How PTSD Affects the Veteran
PTSD is a very complicated syndrome and can affect the veteran in many ways. As explained in last months’ column, there are many symptoms and the combat veterans don’t all have the same symptoms. The degree of trauma affects the degree of effect on the veteran.
The re-experiencing of a traumatic event, or flash-back, brings with it all of the effects that came with the original experience. If the veteran was in constant danger for his life, for instance, the fight-or-flight response of high adrenaline output would have been pretty much constant. Some veterans experienced that for long periods of time and some of them for more than one tour of duty. When a flash-back occurs, so does that effect of high adrenaline. It can soar from a high which is normal to them to extremely high in the time it takes for that event to flash into the mind. This frequent soaring of adrenaline has a huge effect on the physical health of the vet, not to mention how it affects his emotions when the flash-back occurs. (irritability, health problems, exaggerated startle response)
Quite frequently, it seems, these flash-backs also bring feelings of anger, or even rage. After any engagement with the enemy, the resultant numbing and rage would increase. But what do you do with all that anger, with the reality of your experiences when you are thrown back into civilian life with no de-programming to prepare you? However, this numbing of feelings which served a purpose at the time, continues. Unless and until there is a safe place where these feelings can surface and be felt and dealt with, little by little, they fester and explode with little provocation. The least little thing will cause them to erupt. The vet feels out of control and isolates himself to try to keep these outbursts to a minimum (explosive aggressive behavior, fear of losing control, panic attacks, social avoidance, job instability, difficulty in parenting and bonding, phobic-like avoidance behaviors)
They returned from literally life and death situations; from terror and horror, to everyday activities that seem mundane and pointless. They frequently feel that no one but other combat vets can understand what they experienced and continue to live with. They are right. Even their spouses often don’t understand why they act the way they do. These feelings of alienation, of being “different” also make the veteran want to isolate.
They have learned what it feels like to kill and to have someone want to try to kill them. They lost, at an early age, most of them, all innocence and trust in their fellow man. They learned to survive by watching their backs at all times…and most of them still have a hard time sitting in the middle of a room, with other people behind them. They don’t feel comfortable in crowds, their eyes darting about, always aware of anything or any one that could be a threat. (lonliness, distrust of authority figures and the system, lowered trust of others, hyper-vigilance, persistent anxiety, paranoia)
There is a lot of self-blame and guilt associated with combat. Some of their buddies didn’t survive; why did they? There was a lot that they saw and had to do that makes them feel guilt. They know that they did their jobs, what they were trained and sent to do, when you are fired upon, you shoot back. But how do eighteen year olds get a grip on having to kill?
Men tend to associate with their jobs. Does having to kill make them killers? Does that make police killers? These are extremely difficult issues to come to grips with. (intrusive thoughts, decreased intimacy, personality disorders, self-destructive behaviors, depression)
They also feel guilty about raging at their families. They don’t want to feel constantly angry and irritable, they feel helpless: the symptoms are crazy-making for them, as well as for their spouses and children.
The constant re-enacting of traumatic events, the constant ebb and flow of adrenaline in their bodies makes it almost impossible to maintain an even mood. The constant, for some, nightmares, year after year, means that they don’t get peaceful sleep. This also causes irritability. (memory and cognitive impairment, insomnia, sleep disturbances, impaired concentration, sexual dysfunction)
Some veterans try to cope with the symptoms of PTSD by self-medicating: they try to keep the flash-backs and nightmares at bay by taking drugs or alcohol. They cope by running: if you stay busy enough, long enough, you fall into bed so exhausted that you might be able to get a few nightmare-free hours of sleep.
The frequent coming and going of flashbacks, keeps them off-kilter, not quite knowing if they are there or here: is it then or is it now? They exercise immense effort of will trying fruitlessly to control this.
I understand that trauma can affect a person in other ways. The person can become stunted in their emotional growth at the age at which the trauma occurs. For instance, if the soldier was eighteen when they went into combat, (a very formative and vulnerable time in their lives), they could continue to behave and think as an eighteen-year-old would, ten, twenty or more years later. In other words, somehow their emotional growth can stop there, or continue at a much slower pace.
Sometimes the horror of their experiences will wash over them; especially at anniversaries of particularly horrible events, and it will feel unbearable. They can feel overwhelmed by them and feel as though they cannot endure one more second of it. They feel, right then, as though it will never end. (suicidal or homicidal thoughts, depression)
Holidays are particularly hard for them to deal with. Others around them are feeling joyful and happy. They, on the other hand are re-experiencing horrible events, death and destruction that happened during those holidays, events which super-impose themselves over today. (emotional numbness)
This is not just bizarre behavior, it is the normal result of experiencing tremendous trauma. But some of these symptoms can be controlled to some extent and the veteran can learn to have some quality of life.
If you would like to ask questions of Sue and the members of their PTSD Support Group located in Albuquerque, NM who have been, or are in a relationship with PTSD husbands, please join our online forum here