with their unit,'' she said. "If they're not able to do their job and they don't respond to treatment, then we're going to probably keep them here in the States for at least a while longer.''

But whether the military can even gauge the impairment level of its veterans is in question. A newly released report by the Government Accountability Office found that nearly four in five troops returning from Iraq and Afghanistan who were found to be at risk for PTSD, based on responses to a screening questionnaire, were never referred for further evaluation or treatment. Still, top military officials continue to insist they are doing a good job of identifying and treating PTSD cases.

Dr. Matthew Friedman, director of the National Center for PTSD, an arm of the Veterans Administration, said that while he shares the concern that multiple deployments may exacerbate PTSD symptoms, he does not believe the military should take a "one size fits all'' approach to the disorder and bar all troops from deploying. Drug treatments for PTSD prove successful in some cases, he said, and some service members are more resilient than others.

"My belief is, let's look at the data'' that are being gathered by pre- and post-deployment mental health screenings, he said. "Once we have the data, we can go back and look at how people with PTSD perform.''