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| 7 Issues that Inform you about Readjustment, Intervention, Family Support, Diagnosis and A New Life Ahead
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Post Traumatic Stress Disorder Symptoms and ResourcesAn Iraq Veteran's story, suggestions for support, healing and for
changing the system Introduction: Specialist Joe Collins is the veteran that inspired Veterans' Families United Foundation. He volunteered for the first wave of Operation Iraqi Freedom in 2003. After serving a year in Iraq, Joe returned home, got a great job with the Department of Defense, bought a home and donated a sizable amount of money to Veterans of Foreign War. All of this, he had accomplished by the age of 21. However, after about 6 months back home, Joe started experiencing the initial signs of PTSD. He DID NOT tell anyone for fear of losing his job and because he did not really know what was happening to him. After hanging on as long as he could, Joe's breaking point came. In 2005, Joe lost his job, his home and his health, but not his hope. He has been struggling since, determined to overcome his illness and to help other veterans and their families to understand the signs and symptoms of PTSD. Following is his account of the story. The Adobe version has been provided for those who may be interested in a printed version. Some Personal History on PTSD: I now consider myself an expert on the signs and symptoms of PTSD. I spent 366 days in theater and after returning have suffered from PTSD for more than 3 ½ years, not nearly as long as many. I have suffered to the most extreme of each of the symptoms I have listed below, so I believe that merits my understanding of the debilitating effects. For 2 ½ of those years, I was so ill and devastated from its effects that I was bedridden, only leaving my room maybe 7 hours a week to see my counselor and psychiatrist. My reason for writing this pamphlet is to better educate and spread awareness of PTSD and its effects. In my own personal experiences, I have gone through countless psychiatrists. While showing "text book" signs of PTSD, I was given a 15-minute (mis)diagnoses and quickly written a prescription. On two separate occasions, I went to see psychiatrists in the earlier stages of my illness. The first time, I filled out a True-False survey and then spoke with the doctor for 15-20 minutes and was told that I had Attention Deficit Disorder and was prescribed Adderall. Another time, I was accompanied by my mother who a Licensed Professional Counselor. When I spoke with the doctor myself, I basically went through the exact same process except he spent less time with me and (mis)diagnosed me as Bi-Polar Disorder, sending me off with 3 different prescriptions. Luckily, after enough failed attempts, I found an excellent psychiatrist who would communicate, not only with me, but with my counselor (who has also helped me tremendously and who I was lucky enough to find on the first try) and mother to really try to find out what was wrong with me and help. From my experience, it is hard to find the types of doctors who have knowledge to properly diagnose you from the symptoms you might be suffering. My experience has shown me that I was MORE OFTEN misdiagnosed and sent down the wrong path of recovery…and even worse; I was put on an addictive medication that only masked the problem. Then, I had 2 battles to fight; ADDICTION AND PTSD. I think, when it comes to PTSD, the most positive and effective way of treating it is catching it early on and having a good support system (family and friends) and a treatment team (counselor and/or psychiatrist) who are all on the same page when it comes to what the illness of PTSD brings and what steps are needed to get you back on track to living a healthy and fulfilling life. To help soldiers and/or their families and friends REALLY understand what PTSD looks like, I have described the symptoms and how they look below. Hopefully, if you see something familiar in yourself or someone else, you can get treatment soon and not have to experience as much suffering as I have. PTSD symptoms usually do not begin to surface until 3-6 months after the deployed soldier returns home.
