Showing posts with label flashbacks. Show all posts
Showing posts with label flashbacks. Show all posts

Thursday, July 23, 2009

Volunteers Sought for Stanford PTSD Emotion Regulation Study

Received the following from the Department of Psychiatry at the
Stanford University School of Medicine:

Stanford University Anxiety Brain Imaging Study
...................................................................................
Do you qualify?
  • Have you ever experienced, witnessed or had to deal with an extremely traumatic event?
  • During the past month, have you re-experienced that event in a distressing way, such as dreams, intense recollections or physical reactions?
  • Have you been diagnosed with post-traumatic stress disorder (PTSD)?
We are seeking people who are currently experiencing anxiety and have been exposed to a traumatic event in the past to participate in a research study about how people process faces and emotional pictures.

The study is at Stanford University Medical Center and compensates up to $50 for participation.


Monday, January 19, 2009

PTSD, the VA and Suicide: Massachusetts Family Settles Government Lawsuit

On the heels of last week's news that the U.S. Marine Corps suicide rate is the highest seen since 2003, came the close of a chapter on one of the Iraq War's first such casualties. It was a case that received national exposure and made many stand at attention, wondering how the system that was meant to take care of our returning troops could fail so desperately.

Kevin and Joyce Lucey were at the leading edge of military families coping with the loss of a loved one returning home forever changed following deployment to the Middle East. Their pain moved them to go public, shining a light on the grave consequences of shortfalls at the VA at the time.

By sharing the story of their son Jeffrey's 2004 suicide, they went far to drag post-combat suicide out of the darkened corners of our military family homes and into the lap of the civilian population, asking if what was happening to our returning troops was right or just. The verdict to the family's 2007 VA lawsuit came last Friday.


Friday, March 14, 2008

PTSD Sculpture Therapy: One Woman's Clay Journal

Recently, a sculptor pointed me in the direction of her series of figurative pieces created while she was in therapy for PTSD. At the Tri State Sculptors website, Kim Marchesseault (who blogs at Spackel) says of her work:

My work is about relationships among people, with self, with the universe. It’s a study of why we are here, what makes us who we are and how each one of us affect everyone and everything around us. I move shapes and lines until they work together to soothe and heal.

Kim, who in the past has practiced a wide variety of art expression including bronze casting and mural painting, was kind enough to answer a few of my questions regarding her ethereal ceramic sculptures. I believe her creations and answers offer us a glimpse into the heart of someone processing their PTSD. Her impressions are deep, funny at times, and always thought-provoking.

A heartfelt thanks to Kim for sharing so much with us.


Wednesday, March 12, 2008

Vietnam Veteran Believed to Have Found Missing Iraq Vet Suffering with PTSD

Sad conclusion to the latest missing Iraq veteran case.

Condolences to Eric Hall's family and a great debt of gratitude to the volunteer Vietnam veteran, Charles Shaughnessy, who would not leave a fellow battle brother behind until he was found.

From the WINK News [Ft. Myers]:

The father of Missing Marine Eric Hall says he believes the body found this weekend in Deep Creek is his son's. Kevin Hall says the body found in a drainage pipe by a volunteer had a titanium hip like Eric's and had on the same clothes Eric was wearing the night he disappeared.

Hall has been missing since February 3rd when a witness told wink news he saw Hall jump off his motorcycle and run into the woods. His family says Eric suffered from Post Traumatic Stress Syndrome after a tour of duty in Iraq. The Medical Examiner's Office is still awaiting dental records for an identification of the body.

The family has scheduled a memorial service for Eric Hall. It will be held this Thursday, March 13th at noon at the Faith Lutheran Church in Punta Gorda. The family says Eric will be buried at home in Indiana.


Tuesday, February 19, 2008

Comforting, Yet Discomfiting, New Clue Found in Florida Missing Iraq Veteran Case

From ABC News:

The discovery of a military-style "spider hole" that may have been used by a missing ex-Marine who is likely suffering from post-traumatic stress disorder has restored hope for the combat veteran's family that he is alive.

Eric Hall, 24, disappeared on Feb. 3 in Port Charlotte, Fla. He was staying with his grandmother when he experienced what his family and authorities have described as a "combat flashback." The Marine, who was left with a permanent limp from a 2005 bomb blast in Iraq, began walking around the house shooting an imaginary gun at imaginary enemies.

Hall then took off on his motorcycle, which later was found with engine running lying in the middle of a road in Deep Creek, near Fort Myers, on Florida's west coast.

The local sheriff's office called off its search more than a week ago, but Hall's mother, Becky, and a cadre of volunteers led in part by retired members of the military continue to look for the former Marine in an area densely covered with trees and shrubs. [pictures of the search and the spider hole they found]


Friday, November 16, 2007

Study: Asthma-PTSD Link Found

From HealthDay News via Forbes:

A study of male twins who served in Vietnam has uncovered a strong link between asthma and post-traumatic stress disorder (PTSD). Columbia University researchers, reporting in the Nov. 15 issue of the American Journal of Respiratory and Critical Care Medicine, found that those who suffered the most from PTSD were more than twice as likely to have asthma.

"This is very good data," said Keith A. Young, co-director of the Central Texas Veterans Health Care System Neuropsychiatry Research Program. "One of the things that is very clearly delineated by this study is that there truly is an association. This association has been seen with other anxiety disorders before, and there were some hints with PTSD, but this is the best. This kind of sets it in stone."

The challenge now is to find out whether this is a cause-and-effect relationship. Previous studies have indicated a more general link between anxiety disorders and asthma, but this study focused specifically on PTSD, a disorder that involves nightmares, flashbacks and panic attacks linked to "triggers" that develop after exposure to combat or other extremely disturbing events.


Thursday, November 15, 2007

Another Fort Drum Soldier, AWOL to Seek PTSD Care, Arrested

From the Associated Press:

A soldier who served two combat tours in Iraq was arrested Wednesday for leaving the Army without permission more than a year ago to seek treatment for post traumatic stress disorder.

At a news conference hours before his arrest, Sgt. Brad Gaskins said he left the base in August 2006 because the Army wasn't providing effective treatment after he was diagnosed with PTSD and severe depression. "They just don't have the resources to handle it, but that's not my fault," Gaskins said.

Tod Ensign, an attorney with Citizen Soldier, a GI rights group that is representing Gaskins, said the case is part of a "coming tsunami" of mental health problems involving Iraq and Afghanistan vets. Last month, the Veterans Administration said more than 100,000 soldiers were being treated for mental health problems, and half of those specifically for PTSD.


