PTSD – Week 2
PTSD SERIES: “THEIR STORIES” (LIVING WITH PTS)
WEEK 2 OF 6
This series will include very rough language and real-life battlefield and military experiences that could be very disturbing to some people reading these articles.
STIGMA OF PTSD :
Post-Traumatic Stress Disorder – PTSD – has been an accepted diagnosis since 1980. And that’s a good thing. So why is it now making controversial headlines? Why are some clinicians – along with a wide range of veterans’ advocates, women’s groups and others – arguing for changing the name of the diagnosis, PTSD, to PTSI – for Post-traumatic Stress Injury? (SOURCE: An Injury, Not A Disorder www.dartcenter.org)
GRUNT: “In my entire life I have seen a lot of things but never thought I would have this thing called PTSD. The psychologist called it “THE POST.” It is the Post coming on. I was first diagnosed with PTSD in 2010. 26 years after I got out of the military in 1984. Can you imagine what I went thru during those 26 years NOT knowing I had PTSD? I look back and knew now what was causing all those things that were going bad for me.
I was diagnosed in 2010 by a private doctor contracted by the VA in Fort Worth. I was still in denial and didn’t understand what PTSD was. The more I got with these social workers and psychiatrists, I realized it. It could have happened in the military or before the military.”
BRAVO: “The veteran is a very proud person, just prideful. When they were in the service they were something special. They were defenders of our country and they were defenders of our nation. They lived very structured lives when they were in the military. They get up at 6 and do PT, come back and shit, shower and shave. They go to chow hall and then at 8 o’clock they go to work. They just don’t want to admit that something is broke. Most all of the veterans at one time or another believe they don’t have a problem. I will suck it up and everything will be ok. Nobody wants to admit that they have a problem nobody wants to admit that they’re broken even if they’re not a veteran. You are bipolar or have schizophrenia, you don’t want other people to know that you’re broken. It is a sign of weakness to them. Plus, the stereotypical crap that comes with it.”
Is There a Stigma attached to PTSD and its diagnosis?
Dr. Lia Thomas
VA Medical Director, Mental Health Trauma Services: (VA North Texas Health Care System): “In general there is a stigma about mental health in our communities and in our society. We know that there are issues of the fact that we had to add in mental healthcare to parody laws and things of that nature. It is unfortunate that media and our society will toss around the words like you are crazy or you are this, you are skitzo. So, there is a global sense of stigma against mental health.
We recognize there is a mental health stigma. We often do outreach events as an effort to help people know that treatment works, it’s beneficial and we know it is hard to come in and ask for help but we want you to do that. We try to offer a safe and welcome environment.”
Julia C. Smith, Psy.D
VA Clinical Director, Mental Health Trauma Services: (VA North Texas Health Care System): “There is an internalized stigma about I don’t want this label or what does it mean if I have that label. We address that internally here within the context of treatment. We understand that a diagnosis are labels. We have treatments that work and it doesn’t mean that this has to be part of your identity that it is not something you can’t overcome.”
Brenda McBride / Counselor: “I am careful not to pathologize, this is a series of symptoms that interfere with a person’s ability of function, interfering in every area of their life. If Depression interferes with every area of your life it becomes a diagnostic area. Same with anxiety and same with schizophrenia. So, post-traumatic stress interferes with your ability to engage in the world.
I don’t like putting people in a box. If a person gets a disorder, they tend to live up to the disorder. I have Bipolar, bipolar made me do it so I am bipolar. I put a name on it and it becomes a self-fulfilling prophesy. I am angry, I cuss someone out, that is my bipolar. It can be used as a crux or in the wrong way.
Sometimes it is used against people. If someone has a certain diagnosis, like PTSD, if it is PTSD then they meet certain criteria which are just boxes that are checked thru a diagnostical and statistical manual which are made by a bunch of suits. These suits may have inappropriate ties to people that profit off people being ill. Whether it be pharmaceutical companies or whatever, we need to be careful not to pathologize people. Everybody has had stressful events.”
“A large part this argument has been inspired by retired General Peter Chiarelli, the former Vice Chief of Staff of the U.S. Army. After two tours in Iraq, Gen. Chiarelli grew alarmed by rising suicide rates in the Army. He reviewed every case, and concluded that many service men and women hate the term “disorder,” and suffer in silence rather than endure that label. For a soldier who sees the kinds of things soldiers see and experience on the battlefield today, to tell them what they’re experiencing is a disorder does a tremendous disservice,” he has said. “It’s not a disorder. It’s an injury.” (SOURCE: An Injury, Not A Disorder. www.dartcenter.org)
The D in PTSD, is there a stigma here calling it a Disorder?