Signs and symptoms of PTSD explained in detail:
Often these symptoms will lead an individual to avoid sleeping as much as possible or turn to alcohol or other drugs to try and self medicate the problem. Early Stages: The individual will begin to slowly start cutting himself or herself off from society. These symptoms can be shown by a lack of wanting to go out to social places that they used to find enjoyable. The individual may not show an interest in meeting new people or feels uncomfortable or alert if placed in a situation with a large crowd of unknown people. They might begin eating meals alone or may become workaholics, throwing themselves into materialistic things rather than people. At this stage, the person usually begins to sever many social ties, only leaving those close members of family or closest friends who he/she trusts and feels enough comfort around to allow the relationship to last. Human interaction is an important part of emotional growth and recovery. Without it, the soldier will continue on a downward spiral. Later Stages: Usually by this time the person is nearly crippled by other symptoms and often can be misdiagnosed as being depressed. By this stage the person has most likely completely cut him or herself off from society including friends and family and will most likely surround themselves only with materialistic things. They usually will only go out on a required basis (to get food or medication). Often, to reach this level of isolation, the person is in a severe, deep stage of PTSD and needs immediate medical attention. Without it, things will only get worse if left untreated. Anxiety can be tied in to nearly every symptom of PTSD. This is another symptom that often leads to misdiagnosis. A misdiagnosis can lead to the wrong type of medication, which may seem to help at first, but often can lead to addiction problems and most anxiety medications are more of a band-aid solution and do not really solve the problem. The strongest symptom of anxiety for PTSD sufferers is remaining in a constant state of hypervigilance (on the alert). This happens at a subconscious level. Often, the returned soldier is not even aware that they are stuck in this hyperactive state. They will sometimes seem on edge and always be prepared as if something is about to happen. Good warning signs for this is that the soldier will never seem to be calm or in a relaxed state, especially in a public place. They may appear to constantly be looking around and sizing things up. Another good sign is if you go to a restaurant to eat, the soldier will always request to sit in a corner or with his/her back to a wall. From personal experiences and those of others who have suffered from PTSD, if put in a situation when UNABLE to sit in a comfort zone (a back/corner booth), then the soldier will feel uncomfortable throughout the entire meal while people walk behind him/her and the soldier will be constantly looking around feeling uncomfortable or insecure. Other symptoms of anxiety are shortness of breath in stressful places or situations, rapid heart rate, muscle tension (often in the jaw area, which could lead to grinding of the teeth and severe headaches) and severe stomach problems. Anxiety often leads to many avoidance activities and in some cases can be the cause of isolation. For example, in many cases returning soldiers who are suffering from PTSD will stop watching news about the war or even can't handle watching movies or TV shows with war in them. These things trigger anxiety levels that go "through the roof" and bring back unwanted or unpleasant memories that they are not ready to deal with or face yet. It's very important to keep a watchful eye for these symptoms because they are easy to notice at first, but if immediate action is not taken, a domino effect will occur at a rapid pace and make it much harder to help the soldier the longer it goes on. Hypersensitivity and anxiety usually go hand-in-hand. The most common symptoms are sensitivity to bright light, loud noises, large crowds, unfamiliar places and/or being easily startled. At first these symptoms may appear to be slight or almost unnoticeable, but a soldier will be able to begin to feel an increase in an anxiety levels and discomfort when exposed to some of these elements. Over time, and without treatment, symptoms can get worse. In several cases, those who suffer from PTSD and have not sought proper help can suffer severe anxiety attacks (panic attacks) and often complain of migraine headaches if they are triggered by one of these symptoms. Memory problems are probably the most commonly shared symptoms of PTSD sufferers. As first, memory problems may be somewhat hard to diagnose, but often it is a progressive symptom and will get worse as time passes without proper treatment. Early Stages: The first stages of memory problems might show up as absent-mindedness. Easily forgetting things like important dates, appointments, names of new people that you meet, are some examples as well as constantly misplacing or losing things. If the returned soldier never had problems in any of these areas before he/she deployed, it is important to keep a watchful eye on them. Without proper care, memory problems can become progressive and debilitating. Later Stages: By this time, the returned veteran is most likely showing many other symptoms of PTSD. Late stages of memory problems will be very obvious. The person most likely will forget things on a day-to-day basis. They might even have trouble remembering things from the past. Sometimes the returned soldier may be in the middle of a sentence and pause and forget what they were talking about. Or, they might tell you something and minutes later; tell you the exact same thing because they forget they have already said it in the first place. Another thing to be aware of is that soldiers are trained to adapt and to keep functioning. In many cases, if a returned soldier begins to realize they are having problems with memory and they are unaware that it might be PTSD or they are