This blog is not FDA approved
I was honored when Eric offered me an opportunity to write here on Black Box Warnings. Many of you know me from my screed/blog, BrainRants. If you’re expecting a laugh or some curmudgeonly behavior here today, I’m sorry. What I’m sharing today isn’t really funny, and from my point of view this is a time-bomb waiting to explode.
I thought I was immune, but facts would seem to indicate I am merely not predisposed to the problem. This makes me lucky that I’m not worse now than I could be. Coming home from Afghanistan after my first tour in 2010, I felt glad to be home. But then I noticed things. I was jumpy and easily startled. I felt irritable and stressed for no apparent reason. I had two emotional states: indifference and rage.
Driving down roads, I caught myself scanning the sides of the road for signs of explosive devices, and rooftops for signs of snipers. Meeting new people, I watched their hands and stayed alert for signs of deception. I sought out some Army friends with similar experiences. I talked about it, and in a few months the problems went away. I started my blog, and found that venting my feelings into words in a sarcastic but funny way helped. It became my therapy.
On my second tour, I became unable to sleep more than a few hours – less than twenty – each week. I’d love to explain how I managed an important job there but to be honest this problem left holes in my memory that have yet to fill themselves in. I was irritable to say the least, and I snapped at people for the simplest of things. My boss there grew concerned and advised me to see the medics. I refused their Ambien because of the side effects, but found eventual relief in melatonin. By the time my ticket home came, I felt restored to something resembling fatigued normalcy.
Post Traumatic Stress Disorder, commonly referred to as PTSD, is an insidious and hard to define condition. PTSD has occupied public consciousness now for most of the past decade, although the medical community has been pushing data into categories to define the problem since the 1970’s as American doctors struggled to come to grips with American men home after service in Vietnam who simply failed to re-adapt to peace.
Sadly, the stereotypical PTSD victim can show the signs that the mainstream media and entertainment industry portray. Think of the twitchy veteran, the angry military guy, the burnout homeless man who wears a battered fatigue jacket. All indicate symptoms or outcomes, or both. I’m a tanker, not a doctor, so I’ll let you scroll to the end of this post and click some scholarly links if you want clinical input on symptoms, causes and treatments. My story and experience is mild compared to some I’ve known and luckily I’ve largely been able to work through each bout to a point.
More important than knowing the basics, I think, is understanding the whole problem. PTSD may just be a modern manifestation of the human mind’s reaction to an efficiency at making war that has outstripped any one person’s ability to comprehend it. Make no mistake – there were PTSD victims of both World Wars and all the ‘small’ fights in between. Earlier proof gets more difficult to discern, because part of PTSD’s controversy is the notion that symptoms are common across many other well-known disorders, or are disorders unto themselves.
As a Soldier, I’ve seen this at work first-hand. I know brave men who have taken cover at the sound of a car backfiring; good Soldiers who show long-term sleep deprivation; family men whose families dissolve upon their return as a different man. The military is still struggling to get a firm grip on elevated suicide rates across the force that are coincident with our wartime buildup beginning in 2001.
America lost about 58,000 service members in Vietnam, and my quick internet search shows that we lost between 50,000 and 100,000 more to suicide as well, long after they “came home.” The numbers are hard to corroborate, confirm, or verify after forty years. The sad fact remains that the post-combat, time-delayed deaths have approached a 1:1 ratio with those killed in combat in that war.
Part of the problem, I believe, lies in training. Former Army Colonel Dave Grossman suggests that we humans by our very nature do not have a propensity for killing inside our species in spite of evidence to the contrary. He believes that military training overcomes our wired instinct to not kill. In the end, the dissonance between instinct and training ultimately damages the man or woman. We do well making warriors, we’re learning to treat the symptoms of this now, but we have not addressed how to undo this sort of operant conditioning. We’re taught to protect and defend but given no skills later on how to accept protection or comfort.
This is not the only cause, of course. The sheer terror of being shot at, or believing incoming rockets are headed for you is damaging. Driving down a road and knowing something could blow up and kill you – or worse – at any moment is damaging. Existing in a stressful environment without pause will change the way your brain functions. I know this because I’ve lived it, and if I had to pick the worst of that list, I choose a two-hour drive down roads where every culvert, bridge and pile of garbage on the road could be the last thing you ever think about.
The damages don’t end in the service member’s mind. Many men, and now women, come home ill-equipped by nature to handle the way they feel. Some bury their feelings out of fear of ostracism. Some self-medicate in various ways. Some act out in abusive ways that will, in turn, produce more PTSD like ripples from a stone dropped in a pond. You’ve read the headlines of the men who kill their families and turn the gun on themselves. Those are the iceberg tips visible above the water because they are dramatic. The submerged problem is larger and more dangerous, and largely unaddressed.
There is hope but progress here is an uphill battle. The military is making sincere and deliberate efforts to de-stigmatize these mental health issues. We’re urged to self-refer and seek help, but most of us were raised to be silent bearers of our problems, which is why the military culture suits us well – we are by nature stoic and Spartan. There are some substance abuse issues associated with the medications provided for those of us brave enough to seek help and afflicted enough to need chemical assistance, but by and large we are making progress.
It doesn’t have to be a Soldier or military veteran of war, either. PTSD is associated with trauma. Nowhere in the definition does it state, “Trauma suffered in a time of war.” The causes can be various, but the effects can be consistent. The medical community is seeing trends with car accident, abuse and violent crime victims now that they are looking for the signs.
Prevention is often not much of an option, so the real way you can help is to provide understanding and encouragement where you find it. Most cases are relieved to some degree simply by sharing what bothers the person. Above all, be encouraging and avoid attaching stigma to the issue.
To circle back to where I started, I’m less than one month into being home from my second tour. The readjustment is jarring because living in a state of constant alert for a year makes it hard to simply relax. I am feeling the anger, impatience and frustration again but admittedly not as badly as three years ago after my first post-deployment homecoming. I’ve spoken to a counselor, but I’m unsure about going back. If I do, I’ll go after my divorce is final and I have that stress and responsibility off of my shoulders. Then again, like my WW II Veteran father, I may be too stoic and closed-off to put down my burden.
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Read more about PTSD:
Read about the stresses inherent to creating warriors and soldiering at war: