By David McNease
As a combat veteran with Post Traumatic Stress Disorder (PTSD) I have had to learn many ways to cope with the illness. Over the past twenty years I have been admitted to several treatment centers for coping with PTSD. I have been held in both military and VA hospitals against my will because care providers thought I was a danger to myself. There is no cure for PTSD. So one can imagine I write about this because I know first hand how this can affect and debilitate a person.
For those whom do not have PTSD it is best explained as survival instincts that are acquired during combat or a highly stressful situation. Moreover, when a service member goes into a combat environment they pick up survival instincts that are much more acute than normal. The best analogy one could make would be similar to a deer in the wild. If a deer hears a noise or picks up a smell it has survival instincts to jump and run. To do this the heart rate increases and endorphins are released into the bloodstream that help the deer to run away from danger.
A service member also has these same acute instincts in combat. These instincts are great in combat as it helps to avoid becoming a casualty. Supposedly, most service members return home from combat tend they cease having these acute abilities. For others these heightened senses do not go away. When the heightened senses do not go away it can lead to a service member acquiring PTSD. I use supposedly because most cases of PTSD probably go undiagnosed and untreated for a variety of reasons. Many veterans, including myself, self-medicate with alcohol to numb the senses and avoid dealing with the trauma.
Psychologists and psychiatrists believe psychotherapy and medications are the best way to treat PTSD. However, there are other measures one can take to reduces the symptoms. One can avoid or reduce stressors that trigger psychological and physical responses with some very simple measures.
Sadly, many service members with PTSD are easily irritated by sounds, smells, situations, people (such as authority figures), as well as psychological situations. This is the core to PTSD. A person whom has either witnessed or been in a highly stressful situation has increased sensibility to both environmental and situational stressors. These create both physical and psychological problems.
Physically a veteran may have headaches, joint pain, difficulty sleeping, gastro esophageal reflux disease (GERD), high blood pressure, asthma, unexplained pain as well as numerous other illnesses. Psychologically a veteran may have severe anxiety, all or nothing thinking, irritability, anger, rage, survivor guilt, and disturbing thoughts to the point of ideations of death or suicide.
Many believe PTSD can be pinpointed to one specific traumatic event. However, PTSD is nearly impossible to link to one specific event. For many people, PTSD can stem from multiple events as far back as childhood. The stress of combat or witnessing a horrific event may be the actual breaking point for a person to cope. Therefore, the key to helping a veteran recover from PTSD is through a variety of coping mechanisms.
Many 12-step programs recommend “HALT” (Hungry, Angry, Lonely, and Tired) and I have added one more letter “E” (Exercise). If one is hungry, then eat. If one is angry, then get over it. If one is lonely, then be with friends or talk to someone. If one is tired, then sleep. Lastly, exercise. Exercise several times a week for at least 30 minutes. Beyond HALTE, one should adapt ones lifestyle to reduce reactions to stress.
These reactions are called triggers. For instance, fireworks or loud noises are very difficult for me to be around. When exposed to a trigger I react in numerous ways. For instance, when I hear a loud noise my heart rate increases, I jump or move in the opposite direction of the noise. To counter the chances of this, I bought a home in a quiet area of the city. I wear ear plugs to sleep. I shop during off peak times when there are less people around to trigger PTSD responses.
When I am exposed to authority figures I tend to rebel. It is more than not being told what to do that bothers me. Authority figures and the way they interact with me remind me of hopeless and helpless situations. When pinned down at Walter Reed Army Medical Center in 2003 on the psychiatric ward, I was forced to behave in a certain “military” manner or be drugged. I was often given an injection or what the nurses used to joke about being a “cocktail” (Haldol, Benedryl, and Atavan). This combination would basically knock me out and make me powerless. This occurred to me no less than six times. The last time I was strapped down to a bed with what they refer to as a four point of contact. My wrists were strapped down above my head and my ankles were strapped down to hold me in place. I laid on the same bed for over three straight days. Because I was “upset,” they refused to rotate the straps. I literally wanted to die. Finally, I mentioned that I wanted them to call my dad because I wanted to say good bye. Just before he arrived they suddenly released me and had me shower. I had laid there literally unable to use the bathroom, feed myself or do anything for three days. My mind went crazy. To make matters worse, during my career in the Army I had broke both my wrists and either sprained or fractured both my ankles these were the exact same spots where the straps were located. So triggers… I do not trust psychologists, nurses, psychiatrists, or people whom have power over me. I not only want to rebel, but I want to go the other direction.