SUSAN OXFORD / COUNSELOR: “Some need the disorder to feel like there is a reason that this is happening, this is ok, I am not crazy, that there is something going on. For some it feels like a death sentence or a for of life sentence so this is never going to get better, so Brenda and I try not to fix anyone into a box. We try to meet them where they are at and help them understand why they are where they are. Education is a huge piece of our group but also as individuals to understand about the brain and the body.
The response to the trauma, they feel at a loss, or feel overwhelmed. They feel like something is wrong with them or they are damaged or that is how any brain or body would respond.
Some of the older veterans feel like this is just me and nobody else gets it. Stigma is huge.”
WIFE OF VETERAN: “PTSD is not a good name. It should be treated as both a medical and mental condition. It has both parts to it but we are ignoring the medical part of this and concentrating on the brain. Your entire body is going thru this process. I will get fired, I will lose my job if I let them know I have been diagnosed with PTSD. They never want to put on an application they have this diagnosis. The country and the government are so FREAKED out over that word PTSD. That word just needs to go away. I have a medical condition is a lot easier to deal with than, oh, I have a disorder called PTSD.”
BRENDA McBRIDE / COUNSELOR: “It is Shame. I did bad, I am flawed, I am damaged, I am unworthy, I did something bad shame on themselves. Shame is that fear of disconnection. If they knew this about me, they wouldn’t want me. I wouldn’t belong if they think that of me. Humans are hard wired to connect with others.
Fitting in means I want to be part of that group, but I could change something about myself in order to fit in. Belonging means, I get to be me, you get to be you, and the group wants me there. Belonging turns on a part of our brain where we want to be, where we want to live. It gets you out of that fight or flight, I can be with safe people without judgement and allows you access to more of your brain.”
BRAVO: “I don’t run around and tell people I have PTSD. I am ashamed of my PTSD. A lot of veterans say they have PTSD, but that is bullshit. You don’t run around and talk about shit that doesn’t make you feel good.
People need to see how they treat veterans. They need to see the stigmatism that is put on it. Just listen, that is all the veteran is asking you to do.”
Dr. Sean Mulvaney: “I tell my patients that come into my office. I am sorry you are here and you have to deal with this. A lot of people feel guilty because they just can’t get over it. They are guilty because they are still dealing with PTSD and guilty for the way they are treating their family. I stay STOP, I just want to squash that thought right now. You have a medical condition. Would you feel guilty if you just couldn’t get over your cancer? Would you feel guilty if you just couldn’t get over your pneumonia? NO.
You have a medical problem, we are going to treat it like a medical problem, we are going to reset your fight or flight nervous system and you are going to get better and we are going to work with you until you feel like you got to go where you need to go. A lot of it is just getting rid of the guilt they have. This is a medical thing. We are going to take care of it.”
PHIL SMITH: Out of Respect for all our veterans and especially the six veterans participating in this series diagnosed with PTSD, I prefer not to put them in a box and call their struggles a Disorder.
Drugs and psychotherapy can be very beneficial in helping those struggling with PTSD, however, there is NO evidence, white papers or Peer Group Studies showing that a multitude of “COCKTAIL DRUGS” have any beneficial relief from PTSD. I believe they are doing more harm than good.
I will, for the rest of this series, refer to PTSD as Post Traumatic Stress, PTS and prefer not to call it a Disorder. The stress caused by trauma whether it be from war, assault or any form of trauma causes tremendous stress on the mind and body.
SYMPTOMS OF PTS:
1. Detachment from Others
One of the first symptoms of post-traumatic stress is detachment from others. This can happen for a myriad of complicated reasons. Often, those with PTS are afraid of how they might behave in front of other people. They worry that they might become angry or react strangely to normal occurrences.
2. Flashbacks
Flashbacks are another symptom of PTS. The symptom causes a person to relive a traumatic event. The emotional response is different for everyone. However, flashbacks often cause feelings of panic, extreme stress, and physical issues like fainting, heart palpitations, and high blood pressure.
3. Nightmares
Frequent nightmares are a common symptom of PTS. These nightmares may focus on the event that created the trauma or they may appear unrelated. Nightmares are different from flashbacks in that they occur on a subconscious level during sleep, while flashbacks take place while the mind is alert and awake.
