“To this day, every time I smell firecrackers or fire arms being shot, I feel like I am right back there. All I have to do is close my eyes and I see the whole scenario over and over again. I can’t erase it.”
Hundreds of thousands of US veterans are not able to leave the horrors of war on the battlefield. They bring the combat home and re-experience it in their minds each and every day, no matter how much time has passed.
“I don’t like people. I just live my life.”
Many PTSD veterans live a life riddled with divorce, unemployment, and loneliness because they are unable to form lasting social networks within civilian life. It is not uncommon for a war veteran plagued with PTSD to desire a solitary life in the mountains. One informant described Montana as the ideal locale – far away and quiet.
“I should have buried him.”
This veteran is still tormented by the fact he did not give an honorable burial to a fellow soldier. He knows he would have met a similar fate if he tried to leave his foxhole; yet his inability to act haunts his memory. He asks himself everyday why he didn’t even try to honor his fallen comrade. He also has never been able to justify why he wasn’t the soldier left unburied on that remote Pacific island.
“I didn’t even have the motivation to kill myself.”
Many of these men and women believe their situation will never improve. Some contemplate suicide as their only relief from the symptoms of PTSD. A number of the veterans we spoke with had thought about or even tried to end their own lives. They also participate in risky activities, threatening their life in a deliberate yet indirect way.
“I always feel like there is someone behind me – following me.”
Being on edge is the only way to survive in combat. Unfortunately, many PTSD veterans are unable to readjust within the civilian world. Everyday life becomes a battlefield.
Something as mundane as walking through a crowded grocery store aisle can be a source of intense anxiety for a veteran suffering from PTSD. Overwhelmed by a feeling that the shoppers behind them are enemies, PTSD veterans always feel as if they are under attack. A trigger as simple as the clashing of shopping carts can make them jump in fear of an imminent explosion. They are forever at war.
Over the course of 4 months, South Bend veterans with Posttraumatic Stress Disorder (PTSD) have revealed their daily realities to us, five undergraduates at the University of Notre Dame. In conjunction with a course taught by Dr. Daniel Lende entitled Researching Disease: Methods in Medical Anthropology, we have engaged in community-based research with members and supporters of PTSD, Vets, Inc. Here, with the approval and encouragement of these vets, we seek to give their experiences a well-deserved voice.
We’ve come to understand that PTSD is a debilitating condition. However, there tends to be a general lack of understanding of the condition itself as well as its symptoms, diagnoses, and treatments. Here are some things these PTSD veterans want every person to know:
Many older veterans have suffered from PTSD for decades without ever knowing they had the disease. These men and women insist that their quality of life would have been significantly improved with early intervention. This has been supported by numerous studies, which suggest that diagnosis soon after the traumatic event is critical for positive, long-term outcomes. Traumatic memories tend to become resistant to treatment over time. The quicker the symptoms can be addressed, the better the outlook for a PTSD veteran.
A clinical diagnosis serves as a profound moment for a veteran with PTSD. It confirms and validates the symptoms experienced by the individual. One informant describes his diagnosis: “It was like a nail on the head. Finally someone knew.”
Veterans with PTSD often believe that they are “crazy” before a formal diagnosis by a healthcare professional. Previous to having a diagnosis, these men and women have the symptoms but no explanation for their cause. They begin to question their sanity. They ask, as one veteran phrased it, whether or not “it’s all just in [our] heads.”
A formal diagnosis is an empowering facet of PTSD treatment because it lets veterans know that there is a physiological and psychological basis for their behavior. War has changed their brains and there are ways of learning to cope with those changes.
More than anything else, a diagnosis lets them know that they are not alone.
Many of the vets expressed that feeling alone in handling their condition and the isolation that often results are the most painful aspects of PTSD, often making it difficult for many PTSD vets to ask for help and seek treatment. Group therapy among PTSD veterans is a vital component of treatment because very few civilians have seen and experienced the same events that these men and women have. Nor can civilians understand the trials and tribulations of living with PTSD caused by war trauma. In this way, it can be seen that many PTSD veterans will only talk about their experiences with other veterans.
We have received direct feedback that group therapy benefits many of the veterans, as it provides an avenue for them to speak openly about their suffering. While many veterans destructively turn to alcohol and drugs as a means of coping, group therapy provides a healthy alternative and is an outlet for them to express their anger, fear, guilt and countless other emotions attributed to PTSD. In confidence they can tell each other things that they haven’t even told their husbands or wives. In the group they are getting these things out in a sensible manner. Telling their stories matters.
An important question in regards to group therapy is how it can be improved in order to provide the most benefits for the veterans that are returning home from war. The VA and several other organizations are examining what aspects of group therapy may be altered to make it as effective as possible for providing PTSD treatment to veterans.
One approach that veterans in South Bend are attempting is peer counseling. Those with PTSD consider a commitment to helping other veterans to be a central facet of managing the disease. Older members of the group want to reach out to soldiers returning from Afghanistan and Iraq with PTSD. They know better than anyone what it is like to live with PTSD and want to stress the importance of receiving early treatment. By counseling young veterans, these members hope to prevent a lifetime of suffering which they themselves had to live through. This then helps to validate their own suffering.
