A Combat Vet’s Take on PTSD

Spending an hour with a highly articulate combat veteran sharing his experience of trying to return to normal life after deployment in Afghanistan brought me to a much greater awareness of PTSD than many years of formal training.

Recently, I attended a film festival showing of a riveting documentary about one combat unit’s experiences in the rugged mountains of Afghanistan. The documentary provided an unparalleled glimpse not only into the evils of war but also into the soldiers’ unique perspective on the impact of multiple deployments to some of the world’s most dangerous regions. As a bonus, some of the members of the platoon that was the subject of the documentary were on hand to network with the audience. It was a most educational experience.

To say that some veterans have a hard time adjusting to a more “normal” life after their return from such deployments is probably the height of understatement. And to say that the average lay person lacks a full understanding of unique stresses combat veterans face in these days of terror attacks and improvised explosive devices (IEDs) is also an understatement. But I was particularly fortunate to get a brief yet concise briefing on these very topics by one intelligent and highly articulate young veteran who freely shared his personal experiences as well as his thoughts on the nature of Post-Traumatic Stress Disorder (PTSD), from which he has suffered. Although it lacked the traditional charts, graphs, and citations of research findings that are almost always part of a professional training, I would venture to say that the crash course on PTSD this young man provided me rivaled in value any workshop I’ve attended over the years.

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PTSD is a syndrome that can develop in individuals who have experienced trauma. Survivors of natural disasters such as tornados and floods, violent assaults, and various other life-threatening events are prone to developing the condition. We don’t know all the constitutional and environmental factors that make some people more vulnerable than others, but the experience of trauma is always the trigger.

Symptoms of PTSD vary but can include:

• intrusive and unwanted thoughts
• memories, and feelings such as “flashbacks” (i.e., reliving the event as if it were happening again)
• terrifying dreams
• memory and attention problems
• episodes of anxiety, panic, or other troubling emotions
• avoidance of people, places, or things, especially those circumstances and events that are in some way reminiscent of the terrifying event
• changes in thinking and attitude patterns
• increased irritability and moodiness, edginess, anger and impulsive outbursts
• difficulty with intimate relationships
• feelings of guilt and shame
• emotional numbness
• depression

It’s not uncommon for individuals who suffer from PTSD to try and self-medicate their condition through alcohol and drug use or other problematic behaviors that temporarily alleviate anxiety and stress but can easily take on an addiction-like quality.

For many years in my early career, I specialized in the treatment of anxiety disorders. I not only studied PTSD quite thoroughly but also provided treatment to individuals suffering from it. Still, I was more than illuminated by what this particularly articulate and forthcoming PTSD victim had to say about the illness that changed not only his life but also the lives of so many of his comrades. He spoke about how be believed his brain changed as a result of its attempt to accommodate a situation in which threats to his life and well being were persistent and frequent yet unpredictable during his active tours of duty. He related how acutely aware he’d become of his body’s automatic responses to the perceived presence of danger. He knew all too well what it was to go into full “defensive mode” during times of imminent danger. He lamented how tragic it was that his brain naturally “generalized” the perception of danger to other events that might seem relatively innocuous to other people yet threw him into “full combat ready mode emotionally and psychologically” at times when he least expected it, and always with disastrous consequences. As a result, his marriage of 20 years fell completely apart, his relationships with his children and other family members became strained, and he ceased functioning as the person all of them once knew. As bad as all that was, the worst thing for him on an emotional level was the chronic feeling of emptiness and loneliness. For in the end, no one really understood him or what had happened to him. Only his closest platoon members could possibly do that to some degree and he was not with them anymore. Still, all he really craved was for someone who really understood to afford him some degree of acceptance and reassurance. It was the impossibility of those whom he cared about the most to provide him these things that was perhaps his greatest trauma. They couldn’t give him what he needed most, and that was a horrific and almost unbearable loss. In a nutshell, this is how one returning soldier understood PTSD.

PTSD is a challenging condition to treat even in the most optimal of circumstances. But in a highly stressed veterans’ medical care system, it’s an even bigger challenge. While effective modalities are available, there’s a lot of pressure for doctors to merely prescribe medication, especially selective serotonin re-uptake inhibitors (SSRIs). The young veteran who spoke to us took a very dim view of this approach, citing the drugs as a “common denominator” in several instances of PTSD sufferers who had “gone postal.” Comprehensive care — including cognitive therapy, exposure therapy, and group therapy — is what he advocates (and the professional literature supports his view), along with much patience and, above all, understanding. It is that very type of care that appears almost impossible these days to access.

The young man who shared his experiences and opinions with us truly captured our hearts. He was about as genuine as anyone I’d ever met, and he was unashamed of sharing both himself and his pain. He wanted us to know that he still struggles with some very big questions: why we don’t seem to learn any lessons about life and the human condition after so many senseless wars, and why we don’t seem to appreciate how certain experiences can change and potentially damage us forever. He has far more questions than he has answers. But in the short space of an hour, through his sharing, he brought me to a much greater awareness about a disease than many years of formal training. And for that, and for his service, I’m truly grateful.

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