4. Avoiding Reminders
Someone with PTS may avoid situations that remind them of the events around the trauma. For example, if the traumatic event happened at work, then the person with PTS may have difficulty returning to their job. Additionally, they may not want to be around family or friends they associate with the traumatic event. This symptom can interfere with one’s livelihood and social life.
5. Insomnia
Insomnia, or the inability to sleep, is another symptom of PTS. There are many reasons this occurs. Some people may find that they keep worrying about the event that caused the trauma, making it difficult to clear their minds and drift off to sleep. The knowledge that nightmares begin after they drift off can also make sleep difficult. Doctors can prescribe medications and holistic methods such as meditation to help reduce instances of this debilitating symptom.
6. Lack of Motivation
Sleeping too much or generally losing interest in day-to-day activities and hobbies about which one used to feel passionate can be an indicator of PTS or another condition such as depression. If someone experiences this symptom over the long-term, on a regular basis, it may be advisable to seek professional help or advice.
7. Anger
An individual with PTS may exhibit irritability and anger in varying degrees and at sometimes unexpected intervals, often to a greater degree than they once did. This can happen for a variety of reasons and can impact interpersonal relationships and job performance.
8. Memory Loss
Memory loss can be associated with PTS. Often, an individual will mentally block out the traumatic event temporarily or permanently. This presents challenges in the diagnosis, acceptance, and recovery, as many mental health professionals encourage their patients to face and discuss the circumstances that led to the condition. In addition, people with PTS may have difficulty recalling recent events unrelated to the trauma.
9. Feeling Jumpy
People with PTS may find that they feel jumpy or are never completely at ease. This often occurs when a traumatic event that caused the condition is particularly frightening and life-endangering. For example, many soldiers who have spent time in active war zones and other dangerous situations may experience PTS and, as a result, loud noises and stressful situations reminiscent of the trauma can trigger emotional and physical responses.
10. Turning to Drugs and Alcohol
Sometimes, people with PTS turn to self-medication in the form of recreational drugs and excessive alcohol consumption. This is another sign that professional medical care is necessary as soon as possible. The excessive use of drugs and alcohol can exacerbate feelings of depression and other dangerous symptoms that can lead to suicide or otherwise put an individual’s life in danger. (SOURCE: www.facty.com 1-10)
THE SPECTRUM OF DEMONS AND CAUSES:
Doctors aren’t sure why some people get PTS. It is a complex mix of: Stressful experiences, including the amount and severity of trauma you’ve gone through in your life like rape, family history, stress from battle and cumulative prolonged traumatic experiences and more. It could be caused by viewing of bodies and body parts from war or auto accidents, death in the family and any other stressful situations. The stress could come from experiencing or witnessing a traumatic event.
Afghanistan:
DUB: “This guy was on the ground, no pulse, not breathing. He was in a motorcycle accident. No signs of trauma. He was in uniform and well protected. The MP’s kept saying he was choking on something. My first indication was he was pulseless. They were hitting him on his back like they were trying to dislodge something from his windpipe. I bent down and said let’s cut his clothes off and start CPR. I was going to give him two rescue breaths. The first one was good. The second one he threw up all into me. I actually swallowed it, a large amount of it. We are pretty sure the guy did not live.
It was a huge dramatic incident that started my PTSD. I would have nightmares and dreams that the guy is in bed with me. One of his eyes was closed and the other eye was fully open. That vision stuck with me. When I dreamed that he was in bed with me I would see him with that one eye open. This happened over and over and over again. This is when I began drinking heavily hoping I would not have that dream. I tried to mask and wash that memory away.
The same thing happened with my dad in 1995. He passed away with cancer. I was there when he passed away and he had one eye opened when he died. This enters my head daily.”
GRUNT: “We were at 29 Palms, California. I was an MP. They were having a huge exercise out in the desert. They have it every year, it is like a real combat exercise. There was an F-16 that went down. They gave me and this guy the coordinates and we went 26 miles out in the desert.
This F-16 came in low in this valley surrounding the mountains and got into trouble. He turned sideways and hit the eject and hit into the mountain. These mountains are solid rock. Piece by piece we picked up the body parts. That is the thing that keeps coming back on me. I remember carrying the dudes head and taken it to the body bag we had on the ground.”
BRAVO: “I was a youth Minister for seven and a half years at a church and when I got out of the military in 95 I self-medicated until 2005. About four and a half years ago I had a break and attempted to take my life. Ended up in a health center in Tyler, was diagnosed with PTSD. About two weeks later I came back to the church and the kids that I had baptized, in that church, the parents stopped bringing them.