Sunday, November 11, 2007

Los Angeles Times Photographer Offers Update On Marlboro Marine

At the end of April 2006, I returned home from a few days of down time with my husband to a surprising email from a small New York publishing firm. Ig Publishing said that they were interested in putting out a book on combat PTSD. Would I write it?

The following month I set about fashioning a proposal for what would eventually become Moving a Nation to Care and began reaching out to possible interview subjects for the project.

It didn't take me long to know without any hesitation whose story I needed to open the book with: James Blake Miller, aka the Marlboro Marine. I'd begun covering the issue of combat PTSD and our returning troops in September of 2005 and Miller made a deep impression on me when he came forward only a few short months later, in January 2006, to tell the world of his struggle with PTSD.

He was so honest about his experience in the many interviews he gave, and so clearly carried no other agenda than simply wanting to help destigmatize the diagnosis he'd been given. Dr. Robert Roerich, who eventually contributed Moving's foreword, was in touch with Miller at the time that I was working on my proposal and contacted him on my behalf.

Miller agreed to an interview, writing, "I'm interested only if it's going to be a positive outlook on PTSD and it is aimed at helping our veterans, and others, who have it. I want to tell the story, not for the sake of telling it, but to try to change how things are perceived and maybe to alter the labeling."

That was at the end of May 2006.


Thursday, August 30, 2007

Jonathan Schulze "I Can't Hear You" Foundation Established in Honor of Minnesota Veteran

From the Associated Press:

Robert Herubin knew his friend Jonathan Schulze [in the bottom front photo of the three to the left; Joshua Omvig is in the middle, Jeffrey Lucey at top], after a tour of combat duty in Iraq, was on a downward spiral. Depressed, drinking heavily and suffering from post-traumatic stress disorder, nobody was able to reach the troubled Marine before he killed himself in January.

Herubin and others close to the Purple Heart recipient wondered what more could have been done. An answer has since emerged in the form of the Jonathan Schulze "I Can't Hear You" Foundation, which aims to pair veterans returning from combat with other veterans who have experienced war. ...

The group is launching its first chapter at a VFW post in suburban Prior Lake, where Herubin first met Schulze after he returned from Iraq and a grueling tour that included door-to-door combat in the city of Fallujah.

Schulze died at his New Prague home, at the age of 25, on Jan. 16, about two years after he came home. His family has said that in the days prior to his death, Schulze was placed on a waiting list after telling workers at the St. Cloud Veterans Administration Medical Center that he was suicidal, a claim the VA denied after an investigation.

Click on 'Article Link' below tags for more...

In the interest of education, article quoted from extensively.

From the foundation's website:

Through charitable donations and various support organizations, we will move forward to establish this mentoring program with veterans service organizations. We will continue to explore partnerships with other organizations to serve our veterans and active and reserve service members. ...

The Jonny's Lounge Mentoring Program [pdf] will be part of the process.

Jonny's Lounge will be a discreet place that combat veterans and active duty service members may go for support, without any duty of disclosure
. Mentors will also provide a comprehensive listing of viable options: private and public sector assistance programs.


Continuing from AP:

[T]he foundation believes mentors would provide veterans with a long-standing personal connection that the VA or most social services can't provide. Moreover, such an approach would encourage communities -- through their VFW or American Legion posts -- to care for their own veterans, Herubin said.

The initial mentors are being recruited through the Prior Lake VFW, with plans to reach out to veterans at their service organizations in other cities across Minnesota. The mentors will be trained to be confidants as well as guides who can navigate the complex social services network and make sure the veterans are following through with the care they need. Sometimes, they'll just be there for dinner or a movie.

The Rev. John Morris, a chaplain who oversees the [Minnesota National] Guard's reintegration program, called the idea behind the Schulze foundation "a neat synergy." "When they first started, the VFWs and Legions were sort of doing this by bringing veterans together, but before we knew much about the psychology part of it, before we knew much about what returning soldiers are dealing with," he said.

In Schulze's case, he was OK for a few months after returning to Minnesota in January 2005 (his 10-month tour in Iraq ended in the fall of 2004). But flashbacks, nightmares and depression began to take their toll, and Schulze began drinking more than he should, said his mother, Eileen Carlson.

He found a measure of solace at the VFW, where he attended some weekly meetings and served on the post's honor guard for funerals. He also met several times with VA health workers for help with PTSD, but he remained troubled, she said, with his family unsure how to break through. "I was his mother, so I wasn't over there when his buddies were killed beside him and he was killing people, so it's hard to understand what he was going through and dealing with," she said. "Just to have someone who has been in something like that to talk to, that's important."

My greatest admiration to military families like the Schulzes who have worked so hard to improve benefits and services for returning troops.

Contact "I Can't Hear You" to offer or receive support.


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Thursday, June 28, 2007

A Discussion on PTSD

WPSU-FM's "To the Best of My Knowledge" discussed PTSD w/guests Thomas Uhde, chair of the Department of Psychiatry at Penn State College of Medicine and Philip Bressler, a psychologist with the James E. Van Zandt Veterans Affair Medical Center in Altoona this past Tuesday. The program is now available in WPSU's archives. Listen now. Details:

Exposure to a severely traumatic event can cause nightmares, flashbacks and difficulty sleeping. For most people, these post-traumatic symptoms disappear over time. For others, the symptoms become chronic and lead to PTSD.

More audio discussions on PTSD.


Wednesday, January 03, 2007

A Sample of the Latest PTSD Study Results

Two new studies have arrived on the scene this first week of the New Year. Main findings:

A groundbreaking study of 1,946 male veterans of World War II and Korea suggests that veterans with symptoms of post-traumatic stress disorder are at greater risk of heart attacks as they age. The new study is the first to document a link between the stress disorder symptoms and future heart disease, and joins evidence that veterans with the stress disorder also have more autoimmune diseases such as arthritis and psoriasis.

A second study, funded by the Army, found that soldiers returning from combat in Iraq with post-traumatic stress disorder reported worse physical health, more doctor visits, and more missed workdays. The Army study is based on a survey of 2,863 soldiers one year after combat.

"The burden of war may be even greater than people think," said the first study's lead author, Laura Kubzansky of the Harvard School of Public Health.

Kubzansky goes on to say that the results may be due to the repeated release of adrenaline in those who deal with PTSD after a traumatic event. This may end up wearing down the cardiovascular system over time.

Click on 'Article Link' below tags for more PTSD study results...

Another study, looking at the link between memory and trauma via experiences of those closest to the World Trade Center on September 11, may shed some light on PTSD flashbacks:

Most Americans remember where they were on the morning of Sept. 11, 2001. But a new brain-scan study suggests that not all those memories were created equally. "If you were near the World Trade Center, your memories are qualitatively different from other people -- even those who were elsewhere in Manhattan," said lead researcher Elizabeth Phelps, a professor of psychology at New York University.

