Source: How Self-worth Affects Identity
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The Precipice of PTSD
Most people don’t understand PTSD, the change that happens within a soldier that just gets back from war. Everyone comes back changed, whether they’d like to admit it or not, some worst than others.
In my case, I was the worst.
Not a day has gone by in these past 13 years that I haven’t thought about Iraq and the messed-up things I saw and did there. I have only recently started moving on with my life with the intent to show America what it’s like to be on the battle front, fighting for our country and our lives only to come home to a never-ending battle.
This scene from the first chapter of my book Combat Medic takes place at the precipice of my PTSD, the worst moment of my life.
” Slamming the door, I locked it and rested my head against the wood frame, trying to regain my thoughts. You’re home…you’re safe.
Sunlight is beaming in through the blinds, making it hard to see. Leaning against the marble counter in the kitchen, I set my keys down before wiping the sweat that wasn’t there from my brow. I wondered, Does it ever stop? My angst was making me feel cold. No…it never will. I stared at the floor. What if I was dead? Would anybody really care? I wouldn’t have to deal with this pain anymore. The thoughts; the nightmares…
My lower back throbbed. I pushed myself up on my hands, thrusting my hips back and forth, waiting for the pain to go away. I closed my eyes, put my head down, and started taking deep breaths, trying to calm down.
Standing up I grabbed a glass of water when a loud bang shook the room. My heart started racing; a chill ran through my body. The hearing in my right ear fell out, leaving a high-pitched ringing in the background. My heart jumped then started beating faster. I closed my eyes and saw flashing lights and heard gunfire – echoes and bangs.
I squatted to the ground behind the counter with my eyes wide open staring at the door. A chill ran through my back, into my heart. My jaw started shaking; teeth chattering like I was stark naked in a blizzard.
Someone kicked down the door dressed in battered, torn clothes with dirty rags covering his face. He ran towards me with an AK-47 rifle pointed at my face, shouting gibberish. I felt a rifle in my hand, the weight of the barrel upon my fingers; but it wasn’t there. I felt naked without a weapon, cold and unsafe.
My heart felt like it was being pulled in four different directions. It thumped, pumping me full of cold blood and adrenaline. My mind raced. What should I do? I smelled gunfire and smoke, but I could see that I was in my apartment. Is this real? The back of my throat was sore; there was a bad, acidic taste in my mouth.
I took in a couple of shallow breaths then jumped up and ran over to the kitchen. I grabbed the handle of my 8-inch chef knife and pulled it from the drawer figuring it would be better to have a weapon in case it wasn’t my imagination. I turned toward the door crouched down, waiting for anything that came through.
A minute slowly passed. “This isn’t real.” I thought out loud, “What am I doing? This is crazy.” At that moment excruciating pain shot from my mid-back down to my left foot. It was like someone had sliced my back in half with a searing hot knife. I tried taking a deep breath in, but stopped short when pain wrapped around my lung.
I dropped the knife. Feeling dizzy and nauseated, I slowly walked over to the bathroom, flipped the light on, and stood over the toilet, holding my stomach and head. I was sweating hard now. The room started spinning as an overwhelming smell of gunpowder filled it.
Images from war started shooting through my mind. In one, I was holding pressure on a wound, trying to stop the bleeding from a severed leg. In another, blood was splattered all over a sand-covered ground. Specialist B pointed to the blood, then over to a building. I raised my weapon as we went in for the kill. The last image was of eyes. A pair of glazed over, hauntingly sky blue eyes. They were staring directly into mine. I stared blankly into the toilet, engulfed in those eyes. The sight of death captivated me. I wanted it; it wanted me. It almost had me.
My focus shifted from his eyes to his head. I started to see blood running down his face as it came into focus. A green aid bandage was wrapped around it, attempting to hold his severed skull together. I looked down and saw blood covering my hands. I knew it wasn’t really there, but it all felt so real.
At that moment I felt numb, emptiness grew inside; my chest slowly became cold. Icy blood pumped through my veins. It felt like I was dying; like life was being drained out of me. I started shaking as a chill crept through me. Death enveloped me, clutching my soul with a wanton lust. My spirit quaked as my heart blackened.
