PTSD — Often Denied, Resistant To Mainstream Treatment

When we talk about sending troops out to fight with numbers that have lots of zeros on them, chance are that nobody is thinking about how the lives of the survivors will never be the same.

Recently, ABC News made an attempt, a praiseworthy attempt, to help people see at least a little of what the human devastation means. “PTSD” stands for “post-traumatic stress disorder,” which leaves lives devastated.  People come out with devastated personal relationships, often unable to maintain marriages, unable to maintain jobs, with sometimes a high potential for violence.  The devastation all too frequently progresses to suicide.

Adding to this the fact that the bureaucratic institutions do not generally encourage or even permit the most efficient means of treatment, we have a domestic mess and a domestic mortality of veterans, the very people who put their lives on the line, that is nothing short of horror.

From experience working in the VA system and in a military hospital during my active service, I have seen more patients with this disorder than I can count, mostly returnees from war.  Sometimes from World War II and Korea, but not frequently because of their advanced ages and lack of knowledge about the illness.  More likely Vietnam, Desert Shield and Desert Storm and after.

In the VA, I didn’t treat them — I was the person who evaluated the severity of their disability and their appropriateness for a pension.  These dedicated American soldiers told me about the inappropriate and incompetent way in which the military dealt with their conditions.  Most “debriefings” were performed by either marginally or minimally trained personnel, often religious personnel which some found alienating.  One soldier swore to me his debriefing was “tell me about anything horrible you saw, and if you start feeling like beating somebody up, go to the VA.”  Many had no debriefing.

Many victims were convinced that their suffering was a “sign of weakness,” that they were cowardly to have been affected by “being in action.” Most were not referred through military channels — they were referred to treatment by frustrated family members — sometimes years after their separation from service.

I have actually seen, evaluated, or cared for in some way patients who did the following things:

• -wake up in the middle of the night, think his wife was a member of the enemy, and engage in hand-to-hand combat with her.
• -attack a total stranger in the downtown of a major American city who reminded him, in their dress, of the enemy.
• -have severe panic attacks in the rain which stopped him from eating or sleeping because the Tet offensive, where buddies were killed, was in the rainy season.
• -“hit the deck” on a street in a major American city and crawl on his belly in combat mode because a siren sound reminded him of his war experience.
• – become too terrified to drive because every expressway had a truck and the trucks reminded him of a military convoy where people were shot.
• – develop a paranoia of cell phones, as he had seen them used to detonate explosive.  This fear was intense enough he could not leave his home without two family escorts to make sure he did not see or hear a cell phone.

There are a few descriptions online of the disorder, National Institute of Mental Health does a fair job.

To their credit, they even have an “easy reader” version.

There is an “official” online manual with material from the VA.  It may help with benefit applications, but the descriptions of treatments and their efficacy just do not cut it.  If they understood the illness, they would not have made it look like a military manual.  People sensitive enough to find that disturbing should not even look.

Although online tests are imperfect for many reasons, any returning military veteran who is unsure or who has a mild case can do the online test.

I hate diagnostic categories that fail to recognize individuals and their differences and pains, but I can give you the three types of basic signs to look for.

• 1. People who relive the combat experiences, intensely and often without warning — generally as either dreams at night or thoughts that they can’t get rid of during the day.  This can, unfortunately, sometimes actually progress to violent enactment.
• 2. People who want to avoid as much as they can of what reminds them of these activities.  Sometimes they just avoid things that remind them of the military.  This can include treatment. This can become an avoidance of much in life; some people simply are too functionally paralyzed to leave home.
• 3. People who are “high-strung,” often so nervous that the slightest “startle” can make them jump in the air or scream.

Their are some other big factors which are not strictly speaking “diagnostic criteria:”

• 1.  “Survivor guilt.” People who get this have often seen someone else die or get maimed and actually feel guilty for living.  This is a big factor in suicidal thinking.
• 2.  Sometimes a “new” event can make someone feel worse.  I can assure you all the Vietnam veterans I was treating in Oklahoma City got worse at the time of the bombing.  They actually felt compelled to watch television coverage even though they felt horrible.  I am sure that any previous PTSD cases living at Fort Hood had their share of problems at the time of the massacre.
• 3.  Most people still think medicine is the cornerstone of treatment. Although I have seen studies that say that the frequency and intensity of the “flashbacks” can be diminished, in my heart I believe antidepressants treat the associated depression; I mean, anyone who had this problem would get depressed.  An awful lot of these folks go on to have addiction problems, either to prescriptions or to substances of abuse.  This seems to give people another layer of problems.

There are solutions. The best one is to get out of the VA system immediately.  The amount of their resources is dwindling, and the way they are being used is too conservative. Natural substances can and do work: many work together and well, but in the unlikely event I had to choose only one pill, it would be EMPowerPlus from TrueHope Nutritional Support.

Dramatic results are often achieved with Emotional Freedom Technique. These people actually achieved documented video results with patients while they were hospitalized inside the West Los Angeles Veterans Affairs Hospital  and the head of the group actually told me that nobody cared about or had even the most minimal interest in what they were doing.

Interview doctors and therapists for previous experience with this diagnosis and these methods. If lack of economic or other resources compels a patient to do this as an exercise in self help, hit the web and be persistent.
I have also known Post Traumatic Stress Disorder Patients who have:

• -Started successful businesses, using Small Business Administration assistance
• -Had good marriages, decent families, and taken on foster children joyfully–and successfully -Assisted in the development of veterans organizations. -gone to University to get better, higher paying jobs.

People do get monetary compensation once their Post Traumatic Stress Disorder case has been adjudicated by the Compensation and Pension folks at the Department of Veterans Affairs.

The smartest thing to do, I think, is something I have seen very few veterans do. Get the money and pay it to someone who knows what they are doing and can heal you.