Thursday, November 15, 2012

PART 2- What Living with PTSD is Like on a Day-to-Day Basis


It should have been a day of fun, a time to unwind and play with the kids before heading back to Iraq after coming home on emergency leave after his father passed away.  The last week had been pure stress and emotion, and I was hoping to squeeze in just a little bit of family time before he had to go.

We went to Jump ‘n’ Jive, a place in Amarillo full of bounce houses for the kids to play on.  We did what most parents do with two young kids: divide and conquer.  You take that one, and I’ll take this one.  It wasn’t long before he brought me our son and said he had to make an important phone call.  He walked outside, and I did my best to chase them both until he got back.  It seemed to take forever, and I kept walking by the window, pointing at the imaginary watch on my wrist and motioning for him to come back in.  About 30 minutes later, he did, but less than 15 minutes after that, he grabbed my arm and whispered through clenched teeth that he had to go wait in the car.

I tried to talk him out of it, but it was like he wasn’t hearing me.  He quickly exited, leaving me to chase two kids determined to go in two different directions.  I was furious.  He hadn’t seen the kids since the day after Christmas when he was recalled back to Fort Bragg.  I was the one who had to deal with the stress of being a single parent while he was away, and he couldn’t even focus on them for one afternoon!  I finally calmed down and told myself that after being plucked out of a war zone on short notice and dealing with the funeral details, he hadn’t really had any time to himself to think, to let it all sink in.  I later found out that wasn’t entirely the case.

What he wasn’t able to verbalize until later that night was that he just couldn’t handle the environment.  The constant whirring noise of the blowers was unbearable.  The children screaming, darting in and out of hidey-holes, hiding in the shadows, and popping up unexpectedly was more than he could handle.  He felt like he was on high alert, his heart raced, and he was starting to sweat.  While I understood that it was a normal reaction coming back home for such a short period with no time to decompress, I had no idea that it was a sign of what was to come when he came home for good.

LIVING WITH PTSD
Last week, I wrote about the symptoms of PTSD, why the body reacts the way it does, and tried to defuse some of the violent Hollywood stereotypes.  This week, I’m going to focus on what living with PTSD looks like for many families every day.  Hopefully this will explain why we sometimes do the things we do.

TRIGGERS
There are endless lists of what sort of things can “trigger” a veteran to become “amped up” or agitated.  What bothers one vet may not bother another, so it’s by no means a perfect list.  Sometimes a certain thing may not bother a veteran until they are already feeling stressed and possibly exhausted by sleepless nights.  Here are some of the most common triggers:

NOISE:  Loud, unexpected noises are probably the number one trigger that affects veterans with PTSD, especially those that can be interpreted as gunshots or incoming fire.   Fireworks, cars backfiring, slamming doors, dropping something heavy, the sound of machinery, loud crowds or screaming kids, even if they’re having fun, can cause a reflex reaction.

I’ll never forget driving back onto post at Fort Stewart right after the 3rd ID got home from Iraq in 2003.  The main headquarters shot off a cannon every weekday at 5:00 p.m.  We were directly in front of the building, chatting away about something, not noticing the time.  When the cannon fired, my husband almost put my Chevy Blazer in the ditch.  We weren’t the only ones.  Several other cars also slammed on the brakes or swerved to “take cover”.  We made it a point after that not to go near the front gates at that time of day again.

CROWDS:  A lot of veterans with PTSD say they feel uncomfortable in large crowds.  When going to restaurants, they report having to sit near an exit or with their backs against the wall with a clear vantage point of their environment.  Especially in the wars in Iraq and Afghanistan, warriors were constantly on guard and were trained not to trust any civilians.  Suicide bombers were using women and children.  They didn’t know if an old crippled man was motioning for help or trying to lure in soldiers to detonate a hidden bomb.  They were able to control crowds and do their jobs with their fellow soldiers there to watch their back.  Even back home, their training tells them to scan the crowd, look for anything suspicious, and identify threats.  Again, some days this may not bother them, but other days, they can become distracted or even obsessed with it.