Specifically, people who were within about two miles of Ground Zero on that day now retain especially vivid, detailed recollections of the scenes and events of that morning -- a kind of recall that experts call "flashbulb memories." Brain imaging suggests that these memories are especially strong because the amygdala -- a brain area focused on fear and memory -- kicked into high gear as these people watched that morning's catastrophic events unfold.

Nearly all of the study participants who had been in lower Manhattan on 9/11 said they experienced first-hand the sights, sounds and smells of that day. And many said they feared for their own safety. All of that may have played a role in imprinting these highly potent memories in their brains, Phelps said. "This isn't unique to 9/11," she added, noting that flashbulb memories can be laid down in any kind of traumatic event, be it personal or very public....

The subdued parahippocampal function seen in the Downtown group might play a role in PTSD, Phelps said. "The amygdala helps you form a very strong memory," she explained. But in the normal brain, the hippocampus acts as a counterweight, "giving you the ability to keep it all in the right context."

With PSTD, the hippocampus' ability to reign in frightening memories may get lost. "We know that there are differences in the hippocampus in people that will go on to develop PTSD and those who will not," Phelps said.

Researchers are also examining the relationship between PTSD and pain:

PTSD may alter the way the brain handles pain, a new study shows. The researchers included Elbert Geuze, PhD, of the Netherlands' Department of Military Psychiatry. Their study appears in the Archives of General Psychiatry.

Geuze and colleagues studied 24 male Dutch veterans who had served on U.N. peacekeeping missions in Lebanon, Cambodia, or Bosnia. ... The veterans rated how much pain they felt when their hands were briefly subjected to heat at temperatures ranging from 104-118 degrees Fahrenheit. Those with PTSD had a higher tolerance for the heat, compared to those without PTSD.

The veterans also got brain scans using functional magnetic resonance imaging (fMRI) while they took the heat test. Those brain scans showed different patterns of brain activity between the veterans with and without PTSD. For instance, the veterans with PTSD showed less activity in part of their amygdala, a brain area that's involved in the brain's pain response.


Last week, the Army released the following "snapshot of the morale and mental health" of our troops:

The recent data on troops who have deployed to Iraq, released in a Dec. 19 report, paints a stark picture. For example, the suicide rate among soldiers supporting Operation Iraqi Freedom almost doubled in 2005, going up to 19.9 per 100,000 troops from 10.5 per 100,000 the year before.

Yet the data from 2003 show the rate that year to be 18.8 per 100,000 troops, which makes officials cautious about drawing conclusions. “We haven’t made a connection between the stress on the force with a significant increase in suicides,” said Lt. Gen. Kevin Kiley, Army surgeon general, who discussed the data Dec. 20 at the Pentagon. “That isn’t to say there aren’t any. [But] I don’t have any evidence that there is a correlation between PTSD and suicides.”

The report also found that troops who have deployed to Iraq more than once reported higher levels of acute stress symptoms as well as higher levels of anxiety and depression than those serving their first tours. Almost 19 percent of troops with at least one prior tour in Iraq reported acute stress symptoms, compared with 12.5 percent on their first tour.

On the plus side, troops say getting help in theater is now easier and the stigma of seeking that help is decreasing. The study was compiled the Mental Health Advisory Team III, established at the request of Multi-National Force-Iraq, using data collected in October and November 2005 in theater. Similar assessments were made in late 2003 and 2004.

Last year, European researchers measured the effect personality has on the incidence of PTSD:

[O]ne study suggests that, whether a veteran of combat or a victim of accident or crime, your chances of facing the anxiety or depression of post-traumatic stress disorder (PTSD) may hinge as much on your personality as on your experience.

Inge Bramsen, a psychologist at Vrije Universiteit in Amsterdam, tested 572 men who participated in the United Nations Peacekeeping Force in the former Yugoslavia for PTSD. Men who reported seeing the highest number of stressful events—shootings or dead people, for example—showed the most severe symptoms. But those who rated highest on personality traits such as negativism and paranoia before deployment also tended to show more signs of PTSD later. A hostile person may see more personal menace in events than others do, says Bramsen. An anxious person may also cope with stressful situations less effectively.

Another study appears to show the gradual development of PTSD over time:

A study released in October by the American Journal of Psychiatry .. of 613 U.S. soldiers revealed that as time goes by after war service, PTSD becomes more evident, particularly in veterans with physical injuries. When the soldiers in the study first returned from overseas, the level of PTSD was 4 percent. After four months, that rate rose to 12 percent. Of those who were diagnosed with PTSD after seven months, 78.8 percent had screened negative for the condition at one month.


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Friday, December 01, 2006

NPR: Major Military PTSD Troop Abuse Investigative Report Coming Monday

Important program set to air on NPR's All Things Considered on Monday, Dec. 4:

Award-winning NPR News journalist Daniel Zwerdling reports on the military’s treatment of soldiers returning from Iraq who suffer from emotional problems, including Post Traumatic Stress Disorder (PTSD), in a special half hour investigative report on All Things Considered Monday December 4.

Soldiers who have come back from war to Fort Carson, Colorado, told Zwerdling that their officers and lower level supervisors have harassed and punished them and in some cases discharged them for seeking help for what they believe to be emotional problems triggered by their service in Iraq.

Zwerdling also interviewed some of the soldiers’ supervisors, most of them sergeants at the base, who admit to the treatment, telling Zwerdling that it’s true, that they are giving these soldiers a hard time, and explain the reasons why. Zwerdling obtained Army documents and talked to witnesses who corroborated the soldiers’ allegations.

Click on 'Article Link' below tags for more...

This isn't the first time such incidents have come to light. The Colorado Springs Independent (CSIndy) and CBS News ran a series of articles in July on the soldier abuse problem.

First, from CSIndy's "Patterns of Misconduct:"
Less than a year ago, Jennings was a hero, a Purple Heart recipient who'd re-enlisted for six years. But stationed on a remote highway outpost near Ramadi, he faced a daily onslaught of insurgents' roadside explosions. He saw a sergeant he knew "folded in three like an accordion" behind the wheel of a Humvee, alongside a soldier literally split in half and decapitated. He watched in horror as Pfc. Samuel Lee, a 19-year-old from Anaheim, Calif., committed suicide, shooting himself in front of his platoon.

Once back at Fort Carson, Jennings says he suffered panic attacks, jitters, sleeplessness and flashbacks. He turned to drugs, alcohol and sleeping pills to ease his afflictions. When urine analysis tests came back positive, the Army began to process his discharge for "patterns of misconduct."

