PTSD: The new four-letter word

The acronym is familiar to me, as it is to anyone who has access to mass media in the western world and can read, watch and listen to how it’s “breaking” young men and women returning from military deployments. It’s familiar to me as a veteran, who has known and worked with many whose records bear those letters. I witness every day how it colors the words and actions of someone I love.

But recently, PTSD hit me in a new way.

As of last week, I’m donating my body to science. (Incrementally, by way of Veterans Affairs research studies.) My initial study is investigating brain functioning in veterans with diagnosed stress disorders and/or traumatic brain injury. I spent a day clicking blinking computer boxes, memorizing words and pictures, and counting backwards by threes (by FAR the hardest!). The study also involved a lengthy psychological evaluation. As I prepared for that section, I settled into my chair, ready to rehash what I’ve been discussing with social workers, psychologists, and my unwitting creative writing classes for the last two years.

I talked. The psychologist nodded, scribbling notes onto a series of pages. She prompted me, I kept talking. Then there were no more pages and I had nothing left to say, and, flipping back through her notebook, the psychologist said, “Well, you’re definitely still exhibiting symptoms of low-grade PTSD.”

???????

This was not something I’d been told by the previous social workers or psychologists. This is not the diagnosis reflected in my VA disability rating, which proclaims me a sufferer of Chronic Adjustment Disorder . . . Is that the same thing?

“No,” the psychologist clarified, “they’re definitely different. What I get from you is definitely PTSD.”

Definitely PTSD. Not an official diagnosis, really. An opinion rendered in a non-treatment capacity, one of many professional opinions I’ve received. The outlier. But hearing those letters with my name brought an onslaught of emotions:

Affirmation – so that’s why I feel and act the way I do. Maybe I’m justified, after all. (Followed quickly by . . .)

Guilt – what right do I have to be linked with PTSD? I, who spent most of my deployment behind a desk, who was never shot at, who never shot at anyone, who was never blown up, who made it home safely with my entire unit. So many horrible things I didn’t experience. How can I be associated with veterans who did?

Weakness – maybe I am linked with those who suffered more, and because I suffered less but had a similar reaction, that makes me weak. They say everyone has a breaking point, maybe mine came sooner than most. Maybe I was never meant to be a soldier.

Fear – if I do have PTSD, what does that mean? There are so many things that scare me about that acronym, about the complication, the destruction it can leave in its wake.

More guilt – how can I fear the things in others that I myself embody?

Ultimately, I know I’ll be okay. I know I’ve come a long way in the two years I’ve been back from Afghanistan. In many ways, I think I’m stronger. I know I’m stronger. Those four letters are merely scribbled in a research notebook. They hung in the air for a moment over a table in a VA testing room, then disappeared.

But they seeped into my consciousness, where they’ve been gnawing at me, making me think about how we view PTSD as a society – something that has colored my perspective more than I’d like to admit.

Despite living on the fringes, I don’t understand PTSD. Most people don't. My boyfriend, Colin, had been lecturing on PTSD for a couple years before he was officially diagnosed. When we started dating, I was hesitant to get involved because of those four letters. Conversely, I was convicted by my fear. If anyone can understand a veteran’s emotional state, shouldn’t it be a fellow veteran?

PTSD is scary because it is unknown. Until recently, no one talked about it; military mental health care has always been shrouded in stigma. Now, it seems, as soon as the military is beginning to acknowledge the inevitable mental and emotional affects of war, the issue is being sensationalized outside the military, and veterans are stigmatized by the civilian community.

Lack of knowledge breeds misrepresentation and misunderstanding – two things the media is famous for propagating.

In the latest example, on April 19, “Dr.” Phil (quotations added), aired a show titled “PTSD Takes Veterans from Heroes to Monsters.” As if the title weren’t enough, it came with this melodramatic ad. Following heated response from the veteran community, the show’s name was changed to “Heroes in Pain,” post-broadcast. But the message was already out. As they stressed in public affairs training, the initial message is the one that sticks.

Before Dr. Phil’s show, military mental health advocacy faced another hurdle when U.S. Army Staff Sgt. Robert Bales became the new face of modern warfare after allegedly massacred 17 civilians in southern Afghanistan. For many, Sergeant Bales has come to represent this generation of veterans: broken, unstable, a hopeless tragedy.