BEING SURPRISED: In war, surprise is rarely a good thing.  Many PTSD veterans have an exaggerated startle response when they are taken by surprise, especially if they’ve already scanned the area and didn’t see someone before.  If someone comes up behind my husband and taps him on the shoulder, even a familiar face, a friend just wanting to say hello, you could very well see him “jump out of his skin”.  The added stressor to this is the embarrassment that follows. 

I’ve also learned through the years that when my husband is alone in a room that I’m about to enter, I need to cough, clear my throat, or tap on the wall to announce my presence in advance so he doesn’t turn around and startle when he sees me mere feet from him.  It also doesn’t help that he sustained mild hearing loss from repeated blasts.  We’ve also had to teach our children that you don’t sneak up on Daddy.  Most normal families don’t usually have to have that talk with their children.

ON THE ROAD:  There are two things my husband hates about driving: debris on the road and inconsiderate drivers.  While most people could probably agree with the last one, it is particularly disturbing when you have PTSD.

Road debris was another trigger that took me by surprise.  We were driving to Amarillo one day shortly after he returned home, and he nearly put his truck in the ditch to avoid hitting a styrofoam cup in the road.  He jerked to the side out of reflex, and for a split second, I thought we had blown a tire.  He apologized and explained that debris in the road in Iraq could mean an IED (improvised explosive device).  While I haven’t seen a reaction that intense again, I can still see him tense up any time there is debris in the road.  He’ll still do all he can to avoid it, but the knee-jerk reaction has tapered down dramatically.

As for inconsiderate drivers, you would think this would be plain old common sense for all.  Unfortunately, this is not always the case.  People who tailgate, purposely box him in, cut him off, or are just plain aggressive will kick in that instinct to take evasive action.  You never know that the other driver is dealing with.  This goes for civilians, too.  I think everyone has heard the stories about people with such horrible road rage, they brandish a weapon or follow the other car when they exit the highway.  This is not just a veteran problem.  Please, be courteous on the road.

SMELLS: The first sign of PTSD I ever saw in my husband was triggered by a smell.  We had moved from Fort Stewart to Fort Bragg at the end of October.  With the holidays and going home for Christmas, we didn’t get every single box unpacked right away.  My candles were one of the boxes that collected dust for a few months, and one day when I was in a hurry, I lit one without dusting it off first.  It had that distinct burnt hair smell.  My husband retreated to our bedroom so abruptly, it caught me completely off-guard.  I followed him to find out what was wrong, and after almost an hour of trying to get him to talk, all he could say was “I can still smell it.”  He then broke down and told me about a car bomb that killed four of his men at a checkpoint.  The New York Times would refer to that incident as “the first suicide attack on United States soldiers fighting in Iraq.”  He had never told me about it until that day.

Some veterans report not being able to tolerate the smell of fire or diesel.  Just like the scent of your granddad’s Old Spice or your grandmother’s chocolate chip cookies can take you back to warm, happy memories, scents can take warriors back into the scariest moments of their lives.

CERTAIN DATES:  Many veterans also report feeling more “amped up” or emotional on certain dates or times of the year, especially if it involved the loss of a friend and fellow soldier or the date of personal trauma or injury.  On the anniversary of the car bomb, you can pretty much bet that we’re not going anywhere.  Some wounded warrior organizations have coined the term “Alive Day” for the day a soldier survived a horrific injury.  Some say it is a day to be celebrated.  For most of the wives I talk to, it’s a day they dread each year because it usually means their husband is on edge for days, sometimes weeks leading up to that day.

Again, this is not the complete list of triggers, just to ones we personally deal with the most often in our everyday lives.

AFTER THE TRIGGER
Once the limbic system of the brain (the fight-or-flight reflex) is triggered, the body will react by preparing the body to act, and act fast.  Adrenaline starts pumping, heart rate increases, and the mind becomes sharp and begins to work overtime processing every little thing in the warrior’s environment.  This is what we refer to as being “amped up.”  As explained in the previous article, the one emotion that seems to bubble up the fastest is anger.  Anger keeps the soldier alive on the battlefield, but is not particularly helpful back home.

My husband, Will Montgomery, explained “When you get “activated” or “amped up”, you automatically get angry, even if there is nothing to be angry about.  Then you start looking for things to be angry at, because it makes no sense to be amped up and angry for no reason.”