But the therapist he obtained off base says Jennings resorted to drugs as a way to cope with the horrifying memories of war, the people and places that trigger those memories, and his sense that an attack may be imminent, even in Colorado Springs. "It makes sense [that] one would turn to substances to treat the stress that goes with all the bad memories," says Gerald Sandeford, Jennings' licensed counselor.

Sandeford has diagnosed Jennings with post-traumatic stress disorder, or PTSD, which is among the mental health conditions affecting one in three troops returning from war.

"They're trying to throw me out of the Army because of this," Jennings says.

Other soldiers spoke of intimidation, too:

Ryan Lockwood, a former 2nd Brigade Combat Team private, returned from Ramadi in August 2005 after a yearlong tour. The 22-year-old says an Army captain issued an ultimatum after he displayed symptoms of PTSD.

"He threatened that if I tried to get a medical disability for my PTSD, he would make my life a living hell," Lockwood says from his home in McHenry, Ill.

From the second CSIndy piece, a brief graf on the rising rate of drunken driving arrests on Fort Carson. Self-medicating with drugs or alcohol often goes hand-in-hand with PTSD; I can't help but wonder if all of the military's 'sweeping it under the rug' and intimidation might have been a contributing factor as well:

Georg-Andreas "Andrew" Pogany, a former Fort Carson soldier who leads Operation Just One, a group that helps Iraq war veterans obtain confidential, free counseling, says local agencies should be gathering data to see if PTSD is causing a rise in social ills. "We know it is out there," he says. "But how will they know how and where to target resources -- how to help these soldiers -- if they aren't taking the time to track what happens when soldiers return? How will they prevent problems before they escalate?"

One of those problems is drunk driving. The base acknowledges a rise in arrests, but does not necessarily connect the problem to PTSD -- although many doctors and therapists say alcohol abuse can be a symptom of untreated PTSD. ... Yet the drunk-driving arrests continue.

In the six months through June 30, Fort Carson had logged 75 drunk-driving arrests involving soldiers on base -- putting the base on pace to top arrest totals in each of the past three years. In fact, the 2006 total to date already surpasses the total arrests for soldiers and civilians on base in all of 2003.

CBS Evening News kicked in "Stressed-Out Soldiers:"

CBS News chief investigative correspondent Armen Keteyian reports that at least in one large military base in Colorado, soldiers are saying members of the Army Command are simply paying lip service, at best, to PTSD -- hindering their treatment and upending their careers. ...

Kaye Baron is a clinical psychologist in private practice in Colorado Springs, Colo. Each week, she counsels up to 25 soldiers and their families who are either unwilling or unable to face their problems while on base. "I think it's a very big problem," says Baron. "They could potentially lose their promotion potential, or just feeling like they're not able to advance in their career. That it's kinda over for them."

Lt. Col. Eric Kruger, Commanding Officer of the 2nd Brigade Combat Team at Fort Carson, says he's concerned that soldiers aren't seeking help due to fears of fearing ridicule or reprisal. "It's a tremendous concern," he says. "You don't want a soldier not to seek help for anything. They're our No. 1 asset. Leaders have to engage that every day -- and in my experience here, we do.

Video available of the segment (look on the right top corner of the page for the embedded video player) or listen to military ethicist Nancy Sherman talk on PTSD.

Please help us track OEF/OIF combat-related PTSD incidents in ePluribus Media's PTSD Timeline.

UPDATE 12-05-06: Read post-show comments.


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Thursday, June 15, 2006

Vietnam Vets' PTSD Experience Helping Today's Troops

An informative and in depth piece on combat-related posttraumatic stress disorder appeared this weekend in The Spectrum out of St. George, (Southern) Utah.

In addition to a brief history of PTSD, and a look at how the book Down Range: To Iraq and Back is being used to help troops in the combat zone deal with the stress of war, you'll read how one Vietnam veteran recently came to terms with the PTSD that had been tailing him (yet that he refused to believe existed) since his return home decades ago. A solid piece of reporting that challenges those who believe PTSD is hogwash to take another look at their own reasons for denying its existence.

Click on 'Article Link' below tags for more...

From The Spectrum:

Despite the signs, 57-year-old Steve Cantonwine spent the last 34 years believing his symptoms were simply part of his personality - one that had been steeled by the rigors and scenes of the Vietnam War. "To me, there wasn't anything wrong with me. I was a Marine. I didn't believe in post-traumatic stress disorder. 'They' were just a bunch of people that were whining and crying for sympathy," said Cantonwine.

But his wife, KayAnne, always knew something had a grip on him, though she didn't have words to explain their experiences. So the two blindly worked their way through, daily facing and unknowingly dealing with the symptoms of PTSD. "I don't think you can see and do the kinds of things you have to do in war to survive and not be affected in some way. They can't ever go back to the way things were, too many things have happened. But there's healing that takes place," said KayAnne.

As soldiers now serving in today's foreign wars prepare to return home, families like the Cantonwines, along with the medical community and military officials, are sharing their knowledge and experiences with PTSD and offering resources and education to soldiers, their families and the community.

PTSD, the piece continues, is not only for those who've served in combat.

Events leading to PTSD include plane or train crashes, vehicle accidents, cave collapses, sexual abuse, rape, domestic violence and other trauma. But the differences in healing and symptom management may vary for individuals depending on the severity, length and intensity of the event.

Cantowine, a Marine who'd returned from two tours in Vietnam in 1973, had shown signs of PTSD for decades, but it wasn't until 2004 that he realized he was having problems coping.

After he left the Iron County Sheriffs Office, Cantonwine began work as an over-the-road truck driver. During the long hauls, depression set in and in April of 2004, the second trigger hit. Cantonwine, along with his best friend - a fellow Vietnam veteran - was involved in a rollover outside Coeur d'Alene, Idaho.

The two events, a major life change coupled with a traumatic event - both triggers for PTSD - sent Cantonwine reeling. He struggled through nightmares that echoed the dreams that once plagued him when he first returned home from the war and he battled suicidal thoughts and tendencies. "I didn't feel like there was anything left for me. One was to be a Marine. One was to be a cop, and being a cop was taken from me," he said.

Those events landed Cantonwine in the doctor's office for medical assessments where his primary care provider quickly cued into his condition and recommended treatment for PTSD.

At first, he refused to believe that he had PTSD, denial being a common defense mechanism. His wife, however, could see that the doctors were on to something.

"I had a lot of signs as I look back on it," Cantonwine said, recalling symptoms of the last 30 years. Signs from uncontrolled bouts of anger that included scenes of road rage to an obsession with adrenaline that he sought out through employment as a deputy, EMT and as a hospital volunteer. "Some vets had drug and alcohol problems. Steve's was adrenaline. That's what fed him. It was like a combat rush," said KayAnne.

