Needless to say, there is a stigma surrounding mental disorders in our society. Somehow, they seem to get the back seat to physical or “seen” diseases. But did you know that the American Psychological Association recognizes that stress can play a role in physical disease development and progression? [1] I think it’s time for mental illness to stop playing second fiddle to physical illness. We need to treat it as an equal problem, and this includes PTSD.
What is PTSD?
In the military, PTSD (post-traumatic stress disorder) has become the mental disorder buzzword. While great strides have been taken to eliminate the stigma associated with it, PTSD is still not addressed as openly as it should be. Because it is classified as a “mental disorder,” many of our warriors are still very hesitant to admit that they struggle with it. They are supposed to remain strong…right? They aren’t supposed to have something “wrong in the head”…right?
However, PTSD is so much more than a mental problem. It is actually a physiological condition that stems from being exposed to a traumatic event. In my mind, I classify it as a mental injury rather than a disorder. As Dr. Charles Hoge (a retired Colonel and M.D.) says on page two in his book Once a Warrior, Always a Warrior: “Physiology is the science of how the body works, including how the brain and the rest of the nervous system functions…PTSD is a contradiction, a paradox – a collection of reactions that are both normal and abnormal depending on the situation…” [2]
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Technical Break-down of PTSD
So what exactly is post-traumatic stress disorder? Basically, it is a collection of symptoms stemming from experiencing a traumatic event. The American Psychiatric Association has “diagnostic criteria” in its official handbook, the DSM-5, which is used to diagnose PTSD. An overview can be found through the links HERE, on the Veterans Affairs website, but in short there are six factors. (Disclaimer: for the sake of reading ease, I use male pronouns when referring to the service member, but please know that these criteria also apply to female service members. I am not trying to exclude anyone.)
- Stressor: A warrior must have experienced a traumatic event where he felt that his life or others’ lives were in danger, or there was actual death. His response included feelings of helplessness, fear, or horror. In combat, this includes a myriad of things: being involved in a firefight, being in a vehicle that was blown up or was in a rollover accident, or witnessing others dying. It is also important to note that what might be traumatically scarring to one person might not be the same to another. It is different for everyone.
- Intrusive recollection: The traumatic event will be relived or re-experienced in some fashion. For example, some warriors will have flashbacks of the event, as if they were actually there again. Others will have nightmares, and still others will become psychologically distressed by a “trigger” that reminds them (even unconsciously) of the traumatic event. A trigger could be a smell, sound, dates (like the anniversary of the event), or situations (like being in a crowd).
- Avoidance/numbness: The veteran will consistently avoid situations or stimuli that remind him of the trauma, and will also experience numbness of some sort. The official diagnosis requires that at least three symptoms are exhibited, so for example: the warrior could feel detached from others, be unable to feel loving emotions towards his wife or children, and make the effort to avoid conversation or thoughts of the trauma.
- Hyper-arousal: The warrior’s senses and reactions to stimuli are extremely heightened and at least two of these symptoms must be present. For example, he could have outbursts of anger and have trouble sleeping, or be hyper-vigilant and suddenly startled by seemingly minor things….or any combination of those types of reactions.
- Duration: Symptoms from #2, 3, and 4 must persist for more than one month. It is normal upon returning from combat to experience disturbed sleep, hyper-vigilance, and angry outbursts. These things are what kept the warrior alive in the combat zone, and so they are completely normal to experience in that environment! [3] But if they come home and these symptoms continue for more than one month or so, it becomes abnormal.
- Distress or impairment: Finally, these symptoms must cause marked distress or impairment. Oftentimes the spouse or loved ones is the first to notice that something is “off,” partly because they are the “soft targets.” They are blamed for problems or yelled at. They are the ones who have to endure the warrior’s hyper-vigilance and avoidance of normal situations such as family gatherings. The symptoms also may cause impairment on the job. [4]
Who is Suffering with PTSD?
According to the Wounded Warrior Project, approximately 400,000 veterans of the Afghanistan and Iraq wars suffer with post-traumatic stress disorder. But how many of us realize this fact? It is one of the “invisible wounds of war,” along with traumatic brain injury (TBI). It’s not something that we can see, yet invisible wounds are just as valid as the wounds we can see. In some ways, they can be even more soul-crushing because many Americans don’t understand or don’t take the time to learn about these injuries.
While there is no “cure” for PTSD, it is possible for healing and progress to take place. Many veterans will struggle with PTSD to some degree for the rest of their lives, but they still have hope for a bright future and a fulfilling life! I have seen my own husband grow by leaps and bounds in his post-combat journey. There was a time where I wondered, “Will things always be this way? This is awful.”
Next Steps: Survival Guide for PTSD
Now, I only see vestiges of the PTSD. Sometimes I even forget about his diagnosis. I am thankful for the holistic ways we found to treat his injury, which I will talk about in subsequent posts. But for all you wives whose soldier is in the throes of PTSD, know that this does not have to last forever. Life will never be the same after combat, that is for certain. But we can take positive steps forward. This is why I created the checklist guide “How to Survive PTSD.” You can download it for free by signing up below. You will also join my email list through which I communicate with my tribe. This is just the first of many PTSD and post-combat resources I plan to create for you all!
Yes, I want to download “How to Survive PTSD”!
References:
[1] http://www.apa.org/helpcenter/stress-body.aspx
[2] Once a Warrior, Always a Warrior by COL (Ret.) Charles Hoge, M.D.
[3] On Combat by LTC (Ret.) Dave Grossman
[4] https://www.ptsd.va.gov/public/PTSD-overview/basics/index.asp
Recommended reading:
On Combat by LTC (Ret.) Dave Grossman
Once a Warrior, Always a Warrior by COL (Ret.) Charles Hoge, M.D.
Tribe: On Homecoming and Belonging by Sebastian Junger