Tears started falling down my cheeks as the visions slowly faded away. I felt like a hollow shell, void of any substance of life. Shaking my head I wiped the tears, but kept crying; unable to stop myself.
I walked to my bedroom, empty except for a small dresser. It’s been 7 months since I moved and still no furniture. Saddened, I closed the door and opened the window. A cool breeze blew through. The sun was bright, warm, and comforting. I took in a couple deep breaths; my jaw still jittered from the flashback as I let it out. My shirt was drenched in sweat.
I opened the drawer of the dresser and grabbed my pipe and weed. I ground some up, put it in the pipe and took a couple of long, slow hits. After about 15 minutes I was fully medicated, seeing everything in a haze. I stared out of the window and looked down at the courtyard. A young couple sat at a table drinking wine; talking… they looked happy. I could see smoke rising from the grill next to them and smelled the scent of barbeque.
Everything I was worrying about started to fade away. The pain in my back turned into a slight annoyance. I smiled a grin ear-to-ear and started beat boxing and singing; doing anything and everything to stop thinking about things – the nightmares from hell that still haunt me.
I poured a glass of cold water from the tap. After slamming a couple, the blue eyes started haunting me again. I felt myself sliding back into the other place when my phone snapped me out of the fall.
I looked at the screen and saw that it was Jessica; I answered annoyingly, “Hello.”
“Hi, what are you doing?”
“Just got home from work,” I said sharply. “Why, what’s up?”
“I don’t know; just seeing what you’re doing. You never call me just to talk,” she said, waiting silently for an answer.
I didn’t know what to say. “Sorry, I’ve just been busy.”
“Working. You know my hours at work.” I got upset. “Is there something you want?”
“Yeah, I was wondering if you would like to come over and eat dinner with me and Aleah tonight and this weekend? You know… have some family time.”
I was torn, feeling deep in my heart like I wanted to. But then I start thinking about what had just happened. The pain, the flashbacks, I was afraid to leave the house. I missed my daughter so much but I couldn’t drive like this. I lied, “I can’t, I have an appointment later today and I have to work this weekend.”
“Really? You told me you were off,” she said angrily.
“Well Mick asked me to work a couple extra shifts and I said yes.” I got upset again. “What do you want me to do about it? I can’t just say ‘No’ now; it’s work.”
“You never want to spend time with us. Aleah is always asking about you. What should I tell her?”
I felt awful. My heart started to burn.
“I’m sorry, Jessica, but I have to work.” I gave in a little, “I can come over after my shift is done. We can eat and play games. You can tell her I have to work and I’ll see her later.”
“Ok. Whatever,” she said.
Then it went silent for a minute.
“How come you don’t love me?”
“I never said I didn’t.”
“Then why did you leave?”
“Because we argue too much.”
“We argue because you don’t even try to listen to anything I have to say and you yell,” she said.
“You do too!” I quickly chimed in. “All you do is yell and I can’t take it. I don’t need people around me yelling all the time. I can’t handle it.”
“If you loved me you would try.”
My gut started hurting. “I do love you, Jessica; I just don’t know what to do.”
“Talk to me.”
Silence fell again, I felt so bad that we couldn’t get along. I do love her, but the arguments and fights, yelling in front of Aleah… it was too much. I don’t want her to think that is how relationships are. She should have a happy life.
“Ok, Sam! Bye!”
“Tell Aleah I’ll call her tonight. I’ll see you tomorrow.”
“Yep, bye.” She hung up, her tone saying all she needed to say.
The room fell quiet. I looked down at the phone and thought of all the good times I’ve had with them. The times I’ve curled over laughing when playing with Aleah. Hearing her laughs echoing throughout the house when I tickled her, I loved it… missed it.
How did I get here in this empty apartment, feeling sad and numb inside? I’ve tried my whole life to feel alive; to feel wanted, to be someone special. I joined the Army because it was where I belonged. Fighting for America, saving lives and making a difference, proving to myself that I could do anything, go anywhere.
Now I’m lost, stuck; sealed away in a cave at the center of a deserted world. I want to feel normal again; feel alive, not numb. My past keeps taking over my mind, flooding it with blood and explosions. I want it to end. I want everything to end.
How did I get here?