And his authoritative qualities as a Marine and deputy, at times, carried over to loved ones. "He expected perfection from co-workers and family. I think it goes back to 'If you don't do things right, people might get killed.' There wasn't a lot of room for excuses," said KayAnne.

Of all the symptoms, it was the anger that worried his family most. "We never would know what would make him angry," said KayAnne, noting that at times her husband's ire would last for several weeks. Cantonwine's anger never led to physical violence or abuse, but his tension was hard to live with and often left the family on edge.

When Cantowine finally reached out for help, he also found acceptance and a feeling of 'fitting in' that had been elusive in the civilian world.

Cantonwine traveled to the VA hospital in Denver to receive treatment and still attends group therapy sessions. "He always felt like a fish out of water in the civilian world and all of a sudden he was surrounded by people who felt the way he felt," said KayAnne.

And Cantonwine appreciates the opportunity to learn skills to manage his symptoms. In the past year, he has missed only one group session, which was for surgery on May 3 when doctors removed a 2-pound cancerous tumor from his abdomen, possibly linked to Agent Orange exposure. "We don't sit and talk about specific memories. I don't have to tell them what my flashbacks are, what nightmares I'm having. But we're able to sit there and offer support to one another," he said.

Despite frustrations with the VA's bureaucratic process, the treatment and ongoing healing Steve has received have become welcome blessings for the Cantonwines. "Now things are so good. Steve's learned how to manage it and he's healing," said KayAnne.


The Silver Lining

The silver lining to this journey is, of course, how the struggles of our Vietnam vets can be lessons for learning how to do better with the next generation of warriors returning home from combat. Cantowine wants to ensure that we learn the lessons, and not repeat the same mistakes.

"People have woken up and Vietnam vets primarily brought it out into the forefront," said Cantonwine. "I don't want to see anybody go through what I went through or see anyone put their family through what I did unknowingly."

"I think we've come to a place where you can support the soldier without supporting the war and it's too bad we didn't know that in Vietnam," said KayAnne.

This isn't to discount the fact that there are very real problems that still face our returning veterans as they move towards reintegrating into civilian life.

Despite the gains made in recent years, the strain of transitioning home today is as great as ever on soldiers and their families. "It wasn't easy and it's not going to be for this new set of war veterans," said KayAnne. "I think the biggest thing for the vets is the stigma that they perceive in asking for help. They all want to think they're just fine and haven't been affected by anything."

As a wife of a Marine, KayAnne had to learn the delicate balance of simply being there for her husband and listening without prying when he returned home. And for healing to occur, Andrews and Cantonwine say vets need to be heard. "Hearing it sometimes isn't pleasant. Vietnam vets, nobody wanted to hear their stories, what happened to them. It was such an unpopular war that they soon learned not to talk about it," said KayAnne.

Today, Barbara Stringham is anxiously counting the days until her son returns home with the Utah National Guard's 2nd Battalion, 222nd Field Artillery, which has served a year in Iraq.

While her son was home on leave, Stringham found herself struggling with the balance between her own instinct as a mother to nurture and her son's need for space and need to handle things on his own. "They've just served in open-hand combat. They've seen death and destruction. They don't know to receive that nurture from a mother. They're soldiers. They're supposed to be tough. Some of these guys are going to just need to break down and the public needs to know that's OK. Heck, we as family members sometimes need to break down," Stringham said.

And while family members like Stringham say they may not fully comprehend all that their soldiers have been through, they know lasting changes have taken place. "I just hope that he doesn't go through the mental anguish that you hear so prevalent from soldiers. It's scary as a parent because you're at a disadvantage. You don't know where to turn for the help they need," said Stringham, a member of the Triple Deuce family support committee that assists families during their soldier's absence.

Though Stringham wants her son to feel open to talking with her, she's prepared for him to set the pace. "You don't want to pull it out of them. In time they'll share, but they have a lot to cope with. And also I think it's something of them not having to relive it. When he's home and he's home for good, he wants it to be behind him and not have to relive it, he doesn't want to have to relive it over and over and over again," she said.

Stringham and other family members say their focus will center on one thing as soldiers return home, integrating them back into the society that they served and getting them back into their daily routine. Families are also hopeful the military and VA will continue to support soldiers who served in military action.

Though communities like St. George are preparing for top-notch celebrations upon their return, Stringham's looking ahead to the coming weeks and helping the soldiers adjust. "That initial homecoming day will be full of hoopla and pageantry - and that may carry through for the next few weeks. But afterwards, that's when the help really, truly needs to be there in the next months and years ahead," Stringham said.

Be sure to read the rest of the piece for an IM interview with 1st Lt. Bryan Hofheins, physician assistant of the Utah National Guard, 2nd Battalion, 222nd Field Artillery, and an interview with Gaylan Springer, chaplain for the 222.

And consider sending your thanks to The Spectrum for providing us with such rich coverage of this topic.


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Wednesday, May 31, 2006

APA Meeting: Worse Physical Health Follows Combat PTSD

Last week in Toronto, at the American Psychiatric Association's 2006 Annual Meeting, medical researchers presented data to their peers on a recently completed study of US Army combat veterans. The study revealed a connection between the incidence of PTSD and decreased physical health.

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First a few details on the meeting:

The American Psychiatric Association (APA), the leading psychiatric medical society in the United States, convenes its 159th Annual Meeting this weekend in Toronto, Canada, from May 20-25. ... The APA Annual Meeting, which assembles during Mental Health Month, continues to be the largest gathering of psychiatric physicians on the globe and attracts more than a thousand clinical papers, symposia, new research poster sessions and workshops.

A few study specifics from MedPage Today:

Combat troops meeting the criteria for post-traumatic stress disorder (PTSD) who are still on active duty are much more likely to have physical health problems than their comrades, according to research presented here.

Most earlier studies of PTSD have focused on veterans many years after they have returned from combat and found strong associations between the disorder and poor physical health, said Artin Terhakopian, M.D., of the Walter Reed Army Medical Center in Silver Spring, Md., at the American Psychiatric Association meeting here. The new research is on active duty personnel—"working soldiers"—he added.

The researchers studied 2,863 soldiers of U.S. Army combat brigades that had been rotated back to the U.S. after duty in Iraq, Dr. Terhakopian and colleagues found dramatic differences between the 16% who were diagnosed as suffering from PTSD and those who were not.

Using an anonymous survey a year after the soldiers' return from combat duty in Iraq, Dr. Terhakopian and colleagues examined PTSD symptoms, self-rated health, sick call visits, and missed work days, as well as physical symptoms evaluated on a 15-point Patient Health Questionnaire (PHQ-15).