This is where warriors and their spouses can face the most problems.  Until they both realize that the anger is a result of a trigger, feelings can get hurt and marriages can start to unravel.  Part of many treatment programs focus on recognizing the true reason for the anger and finding new ways to deal with the triggers and the reaction to them.

LEARNING TO ADAPT
Wounded warrior wife Tammy M. of Texas said, “The biggest change our family had to make because of PTSD was the ability to change at any given minute.”

Most veteran families dealing with PTSD can agree.  It’s hard to commit to future plans because they never know what kind of “day” their veteran will be having.  Sometimes they will have every intention to do something, only to be triggered and need to make an early escape, or cancel altogether.  We learn to plan for every possible scenario, and always, always, always have a backup plan.  Sometimes, that means the veteran may need to stay at home while the family goes without them.  It’s hard on everyone, especially when they feel like they are being judged for not being there.

Jim G. of North Carolina was a Navy Corpsman who was injured during his third deployment to Iraq.  He says the hardest part of living with PTSD is feeling alone and secluding himself.

“I avoid fun, people, and crowds because I don’t want to get anxious or angry,” said Jim.  “This means that I don’t get to spend time with my wife and daughter like I used to, which I miss a lot.”

Jim’s wife, Alishia, agrees.  She very often will deal with her daughter’s activities alone, and admits that mostly they stay home to have some form of family time together.

“It has become easier to not do anything than to have to deal with the consequences of him being so on edge,” she explains.

A common practice among families dealing with PTSD is to try to avoid known triggers if at all possible.  The Fourth of July is a big topic of discussion in many PTSD groups.  Some choose to stay home and try to drown out the noise with music or movies.  Others choose to leave town and go to a place where there are no fireworks, or a place where they can be in control of them so they aren’t taken by surprise.

This year, my husband really struggled with fireworks.  He was coping pretty well until one day when he went to take the trash to the dumpster, and as soon as he opened the back door, a big and extremely loud mortar round exploded above our backyard.  We spent nearly the next week out of town at a family farm in Wheeler County, away from the noise.  We didn’t want to be the “cranky neighbors” who called in to complain about fireworks, something we would have otherwise enjoyed had it not been for PTSD. 

He tried his best to ignore it the rest of the time, and he would take our daughter to her week-long TEXAS performance in the canyons.  At least their fireworks were choreographed with music so he knew when and where to expect them.  We thought we had made it past the stress until someone started shooting off big fireworks after 1:00 a.m. on July 6th.  He was livid and was amped up for the next few days, especially because he really hadn’t had a decent night’s sleep in over a week.

Over time, most spouses become acutely aware of their veteran’s triggers and can easily spot their “tells” when they begin to get stressed out.  It can be the way they look, a change in pitch or volume when they talk, or the need to be alone and have some space.  We watch for these signs, sometimes even spotting them before our spouses realize they are beginning to project them.

Wounded warrior wife Heidi W. of Nevada says the best way she can help her husband sometimes is to give him space.

“I created a space for my husband that he could escape to when he needs to step away,” she said.  They also established a code word so he could let her know he needs some alone time.

Sometimes the hardest part as wives is having to learn to not ask questions and let it go, at least for the time being.  Before I really understood how his PTSD affected him, I would follow my husband from room to room, begging him to talk about what was bothering him, which only added fuel to the fire.  It’s a give and take.  Wives have to learn to let them be, and husbands have to learn that we are concerned and still want to talk about it at a more appropriate time.

No matter how far along in treatment the veteran is, there is almost always worry about triggers.  As Cheryl G., wounded warrior wife and advocate, says, “PTSD is manageable, [but] it is always there.”

“He is constantly battling it everywhere he goes,” she says.  “It is manageable, but it isn’t always easy.”

****

I’m amazed at the number of people who have already contacted me following the publication of the first article.  People have shared stories, requested more information, and even told me that because they shared the link, a friend or family member opened up to them about the problems they were having with PTSD.  This is the reason I’m doing this series.  Thank you all so much for helping spread the message to those who needed to hear it.

Always remember: 
YOU ARE NOT ALONE.


