Post-traumatic
stress: It's not just a Vietnam disorder
By Christiana T. Elieson
November 7, 2005 | War,
an experience nightmares are not only made of, but created
by. For those with post-traumatic stress disorder, or
PTSD, it's not only the horrors of what happened in
battle that live in their dreams, at night and during
the day, but their reactions and actions that form everything
about their daily life.
For a former Marine who served in
Iraq in 2003 PTSD is something that is a part of him
and his daily life. Ender -- name has been changed --
said, "It's not something you say, 'Oh, I have it,'
you have to be told you have it. It's just a part of
you."
Ender was told he had it after an
incident where another man tried to pull a weapon on
him. He did what he knew to subdue a person and put
the man in the hospital. The man was sent back to the
country he had come from. When he visited the judge
for what would happen to him for the severe beating
the man with the weapon received, he was given a warning
to "seek help." The judge, he said, did not give him
a direction to go to get help. He sought that help at
the veteran's hospital in Salt Lake City where they
diagnosed him with PTSD.
Daily life is changed by PTSD for
those who suffer from it and the reactions to normal,
everyday things bring a bigger sensitivity to daily
activities that most would not take notice of.
"Post-traumatic for me is a
constant fight. When I get into a conversation with
somebody and they start to get edgy or they start to
voice their opinion, start to raise their voice, start
to puff up their chest, bulk out their shoulders, start
to flex, start to, you know, someone could look like
they're ready to fight, or they just could be giving
hand gestures to the way they feel; but to me that is
all signs of fighting and I freely admit there is no
such thing as a fair fight. There's a winner and there's
a loser. And the winner lives, the loser dies. I don't
spar; I don't goof around like that. I might wrestle
and have fun, but ... I get prepared for combat every
time someone gets confrontational."
Day-to-day life with PTSD can be
a struggle for those who suffer from it.
"You think the worst of everybody;
you never quite trust or expect anything out of anybody.
You depend on yourself before you'll depend on anybody
else. People say, 'Oh, that's quite normal,' but you
do it to the extreme effect. At work ... I don't ask
for help. I will volunteer and ask other people if they
need help but I don't accept help unless I'm overly
smashed and by then I'm over my head."
Rest doesn't come easy for those
with PTSD and for Ender getting sleep can be frightening.
"I sleep with weapons, I sleep
with the door locked and chairs behind the door. I have
a weapon right by the shower because when I'm in the
shower I'm the most vulnerable. My hands, my thoughts
and my body are occupied with getting cleaned and it's
a prime time to strike at somebody," he said.
"I have nightmares," Ender
said. "I don't sleep good sometimes.
"You can't go out and see (war)
movies. There's video games that I don't play. I play
like the fantasy 'Halo' because, ok, I'm killing aliens,
how realistic is that? But there's some video-murder
games that you can't play. It brings back too much memories.
They say, 'oh you're just killing zombies or you're
killing little girl zombies,' they're still a human."
Triggers for PTSD can be anything
from a smell, sound, or just the local geography. It
envelopes everything the suffer does each day.
So how does one get through post-traumatic
to where they can live life without having war remain
intrusive in their life? For Ender, tai-chi, aikido
and "quiet, peaceful moments" help him stay in the present
rather than living through the past. They help because
they are "calm and soothing," he said. "There's no intent
to harm and there's no malice" within the movements
of tai-chi and aikido.
There is also help available through
the Veteran's Affairs. Ender said it is not enough however,
for those who suffer from PTSD.
"The VA's resources and ability
to really help is highly lacking. I correspond with
my counselor pretty much via e-mail and telephone calls.
There's no counseling where I go down and sit down and
talk with them, because they don't have time. There's
no quality time there. They might say, 'oh yeah, we
give all our patients quality time,' well, they really
don't."
Although according to Ender the VA
may not be fully able to help, they do have a variety
of ways to help those who suffer from PTSD, however,
the first step is recognizing one has it.
Steven Allen, coordinator of the
PTSD clinical team at the VA Hospital in Salt Lake City,
said, "troublesome signs that show up oftentimes are
difficulty with sleeping and not being able to get enough
sleep, restless sleep and nightmares. Difficulty with
anger is one of the often things people experience when
they return from a combat experience, and then substance
use, too, has been a way that many servicepeople have
dealt with a persistent fear that is associated with
PTSD."
When someone is having these problems,
"getting them referred to help" is something that is
helpful for a person suffering from PTSD, said Allen.
When one does begin treatment with
the VA they are taken through several steps to help
the sufferer and the partner of the sufferer get through
PTSD. Allen said, "Treatment begins with an initial
assessment of somebody's functionings or their strengths
or weaknesses, areas where they need assistance."
The initial assessment usually involves
several questionnaires, Allen said. These include symptoms
they have and what their life was like before, during
and after the military. He said they also do an interview
regarding those experiences they had in the field.
The next step is getting the veteran
the help they need to lead a normal life.
"Treatment usually involves
assessment for medication," Allen said. "Medications
have been really helpful in decreasing the hyper-arousal
that people often experience, and medications have also
been very helpful for getting people some sleep." The
treatment will then go to a general assessment which
begins teaching skills needed for everyday life, he
said.
"(In) general assessment we
begin people in a coping skills group, oftentimes trying
to help them learn more moderate kind of behaviors,"
Allen said. "After they've completed about 10 or 12
sessions of that coping skills group then they go on
into an advanced PTSD group that deals with more particular
issues of trauma that the person may have experienced."
If they are returning from the war
in Iraq there is a group devoted to the veteran and
their partner that helps them get adjusted back to everyday
life, he said.
"The idea of that group is
essentially to help people understand what's happened
to them, what kind of changes they may have experienced,
and to help decrease some of the overall arousal they
have, the physiological arousal, that's specific for
Iraq veterans," Allen said.
This treatment goes on for about
a year, Allen said, after which the veteran is put on
a maintenance program where they go to the treatment
center once a month. For World War II and Vietnam veterans
the maintenance and treatment programs are still ongoing,
however, for Operation Iraqi Freedom veterans, Allen
believes this may not end up being the case.
"I think for many of the people
coming back from Iraq I would expect that they would
be able to do fairly well in the course of treatment
over a year and then be able to go on and function well
in their social and occupational lives," he said.
For those whose loved ones are suffering
through PTSD there are many groups out there, especially
online, that can give support and needed advice.
One site that is often quoted or
refered to in these online forums is a site by Patience
Mason. She is a woman who has a husband who suffers
from PTSD and had for many years before it was diagnosed.
One of the pieces of advice she gives
is that through her and her husband's ordeal with PTSD
she would try to heal her husband with her own ideas
instead of letting him find ways to heal himself. In
her article,
How does PTSD affect families, she reminds those
who are loved ones that "part of recovery for trauma
survivors is regaining control of their lives, so following
our directions is not healing."
Loved ones also need to remember
that PTSD affects them, too, and getting help for themselves
can be helpful for theirself and the survivor in recovering
from the effects of trauma.
Mason said in her article, "Families
are systems. What affects one member will affect others."
There are several numbers and Web
sites that are available to call that can get one started
in the right direction when trying to get treatment,
said Allen. They can call the VA Hospital directly at
(801) 582-1565 or (800) 613-4012. Or they can also use
some of the online resources like the National Center for PTSD, which contains ideas, FAQs
and other literature for veterans and their families,
or the International
Society for Traumatic Stress Studies, which has
many different resources on its page for all people
who are associated with PTSD, said Allen.
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