Stats arrived at following the study:

  • 16.6% (468 of 2,815) of survey respondents had PTSD
  • 46.7% of those with PTSD (vs. 19.8% without) rated their health as fair or poor
  • 37.6% with PTSD (vs. 20.5% without) had 2 or more recent medical care visits
  • 11.8% with PTSD (vs. 6.5% without) recently missed 2 or more days of work due to illness
  • 34.4% with PTSD (vs. 5.2% without) had a PHQ-15 score indicating ill health
Continuing MedPage Today's excellent coverage:
Dr. Terhakopian noted that the study was cross-sectional, so that no conclusion can be drawn about whether PTSD causes ill health or vice versa. But he added that the clinical implication is that veterans with ill health without other obvious causes should be suspected of suffering form PTSD and offered treatment.

The Walter Reed researchers did not report the effect of injury on PTSD, but scientists from the Naval Medical Center at San Diego showed that battlefield injuries are more highly linked to PTSD than the usual run of medical conditions that can cause soldiers to be evacuated from a war zone.

In a retrospective chart review, David Oliver, M.D., and colleagues at the center, analyzed the relationship of PTSD with both branch of service and reason for being evacuated from the war zone. Since 2004, the San Diego center has been the receiving station for military personnel medevaced from Iraq, he said.

The majority of the personnel with PTSD or acute stress syndrome were marines, Dr. Oliver said, and most of the remainder were sailors, many of them hospital corpsmen. However, there was no statistically significant link between branch of service and the chance of having PTSD, he said.

On the other hand, the researchers found, there was a significant link to the reason for evacuation. Those who came home because of a battlefield injury or for psychiatric reasons were significantly more likely to suffer from PTSD, compared to those with non-battlefield injuries or other medical circumstances.

Specifically, 26% of those with battlefield injuries and 48% of those with psychiatric issues had PTSD, compared with 17% of those with non-battlefield injuries or other medical concerns.

USA Today also reported on the study:
A year after combat soldiers leave Iraq, those with symptoms of post-traumatic stress disorder say they're in worse physical health, suffer more pain and are more likely to miss work than veterans without PTSD symptoms, according to a military study out Monday.

The anonymous survey of nearly 3,000 Iraq veterans is the first to look at a link between PTSD and physical symptoms. ... "Their mental health problems may be taking a toll," says psychiatrist Charles Hoge, chief of psychiatry and neuroscience at the Walter Reed Army Institute of Research in Washington, D.C. Physical complaints may send a disproportionate number of these stressed soldiers to primary-care doctors, he says. ...

Anxiety can contribute to these health problems, Hoge says. Also, nightmares and flashbacks — symptoms of PTSD — can interfere with sleep, leading to worse health, he adds. About one out of five soldiers without PTSD symptoms said they were in fair to poor health, compared with nearly half of those with PTSD symptoms.

Soldiers are screened for mental and physical problems when they leave Iraq, then three and six months later, Hoge says. New "practice guidelines" are alerting military and Veterans Affairs doctors to possible ties between physical and mental symptoms in soldiers, says Charles Engel, director of the Deployment Health Clinical Center at Walter Reed Army Medical Center.

Soldiers sometimes downplay their stress reactions, so the number of soldiers with PTSD who also have physical health problems is, "if anything, conservative," says psychologist Charles Figley, a traumatic-stress expert at Florida State University. "When they come in with back pain, doctors are going to have to keep asking what happened to them in the war, not just now but five years from now."

There's strong evidence in civilian studies that trauma survivors use more health care at a higher cost, says University of Tulsa psychologist Elana Newman, who has studied health and traumatic stress.

As the costs associated with warfare mount, we need to be vigilant in our advocacy for proper veteran healthcare funding.


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Wednesday, May 24, 2006

Women in Combat: Females and PTSD

According to the Department of Defense (DoD), 11% of those serving in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are women. Officially, they are restricted to non-combat roles; however, in wars such as that being waged in Iraq, there are no front lines. Combat roles or not -- they are in the thick of things.

Last week, the Chicago Tribune covered how war has lingered with some of the women returning home. I'll round things out by reposting a related January commentary of mine which appeared online before PTSD Combat was up and running.


Sunday, May 21, 2006

HBO's Baghdad Er: Army Issues Warning to Combat Troops w/PTSD

A documentary airing tonight on HBO, Baghdad ER , has received a warning from the Army's chief surgeon, Lt. Gen. Kevin Kiley, via a memo sent out to Army post medical staff across the country. The worry is that the graphic content may trigger flashbacks and nightmares for those troops coping with PTSD. From CNN:

In a memo dated May 9 and obtained by CNN, Lt. Gen. Kevin Kiley said the film "shows the ravages and anguish of war. Those who view this documentary may experience many emotions," he said in the memo. "If they have been stationed in Iraq, they may re-experience some symptoms of post-traumatic stress, such as flashbacks or nightmares." ... "This film will have a strong impact on viewers and may cause anxiety for some soldiers and family members."


Saturday, May 20, 2006

Update: PTSD and the 'The Marlboro Man'

Snapped by embedded Los Angeles Times photographer Luis Sinco, tagging along with Charlie Company, 1st Battalion, 8th Marines in Fallujah on November 9, 2004, this photo would run in 100 newspapers worldwide. The Times gives us an update on how the iconic Marine is doing. Through both a new article, and a photo gallery, you'll peer into Lance Corporal James 'Blake' Miller's life as he fights his latest battle -- with PTSD. All my best to him.

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From the LA Times:

He survived a harrowing all-night firefight in November 2004, pinned down on a rooftop by insurgents firing from a nearby house. Filthy and exhausted, he had just lighted a Marlboro at dawn when an embedded photographer captured an image that transformed Blake into an icon of the Iraq war.

His detached expression in the photo seemed to signify different things to different people — valor, despair, hope, futility, fear, courage, disillusionment. For Blake, the photograph represents a pivotal moment in his life: an instant when he feared he would never see another sunrise, and when his psychological foundation began to fracture.

A year after the photo spread like wildfire around the world, Miller would receive an early but honorable discharge from the military due to his PTSD.
He feels adrift and tormented, dependent on his new bride, his family and his military psychiatrist to help him make sense of all that has befallen him. He barely sleeps. On most mornings, Blake says, he has no good reason to get out of bed. Often, his stomach is so upset that he can't eat. He has nightmares and flashbacks. He admits that he's often grouchy and temperamental. He knows he drinks and smokes too much. "He's not the same as before," said Blake's wife, Jessica, who has known him since grade school. "I'd never seen the anger, the irritability, the anxiety."