The peer counseling doesn’t just benefit one side of the relationship, however. By instilling them with some agency over the disorder, the counseling provides a method of coping in addition to more standardized treatment for the older group members. More generally, this emphasis on helping other veterans simply by making them as aware of PTSD as possible underscores the importance of awareness in the effort to improve its diagnosis and treatment among all veterans.
The substantial impact of PTSD on the lives of veterans afflicted by it makes greater understanding of this disorder of utmost necessity. With knowledge about PTSD, returning veterans can seek the early diagnosis and treatment they need, giving them a chance to reclaim their quality of life. Although many veterans we spoke with stressed that PTSD never goes away, with treatment, including group therapy, counseling, or medication, veterans can avoid a life ravaged by isolation, drug and alcohol use, depression, and the countless other daily struggles of PTSD.
Awareness and understanding can also foster the support of families that is often necessary to motivate vets to seek the treatment they need. Increasing the visibility of the prevalence of the disorder among veterans and working to remove the stigma associated with it can help veterans get the support they need and deserve. Finally, awareness among the general public will give veterans an additional level of acceptance and advocacy that may work to reduce the impact of PTSD on their lives.
A true knowledge about all aspects of PTSD needs to rise amongst veterans, their families, the public, and our policy-makers, so veterans currently suffering with PTSD and the soldiers returning from Iraq and Afghanistan may acquire the help needed to fight back in the war that rages within their subconscious.
For more information on PTSD and how to seek treatment please visit the helpguide. To learn more about the veterans of PTSD, Vets, Inc., who so graciously shared their stories, visit www.ptsdvets.com.
Written by: Christina Del Guzzo, Megan Ericson, Daniel Graciaa, Casey McNeill & Mark Quaresima
Acknowledgements: Many thanks to Dr. Michael Sheehan, PTSD Vets, Inc., and the many veterans who opened their hearts and shared their stories with us.
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Essay on Post traumatic stress disorder
Post-traumatic stress disorder is one of the mental health illnesses. For one to have the disorder, they must have gone through the traumatic event which are usually painful. The advantage of post traumatic disorder is that its caused is known as compared to other mental illnesses. This way a therapist knows what they are dealing with when attending to their patients.
Most of the people affected by post-traumatic stress disorder are war veterans. This is because during the war they come across traumatizing experiences which are hard to erase. Most of the victims end up taking excess alcohol, or get depressed (Thio, 12). Some of the victims end up isolating from the rest and avoid situations that will lead to them remembering what happened during the war.
The government has set up centers where the victims can seek help in case they feel they have symptoms related to post-traumatic stress disorder. There are veterans who seek help while there are those who decline to have the help.
Casualties of post-traumatic stress disorder find it hard to find the best solution for their condition. The problem that they face is because the condition is entirely mental. By being mental, it affects most aspects of the victim including the physical part. Post-traumatic stress disorder is a condition that causes the victim to experience hyper arousal, avoidance and emotional numbing, Corrales (24). These characteristics result from traumatic events that victims go through in a part of their lives. The study of PTSD involves observation of symptoms.
This leads to many psychologists to believe that the condition arises as a result of the body reacting to normal stress. They believe that this is the normal way of the body of reacting to stressful conditions.
There are several theories that suggest that symptoms of PTSD vary from one victim to another. This variation depends on the ability of the body to withstand and cope with a certain traumatic event. Some victims are able to recover from the condition after a very short time. Others seem to maintain the condition for a long time with some cases lasting for the rest of the victim’s life. This condition occurs as a result of breaking the basic assumption of an individual about his invulnerability and the overall safety in the environment surrounding him. Exposure to these conditions causes the brain to break down and become weak.
The brain of a person in normal circumstances can integrate the trauma in his memory. However, PTSD causes the individual’s brain to form faulty beliefs about why some situations took place. The individual’s brain interprets the activities with guilt and self-blame. This causes the individual to get problems in trusting himself. Loss of self-esteem, control and intimacy causes the person to have problems integrating trauma in his memory.
Post-traumatic stress disorder is the only disorder which is caused by anxiety and has its cause known. This uniqueness helps in its treatment since the therapist and counselors tackle the issue directly. In post-traumatic stress disorder, anything that makes one feel like it’s a traumatic experience may result to the disorder. Some of the events that are likely to cause the disorder include violent acts, life-threatening disease, surviving car crash, natural catastrophe, war, and sexual assault.
PTSD often occurs to war Veterans, for example, after the end of the Vietnam War, most of the American troops returned home. However, most of the veterans were faced with a number of psychological and social challenges. Following the Great War, most of the Vietnam veterans were diagnosed with post-traumatic stress disorder. On the other hand, those who were not diagnosed with the disorder, battled with the symptoms of post-traumatic stress disorder (Cordesman, 27).