I didn’t try to hurt any of them. I had been with them for seven and a half years, and because I had attempted to kill myself, not because I was diagnosed with PTSD. I was this monster all of a sudden. When I got the PTSD diagnosis and came to the Church and told them It was even worse. He might be one of those freaks and run around and blow up our Church. I left. I was pissed at Church, I was pissed at God and pissed at people.”
DUB: “We flew into Manis, Kurdistan which was a civilian airport. I was going as light infantry. We were on standby to fly into Kandahar Airfield on a C-130.
We arrive at the Airfield and headed over to a large hangar and get loaded onto a bus where we hear this voice come over the loud speaker, “Incoming missiles, prepare for impact, incoming missiles prepare for impact.” We are the 101st, can’t nobody hurt us. We are here to square this place away. We are here to kill the Taliban, we are here to catch Mullah Omar and we are going to make this place a Democracy.”
DANO: “In Kandahar you would hear the siren go off then hear the British accent say, “Rocket Attack, Rocket Attack, Rocket Attack.” It was very calming. As long as I was able to dive to the floor and cover my head. I was not worried whatsoever. I felt safe. Even today when someone has a cellphone with an alarm going off that has a similar sound, watch out. It can get dangerous.”
DUB: “We were in high pursuit of an asset named Mullah Omar who had one eye. We only had one picture of him. To a degree we were considered Special Forces. We were not considered Delta Force, Rangers, Navy Seals or Special Ops. We were perceived as brothers to them. We were considered by the Taliban as “MONSTERS.”
If any of us say the sky is purple, roger that, the sky is purple. We were trained to work with everybody and everybody appreciates the 101. They know that we are just machines to kill and kill. We trained at Kandahar for about a week, hop on another C-130 and head to a camp called FOB Wilson. It is horrible. My best buddie catches pneumonia. It is 129 degrees when we hit the ground.”
THE HORRORS OF WAR:
This series will include very rough language and real-life battlefield and military experiences that could be very disturbing to some people reading these articles.
BRAVO: “You don’t know how each soldier processes stuff. Mine is not so much from being a medic, so much as it is from the humanitarian aid afterwards with the kids. Mine is not for having to shoot somebody I don’t have a problem with that.
Mine was not so much trauma that I dealt with during the ground war. I wasn’t treating the Americans, I was treating the Iraqis. Afterwards I pulled about eight months of humanitarian aid out in the middle of the desert. It was the kids that were coming in with hands blown off because of cluster bombs and so on. That’s what screwed me up. I don’t have a problem with doing my job, if you have to go, you just go. I am a soldier, I have a job to do. It is that simple. I have clean conscience on that side of the board, it was afterwards that screwed me up.
If you sign up to be a soldier, you damn better well have that in your mind, that you may have to kill somebody.”
JACK: “You face death and you have to face that. At the time it doesn’t mess with you but when you come home it is still there. It doesn’t leave you. You see the stuff on the news, mass shootings you have to be hyper vigilant. You have to be aware of your surroundings. You never feel safe.
I saw a lot of dead enemy. Stone cold face when I saw a dead body. Nothing for me. Took bodies out of rivers, burnt bodies. Two different smells that will never leave you. See guys shot in face with a 50 cal, looked like a deflated balloon. You don’t want to think of yourself as weak. That could be me laying there. Better you than me. It is not going to be me. My PTSD was caused by all the bodies I saw. I saw them in both Iraq and Afghanistan.”
DUB: “I spent the next seven years at Fort Campbell with the 101st Airborne and I was taught one thing, “HOW TO KILL.” Seven years of hard training. They taught us how to kill with small arms, anti-tank weapons and AT-4s. We learned how to channel the enemy into a certain point. We learned the correct use of air assets and using them for anti-IED’s. Everybody wants to kill us, so we have to kill them first.”
DANO: “The rocket attacks are their favorite mode. They would go to an area and set up the rockets. Like a 2 x 4 shed and line up all the rockets. Put them on a stop watch or an egg timer. Then drive away. 10 minutes later they explode. We sent up choppers and they are gone. We had a lot of false rocket attacks. If an F-16 flies over the runway and it is below a certain level or above a certain speed it still trips the sensors and we have to respond. The response still takes 45 minutes. They know we do a bulk of our work doing the day and have skeletal crews at night. Crews are exhausted when they get off work. Say they get off at 9. They launch an attack at 9 then at 11. Each time it takes 45 minutes to clear. Launch at 1 in the morning. It still takes 45 minutes to clear. Each time all these people are up and in these shelters. I do it again at 3, and again at 5. None of those people got sleep. How effective are they going to be today? That is what they did. Whether or not those attacks destroyed anything is not important. The psychological effect was huge. “
DUB: “The second attack haunted me for years. This is the one that tore me up. I got a call from one of the towers saying I had a herd of sheep passing. I have a translator to my left. He tells me they are moving into the sheep. Meaning the Taliban were moving into the sheep setting up IED’s. I said, I need a Predator or a Scan Eagle now. Battalion had them tied up, I could not get either one. I had three Canadians sitting on the top of the mountain with nothing to do. They saw them putting down the IED’s. They asked for what kind of rounds I needed and I said I needed high explosives. They opened up on them. Just greased them. There were three of them. I won a Dr. Pepper out of that one.