Blake says he feels guilty about taking money — $2,528 in monthly military disability checks — for doing nothing. Yet he's also frustrated that two careers made possible by his military training, police officer or U.S. marshal, are out of reach because law enforcement is reluctant to hire candidates with PTSD.

So he broods, feeling restless and out of options: "I'm only 21. I'm able-bodied as hell, yet I'm considered a liability. It's like I had all these doorways open to me, and suddenly they all closed on me. It's like my life is over."

The article goes on the document a recent trip to a restaurant with this wife; although he was able to control it, Miller admits he became enraged when he believed a man was was looking at his wife Jessica's bottom.
Jessica, who graduates this spring from Pikeville College with a psychology degree, has persuaded her husband to undergo visualization techniques in which she helps him confront his demons.

"It's understandable that Blake has PTSD, after all he's been through," she said. "Ordinary people can't comprehend what it's like to be constantly shot at and have to kill other human beings. They need to know what it means to send people like Blake out to fight wars. You're going to have a lot of people breaking."

Five other members of his platoon of about three dozen have been diagnosed with PTSD, Blake said. A dozen men from his unit were killed in action. A Journal of the American Medical Assn. study published in March found that more than a third of troops who served in Iraq sought help for mental health problems within a year of returning home.

After offering more details on how the photo itself was snapped and made its way into the history books, the piece then moves on to reveal how Miller's PTSD made itself known in the days following his return home.

In early January 2005, as Blake's unit prepared to leave Iraq, what Marines call a "wizard" — a psychiatrist — gave a required "warrior transitioning" talk about PTSD and adjusting to home life. Blake didn't think much about it until he returned to Jonancy in late January and his nightmares began.

He dreamed about the 40 enemy corpses that he counted after the tank demolished the house, he said, and that he had been shot. "He'd jump out of bed and fall to the floor," Jessica said. "I'd have to hold him to get him to wake up, and then he'd hug me for the longest time."

Sometimes, Blake mutters Arabic phrases he learned in Iraq or grimaces in his sleep, and Jessica will keep whispering his name until he wakes up. Some nights, he doesn't sleep at all. "I tend to drink a lot just to be able to sleep," Blake said. "Nothing else puts me to sleep."

He decided last summer to see a military psychiatrist at Camp Lejeune, N.C., where he was based. In August, he was diagnosed with PTSD. But before he could be put on "non-deployable status," his unit was sent to New Orleans to assist with Hurricane Katrina recovery.

While aboard a ship off the Louisiana coast, Blake was taking a cigarette break when a petty officer made a whistling sound like an incoming rocket-propelled grenade. Blake says he remembers nothing about the incident, but was later told that he slammed the officer against a bulkhead and attacked him.

By November, Blake was forced to take a medical disability discharge. "They said they couldn't take the risk of me being a danger to myself and others," he said. He fears that he may have another blackout. "It's terrifying that at any moment I could lose control and not know what I'm doing," he said. "What if next time it's Jessica?"

He suffers from flashbacks along with his nightmares (flashbacks are images that appear 'real' in the person's mind while awake).

This February, while smoking a cigarette and staring out Jessica's dorm room window, Blake said, he thought he saw a dead Iraqi man on the grass. Later, he had visions of an Iraqi father and son fishing — a scene he'd witnessed in Iraq just before a grenade exploded nearby. "I can't tell anymore what really happened and what I dreamed," he said. "Sometimes I feel like I'm dying."

Blake visits a Veterans Administration psychiatrist in nearby West Virginia and speaks with him by phone several times a week. He said his psychiatrist told him that his PTSD has to be managed; his disability will be reevaluated in March 2007.

Meanwhile, he has slowly turned against the war. "We've done some humanitarian aid," Blake said, "but what good have we actually done, and what has America gained except a lot of deaths? It burns me up." Jessica, who sports an "I Love My Marine" sticker on her car, says she and Blake are behind the troops though they no longer support the war.

The piece moves on to describing the Kentucky community in which Miller grew up, then closes with Miller reflecting on things.

For Hillbilly Days, an annual street festival late last month in Pikeville (pop. 6,304), Blake shaved his scruffy beard and got a military "high and tight" haircut. He agreed to help at a Marine Corps recruiting booth at the festival. Just putting on his Marine fatigue pants and boots for the first time since his discharge brought back more memories, and he tried to tamp them down.

He was so worried that the Marlboro Man photo would dominate the recruiting booth that he begged the recruiters not to display it. He also persuaded them to remove a large version of the photo that had hung in the recruiting station in downtown Pikeville. "I can't stand to look at it anymore," he said. Even so, he says the photo has provided him a platform to try to educate others about PTSD.

At the festival, Blake's mood brightened as he chatted with the recruiters. Wearing a Marine T-shirt with the message "Pain Is Weakness Leaving the Body," he was cheerful and animated. He playfully harangued young men, challenging them to a pull-up contest.

Though he has turned against the war, he said, he often wishes that he was back in the Corps and with his buddies. He still recommends the Corps to potential recruits, but advises them that it's a job, not a way of life. He recommends noncombat positions. "In order to do your job in combat, you have to lock up your emotions," he said. "Basically, you're turning people into killers."

Please consider thanking the Los Angeles Times for their coverage of this important issue. We need more of this kind of reporting to get more engaged and ready to advocate for our returning troops.


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Friday, March 10, 2006

PTSD: Columbia University Encyclopedia Definition

Continuing to explore the various definitions of PTSD, today we'll look at what's found inside the covers of the Columbia University Encyclopedia. Other official definitions already examined in this series include those of the VA, the Army's Combat Stress Field Manual, as well as that found on the National Center for PTSD website. Seek knowledge, gain power...

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From the Columbia University Encyclopedia:

post-traumatic stress disorder (PTSD), mental disorder that follows an occurrence of extreme psychological stress, such as that encountered in war or resulting from violence, childhood abuse, sexual abuse, or serious accident. The stressful event is usually followed by a period of emotional numbness and denial that can last for months or years. After that period, symptoms such as recurring nightmares, “flashbacks,” short-term memory problems, insomnia, or heightened sensitivity to sudden noises may begin. In some cases outbursts of violent behavior have been observed. The usual treatment for PTSD is individual psychotherapy, including anxiety management, or group psychotherapy with others who have the disorder. Some antianxiety and antidepressant drugs are being studied for their effectiveness.

Citation:
"posttraumatic stress disorder." The Columbia Electronic Encyclopedia, Sixth Edition. Columbia University Press., 2003. Answers.com 10 Mar. 2006. http://www.answers.com/topic/posttraumatic-stress-disorder



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ABC News: Returning Soldiers Not Getting Care They Need

Yesterday's ABC World News Tonight covered the important topic of veterans health issues. In Soldiers Back From Iraq, Unable to Get Help They Need, they covered the long waits, the long distances necessary to travel for VA care, and the recent Texas protest by veterans.