resistant to getting help, they might purchase note pads, post-it notes, or dry erase boards to try to compensate for their memory loss. From personal experience and other soldier's experiences, when this level of memory challenges has been reached we often compare it to feeling like our memories have been put into a blender and pulled out. It leaves a feeling like everything is mixed up. It can also feel as if some of the memories were left out of the blender, evidenced when we draw a blank trying to recall certain events. Others say they feel as if their memories are like a block of Swiss cheese and they can remember things that happened in the order that they happen, but they have blank spots or there are holes of missing information. It is very, very important if you are a soldier, or a family member or friend of a soldier who reads this and you are aware that someone you know is going through this problem, then SPEAK UP about it. Without intervention or help, then this can continue to be progressive and be harder to treat the longer you wait. Suppressed Traumatic Memories: In many cases, when a person is exposed to a traumatic event, they will often suppress the memory of it. It is a survival mechanism built into us to help us continue to function and survive after being exposed to the trauma. The best way to describe what happens and how it relates to PTSD is by using an analogy. The brain works in similar ways to store memories as a computer does by burning information into a CD. When a traumatic event happens, this leaves a deeper impression in your memory (or a deep groove like in the CD). If you are in a war zone, you adapt after the traumatic event happens even though this deep impression or groove in the CD (so to speak) has already been burned in. You do this to survive. But you still have to "drive" and function. Still "burning information making new memories" after the traumatic event has passed. Depending on the level of trauma, it may start to become difficult to even remember the event. Once the soldier has returned home, there is a good chance they will have suppressed the traumatic memory due to the fact that it is too painful for them to confront. So, they will continue to live life as though nothing happened. Eventually something (a noise, something they see or smell or touch) will trigger (bring back) parts of that memory. Like the "burning" of a CD, the traumatic memory would leave a deep groove. Once a soldier is triggered, it brings him/her back to that groove in the memory and it is like hearing a CD stuck on "skip". It just keeps playing over and over because it is stuck in that groove. This can often be the beginning of PTSD or what starts causing some of the previously mentioned symptoms. Mood Swings (risk taking behavior): These are both common symptoms of PTSD and can be interrelated. Mood swings are very apparent and easy to notice. Usually, when it comes to PTSD and the soldier begins to experience problems with mood swings, it will almost always appear as aggressive or violent. One thing to keep in mind, as with all these symptoms, if you didn't notice any problems BEFORE deployment, but begin to notice them after returning home, then you KNOW something isn't right. Mood swings can often appear to be mild temper tantrums, or irritability towards others, but can often get worse. The best way to describe why a soldier might deploy appearing "normal" and return from deployment showing any of these traits is described below. Let's imagine that a soldier grew up in a hot climate where there are long summers with temperatures usually getting into the low 100's. If the soldier had never been anywhere hotter than on a 100-degree day, he might think that the 100-degree heat is unbearable. But now let's imagine that same soldier has been in the desert for a year or more, with temperatures from 110-130 degrees everyday, (which seems insanely hot normally). Upon return home, the soldier thinks 100 degrees is much easier to bear. The soldier that deployed and then returned from duty, SEEM like the same person, but the experience has made that person different. What seemed "insane" or "unbearable" or "difficult to adjust to" when first thrown into the war zone, becomes "normal" as soldiers adapt to the events to survive. The "insane" becomes "normal". Then, when a soldier returns home, all of those events are brought home as invisible baggage. Violence, aggression and/or risk-taking behavior is part of "everyday life" when a soldier is in a war zone because they are risking their life everyday for their country. So that behavior becomes "normal". If there isn't someone to show the soldier that the violence, aggression and risk-taking are "normal" for the war zone, but "extreme" when coming home, then they often don't know the difference. This is one of the most important symptoms to watch out for, and the most dangerous. If it is not caught early enough, or if the soldier is misdiagnosed, the soldier can be sent down a dangerous and painful path of drug or alcohol abuse. For those soldiers who aren't abusing drugs and suffering from PTSD, they will often turn to alcohol to try and numb the pain of the symptoms and/or the painful emotional memories that they are suffering from and experiencing. Other soldiers might start to become aware of their problems and seek medical help. But if they seek help with someone who does not have a full understanding of PTSD, it is easy to misdiagnose and be given medications that can make things worse. This is tragic because the soldiers' "goal" isn't to become an "addict". But, if a soldier is given something that helps ease the pain, then before long, they can be abusing the drug or alcohol that they think is relieving it. If you notice some of the symptoms listed, it is best to avoid alcohol and medications until you speak with a counselor or psychiatrist. If you can start a path toward recovery without being prescribed ANYTHING, then take that opportunity. If you are abusing drugs or alcohol, or you know