Veteran unemployment continues at an unprecedented rate. There is no denying the PTSD stigma plays a role. In the minds of employers, the “impressive military resume” we were all promised upon enlistment is being weighed against an imagined mental health resume.

No one wants to hire a Sgt. Bales. No one wants to associate with the likes of those profiled on Dr. Phil: the drug addict, the husband who beats his wife, the one who set his wife on fire.

To Dr. Phil’s audience, I’m Frankenstein.

To civilian employers, I’m a loose cannon.

To the VA, I’m damaged goods.

Amidst these messages, how am I supposed to view myself? How are veterans dealing with the emotional scars of war supposed to respond to military messages encouraging them to seek help when seeking help might lead to a diagnosis, and a diagnosis might lead to labels and disenfranchisement?

A new debate, discussed in this article, questions whether a name change would help alleviate the stigma around PTSD. Replacing "disorder" with "injury," for example, communicates that healing is possible.

Whatever you call it, the truth is, PTSD can be scary. It can manifest in ways which, when sufferers don’t get needed treatment and therapy, can lead to violent outbursts like the extreme examples above. These examples are hard to ignore when they scream at us from every news broadcast. But they are the exception. There are many more like Colin and me than like Sergeant Bales.   

Mental health will always be an issue in the military. Just as combat is in the job description, emotional and mental strain are among the expected side effects. Mental health is a bigger issue than it needs to be because we either don’t talk about it, or we talk about it in the wrong way. We ignore it, or we sensationalize it.

On either end of the spectrum, the ones who suffer are the veterans. And they have suffered enough. 

Time flies when you’re keeping resolutions!

I don’t usually make New Year’s resolutions. For one, I suck at keeping them. Then I feel bad. And no one likes to feel bad. But I also believe that if you really want to change something, why wait until January 1st? Like the saying goes, “No time is better than the present!”

That being said, I do like the symbolism of a new year: a fresh start, a clean slate, and, I suppose, a proverbial fire under your rear if you really need one to get you going.

If ever in the Life of Lauren there was a time for fresh starts and clean slates, it was New Year’s 2011. December 30, 2010 was my official last day as an active duty Air Force officer. Thus, I began 2011 as brand-spanking-new civilian. FREEDOM! No work. No title. No responsibilities. No obligations. (And no house, no concrete plans, no paycheck, eeek!)

I didn’t make any official New Year’s resolutions, but if I had, they could have been these:

1. Figure out what I want to do with my life. While I’m still working out the finer details (like how to make a living . . .), I know with 100% certainty that I want to be a writer. I’d even go so far as to say that I’m supposed to be a writer. If you believe in “finding your calling,” I’ve found mine. A career change is always a leap of faith. But sometimes it’s worth it to follow your passion.

1.5. Get accepted into a grad school program in support of said career choice. Check! (Thanks, Emerson!)

2. Make up for lost time with family. Call me old fashioned, but I’m the kind of person who actually likes my family and enjoys spending time with them. Don’t let the fact that I’ve – twice now – chosen to move to the other side of the country fool you. I really do like them. Maybe even a lot. They have always been my biggest supporters, my confidants, my voices of reason, my shoulders to cry on. I hated the geographic separation from Florida and I hate it from Boston. I hated it most from Afghanistan, where “just a phone call away” didn’t really apply. Sure, we had email (as long as a storm didn’t knock out the connection). Sure, I had cards and pictures taped precariously to the plywood wall above my bed that sometimes unstuck themselves and scattered over me while I was sleeping. Sure, we had static-filled, 12-hour time difference phone calls placed from a crowded office where no conversation was really private. Maybe it was the stress, or the danger, or the sheer distance, but during that year away, I ached for my family in a way I never had before.

So, when my conversion from Air Force officer to grad student included an eight month transitional period, I jumped at the chance to move back home. (Wait, you lived with your parents for eight months?! you ask. By choice?! I did, dear readers. And it was wonderful.) I watched chick flicks with my mom, went house hunting in Boston with my dad, bonded with my beautiful baby nieces who previously had no idea who I was beyond my face in photographs. I stashed all my life’s belongings in my parents’ garage.