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From ABC's online transcript of its broadcast:

Eugene Simpson doesn't like to complain. Paralyzed in a bomb attack in Iraq, his initial care was excellent, but ever since then he has felt adrift. ... Getting to the nearest Veterans Administration hospital that can best treat his paralysis means a three-hour roundtrip, and the VA isn't paying for therapists closer to home. So he does without. ...

In Texas, a group of veterans staged a protest march covering the distance to the nearest VA hospital: 250 miles. "[It takes] four-and-a-half to five hours .. one way," said Vietnam War vet Polo Uriesti. Uriesti said his father, a veteran of World War II, suffers a greater hardship. But he said the headaches and flashbacks of post-traumatic stress still flare up without warning. "I just … it chokes me up," said Uriesti.

R. James Nicholson countered back, saying that last year "97 percent of veterans who came to us for a primary care appointment got that appointment within 30 days, and 95 percent of those who came for an acute care appointment got it within 30 days."

Unfortunately, those numbers are far from the last word on the matter, as ABC reported:

But an inspector general's audit found real problems with the way the VA has come up with those numbers. The audit found that some VA staff, feeling "pressured," actually fudged the numbers, and error rates were as high as 61 percent. In Atlanta, one veteran who the VA said got an appointment within a week actually waited nearly a year. Another veteran in Boston who reported seeing a VA doctor within hours actually waited 472 days.

And so, with ever more Iraq war veterans returning to the states needing post-deployment health care, many veterans groups are understandably worried. I applaud ABC News for covering this story last night; please contact ABC World News Tonight if you'd like to join in thanking them, too.


Monday, March 06, 2006

Combat PTSD: What are the Symptoms?

If you're a returning combat veteran having some difficulty readjusting to civilian life, you may be wondering what's going on. Why am I angry all the time? Why am I feeling detached?

If this sounds like you, you may want to review the following list of some of the general symptoms associated with post-traumatic stress disorder (PTSD).

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The following is a composite of PTSD symptom descriptions culled from the Journal of Clinical Psychology Expert Clinical Guidelines Series; the always informative National Center for PTSD website; and the Vietnam Veterans Association of Australia.


What You Need to Know

  • Traumas happen to many competent, healthy, strong, good people. No one can completely protect him- or herself from traumatic experiences.
  • Many people have long-lasting problems following exposure to trauma. Up to 8% of individuals will have PTSD at some time in their lives.
  • People who react to traumas are not going crazy. They are experiencing symptoms and problems that are connected with having been in a traumatic situation.
  • Having symptoms after a traumatic event is not a sign of personal weakness. Many psychologically well-adjusted and physically healthy people develop PTSD. Probably everyone would develop PTSD if they were exposed to a severe enough trauma.
  • When a person understands trauma symptoms better, he or she can become less fearful of them and better able to manage them.
  • By recognizing the effects of trauma and knowing more about symptoms, a person is better able to decide about getting treatment.

PTSD Symptoms/Signs

So, let's take a look at the symptoms or signs of combat-related PTSD. They generally fall into 3 main categories:

Intrusive - Re-experiencing of the traumatic event(s)

  • Distressing recollections
  • Flashbacks (feeling as if you're back in combat while awake)
  • Nightmares (frequent recurrent combat images while asleep)
  • Feeling anxious or fearful (as if you're back in the combat zone again)
Because trauma survivors have these upsetting feelings when they feel stress or are reminded of their trauma, they often act as if they are in danger again. They might get overly concerned about staying safe in situations that are not truly dangerous. For example, a person living in a safe neighborhood might still feel that he has to have an alarm system, double locks on the door, a locked fence, and a guard dog. Because traumatized people often feel like they are in danger even when they are not, they may be overly aggressive and lash out to protect themselves when there is no need. For example, a person who was attacked might be quick to yell at or hit someone who seems to be threatening.

Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience. These symptoms are automatic, learned responses to trauma reminders. The trauma has become associated with many things so that when the person experiences these things, he or she is reminded of the trauma and feels that he or she is in danger again. It is also possible that re-experiencing symptoms are actually a part of the mind's attempt to make sense of what has happened.

Avoidant - Drawing inward or becoming emotionally numb

  • Extensive and active avoidance of activities, places, thoughts, feelings, memories, people, or conversations related to or that remind you of your combat experiences
  • Loss of interest
  • Feeling detached from others (finding it hard to have loving feelings or experiencing any strong emotions)
  • Feeling disconnected from the world around you and things that happen to you
  • Restricting your emotions
  • Trouble remembering important parts of what happened during the trauma
  • Shutting down (feeling emotionally and/or physically numb)
  • Things around you seem strange or unreal
  • Feeling strange and/or experiencing weird physical sensations
  • Not feeling pain or other sensations
Because thinking about the trauma and feeling as if you are in danger is upsetting, people who have been through traumas often try to avoid reminders of the trauma. Sometimes survivors are aware that they are avoiding reminders, but other times survivors do not realize that their behavior is motivated by the need to avoid reminders of the trauma.

Trying to avoid thinking about the trauma and avoiding treatment for trauma-related problems may keep a person from feeling upset in the short term, but avoiding treatment means that in the long term, trauma symptoms will persist.

Hyperarousal - Increased physical or emotional arousal

  • Difficulty sleeping
  • Irritability or outbursts of anger
  • Difficulty concentrating or thinking clearly
  • An exaggerated startle response (triggers bring you back to a certain combat zone event)
  • Hypervigilence, being overly angry or aggressive (feeling as if you need to defend yourself from danger)
  • Panic attacks
Triggers can include any of the following:

  • Specific scenes - crowded streets, sunsets, sunrises, familiar clothing
  • Movement - someone rushing towards the individual
  • TV - even if the story is unreal, the subject or the environment may cause thoughts which act as a trigger
  • Sound - helicopters, songs, unexpected loud noises
  • Smell - jungle or bush, rain, smoke, blood, cordite or explosives
  • Reading - or discussion about subjects of trauma
  • Touch - gun metal, webbing, blood
  • Situational - being crowded, walking across open spaces, feeling vulnerable or not in control

Just Remember

Although you may be overwhelmed by your symptoms, you do have many resources available to you. Please make use of them. If you need immediate help, please get it. If you'd like to talk to someone about what you're going through, there are a lot of people and organizations you can turn to you may not be aware of. If you'd like to learn more, there are a wide variety of PTSD resources waiting to be explored by you.

And if you're seeking professional help, you've a lot of options to help you find relief and resolution to your PTSD.


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