They bet me I could not grease all three of them. Years later, sitting home in my lounger I got to wondering who these guys were. Did they have a family, did they have kids? Did they have mommas brokenhearted? The Shame took over me. They were an active combative and my job was to take them out.”
DANO: “The main entrance for contractors is where they had to come off one road and come down this other road to get to the gate to go thru the security screening. Lot of our MRAPS come thru there. As they are driving thru a guy comes up in a station wagon and detonates a bomb which was basically 500 pounds of TNT and knocked an MRAP head over heels several times. I think eight people were killed that day and dozens injured. Many of them were just contractor’s delivery concrete and other items to the Airfield.”
PROLONGED EXPOSURE:
Is there any data you can share about prolonged exposure is having on trauma and diagnosis of PTSD?
Dr. Lia Thomas
VA Medical Director, Mental Health Trauma Services: (VA North Texas Health Care System): “There is a World Health Organization paper on that about global trauma and even they could not specify on the types of trauma and could not quantify if you have had multiple traumas what does the severity look like. It is multi factorial based on the types of trauma, resilience, coping skills, societal support and other factors.”
Julia C. Smith, Psy.D
VA Clinical Director, Mental Health Trauma Services: (VA North Texas Health Care System): “There are so many individual factors that go into that. It could compound things but it depends on who you have in front of you. I have had a veteran in front of me who had six tours and he was managing quite well. There is no one to one ratio on trauma stress from single or multiple tours. We all digest trauma differently.”
DUB: “This is when I lost it. There was a four way in a field. There was an IED placement here and an IED placement on the other side. We took 14 casualties that night. The Commander said we have MASSCAL, MASSCAL, MASSCAL ( MASS CASUALTIES ).
Which meant anything that had an engine, a jet, a helicopter, vehicle or whatever was to move to our point.
We had everything you could think of, Chinooks, Blackhawks and everything in the area to mark where the injured were located. You take a glow stick on a piece of string and you swing it. With that the pilots can pick a landing zone, (LZ).
They brought some of the casualties to where we were located. We had about seven bodies hidden under blankets. None were injured, they were all dead. Under Military Law a soldier is NOT to identify an American casualty. They have our DNA and our picture. There is no need for an American soldier to go over and look at this mess. This E-6 said, Dub, come over here and tell us who these people are. The first guy just had a shoulder and a piece of torso left on his body. On his shoulder was a tattoo with a picture of all his kids. I knew this guy. Only two weeks previous I had an argument with him. I came to the second guy, and all of a sudden, I saw a huge white light. Different than you could ever expect. Something in my head said, you are done, go back to where you are at. So, that is what I did. In my heart, I felt I am done with this war. I am done. I went back to where I was at and sat down for six or eight hours, without moving. I didn’t talk, didn’t eat or drink water. My best buddy, who was a Lieutenant, comes walking up with his hands up in the air. I am cussing and yelling at him. He had some TBI (Traumatic Brain Injury) and told him to get on the bird and get evac. I went nuclear. I found out my Project Officer (PO) had lost the top of his head; a leg was shot but he was still alive. So, he got evacked. I found out other friends had been killed. I was a wash. I was done. My First Sargant was livid because of what they asked me to do.
When they announced over the radio that my Lieutenant’s Battle Roster Number and his name that he was dead. This was my close friend that lost the top of his head. Again, this was totally against Army regulations. It is called GO-1, General Order Number One.”
In week 3 of our series on Post Traumatic Stress (PTS) we look at the Sympathetic Nervous System along with:
The Amygdala Neurons in the Brain
Fight or Flight Response
Trigger Points/Heightened State of Arousal
Anxiety/Fear/Anger
THANK YOU FOR SUPPORTING THE VAN ZANDT COUNTY VETERANS MEMORIAL. Phil Smith