Monday, November 12, 2012

"Pieces"- Music Video by Combat Vet on PTSD

Here is another YouTube video, but this one is not graphic like the previous one.  It is a country music video by Stephen Cochran, combat veteran and country recording artist.  He speaks truth and hope for families dealing with PTSD.  For every 1 service member killed overseas, 25 are taking their own lives here at home.  If you know a veteran, especially one who deployed since 9/11 who has or is returning home soon, you need to see this music video.  Remember, 1 in 5 (some reports say 1 in 4) returning veterans admit struggling with PTSD.


Here is what he says about his song, "Pieces":

"What comes to mind when you hear the word 'Pieces'? For me it brought to mind the many pieces my back was broken into while serving in Afghanistan with the United States Marines. I like so many others was injured while serving. It was not till after my return to music from combat that I started a different battle, one we are loosing here at home. The invisible and very much lonely fight with Post Traumatic Stress. I like most of my brothers and sisters who have served in extreme combat suffered alone for along time and most of my early career, I almost lost my battle in 2010. I had felt so alone and dare not say I had a 'Disorder' as most hospitals and therapists call this P.T.S.D. So I felt my only coarse of action was to discharge of the damaged gear I had became and attempted to take my life. Luckily with the grace of God and my family I did not, and its been a long road back to normality. As I took 2011 off from recording music to focus on helping my fellow vets and myself heal. I sat down and thought about what 'Pieces' really meant to me…and it had nothing to do with my back or physical injuries. It had to do a lot with putting the 'Pieces' of my life back together after all the suffering. As I toured and visited with other vets I knew it was my duty to write the song 'Pieces' as 'our story'.
All of us who have ever started over from nothing….and that’s most of us in this world not just vets. I hope you continue to help me fight for an end to the lonely suffering and let them know they aren’t alone…and they have no disorder. For we all start over with just 'Pieces' at one time or another in our lives.
"


For more information on Stephen Cochran and his music, visit his website at www.stephencochran.com.

Sunday, November 11, 2012

"Now, After"- A Short Film

I want to share a YouTube video of a short film created by a veteran that shows what PTSD is like from the veteran's point of view.

WARNING:  THIS VIDEO IS EXTREMELY GRAPHIC!  No bad language, but contains brief images of gore to represent the memories that flash across the mind of a combat veteran as he goes about his day.  Some may say the graphic images are unnecessary, but honestly, to truly "see" what it's like, these flashbacks or memories that haunt our troops, there is no other way but to show EXACTLY what they see.  There are brief flashes, but can be disturbing.  It can also be a trigger to veterans already suffering with PTSD, so watch with caution.  Just keep that in mind.  My husband watched it and said it was the best representation he had ever seen.  As a wife, it's exactly as I pictured it would be.


Thursday, November 8, 2012

Part 1- "PTSD: Vets Battle Symptoms and Stereotypes"


