I work with a client whom I will refer to as
“Vince.” Vince lives every day feeling as if he has one foot in the here and
now and one foot in the past. He is constantly on edge and jittery and he jumps
at every loud noise. He feels as if he can never relax. His brain is constantly
racing with images of horror from a time he can never forget. He wakes in the
middle of the night in a cold sweat after having horrendous nightmares. He
feels as if the world just does not understand him, except of course his brothers
in arms. He has a constant feeling of dread and he carries an anger that is
eating him alive. Vince is a veteran who suffers from Post Traumatic Stress
Disorder (PTSD). According to the Diagnostic and Statistical Manual, Fifth
Edition (DSM-V), PTSD is a mental disorder that results from the exposure to
“actual or threatened death, serious injury or sexual violation.” It is a
condition that inhibits one’s ability to function normally in relationships,
work or other areas in one’s life.
Vince is not alone. There are thousands of Vinces out there. They too may be suffering in silence. They may not even understand or realize that they have PTSD. Like Vince, they may be trying to cope with their PTSD symptoms by self-medicating with drugs or alcohol. They may be destroying the relationships with their loved ones who also may not understand what has happened to the person they once knew. Symptoms of PTSD may take years to fully manifest and may linger for years after the traumatic event has occurred. The symptoms correspond to four categories, which include: re-experiencing, for example, having recurrent nightmares or intrusive thoughts of the event; avoidance, for example, feeling emotionally distant from others or losing interest in activities that once gave one pleasure; negative cognitions, for example, constantly blaming oneself or others for what happened and arousal, which often manifests as reckless behavior or hyper-vigilance, as if one is always expecting something bad to happen (DSM-V; www.Maketheconnection.net, 2014). Not only do the symptoms themselves wreak havoc in one’s life, but also the way one deals with those symptoms can exacerbate an already difficult and distressful situation. For Vince, he lives a cycle of sadness, anger, blame, guilt, feelings of isolation, feelings of unworthiness and he turns to alcohol to numb the pain. His traumatic event occurred during the Invasion of Grenada, back in 1983. His friend died a gruesome death as he lie bleeding in Vince’s arms. Vince sobbed as he shared with me the events of that traumatic day,
Vince is not alone. There are thousands of Vinces out there. They too may be suffering in silence. They may not even understand or realize that they have PTSD. Like Vince, they may be trying to cope with their PTSD symptoms by self-medicating with drugs or alcohol. They may be destroying the relationships with their loved ones who also may not understand what has happened to the person they once knew. Symptoms of PTSD may take years to fully manifest and may linger for years after the traumatic event has occurred. The symptoms correspond to four categories, which include: re-experiencing, for example, having recurrent nightmares or intrusive thoughts of the event; avoidance, for example, feeling emotionally distant from others or losing interest in activities that once gave one pleasure; negative cognitions, for example, constantly blaming oneself or others for what happened and arousal, which often manifests as reckless behavior or hyper-vigilance, as if one is always expecting something bad to happen (DSM-V; www.Maketheconnection.net, 2014). Not only do the symptoms themselves wreak havoc in one’s life, but also the way one deals with those symptoms can exacerbate an already difficult and distressful situation. For Vince, he lives a cycle of sadness, anger, blame, guilt, feelings of isolation, feelings of unworthiness and he turns to alcohol to numb the pain. His traumatic event occurred during the Invasion of Grenada, back in 1983. His friend died a gruesome death as he lie bleeding in Vince’s arms. Vince sobbed as he shared with me the events of that traumatic day,
“He was lying there, in piss and blood, with his guts hanging out. I was holding him and he looked up at me and asked ‘what just happened to me? What’s happening Vince?’ and I just held him until he died. I sat there holding him until the medic came and got him. Then I had to get up and keep going like nothing ever happened.”
