Reflections on PTSD: Veterans Day and Beyond

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Today is a national day of observance of Veterans Day, though the holiday was technically yesterday, November 11th. Holiday never did seem like quite the right way to describe the day, to me. It seems too positively connoted. None of my nuclear or extended family have served that I know of, so I generally spend my day off passively considering the sacrifice that our veterans put forth on my behalf. Recently, however, I’ve come to think of the holiday a bit differently, as both my personal experience and the news cycle have made an element of veteran-ship impossible to shunt aside in favor of moments of silence.

Around twenty percent of veterans (though it differs between specific conflicts) and eight percent of general Americans suffer from Post Traumatic Stress Disorder at any given time. While it’s tragically most common among those who’ve served, anyone can develop PTSD after a trauma. One third of rape victims, or nearly four million Americans, have the disorder; the number jumps to seventy percent for female veterans (you read that right; over two thirds of female veterans have PTSD from sexual assault!). The most common traumas behind PTSD include combat, sexual abuse, neglect, rape, terrorist attacks, serious accidents/natural disasters, and the death of a loved one. Not everyone who experiences these things develops PTSD; its development depends on intensity, proximity, reaction, and sense of control, among other factors.

I am diagnosed with Post Traumatic Stress disorder, and I have no interest in disclosing personal traumas in such a public forum as this, but I hope by interweaving my general experience with an exploration of the national scourge of PTSD, I can help shed some light on what eight percent of folks you will encounter experience daily and nightly. Here’s what PTSD is.

Reliving the trauma. Having flashbacks (I don’t) and nightmares, some paralyzing (I very much do) and from which you can’t escape, or emerge from sweating and terrified. Avoiding people and places that remind you of the trauma, voices and noises and volumes and demeanors that bring it all back and make you want to run as far and fast as you can. Falling into old, terrifying patterns with new, benign relationships. Intensely craving safety and trying to find it in others while not being able to truly connect with anyone, anyway. Floating through your days trapped within the trauma, separated from your surroundings as if by a glass sheath that obscures, muffles, and obstructs. Panic attacks, falling into and drowning in them. Intense nausea and vomiting when surroundings, sounds, words, events set you off (a particularly nasty habit of mine). In particularly potent time periods, being startled by loud noises, looming figures (hyper-arousal). Keeping your back to walls whenever possible. It doesn’t seem to ever go away, not fully.

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An indispensable and clearly well-read book that my former psychiatrist gave me when I disclosed traumatic events.

Most of these experiences are so terrifying due to what’s called a fight or flight response. We’ve all heard of it, but its acuity separates it from its common perception and reality. It is activated when people are genuinely afraid, not simply anxious or nervous, which are emotions we all experience. Fear arises from a deep sense of unsafety which, suffice to say, is central to trauma. The fight or flight response is heightened in PTSD sufferers, which leads to intensely external or avoidant responses to things that appear benign to outsiders: crowds, noises, passersby, loved ones, affection.

PTSD can make life seem looming and untenable. Twenty seven percent of folks with PTSD will attempt suicide at least once in their lifetime, up from just half of a percentage point (.5) in the general population. Completed suicide rates among veterans are one and a half times more common than that of the general population (two and a half for female vets). Many sufferers consider that if everything in the outside world induces fear- sleep does too- what is the point of leaving bed? What’s the point of being in bed, even, able to dream at all? If not suicide, more than half of folks with PTSD battle co-occurring addiction, the better to escape what their minds are doing to them, anyway.

How can the scourge of PTSD be reduced, alleviated? There are many therapeutic treatments, though they’re not always accessible, and the federal government is notorious for providing lacking support for suffering veterans. Therapy and medication go a long way, of course. I’m undergoing treatment that involves both. One alternate type of treatment I’ve been exposed to is called EMDR, or Eye Movement Desensitization and Reprocessing therapy. It was developed around twenty years ago to access and treat traumatic memories and their present effects. The patient’s eyes are prompted to dart in tracing a rapidly moving light, and as they do so, the patient is physically stimulated (I held my pinkie finger) while recalling events, positive and negative. For someone like myself, who stores my trauma largely in my body, the combination of physical and emotional stimulation is essential to healing the effects of PTSD. Other common treatments include CBT, exposure therapy, service animals, and medication (most frequently SSRI types). That all sounds good, but in reality, veterans with PTSD often struggle to access the treatment that they deserve.

To President Trump’s credit (not my most commonly used phrase…), in September of this year, he signed into law and fully funded a bill that expands guaranteed Veterans Affairs coordinated therapy for veterans. This, while being an absolute step in the right direction, also served as a highlight of some of the woes of the VA system that had been in place for a gruesome list of American wars. Some sixty percent of veterans had previously languished immediately post-discharge while the government determined whether or not their medical issues were directly tied to their service, a necessary step before care could be provided. The maximum guaranteed time was 180 days of care. Now, immediate care is automatically paid for by the VA department for at least one year after discharge. Such care includes interpersonal therapy, a twenty four hour help line, and reintegration services, among other things.

The element of PTSD treatment that the layperson has control over, however, comes down to de-stigmatization. Not only do all PTSD sufferers experience central stigma about their inability to just “get over” or “move on” from their trauma, but veterans historically face the particular stigma that they are diagnosed with violent tendencies more so than an anxiety-based disorder. Externalized violence is no more common in veterans than in the general population, though internalized (suicide) violence certainly is.

Folks deal with their trauma in many different ways. Some recede from it, run from it, some need engagement with it in order to keep it safe, some need engagement in order to heal. If you know someone who’s been through a traumatic event, I’d encourage you to make yourself present for whatever kind of discussion they’re comfortable engaging in, within reason and if you’re healthy enough to. PTSD is isolating by nature, and even just knocking (softly, please!) on the glass sheath can disarm its solitude, if just by a little bit.

If you are in a position to do so, make sure that PTSD sufferers you know, veterans or otherwise, have access to the care they need to heal. No one deserves to live in constant fear. Try to envision a life in which you do.

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