of a returned soldier who is, then immediate intervention is needed. Be careful in the way you approach the intervention, because it is often met with anger and aggression and possibly violence, depending upon the level of PTSD and if the soldier is self-medicating. Take precautions if you plan to intervene by finding a counselor or expert in war related PTSD to help guide you. It is important to remember that the soldier didn't just wake up one day and say, "I am going to become an alcoholic or addict." The soldier is in pain and trying to find something to take the pain away. They just don't realize that self-medicating only makes things harder to deal with in the end. Personal Hygiene/housekeeping: This is another important symptom that is common among PTSD sufferers. It is often progressive and the person can easily be diagnosed with Depression when it is really a symptom of PTSD. Early Stages: The individual will begin to show signs of not maintaining a clean appearance, such as combing hair, shaving on a regular basis or wearing clean clothes. They might also begin to stop picking up after themselves on a regular basis and/or not keeping a clean and organized home. Later Stages: By this time the individual most likely has no regard for their own appearance and most likely doesn't shower or bathe on a regular basis. They probably can hardly clean up anything after themselves due to the fact that by this stage, even small, simple tasks seem almost overwhelming. If the soldier has reached this level of illness, then immediate medical attention should be sought. By this stage, if there is no one to care for the sick soldier, then it becomes dangerous because they are struggling to even make it day to day. Self-mutilation, which can be burning or cutting of oneself, can be a symptom of PTSD sufferers. If you or someone that you know is doing this, it is extremely important to seek immediate medical help. The only reason someone would purposely harm himself or herself is because they are in an extreme amount of pain. Often, it can be a cry for help, or in other cases, someone might be suffering so much that they hurt themselves to try to take their mind off the pain they are always feeling and focus it on something else. If a soldier is involved in self-mutilation then IMMEDIATE intervention and possibly hospitalization is needed. To reach the point of suffering where you begin to harm your own body can often be followed by suicidal thoughts if gone untreated. Therefore, it is EXTREMELY important to seek help if you are doing this or are aware of someone who is. The Importance of a Strong Support System I believe having a support system (family and friends) to be there for you when you are suffering from PTSD is absolutely necessary for recovery. In my own personal experience, there was a time during my illness that I was suffering so much from the symptoms of PTSD that I was no longer able to advocate for myself. I had to move back to my mother and stepfather's house. My mother had to fill out most of the necessary paperwork for me to receive disability from the VA. They drove me to and from all of my medical and counseling appointments because I was too ill to do it on my own. On top of that, they assisted me with ordinary tasks such as running errands or getting groceries while I focused on my recovery. Without their assistance there is no telling where I would be or what situation I would be in today. Without strong support systems, people like me would most likely end up on the street or in a hospital somewhere or in other ways furthering our illness. Successful Recovery and Living with PTSD With proper counseling and medical treatment and support, it is possible to make a complete recovery from PTSD and function as a normal member of society again. Although when I say "complete recovery", I don't mean that PTSD will magically disappear from your life. I mean that you will have the symptoms under control. PTSD is something you will live with for the rest of your life, but you can learn tools and coping mechanisms through treatment to assist you when you are triggered by something. Plus, overtime, you will begin to know your own limitations and how far you can push yourself before symptoms will begin to arise. Knowing this information and working with your local VA (who will assign you a disability rating for financial compensation) can allow you to still live a fulfilling life without having to worry about the financial loss this disability has/can cause. The main thing to remember in order to make a full recover is to keep hope, faith and to NEVER give up no matter how much pain you might be in. Believe me, I have been there, but I held on at all costs and sooner or later, if you don't find help, then help will find you. Summary Post Traumatic Stress Disorder can be a very serious mental health issue if left unattended. Any person who has witnessed a traumatic event may suffer some degree of PTSD. The most important thing to remember is NOT TO IGNORE the symptoms. The earlier symptoms are identified and addressed, the sooner that helpful intervention and the journey to healing can take place. If you are personally experiencing any of the symptoms mentioned in this pamphlet, or if you know anyone who may be, please don't delay in investigating any of these resources. HELP IS AVAILABLE (see Resource Page) This VA link has specific information about PTSD, including assessments, information sheets for families and where to get assistance. This site is good for information and research but does not offer immediate assistance. This newly developed link for Veterans issues describes common mental health issues and resources for veterans and families who may be in need. An extensive list of resources is available. Changes Needed to Help Prevent PTSD Post Traumatic Stress Disorder can happen to normal people who have witnessed a traumatic event. Military training does not cause a person to be immune from trauma. War, by its very nature is a series of traumatic events.