It was because of the war. Why did I ever sign up to go in? I don’t want to feel like this anymore; alone, struggling to hold onto reality day in and day out. I want a life worth living.”
Taken from the book, “Soldiers Stories: A Collection of WWII Memoirs” with permission by Myra Miller; written by Marshall Miller.
War Stories don’t always end when the shooting stops and soldiers return to civilian life. The family of former Army Corporal Delmer Beam can tell you all about he horrors of Post-Traumatic Stress Disorder.
Cpl. Beam;s separation papers list him as a “Combat Infantryman” in the Army’s 6th Division, 1st Infantry Regiment, C Company. His WWII experiences started in 1939, as a 17-year old, at Fort Jackson near Columbia, South Carolina and stretched into August 1945, after several years of bitter fighting in the South Pacific against Japanese forces at New Guinea and the Philippines.
Delmer’s wife, Gladys, told her children, Lonnie, Roger and Lana, that the father they came to know after the war was nothing like the “joyful, fun guy” who gave 6½ years of his life – and numerous difficult years beyond – to the cause of freedom.
Gladys said the war destroyed her husband, both mentally and physically. In the mid-1960’s, Lana said he submitted to shock treatments at Mount Vernon Hospital to calm down his combat issues. The children couldn’t understand why they weren’t allowed to shoot fireworks on the 4th of July.
The few stories Beam told about his experiences were tough to hear. Like the one where soldiers were ordered to shoot thirty rounds of ammunition every morning into the surrounding trees to protect the camp from Japanese snipers, who would climb high to get maximum angles on their targets. Once, Beam recalled, several soldiers were killed by a sniper, even after the morning strafing. After an exhaustive search, the sniper finally was located hiding in a water canvas bag hanging from a tree. He had crawled in, poked a small hole in the canvas and shot his victims with a pistol.
Japanese marksmen and fierce fighting weren’t the only obstacles thrown in Beam’s path. Malaria was a difficult burden and an attack from scrub typhus mites nearly killed him. Delmer told his family he got so sick from the mites that he was presumed dead while lying on a stretcher on a bench. Someone saw him move however and he was transferred to a hospital ship.
His son Roger, chronicled his memories of his Dad’s experience :
As a young boy, I was always enamored with army war stories. I would ask him about the war many times. Only on a very few occasions would he talk about it. It is strange how I can remember some of the stories he told me when I can’t remember what i did yesterday….
He said he saw GI’s almost kill each other over a piece of chicken wire. The reason is that they would stretch the wire over their fox holes so the Japanese hand grenades would hit the wire and bounce back before it exploded. It rained every day in the jungle and was very hot and humid…
He told me about his best friend, a young 19-year old from Hope, Arkansas. While they were being attacked one day by Japanese, my Dad kept telling him to stop sticking his head up over the embankment they were behind, but the young man kept doing it until he got hit in the head and died in my dad’s arms. This has always made a picturesque impression on me…
I know he was haunted the rest of his life about what he went through, just like so many others. He was a good dad and even got better the older he got… Dad never met a stranger, he would talk to anyone.
Despite his health issues, Delmer spent his post-war years in Dixon, Missouri, and worked at Fort Leonard Wood as a fire inspector. He died in 1991 at age 70. His daughter had these words to remember her Dad: I guess the most uplifting thing about my dad was… he really believed that he survived when others died because God wasn’t done with him yet.
From Beam’s grandson, Roger Beam Jr., :
My grandpa Delmar told me this story several times as a small boy. I think he always got a kick out of it and was probably one of his “better” memories of the war.
He told me of the time his squad was out one evening climbing around the sides of trees collecting peppers that they used to flavor basically all their food. They had rifles slung and arms full of peppers. As they came around a tree, to their shock and surprise they ran into a squad of Japanese soldiers doing the exact same thing! He said the resulting chaos was both terrifying and hilarious, as both groups scrambled away. Not a shot was fired and they saved their peppers!
In the midst of such a horrible time for my grandfather, it does make smile a bit remembering how he smiled when telling this story.
Click on images to enlarge.