When war-weary troops returned from Vietnam, they were not prepared for what waited for them at home.  Instead of applause and the ticker-tape parades that their fathers had received after World War II, they were spat on.  They were called “baby killers”.  Worst of all, they were forgotten.
Decades later, people have come to recognize the disservice to those veterans and have tried to make amends by supporting our troops.  I’m sure you’ve heard the saying, “You can protest the war, but support the troops.”  As a child, I remember a classmate’s father coming to speak to us about the Gulf War.  I didn’t understand what it all meant, but I remember he showed us MRE’s (the ready-to-eat food packets the troops ate that still gross me out to this day) and that we tied a lot of yellow ribbons on everything.  I didn’t really know what was going on in the world, but I knew that our troops were heroes and we supported them!
After September 11th, 2001, that same rallying cry of “Support the Troops!” could be found everywhere.  T-shirts, billboards, posters, bumper stickers.  Someone out there probably retired from the profits off of those yellow ribbon magnets that were on every other car on the highway.  As the war dragged on, folks were less vocal about it, until a local soldier would come home.  The press would show up with their cameras, supporters would come with signs and banners, offering cheers and “thank you’s” instead of the insults cast at so many Vietnam veterans.  Yes, this is indeed progress.
But what happens after the homecoming party?  What happens after that same soldier comes home for good, trying desperately to fit back into a civilian world so different from the military lifestyle he or she has grown accustom to, especially after seeing the horrors of war firsthand?  What happens to them and their families as they try to get back to “normal” following two, three, or even five or six combat tours overseas?  While they were robustly welcomed home by a grateful nation, some are being forgotten all over again as the demons of the past stir up and begin to haunt the service member and their families.  While people are patting themselves on the back for being so supportive of the troops, they are not seeing the epidemic that has slowly begun to chew away at our military families.  That “thing”, that unseen force that is tearing families apart and driving our troops to end their own lives at an alarming rate is PTSD, post-traumatic stress disorder.
The Invisible Wounds of War 
This is a deeply personal topic for me to write about.  Many of you know that my husband is a veteran who served two tours in Iraq.  Some of you might even know that he was a combat medic and that his unit was one of the first to cross into Iraq in 2003.  Extra points to those of you who know he was also in the 82nd Airborne and was a part of the Surge of 2007.  But what you might not know about my husband is that he is a disabled veteran.  That might come as a shock to many because he looks just fine.  He is not missing a limb.  He is not in a wheelchair.  He is not one of the burn victims seen on the Wounded Warrior Project advertisements.  While he does have physical disabilities rated by the VA for various neck and back issues, most of his disability rating is from PTSD and traumatic brain injuries (TBI), which are becoming known as “the invisible wounds of war”. 
If you were to take one PTSD veteran and put them in a line up with non-PTSD veterans, you most likely wouldn’t be able to pick them out.  What many people don’t realize is the magnitude of the problem.  Reports are now being published on the latest statistics of PTSD veterans, and it always seems like the numbers are changing, and what is scary, they are getting higher.  As more veterans exit the military and re-enter the civilian world, they are starting to come forward with their problems.  Most studies say 1 in 5, but a recent study claims 1 in 4 veterans will develop PTSD at some point.  How many veterans do you know?  To the younger generation: How many kids you went to high school with joined the military and were deployed?  Can you name five?  Chances are, at least one of them is struggling with PTSD.
If nothing else catches your attention, maybe this frightening statistic will:
For every soldier killed on the battlefield this year, 
about 25 veterans are dying by their own hands.
An American soldier dies every day and a half, on average, in Iraq or Afghanistan.  Veterans kill themselves at a rate of one every 80 minutes.  More than 6,500 veteran suicides are logged every year— more than the total number of soldiers killed in Afghanistan and Iraq combined since those wars began. (“A Veteran’s Death, the Nation’s Shame”, Nicholas D. Kristof,NY Times, April 14, 2012)
Those heroes whom we all claim to support are falling through the cracks at home, and we as a nation owe it to them to get educated, reach out, and put a stop to the loss of so many of the bravest and brightest of this generation.     
History of PTSD 
PTSD is not new.  Dr. Charles W. Hoge lists in his book Once a Warrior, Always a Warrior many of the different names PTSD has gone by through the years.
“The reactions that warriors experience after coming back from war have been given labels through the generations, including “Nostalgia” (Napoleonic Wars); “Da Costa Syndrome,” Irritable Heart” (U.S. Civil War); “Effort Syndrome,” “Shell Shock” (World War I); “Battle Fatigue” (World War II); “Acute Combat Stress Reaction” (Korean War); “Agent Orange Syndrome,” “Substance Abuse,” “PTSD” (Vietnam); and “Gulf War Syndrome” (Gulf War 1).