And I healed. There’s no Band-Aid like family.

3. Discover who “Civilian Lauren” is. With a massive life change (and no uniform to wear every day, no institutionalized code of conduct, etc.) comes a bit of an identity crisis. Again, I’m still working out the finer details, but this I know:
- Civilian Lauren has bangs. She likes to wear nice, tailored clothing and high heels. Except for sometimes when she just wants to wear pajamas all day.
- She likes to speak her mind, even when people around disagree. If she has a strong opinion about something – and she has quite a few of those, it seems – she’s not afraid to show it.
- She’s feisty, emotional, sometimes irritable (especially when she’s hungry or tired), and a bit moody. But overall, I think she’s pretty cool.
- She’s a veteran. Sometimes she likes to talk about that, sometimes she doesn’t. (It’s a big can of very slippery worms, after all.) But she has accepted it as part of her identity – all the good, bad and ugly parts of it. And she’s proud of it, too.

4. Be thankful. I know it sounds trite, and I won’t get too much into it (you can read more in my other posts), but thankfulness was definitely a theme of 2011. Though they came with a price, with sacrifice and some baggage I still struggle to carry, I’m thankful for the decisions I made to join the military and to go to Afghanistan. I’m thankful for the experiences I’ve had and the worldliness I’ve gained. I’m thankful for the veteran’s organizations and programs that are helping me learn to carry my acquired baggage gracefully.

In a time of financial crisis, foreclosures, unemployment and debt controversy, I’m thankful to be debt-free, that I had the luxury to be able to leave my job and take a leap of faith, that I have the resources to be a homeowner. Sometimes the post-Afghanistan cynic in me tries to convince me otherwise, but in a time of protesting, political/religious/athletic scandals and bad news splashed across every page of the newspaper, I’m thankful that there are still a lot of GOOD people out there; GOOD news and GOOD things about being an American. (And, incidentally, I’m thankful for freedom of speech, freedom to assemble, and freedom of the press. Those are pretty cool, too). And in a time of so many broken, dysfunctional, strained relationships, I am, of course, thankful for my wonderful family and friends.

Huh, maybe I'm better at keeping resolutions than I thought?

Now, looking forward on this eve of another symbolic fresh start, my unofficial non-resolution list-of-things-to-think-about/work-toward-in-2012 is as follows:

1. Have my condo “visitor ready” at all times. a.k.a. be more organized. That’s on my list in some form every year. . . (Reference comment about not keeping resolutions)

2. Work on those finer details from 2011 non-resolution #1. Writing contests and literary journal submissions? Freelancing? A publishing internship? A wealthy benefactor and/or a scratch ticket addiction? We shall see, my friends!

3. Ditto for 2011 non-resolution #3. Namely, I want to learn to manage that irritability and moodiness, balance that cynicism. I want go through that baggage and throw out any bitterness that got stuck between my socks and undies. And I want to keep talking (and writing) about the veteran thing. I think that's important. Plus, most of the time it feels pretty good in the end.

4. Continue to be thankful. ALWAYS!

5. Limit my intake of Twizzlers, chocolate and Cheetos. Seriously. This is just ridiculous.

Cheers to that!

Wishing everyone a blessed 2012! If you’re making New Year’s resolutions, best of luck. (If not, maybe you can help me eat my junk food?)

HAPPY NEW YEAR!

A chance to say "thank you"

(This is a long one, but I think this day warrants it)

When I was in ROTC in college, I remember being angry that my school didn’t observe Veteran’s Day. More than angry; I was pissed. I told anyone who would listen (and even some who wouldn’t) how pissed I was. I was so high-and-mighty back then; a young cadet with really no understanding of what it meant to be in the military. But I was on to something . . . something that has become much clearer – and much more aggravating – in the years since: veterans are underappreciated.

I’d like to say it’s better now than it used to be. And in many ways it is. Thank God we’ve progressed beyond the Vietnam-era, when soldiers – many who were drafted into service against their wishes – came home to face angry protesters, be spit on, called “baby killers.” What a dark period in American history. Now, it seems, whether or not people agree with this country’s wars, they overwhelmingly support those fighting. I’m grateful for that.