It can be difficult to explain posttraumatic stress disorder (PTSD) symptoms to friends, but it helps me to do so. PTSD symptoms include an array of possibilities such as anxiety, depression, panic attacks, difficulty bonding, addiction, insomnia, and dissociation. People experience PTSD in very different ways, based on their trauma history, resilience, supports and a myriad of other factors. So here is why I find it beneficial to explain how my specific PTSD symptoms manifest themselves, and why you might too.
Explain What PTSD Symptoms Look Like to Friends
Many people have a narrow definition of PTSD. With so many veterans developing PTSD, it is understandable that a common perception of PTSD involves someone who has been in a combat situation. However, PTSD is not choosy. It impacts the military, emergency response personnel, victims of abuse, witnesses to abuse, and other individuals who have experienced significant trauma.
When I tell someone I have PTSD it is because I want them to understand me better. I want them to know that at times I might appear spacey or inattentive, react poorly to sudden changes in routines or plans, become hypervigilant in unfamiliar spaces, and seldom get enough sleep. In explaining my PTSD symptoms, I hope to set the stage for supportive interactions when my symptoms manifest.
If you find yourself avoiding situations or backing out of plans at the last minute or you feel trapped at times because you become anxious or agitated, it might be a chance to share some of your symptoms with friends and talk about how they impact you when they appear. It doesn’t even require much detail. For example, I tell friends, “I am hoping to come to your party, but I often get very nervous thinking about being around strangers, so I may not be in the right frame of mind to be there.”
Explain PTSD by Symptoms to Reduce Them
Once I began to explain my PTSD symptoms to my friends, something interesting happened. I found myself attending more functions, more comfortable asking someone to repeat themselves when I had lost focus on the conversation, and more able to respond to last-minute requests by taking a few moments to process. My friends and acquaintances have even begun to show me support by giving me advanced notice for changes, inviting me to arrive at gatherings early, or asking me if I need a break or would like to get some fresh air when we are in tight spaces.
By sharing my triggers and reactions, I have made it easier to join in activities. I find that knowing I have a way out of an uncomfortable situation that those around me can understand removes a significant amount of worry. When my stress is lower, my symptoms are more in control.
Do you have any thoughts on this? How much do you explain to friends and family about your symptoms? Please join in the conversation by leaving a comment below.
PTSD treatments that have been scientifically validated can be very helpful in reducing and/or alleviating the symptoms of post-traumatic stress disorder (PTSD). PTSD therapy and PTSD medications are effective treatments for those experiencing this severe anxiety disorder, developed after a traumatic event. For PTSD treatment, these techniques are usually combined for the best outcome (What is Posttraumatic Stress Disorder [PTSD]?).
Because many psychiatric illnesses commonly occur alongside PTSD, they may also need treatment. Many people with PTSD also have issues with substance abuse (drug addiction information); in these cases, the substance abuse should be treated before the PTSD. In the cases where depression occurs with post-traumatic stress disorder, PTSD treatment should be the priority, as PTSD has a different biology and response than depression.1
Post-traumatic stress disorder can occur at any age and can be caused by any event or situation the person perceives as traumatic (PTSD in Children: Symptoms, Causes, Effects, Treatments). About 7% – 10% of Americans will experience post-traumatic stress disorder (PTSD) at some point in their lives.
Several types of therapy are used in the treatment of PTSD (PTSD Therapy and Its Role in Healing PTSD). The two primary PTSD therapies are:
Cognitive behavioral therapy (CBT) for PTSD focuses on recognizing thought patterns and then ascertaining and addressing faulty patterns. For example, faulty thought patterns may be causing the individual to inaccurately assess the danger of a situation and thus react to a level of danger that isn’t present. CBT is often used in conjunction with exposure therapy where the person with PTSD is gradually exposed to the feared situation in a safe way. Over time, exposure therapy for post-traumatic stress disorder allows the person to withstand and adjust to the feared stimuli.2
EMDR therapy for post-traumatic stress disorder (PTSD) is a technique that combines exposure and other therapeutic approaches with a series of guided eye movements. This PTSD therapy is designed to stimulate the brain’s information-processing mechanisms in an effort to reprocess the traumatic memories so they can be integrated into the psyche without the associated anxiety. (Watch an interview about EMDR Therapy Self Help Techniques for Trauma Relief)
Other therapy techniques used in PTSD treatment include:
- Family therapy
- Play therapy
- Art therapy
- Relaxation exercises
- PTSD Support Groups
- Individual talk therapy – particularly for those with trauma from abuse or from childhood
- Anxiety management
Post-traumatic stress disorder (PTSD) medications can often be used to alleviate the physical symptoms of PTSD enough so that PTSD therapy has a chance to work. Several types of PTSD medications are available, although not all are Food and Drug Administration (FDA)-approved in the treatment of post-traumatic stress disorder.
