War, it's been said, is a serious game. So serious in fact that lives are lost - careers are made, limbs are severed, medals are gained, countries are built or ruined and rumors are started. One overlooked aspect of war is the effect of Post Traumatic Stress Disorder on the returning warriors. What does this disorder look like and how can we assist those who return to the land of the living?
When John left four years ago, he was a boisterous, jovial guy with a lot of ambition, talent and dreams. His wife waited patiently for his return and his children learned that Daddy was a strong, loving and sacrificial type of hero – kind of like Superman. However, when John returned, he drank a lot of alcohol, drove too fast and cursed a lot. He hit is wife putting her in the hospital. John then wound up in jail. This event ended his marriage. John finally realized he may need help, but will it be too late for this warrior turned felon?
This is the story of many returning veterans. This syndrome has been termed "Shell Shock," and "Soldier's Heart," in generations' past. In the 21st Century it is diagnosable as Post Traumatic Stress Disorder, or PTSD, by the Diagnostic and Statistical Manual. It often runs its course hand-in-hand with substance abuse and courtroom visits due to criminal behavior. Gladly, PTSD can be prevented, and if PTSD becomes apparent in a warrior's life – PTSD can be cured.
PTSD is the psychological aftermath of the experience of a traumatic event wherein one may feel life is threatened. Research has shown that not only may individuals feel threatened from events of combat and warfare; but also from rape, other violence – such as domestic violence, car and/or other accidents, and even from an intensive surgery, such as cancer, brain or open-heart surgery. While some traumatic situations in life can be expected and even planned for, the event of not being prepared for the trauma seems to interplay with the out-of-control feeling many PTSD sufferers have experienced. It is therefore very important for these sufferers to be able to regain a sense of self which was lost.
PTSD effects five main psychological facets, these are: Safety, trust, power/control, esteem and intimacy. Soldiers may return from combat and initially friends, family and the soldier him/herself appears to be adjusting normally. However, symptoms of PTSD may surface sometimes even up to a year later. A returned veteran may begin to react in outbursts of anger and in some cases soldiers may even "look for a fight." Some have even chased down other automobiles which cut them off in traffic. One recent occurring injury that may oftentimes mimic PTSD; is Traumatic Brain Injury or TBI. TBI occurs much more readily now than in any time in history. This is due to the fact that better body armor and head gear has been fashioned for the 21st Century soldier. This has allowed for closer combat and contact with explosions. While TBI sufferers have bouts of explosive aggression and anger, PTSD carries with it many other symptoms. Both symptoms and situations need the assistance of a counselor or medical professional.
PTSD has been said to be a very self-centered disorder. Soldiers may begin to isolate themselves from their wives and family as they have lost their way in knowing how to adequately enjoy their lives. Many times they may feel that they "just want to go back to the service where it was easy." Some may believe this because this was an environment they were accustomed to. They then may avoid relationship with their wives to the extent that they become engulfed in pornography. Many times warriors may wish to try to hide from the deep intrusive thoughts, reminders, nightmares and flashbacks. They may also feel they are different than others in society; and this may lead to engaging in substance abuse. At this juncture they may not only need counseling for PTSD but also substance and addiction counseling. As previously stated, sadly many may not find help until they have lost everything, or have wound up in prison and are mandated to attend counseling.
Even dining out can become of chore laden with activities of "hyper-arousal." While in the field these soldiers had needed to "watch their backs" at all times and locate themselves properly. This would allow the visibility to scan the environment for danger and attack. However, back at home these same individuals may sense the need to carry weapons into restaurants and sit in locations where they can scan the restaurant for danger. While some individuals may feel they can overcome some of their symptoms, most cannot and the need to find solace in a counselor equipped in counseling veterans is necessary.
Soldiers are not the only ones who may have occurrences of PTSD. A recent study conducted of the rescue and recovery workers at the World Trade Center disaster, (Perrin, M., et al 2007, http://ajp.psychiatryonline.org/article.aspx?articleid=98914 ) has revealed interesting results. There were 28,692 rescue and recovery workers on scene, comprised of: Police officers, firefighters, emergency medical service/medical disaster personnel, construction and engineering personnel, sanitation employees, affiliated and unaffiliated volunteers, and those of other governmental agencies. The greatest prevalence of PTSD occurred closest to the time period of 9/11; and in those who were untrained and unskilled at knowing how to assist. They were least skilled in knowing what to expect from dealing with the aftermath of a disaster. Those who suffered PTSD from assisting in disaster recovery did not, in fact, witness the occurrence of the traumatic event, or become injured in the event on the date 9/11 first-hand. However, being on the scene and assisting in the aftermath and cleanup of the disaster caused what is referred to as "Secondary Trauma." Many times individuals experiencing PTSD from secondary trauma may also need help.
While superior military training assists our first responding men and women, and grants them a better preparation than most, still the fateful event of losing comrades to death while they are standing beside, is hard for the most prepared to overcome. Incidents of multiple deployments and acts of war can be devastating, as the human capacity to endure is stretched. PTSD cripples the capacity of individuals to come to term with real life experiences which have overwhelmed their capacity to cope. Yet, healing can be attained.
It is crucial for family members and veterans themselves to come to speedy realization for the need of counseling. Until the one affected recognizes the need for support and therapy, it is likely the PTSD will remain constant. It is only by recognition and coming to terms with traumatic events does one truly become human once again. It is human to suffer and overcome; it is disastrous to succumb to invisible enemies on the path of destruction and personal war.
Help for Vets:
United States Department of Veterans Affairs – Benefits: http://www.vba.va.gov/VBA/
Please Help, or gain assistance by visiting USO Wounded Warriors: http://www.uso.org/woundedwarriors/