Taking One Scary Step at a Time

Wendi was casually relaxing, enjoying herself, cuddled in a blanket on the couch, peacefully reading a book. Suddenly, she heard gunshots and what she thought were bombs going off.  

She was no longer safe. Her adrenaline soared as she ran for cover. It was now or never to get out of harm’s way, as her life was on the line.

Opening her eyes, Wendi just had a flashback. What she thought was enemy fire was actually a muffler backfiring on a car driving past her house.

Wendi was physically okay but mentally and emotionally drained. She hadn’t recovered from her time in Afghanistan, and continued to suffer from Post-Traumatic Stress Disorder (PTSD) since returning home to Illinois.

A type of anxiety disorder almost always associated with a scarring event in a person’s life, PTSD is usually tied to military service, especially with soldiers who’ve seen active duty where their lives have been threatened, or they’ve witnessed death. Wendi saw little children in Afghanistan shot during combat. Some of them died. Plenty of adults, both civilians and soldiers, died, too.

That Could Have Been Me!

Wendi was fired upon plenty. But thankfully she was never injured. A day doesn’t go by where she doesn’t think, I could have been killed.

This thought (and the visuals of war in her mind that accompanied it) took a tremendous toll on her, making it hard for her to cope with the reality she found herself in now thousands of miles away from the battlefield. Yet, in an instant—even without a muffler misfiring—she could immediately flash back to the brutal images of war in Afghanistan.

The feelings were real, as if Wendi were there in that moment, even though she was present in the current moment, at home, in the United States. Needless to say, this made Wendi feel awful about everything and anything, especially when it transported her back to the trauma she experienced overseas.

If you’re looking for help with PTSD, sometimes you may need to bounce ideas off of a professional counselor.

The Hopelessness of Hyperarousal

Being numb and detached are common feelings with PTSD. Similar to depression, someone like Wendi can believe as if she has no future, and that all her life will ever amount to is the constant checking of surroundings—awaiting being startled—living in a perpetual state of the hyperarousal.  

A primary symptom of PTSD, hyperarousal occurs when a person’s body suddenly kicks into high alert as a result of thinking about their trauma. Even though real danger may not be present, their body acts as if it is, causing lasting stress after the event. Characteristics of hyperarousal include:

  • Insomnia
  • Concentration problems
  • Irritability
  • Anger and angry outbursts
  • Panic
  • Constant anxiety
  • Easily scared or startled
  • Self-destructive behavior (such as fast driving or drinking too much)

These symptoms can produce a sense of hopelessness in the individual, which is why the suicide rate among veterans is higher than the national average. Statistics put the figure at about 30 per 100,000 population per year, compared with the civilian rate of 14 per 100,000.

"Professionals who treat PTSD recommend the dual approach of medication and psychotherapy."

Who Can Get PTSD?

  • Anyone who was a victim, witnessed or has been exposed to a life-threatening situation.
  • Survivors of violent acts, such as domestic violence, rape, sexual, physical and/or verbal abuse or physical attacks.
  • Survivors of unexpected dangerous events, such as a car accident, natural disaster, or terrorist attack.
  • Combat veterans or civilians exposed to war.
  • People who have learned of or experienced an unexpected and sudden death of a friend or relative.
  • Emergency responders who help victims during traumatic events.
  • Children who are neglected and/or abused (physically, sexually or verbally).

The Necessity of Treatment

Obviously a concern, treatment for PTSD is strongly recommended—even a must. With successful outcomes, it’s easier for veterans like Wendi and others affected by the disorder (SEE SIDEBAR) to cope with symptoms when they arise again.

Professionals who treat PTSD recommend the dual approach of medication and psychotherapy. Both are important to the process of a well-being, they said.

Wendi not only sees a therapist who specializes in working with veterans with PTSD but also a psychiatrist who prescribes medication specifically formulated to address PTSD symptom. Wendi has no problem with the dual approach to treatment. And, she’s not unaware that the road ahead is a long one—perhaps it will even be years before she has left the anxiety and depression behind for good.

That’s okay. She’s excited through therapy to learn new ways of thinking; practice positive behaviors; and take active steps to move beyond her symptoms. In addition to medicine, her counselor is employing a specific type of approach called cognitive behavioral therapy, or CBT. It’s one type of counseling that research shows is effective for a number of different mental health challenges, including PTSD.

“CBT can give you skills to handle distressing thoughts,” said Matthew J. Friedman, MD, PhD Psychiatrist, Veterans Affair National Center for PTSD. “It helps you understand what you went through and how the trauma changed the way you look at the world, yourself, and others. In CBT, you focus on examining and challenging thoughts about the trauma. By changing your thoughts, you can change the way you feel.”

Prolonged Exposure Therapy (PE) as well as Eye Movement Desensitization and Reprocessing (EMDR) are additional—and effective—ways to treat PTSD. See Understanding PTSD Treatment for more details about PE and EMDR.

If you’re looking for help with PTSD, sometimes you may need to bounce ideas off of a professional counselor.

The Need for Medicine

As for medications, they work in different ways to manage the chemicals in the brain that may affect the way you feel, said Friedman. Selective Serotonin Reuptake Inhibitors, or SSRIs, are preferred because they raise the level of serotonin in the brain, which can make you feel better. Two SSRIs currently approved by the FDA for the treatment of PTSD are sertraline (Zoloft) and paroxetine (Paxil).

Wendi is on Paxil. She credits it for “calming my emotional storms,” she said.

 

Accepting Help from Others

Another avenue of healing for her—besides medication and counseling—is a weekly support group for PTSD survivors. Other vets have also found self-help approaches such as groups useful.

Because many veterans who don’t address their PTSD symptoms often turn to substances such as alcohol and drugs, additional self-help approaches may include participating in 12-step meetings such as Alcoholics Anonymous or Narcotics Anonymous. Support of this kind can be a powerful resource during the journey of recovery, especially for men, half of whom with PTSD have problems with alcohol or drugs.

“It is better to get help and be safe than be sorry about an incident that can come from abusing substances,” said Candice Monson, PhD Psychologist and Associate Professor Ryerson University. “If a person with PTSD were to not get help, they could be a possible harm to themselves or others, particularly because anyone under the influence does not have complete control over his or her body—and who knows what other catastrophes can happen from that. DUIs, fights, and suicidal thoughts are just a few scenarios where alcohol and drugs take a part in the motive.”

Those trying to recover from PTSD know that alcohol and recreational drugs can make their struggles worse. So, it’s best to exercise and eat well; to get help; to acknowledge the problem you have; and most importantly to accept support from others.

 

Wendi has had enough stress, tension, dizziness, and headaches to last a lifetime. She still has a lifetime to live.

While her trek could be a long one, she’s prepared for what lies ahead. It’s her biggest battle to date. But her military training—crafted through discipline and determination—should serve her well.

The most important thing is that she’s addressing her PTSD. No matter how long it has been, there’s good reason to think that she can get better.

References

Berger, Fred K. “Post-traumatic stress disorder.” PubMed Health. 08 Mar. 2013. U.S. National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923

Mayo Clinic staff. “Post-traumatic stress disorder (PTSD).”  Mayo Clinic. 08 Apr. 2011. Mayo Foundation for Medical Education and Research. Retrieved from http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

Slack, Charles. “PTSD Timeline: Centuries of Trauma.” Proto Magazine. Aug. 2010. Retrieved from http://protomag.com/assets/ptsd-timeline-centuries-of-trauma

“What is PTSD?” Post-Traumatic Stress Disorder. Nebraska Department of Veterans’ Affairs. Retrieved from http://www.ptsd.ne.gov/what-is-ptsd.html

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