PTSD was first proposed as a diagnosis in 1980 in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM for short).  Part of the push for creating the definition of PTSD was the generation of veterans from Vietnam, as well as the history of conditions described after previous wars, such as shell shock.  This is again very telling for the Vietnam veterans.  When many returned and sought help for their problems, they were not taken seriously by a civilian medical world who simply could not fathom the effects of the horrors of war.  They were told it was all in their head, or worse, that is was their fault because of substance abuse.  The addition of PTSD to the DSM was groundbreaking for veterans.  It validated their claims and gave their struggles some form of legitimacy.  People began to realize that PTSD was a normal reaction to abnormal trauma.
What is PTSD?- Symptoms 
Symptoms of PTSD* can include intrusive thoughts and memories of the traumatic even (flashbacks), emotional numbness, avoiding reminders of the trauma, and hypervigilance (overly alert) to possible dangers.  These are some of the most common symptoms, but not everyone experiences all of them or to the same degree.
Intrusion- Intrusive symptoms include nightmares, “daymares” or flashbacks which feel like the trauma is happening all over again.  This may include “seeing” the trauma or feeling the sensations and emotions that accompanied it.  Memories and thought about the trauma keep popping up, making it hard for the person to focus on life or get to sleep at night.
Numbing- Intrusion phases tend to mix with periods of numbness.  Feelings of being disconnected from life or from family and loved ones may be present when nightmares and intrusive thoughts are not present.  People in this phase often feel depressed and empty.  Some people respond to these feelings by becoming thrill seekers to feel alive again.
Avoidance- People often begin avoiding situations or objects that remind them of the accident or traumatic event.  Many things can be “triggers” for flashbacks including smells, places, people, weather, etc.  As the individual attempts to avoid all these triggers, the person’s world contacts into a smaller and lonelier place.
Hyperarousal- Regardless of whether they have intrusive or numbing/avoidance symptoms, people with PTSD may startle easily and more dramatically than before.  They tend to be anxious and overly vigilant or on alert to dangers, particularly dangers related to the traumatic event.  The worrying may seem out of proportion, even paranoid, to friends and family members.
(*Excerpt from the PTSD Tip Card written by Nadia Webb, Psy.D., ABPdN and published by Lash & Associates Publishing/Training Inc.  They offer lots of resources on PTSD and Traumatic Brain Injury. © 2011)
Looking Beyond the Symptoms 
PTSD is complex and sometimes even contradictory.  To fully understand it, you have to look beyond the generic symptoms and learn what they mean and why the body reacts the way it does.
In his book, Dr. Hoge says, “Virtually every reaction that mental health professionals label a ‘symptom,’ and which indeed can cause havoc in your life after returning home from combat, is an essential survival skill in the war zone.”  This means just about “symptom” is a learned reaction that became imbedded in the warrior’s mind during long durations of high-stress and dangerous situations.  Dr. Hoge does an excellent job explaining how and why these reactions affect the brain, and I will try to summarize the main points.  All italicized portions are excerpts from his book, followed by the page numbers where they can be found.  (For more in-depth information, get a copy of Once a Warrior, Always a Warrior.  This has been the best book I have read so far on the subject, and the easiest to read by far.)
“Under prolonged stress, the stress “thermostat” is reset to a different level.  … Deployment to a war zone, which is a form of prolonged and severe stress, can change the way in which the body adjusts to or responds to normal everyday levels of stress. …  Warriors develop remarkable observational skills and reflexes.  However, post-deployment, they sometimes overreact to things in a way that leads to strained relationships and problems at home or work.” (pg. xiv)
“Neurobiological research has helped us to understand that PTSD is not an ‘emotional’ or ‘psychological’ disorder, but a physiological condition that affects the entire body, including cardiovascular functioning, hormone system balance, and immune functioning.  PTSD can result in physical, cognitive, psychological, emotional, and behavioral reactions that all have a physiological basis.”  (pg. 3)
The limbic system, known as the “reptilian” (reptile-like) part of our brain is responsible for what is known as the “fight-or-flight” reaction.  “It processes danger, threat, and reflexes, and expresses basic emotions necessary for survival (anger, hurt, fear). … [It] is designed to make sure you never forget any memories having to do with serious danger or disaster that affected you personally.    The job of the limbic system is to ensure that you survive by not forgetting anything that happened during dangerous o threatening situations.” (pg. 29-30)  This is one of the reasons veterans get so frustrated when people tell them to “get over it” or insinuate that enough time has gone by that they shouldn’t be reacting a certain way.  The brain holds on to these graphic memories as a survival tool, and even little things like certain smells, sounds, images, or situations can trigger them, even when they are in a safe environment.
