I just read a very well written and awesome article called I Have PTSD… So What? and it has inspired me to talk about my own PTSD, that of my husband and that of my patients.
I’ll start with me. My issues stem from spending two years working on an impatient ward at Landstuhl Regional Medical Center. On average, I would work three or four 12 hours shifts each week (which actually translated to 13-14 hours each shift). On the bad weeks, specifically when we would have MasCals (Mass Casualties) come in to the hospital, we would work 12-15 hours a day, 7 days a week. Luckily, this only happened a few times: When a chinook went down, Fallujah I and Fallujah 2. I have a very specific form of PTSD called “Combat Caregiver Fatigue” or Compassion Fatigue. This particular form of PTSD affects healthcare workers who tend to war casualties. It’s similar to regular old PTSD in a lot of ways. I am hyper-vigilant. I have problems with loud noises and crowds. I have problems with with my sleep and with depression. I have been medicated in the past, when it was at it’s worst. I am no longer medicated. Even when I was at my worst, living on Pop Tarts, diet coke and cigarettes, sleeping 2-3 hours each night (interrupted by nightmares about combat I had never been in) and drinking several pots of coffee each day just to make it through, I was still able to get up and go to work. I was still able to provide the very best healthcare available to these war wounded men and women I saw each day. But eventually, I hit a wall and I had to transfer out of the inpatient ward and into a clinic. I couldn’t do it anymore, I couldn’t see another 17 year old missing both his legs. I couldn’t see another 20 year old with his whole life shattered. I was prescribed sleeping pills for years. I was on heavy antidepressants of for a long time. I was even treated for bipolar disorder (which, BTW, I’m not, but sever mood swings are symptomatic of both PTSD and TBI, which I also have.).
Today, I’m no longer on any medications. I still have a lot of issues with crowds and loud noises but have managed to keep my “freak outs” to a minimum. I even went to a revolutionary war reenactment with my mom and managed to maintain my cool through the fake gunfire. What’s funny is that I can go to a shooting range with no problems whatsoever. I get really freaked out when people invade my personal space. I still have the occasional nightmare, but now it’s more of a “several times a year” thing than an “every time I close my eyes” thing. Bottom line, I’m a fully functional adult despite the fact that I have PTSD.
Now, let’s talk about Husband. Husband has a raging case of combat inflicted PTSD. He’s gotten much better in the last 5 years, but he still has flashbacks, has nightmares so bad he has no idea where he is when he wakes up, can’t handle crowds, can’t handle fire. He’s had fire on TV trigger bad flashbacks. Occasionally, the sounds of helicopters trigger flashbacks. He’s got issues. But, he goes to work every day. He carry’s a gun (even though you’d never know it). He’s armed, but not dangerous. He holds a top secret clearance. He’s currently a full time student (in addition to being a full time Soldier) and carry’s a 3.5 GPA. He’s been in fistfights and had guns pulled on him (recently…ish) and has never once freaked out. He’s even bucking for another deployment because too much time in garrison “gets boring”. He’s a fully functional adult. Hell, he functions a hell of a lot better than a lot of civilians I know with no excuses.
Let’s talk about my patients. When I was in Germany the first time, I spent two years working inpatient. 99% of our patients were war wounded casualties that we would receive within 24-48 hours of their injuries. Needless to say, within 48 hours of being shot or blown up, you’re a little fucked up in the head. And well you should be. I saw the full spectrum: from absolutely no problems to lapsing into flashbacks so often that he couldn’t carry on a sentence. Unfortunately, the inpatient turnover was 3-7 days, so these men and women were usually still in the more extreme phases when they left us to go back stateside. When we went back to Germany, I worked in the LRMC TBI clinic. More specifically, I ran the Vision Therapy program for the TBI Rehab Center. Basically, I would to long term rehab with Traumatic Brain Injury patients to improve their visual function. You want to talk about some PTSD? Look at TBI patients. PTSD and TBI often accompany each other and their symptoms are very similar. Ignoring the physical deficits associated with TBI, that is, and focussing on the mental status changes and mood changes associated with TBI. They’re virtually identical to PTSD patients. But you know what? Every single patient that I did long term rehab with? They might have been a hot mess, but they were trying. They were doing everything in their power to return to that point where they could function. They were amazingly strong and dedicated. And most of them had some form of PTSD. So what? Did that make them unpredictable? Sometimes. Did it make them dangerous? No. Did it makes them any less deserving of the very finest healthcare we could provide for them? HELL NO. If anything, it makes them more so.
A lot of people look at PTSD with the same shameful glances that depression and anxiety have gotten over the years. Like it makes you weak. Like it makes you less of a person. And that’s horseshit. If anything, I think it makes you stronger. It takes a hell of a man (or woman) to be able to admit that they need help. I think that if any of us went through what these soldiers go through we would be lucky to only have PTSD and not a full psychological breakdown. I think that we should be more worried by the man who doesn’t get PTSD from watching an IED kill his teammates, his friends, his family, than the one who does.
I had a friend say recently that PTSD stood for Pretty Typical Sign of Decency. And I’ll agree with that.
**Updated 9 Feb 2012: edited for my shitty grammar.