Currently, 1/3 of the veterans returning from current conflicts are suffering from some form of mental health disorders. Left untreated, the long-term effects include:
The VA System – Opportunities for Improvement As with most large bureaucracies, 90% of the challenges are "process" problems and not "people" problems. The VA Medical and Benefits programs are full of wonderful, qualified, caring people, but many of the "processes" have opportunities for improvement that will honor the injured veteran and family in more efficient and less stressful ways.
Summary We learn something from every war. From WW2, we learned about "shell shock" that was later named PTSD. From the Vietnam War, we learned that veterans needed each other as support systems to deal with the aftermath of trauma and the "Vet Centers" were born. From the Gulf War, we learned than no matter how long a war lasts, there are casualties from emotional, physical and biological contaminants that affect the veterans and their families for a lifetime. It is our hope, that the legacy of OEF/OIF is one that recognizes the need for traumatic intervention IN THEATER and the need for creating new and more personal and efficient processes for the VA Medical and Benefits branches. With growing mental health statistics, homelessness, incarceration and the financial impact to the veterans, their families and our country, we can't afford NOT to change. Post Traumatic Stress Disorder Resources Veterans Families United Foundation VFU is a not-for-profit organization that offers a comprehensive website and resource bank for identifying and helping veterans and families who may need assistance in understanding and coping with war-related illness. Financial resources are not available, but information on how to access benefits and assistance is easily found on the website. Military One Source You may call this number and request to speak to a counselor. Contracted mental health counselors will confidentially speak with you about your concerns and offer targeted information that can help deal with difficult situations. This is an excellent source for immediate 24/7 person-to-person information. You can also ask about contact information to your local American Legion, Veterans of Foreign War or Disabled American Veterans resources who can be advocates for you. National Center for Post Traumatic Stress Disorder This VA link has specific information about PTSD, including assessments, information sheets for families and where to get assistance. This site is good for information and research but does not offer immediate assistance. Suicide Prevention Action Network SPAN is a not-for-profit organization that offers timely and helpful information for suicide prevention, offering a checklist and resources for prevention and intervention. National Alliance on Mental Illness (NAMI) This newly developed link for veteran's issues describes common mental health issues and resources for veterans and families who may be in need. An extensive list of resources is available. References and Reviews: References: GAO "Veterans' Disability Benefits; Processing of Claims Continues to Present Challenges", United States Government Accountability Office, Tuesday, March 13, 2007. Howard, Pierce J. (2006). The Owners Manuel for the Brain. Austin, Texas: Bard Press. "Increased Depression Among Iraq Vets", Associated Press, Chicago, November 14, 2007. NAMI Launches Veterans Resource Center on Mental Health: Online, November 6, 2007. Naparstek, Belleruth (2006). Invisible Heroes: Survivors of Trauma and How they Heal. New York, N.Y.: Bantam Book. Reviews: Jobe, Misty Ann, Administrative Programs Officer IV, Oklahoma Department of Mental Health and Substance Abuse, mjobe@odmhsas.org, (2008). Lensgraf, Dr. Samuel J., Psychiatrist, Oklahoma City, Oklahoma (2007). Pulido, Ed, Vice President, Community Investment and Research United Way of Central Oklahoma, epulido@unitedwayokc.org, (2008). Disclaimer: Veterans' Families United Foundation does not guarantee results or outcome of the information provided in any of its materials. |