Medications for PTSD include:
- Antidepressants – several types of antidepressants are prescribed for PTSD. Selective serotonin reuptake inhibitors (SSRIs) are the primary type. SSRIs have been shown to help the symptoms associated with re-experiencing of trauma, avoidance of trauma cues and over-awareness of possible dangers (hyperarousal). Both sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved antidepressant PTSD medications
- Benzodiazepines – tranquilizers most frequently prescribed for the short-term management of anxiety symptoms. This type of PTSD medication may relieve irritability, sleep disturbances and hyperarousal symptoms. Examples include lorazepam (Ativan) and diazepam (Valium).
- Beta-blockers – may help with symptoms associated with hyperarousal. Propranolol (Inderal, Betachron E-R) is one such drug.
- Anticonvulsants – anti-seizure medications also prescribed for bipolar disorder. No anticonvulsants are FDA-approved for PTSD treatment; however, those who experience impulsivity or involuntary mood swings (emotional lability) may be prescribed medications such as carbamazepine (Tegretol, Tegretol XR) or lamotrigine (Lamictal).
- Atypical antipsychotics – these medications may help those with symptoms around re-experiencing the trauma (flashbacks) or those who have not responded to other treatment. No antipsychotic is FDA-approved in the treatment of PTSD but drugs like resperidone (Risperdal) or olanzapine (Zyprexa) may be prescribed.
Novel pilot studies also suggest that Prazosin (Minipress, an alpha-1 receptor agonist) or Clonidine (Catapres, Catapres-TTS, Duraclon, an antiadrenergic agent) may also be helpful in treating post-traumatic stress disorder (PTSD).
I lived with posttraumatic stress disorder (PTSD) for almost 22 years before I received treatment for posttraumatic stress disorder. After five years of therapy, I healed enough to consider myself living in PTSD recovery. However, I still have symptoms that require maintenance, depression being the most notable. No magic formula exists to cure PTSD, but I have coping skills to manage my symptoms. Let’s look at the reality of living in PTSD recovery, and the myth of being cured.
Living in PTSD Recovery Is Not Like Being Cured
To the average person, curing an illness means you eliminate it entirely. I once broke my thumb. After a trip to the doctor and a few weeks of medical care, it healed completely. Once cured, my broken thumb was gone. It wasn’t suddenly going to break again on its own. With PTSD, there is no guarantee that once controlled, the symptoms will never return, even if months or years pass between occurrences.
By saying we live in PTSD recovery, we can acknowledge the reality that a mental illness relapse is possible, and the need to practice self-care consistently exists. For myself, this includes taking my medication, keeping my stress levels under control, and avoiding triggers.
I learned the importance of this mindset several years ago. I felt fully healed, so I stopped taking my medications. Unfortunately, a few weeks later, I encountered a particularly challenging trigger. As a result, I relapsed and experienced a dissociative fugue. I had not understood the long-term maintenance needed with PTSD.
Living in PTSD Recovery Symptom-Free
Symptom-free recovery is possible. It doesn’t mean you are done taking care of yourself. Here are some tools that are my essentials for continued PTSD recovery:
- Following a wellness recovery action plan (WRAP).
- Establishing and keeping a strong support network.
- Avoiding known triggers.
- Understanding that mental health recovery is a lifelong commitment.
My most debilitating PTSD symptoms have been in remission since my fugue. I continue to follow my recovery plan and seek help at the slightest concern of a relapse. While it has been a long stretch of symptom-free recovery, I know my PTSD still exists, and that’s okay. I don’t need a cure. I need to use my resources to stay on track.
I’d love to hear from you. Have you faced roadblocks to recovery? Do you have supports or tools you use to stay on track? Please let me know in the comments below.