“The primary emotion of the limbic system is anger.  Fear is also present, but warriors learn to control this by falling back on their training.  Anger helps to control fear.  Emotions other than anger are generally shut down.  While the speed of processing information increases, the ability to be self-reflective or consider things in a rational sequence diminishes.  In times of danger, a moment of reflection may make the difference between life and death.” (pg. 55)
Nightmares and difficulty sleeping are very common in veterans with PTSD.  The lack of sleep, or even just repeated nights of poor quality of sleep, can wreak havoc on their nerves and emotions.  Imagine how bad (cranky, even) you feel when you don’t get enough sleep.  Imagine endless cycles of little to no sleep. 
“Five to six nights with only four hours of sleep each night has been shown to have the same effect on cognitive ability as a full night of no sleep or a blood alcohol level of 0.1 percent—legally drunk.  After this level of sleep deprivation, a person doesn’t have coordination problems and can still walk a straight line; however, their ability to think is impaired.  There is also a vicious cycle that veterans can fall into: Sleep deprivation reduces the ability of the medial prefrontal cortex to keep the limbic system under control.  This can lead to feeling irritable and revved up, which in turn causes the medial prefrontal cortex to not function well, making things even worse.  Many veterans feel like they live constantly in a state of fight-or-flight, with little to no rest in between.  Rational thought and reason get compromised.”  (pg. 57)
While these reactions can be quite disturbing to the public, it is the PTSD stereotype that prevents many veterans from seeking help.  It is also endlessly frustrating to those veterans and their families who are constantly working on managing their PTSD with the many treatment options available.  They are tired of being seen, and treated, as monsters.
BREAKING THE HOLLYWOOD STEREOTYPE 
Unfortunately, Hollywood has a done a horrible job at perpetuating stereotypes for veterans with PTSD.  The media hasn’t helped by sensationalizing stories that paint PTSD veterans as crazy, out of control, and violent.   
Dr. Phil had a show this year entitled “PTSD: From Heroes to Monsters” and featured some of the worst cases I had ever heard of, including a man who set his wife on fire.  Dr. Phil, like most of the media, thrives on sensationalism.  They picked out the worst of the worst to get attention and viewers.  It’s all about numbers.  The more eyeballs they can get, the more money they get from their advertisers.  This is not the case for the majority of PTSD sufferers, and therefore PTSD has carried with it a stigma that many veteran families try desperately every day to overcome.
Dr. Paul D. Whittaker with the Amarillo VA agrees that it is one of the biggest misconceptions the public has about PTSD.
“When they hear that term, they may affiliate it with someone who is dangerous or out of control,” said Dr. Whittaker.  “The vast majority of veterans I work with are actually trying very hard to control their emotions.  In fact, those who have not sought out treatment sometimes will become avoidant of others, of certain jobs or places because they don’t want to be perceived in that negative light.”
He likens PTSD to someone being diagnosed with diabetes.
“What happens if a diabetic isn’t treating their condition and eats a lot of chocolate cake?  If someone doesn’t have their PTSD treated and is engaging in behaviors such as drinking or seeking out fights or altercations, it is like a diabetic eating chocolate cake.  It will worsen their condition and it will begin to cause other problems,” he explains.  “That is the vast minority.  The work we do here at the VA really helps prevent that a huge extent.”
Veterans with PTSD have been making the news with horrible cases of abuse or violence.  These are usually the culmination of not seeking help or not being given help when they did seek it.  It is almost always a case of prolonged and worsening stress with little to no treatment, followed by a catalyst, such as divorce, loss of a job, death of a loved one, or even a sudden change of medication that was not properly supervised.  While this kind of “publicity” make us cringe, they are usually bringing to light a legitimate problem that needs to be addressed somewhere.  
Yes, PTSD veterans can and have done some awful things, but so have perfectly “normal” people.  There is also workplace violence, school shootings, and horrible acts of domestic abuse perpetrated by the civilian population making headlines every day.  Stories with veterans seem to catch a lot of attention as we see more troops coming home from over a decade of war.
So no, most veterans with PTSD are not likely going to dive behind the produce at a supermarket, screaming and lobbing imaginary grenades.  They are not “trained killers” destined to snap at any time.  PTSD is not a death sentence; it is manageable.  Those getting treatment should not be feared; they should be applauded.  Most importantly, they are not second-class citizens.



###
By Jessica Montgomery
Published in the Nov. 9, 2012 issue
of The Claude News, weekly newspaper serving Claude, Texas
(c)2012, All Rights Reserved