According to the research that was done, the veterans who experienced combat had higher chances of exhibiting post-traumatic stress disorder as compared to the ones who did not encounter the combat experiences. Moreover, among the veterans who had experienced the combat were divided into two groups depending on their roles. The two roles were the initiative and reactive roles. An example of reactive role was the foot soldier that was on the ground during the war. On the other hand, an example of initiative role was a helicopter pilot whose duty was to initiate and control the combat. However, the two roles involved the veterans risking death and serious injuries.
The foot soldier was to take care of the enemy in an environment that was full of surprise ambush attacks coming from the enemy. In this case, the confrontations from both sides were measured in feet. For the helicopter pilot, they fired at the enemy using machine guns and rockets from above and the confrontations were measured in hundreds of feet. The two groups faced different intense of the stress because there was difference when it came to viewing the after math of the battle and the distance (Cordesman, 20). Those on ground looked at the dismembered bodies, smelled and tasted death. Those who survived had to touch corpses as part of their routine.
In reality, no one wants to go through post-traumatic stress disorder. This is because for one to be diagnosed with post-traumatic stress disorder, they have to go through the traumatic experience, and most of the traumatic experiences are usually painful. Moreover, the experiences end up creating lasting problems and at the same time end up controlling ones stress and anxiety levels.
The ministry of defense is reported to have said that about 11,000 serving members who went to the war have been diagnosed with various mental conditions such as post-traumatic stress disorder and depression. The charity groups that helped the armed forces personnel adjust to normal life cautioned the government that the large scale redundancies meant that the victims who needed treatment would leave the group in case they lost their jobs.
Notably, the disorder can be re-experienced due to intrusive and recurrent distressing recollections of the event such as thoughts, perceptions, and images. Recurring dreams of the event, feeling and acting as if the event if recurring, exposure or reaction to cues symbolizing or resembling aspects relate to the event, physiological reactions due to exposure to cues resembling an aspect of the traumatic event, persistently avoiding stimuli linked with trauma and also numbness in general responsiveness. These include avoidance of feelings, thoughts or talks linked to the trauma, avoidance of places, people or activities arousing the trauma recollections, inability to remember significant aspects of the trauma, diminished participation or interest in important activities, feeling estranged or detached from other people, difficulty loving other people, losing hope and having a foreshortened future (England 80).
In addition, research indicates that the possible symptoms of this disorder are anger outburst or irritability, difficulty staying asleep or falling asleep, hypervigilance, difficulty in concentrating and having an exaggerated startle response. Research also indicates that this disorder causes impairment in occupational, social and other significant areas of functioning.
Research also shows that not all trauma victims develop PTSD. There is no systematic difference between victims of crime developing PTSD and those who don’t in reference to their demographic qualities such as employment, race, income, and education. Their personality or adjustment pattern may have led to the development of PTSD (Goulston, 28).
Research also shows that there is a relationship between the stress levels associated with crime and the depression before crime and the probability of developing PTSD.
This shows that victims assaulted in a severe manner have higher probability of suffering from PTSD compared to victims of lower stress crimes. Additionally, level of social support limits or prevents the development of PTSD and other psychological consequences of rape. However, victims can withdraw and avoid social support available to them. People may be more supportive in after getting full details of an assault while in some circumstances they nay not offer social support to victims. This is because they believe that the patients deserved it.
Research indicates that the most effective forms of PTSD treatment involve antidepressant medication or cognitive-behavior therapy. They can be used in combination or alone. Prolonged exposure is the psychological intervention that has been applied and tested in an extensive way. The procedure begins with information gathering in the initial sessions. Several sessions follow aimed at relieving the scene of rape from the imagination of the victim. The victims are encouraged to imagine and describe the assault to the therapist as many times as possible. The sessions are usually recorded for victims to listen to them at some time. In addition, patients are encouraged to participate outside the sessions of therapy which are safe and also eliciting fear or avoidance responses (Paulsen 98).
Cognitive therapy defines another psychological approach which can be used in combination with prolonged exposure or used alone. This form of therapy is effective in addressing maladaptive ways of perceiving events in the environment of a person. This can also be used to change unrealistic beliefs and assumptions causing negative emotions such as guilt.
Research also shows that there are numerous types of antidepressants medication which are effective in the treatment of PTSD. These include selective serotonin and inhibitors such as paroxetine and sertraline which reduce PTSD symptoms in many patients within a period of six weeks. Therefore, cognitive behavior is usually combined with medication (Kolk, 66).
Kolk, Bessel A., Alexander C. McFarlane, and Lars Weisæth. Traumatic stress: the effects of overwhelming experience on mind, body, and society. New York: Guilford Press. 1996. Print.
Paulsen, Gary. Soldier's heart: a novel of the Civil War. New York: Delacorte Press. 1996. Print.
Goulston, M., Post traumatic stress disorder for dummies. Hoboken, N.J.: Wiley. 2008. Print.
Cordesman, A. H., Frederiksen, P. S., Sullivan, W. D., & Center for strategic and international studies (Washington, D.C.). Salvaging American defense. Washington, D.C: CSIS Press. 2007. Print
Corales, Timothy., Focus on posttraumatic stress disorder research. New York: Nova Science Publishers. 2005. Print.