One can imagine, it is difficult to get care through the VA if you can’t talk about the past. Therefore, I have had to learn more about PTSD on my own. I went so far as to complete all of my doctoral work (all $72,000 worth) in psychology at Walden University. I even had to change my major from clinical to health psychology because I could not tolerate sitting for long periods of time to give the IQ tests (WAIS-II and the WISC-IV). So I changed my study to health psychology. In the end, I could not get a dissertation committee whom would support me writing about PTSD so, I have not graduated.
However, I have learned vital information about PTSD that I could not gain from a psychologist. I learned about all of the medications, different diagnosis’s, and many ways to cope with PTSD and other mental illnesses without medication. For instance, it has taken me years to figure out that I have an extreme allergy to sulfa or sulfur. It is unknown where I picked up the allergy. During the Gulf War I was given sulfur to treat dysentery. Many of us in my unit came down with dysentery all at the same time. It was linked back to the cooks, whom were from Afghanistan. They were found to be using the toilet behind the dining tent, but not washing their hands before they returned to serving us food. So, I was given sulfur to treat dysentery. I broke out in third degree burns or blisters on my penis. Every time I went to the bathroom the wound would reopen and the salt from the urine would burn.
So I have an extreme allergy to sulfur, sulfa, and sulfates. One can not imagine all the products that contain sulfur and sulfates. Bacon, numerous food products, most colognes, and perfumes have sulfur. Fumes from petroleum burning engines, shampoos, detergents, as well as many medications. So exposure to sulfur triggers anxiety which can immediately cause a headache, feelings of hopelessness and helplessness. It also makes it difficult to breath as I have asthma. One can imagine being in an elevator and someone has perfume. There are immediate physical reactions such as difficulty to breathing, headaches, and nausea. Psychologically, I feel trapped, hopeless, helpless feelings, which can lead to suicide ideations. Hopefully, I will write another article about suicide ideations as they do not mean I am suicidal. I only have suicide ideations. It is just a thought not that I have intent of hurting myself. There seems to be a significant panic anytime someone says suicide ideations.
Each individual will have to develop their own coping mechanisms. One needs to understand what causes anxiety or physical problems. Because my traumatic experiences are different than every other veteran what works for me might not work for another veteran.
Once one understands the triggers, develop countermeasures. Just like one has to develop a program to stop drinking one needs to do the same for PTSD. There is no drug or cure. I use relaxation techniques, various forms of exercise, ice packs, hot baths, pets, listening to music, reading, breathing exercises, interacting with others by playing computer games and even watching movies.
Developing countermeasures against triggers one will fail once in a while. I have found TV series and movies can be both therapeutic, but also very stressful. The programs can trigger very intense physical and psychological reactions. Understand all of your medications and the side effects. Once one is taking more than eight or so medications there is probably no one else in the world whom is taking the same type and dosage. So no doctor or computer program can even begin to calculate the probable interacts. Be very critical of any changes you have when starting medications. I could go on and on about what to watch for in side effects. Just pay attention. It is your program and you must become very involved if one wants a better quality of life.
Lastly, and most important, when the triggers become too intense to handle such as one feel dread, death or suicide make sure you know how to get help. I know, I owe it to myself and my family to stay alive. Despite having significant trauma caused by doctors and nurses one has to be able to trust. To ease the transition between home and hospital I carry a list of all the medications, doses, dosage times, as well as a list of allergies, and the name and phone numbers of all of the people that treat me. One can imagine going into an emergency room feeling suicidal and having to wait 12 hours for help because the medical people do not know your current medications.
I welcome any comments as I want to learn more about PTSD. I can be contacted at [email protected].
Note: Service member is used because there are soldiers, sailors, marines, and airmen whom have PTSD.