The Post-9/11 GI Bill is a huge improvement over the outdated Montgomery GI Bill, and more veterans are taking advantage of their education benefits than ever before (I’m one of them!). There are also laws in place now to allow service members to break leases if they’re relocated or deployed (I’ve done that!), and laws that require employers to hold jobs for Reservists and National Guardsmen if they’re activated. There are more and better agencies supporting veterans both in and out of the military (I’m definitely using some of those!).

But even when the support systems work, they’re often mired in stigma and move at an excruciatingly slow pace. Organizations are understaffed, underfunded and tangled up in bureaucratic red tape.

And, if statistics are any indication, there’s still a long way to go. Last year for the first time in history the military suicide rate eclipsed that of the civilian sector. While the national unemployment rate hovers around 9%, the unemployment rate for veterans who left active duty since 2001 is a staggering 12.1% (Maze).

Many veterans return from combat with obvious, tragic wounds like missing limbs and severe burns. But many carry deep, unseen scars as well. Studies show that around 40% of OIF/OEF veterans have been diagnosed with some type of mental disorder (depression, anxiety, PTSD), and an estimated 10-20% of returning troops have at least a mild brain injury (Zoroya).

And since the economy is the “hot topic” of the moment, consider this: A new enlisted troop in the rank of E-1 earns $17,604 in annual base pay (the poverty level is $10,890). A first-year officer in the rank of O-1 nets $33,396. By comparison, the minimum salary for a rookie (now-on-strike) NBA player is $473,604 (2010-2011 data). If that’s not a sad commentary on modern American priorities, I don’t know what is.

The wars in Iraq and Afghanistan are officially the longest wars in this nation’s history. Reserve and National Guard Forces are more than pulling their weight with frequent deployments to backfill manning shortages and often don’t have the support structures active duty troops have upon return. We live in an era where, arguably, more is being asked of the all-volunteer military force than ever before.

Yet still, in the debate over national debt, military retirement benefits are on the chopping block; the benefits that were promised upon enlistment, that were paid for in 20+ years of blood, sweat and tears and unfathomable sacrifice.

I’m not asking you to run out and write your congressman (although that would be awesome!). I’m just asking you – today, any day, every day – to say “thank you.” Sometimes that’s all it takes.

I remember once after a long, hard day at work I stopped for takeout on my way home. I was still in my uniform, looking, I’m sure, unprofessionally frazzled. When I got my food, someone had picked up my tab. I thanked him and he said, “No, thank you for your service.” I cried the whole way home because it felt so good to be appreciated.

When I got back from Afghanistan, all it took was someone saying “thank you” to open the flood gates. I had felt so isolated for so long, in a place where people were, at best, ambivalent about my existence; a place so cut off from the rest of the world. That small gesture – thank you – showed me people cared.

So today I want to say thank you to those who bear the burden:

To those who have served, and those who continue to serve, THANK YOU.

To those who have been force shaped, medically discharged, prevented from deploying or in some way limited in the capacity to which you could serve, you are veterans too. THANK YOU.

To those who serve on the homefront, maintaining families, careers, sanity, LIFE while your spouses, children, parents, siblings, friends, coworkers deploy, we couldn’t do it without you. THANK YOU.

**If you want to say “thank you” in another way, the following link has a comprehensive list of organizations that support service members and their families. You can send letters and care packages to deployed troops, “adopt” a service member, volunteer with or donate to a non-profit veteran support organization, or contribute to a scholarship fund for children of service members killed in action. Check it out: http://www.military.com/spouse/content/military-life/military-resources/how-to-support-our-troops.html


References:

Fairweather, Amy (prepared by) “Swords to Plowshares Iraq Veteran Project.” Nchv.org. National Coalition for Homeless Veterans, Dec. 7, 2006. Web. Nov. 10, 2011.

Maze, Rick. “Jobless rate increases for young veterans.” Airforcetimes.com. Air Force Times, Nov. 4, 2011. Web. Nov. 10, 2011.

“Veterans’ Mental Health Concerns Rising.” Psych Central Online, July 18, 2009. Web. Nov. 11, 2011.

Zoroya, Gregg. “Troops risk undetected brain injury.” Usatoday.com. USA Today, June 7, 2006. Web. Nov 11, 2011.