Vince drinks to keep the demons at bay, to silence the voices, to quell the images, to lessen the anger and to numb the pain. This is a very common occurrence among our military who suffer with PTSD. For example, in 2010, the Treatment Episode Data Set (TEDS) reported that 50.7 percent of those who were admitted to substance abuse programs where alcohol was the substance of choice were veterans versus 34.4 percent who were civilians or non-military (Center for Behavior Health Statistics and Quality via www.SAMHSA.gov). Vince’s drinking is taking a toll on his relationship. His significant other, whom I will call Charlene, loves him, but Vince becomes verbally abusive when he gets drunk. He basically transfers all of his pent up anger onto Charlene and verbally attacks her for what she perceives to be no reason. She is at her wit’s end and has decided that, unless Vince gets help and gets sober, she may have to end the relationship. This is the last thing Vince wants, but he is terrified to face his pain without his safety net-alcohol. Currently, Vince has dropped out of therapy and has not yet attended an Alcoholics Anonymous (AA meeting) as he had promised Charlene.
Vince, like many of his brothers and sisters in arms, is at a crossroads. He can either continue in this self-destructive path that will lead him to lose those closest to him or even worse, his own life, or he can emerge from his private hell and seek help. Unfortunately, some vets who have tried to reach out for help have run into a brick wall. A.W. is an example. He served in active duty a few months shy of 2 years. It was enough for him to experience traumatic events, which led to his PTSD. He reached out for help, but was met with nothing but silence. Unfortunately, less than a half of military vets receive care at the Veterans Administration (VA). Some returning vets live far from VA facilities. The VA has started to create Community Based Outpatient Clinics (CBOC), but many are ill-prepared to handle the demands that severe PTSD brings. The CBOC lack the properly trained clinicians needed or they may lack sufficient information about treating severe mental illness. Other obstacles include, but are not limited to, the stigma about mental health issues and the inability of vets to receive support from their employers, who may not allow the time off from work to seek help.
As a result of the lack of assistance, A. W. withdrew into his private hell. His marriage ended. He fell into alcoholism. Although he has been able to get sober and although he is doing a lot better today, he still deals with the ghosts from the past. He still jumps at loud noises. He still feels a sense of distance and isolation because he struggles to feel understood. He, like Vince, believes that no one can ever understand the experience of combat unless he or she has been through it. A.W. decided to do what he could to help other vets and that has been his life line. Helping others with the wisdom A.W. has gained from his painful experience has given him a sense of purpose.
If you are a veteran who is reading this and either Vince’s or A.W.’s stories resonate with you, or if you are someone who loves someone like Vince or A.W., there is help and there is hope. As a therapist, I can tell you definitively that if you are an alcoholic like Vince, you must get sober before dealing with your PTSD. In order to develop the coping skills to face your pain, you need to rid yourself of anything that blocks your ability to process your emotions. I promise you, although your emotions are difficult and the memories painful, you can get through it. Once you allow yourself to feel the pain and learn to restructure your thinking about the event, you will cleanse yourself of that which is keeping you in your private hell.
The first step is to seek counseling from a trained professional. Call your local VA. Many VA facilities offer free counseling for military veterans or support groups for those who served in active duty. Support groups are very effective because the purpose is for you to be with others who have experienced what you have and who struggle with similar issues. You will feel understood. If you have private insurance, contact your mental health provider and ask for therapists in your area who treat PTSD, with or without addiction. If you do have an addiction to alcohol or drugs, please seek out your local AA (http://www.alcoholics-anonymous.org/?Media=PlayFlash) or Narcotics Anonymous (NA) for additional support (https://www.na.org/).
If you have read this article in its entirety and you believe that you may have PTSD, please reach out for help. If you are not sure whether you have PTSD, you can take this self-assessment at https://www.myhealth.va.gov/mhv-portal-web/anonymous.portal?_nfpb=true&_pageLabel=mentalHealth&contentPage=mh_screening_tools/PTSD_SCREENING.HTML . This tool is not a complete assessment, but it may help you determine whether you have symptoms that require further assessment by a trained professional. There are many resources out there for you that will help you understand PTSD, such as www.PTSD.va.gov, which is a comprehensive website designed to help sufferers understand PTSD, its symptoms, its cause and its treatment. To find a PTSD treatment location or VA medical center near you, go to www2.va.gov/directory/guide/FindPTSDProgram.cfm . Please do not suffer in silence any longer. Take the first step and reach out for help. You can free yourself from your private hell, once and for all.
References/Resources
www2.va.gov/directory/guide/FindPTSDProgram.cfm
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