5 Things Nobody Understands About PTSD (Thanks To Movies)
A casual observer would think that America worships its soldiers. Bumper stickers, Air Force flybys at football games, politicians from every side of the aisle singing their praises ... everyone loves "the troops." Or rather, they love the idea of the troops. The thing is that real human beings are coming back from war zones with a long list of nightmarish health problems that pretty much nobody wants to hear about. We want our action movies to end when the bad guy dies. Nobody wants five sequels all about the heroes weeping over a pile of disability paperwork.
Well, in 2007, our source's husband, whom we'll call Warren, came home from a seven-month tour in Iraq with both physical and mental injuries. In 2015, they're still dealing with it in all sorts of ways nobody prepared them for. See, it turns out ...
Civilians Don't Understand What PTSD Really Is
So you probably want the exciting story of how Warren got injured in Iraq. A big firefight? A roadside bomb? The restless spirits of an ancient tomb? Well, he ... uh ... fell off a wall. Yeah, he's probably not getting a dramatic action movie about his experiences.
Okay, there was more to it than that. Earlier, he had been around a few I.E.D.s when they lived up to the "E" part of the acronym (close enough to get concussed, but not maimed). He also managed to break both legs and an arm in basic training, and he got shot at a party when he and his friends intervened in a fight. But it was a wall that finally ended his tour -- he took a nasty fall while climbing over it. And that's it. Thanks to what sounds like a deleted scene from Larry the Cable Guy's Delta Farce, Warren was sent home with a spinal brace. Add that to everything else he's been through, along with the general stress of getting shot at for a living, and it's not hard to see how Post-Traumatic Stress Disorder emerged.
Traumatic injury is enough to inspire PTSD for one in five people. So yes, this really is enough.
In the long term, PTSD tends to be self-correcting, because we wouldn't be here today if our distant ancestors had huddled into balls and waited to die the first time a wolf tried to eat them. But 20 percent of traumatized people end up with long-term PTSD, and an inordinate number of them are soldiers. Unlike other traumatic experiences, soldiering produces mixed emotions. Unless the car that put you in a wheelchair for a year was driven by your future spouse, you generally simply want to put traumatic events behind you. But soldiers are usually proud of what they do, and they make good friends while they do it. So you have some of the best moments of your life melded with some of the worst; it's not as simple as "moving on."
Oh, and I should point out that soldiers who served in Iraq and Afghanistan are less likely to commit suicide than soldiers who never deployed. This is because, and this might shock you, the army tends to not deploy unstable people into stressful, gunfire-filled situations. (And the overall suicide rate for soldiers, while tragic, is generally no higher than the national average.) The real PTSD warning signs are pre-existing mental conditions, past trauma, being less educated, and having a vagina -- women tend to be more susceptible than men.
They get to deal with more causes than gunfire.
So then why are violent, suicidal, male veterans such a cliche? Most of the sociopathic villains in the FX drama Justified are veterans, as are many of the violent bikers in Sons Of Anarchy. Even freaking Happy Tree Friends features Flippy, the soldier character who, wait for it, violently flips out at the slightest provocation. I could go on, but others already have. If you need a character to be ridiculously violent and emotionally unstable, then slap a service badge on him and call it a day.
"Come on. Fuck it, man. Let's go
bowling to much-needed therapy sessions."
So in some cases, PTSD is a self-fulfilling prophecy. We think soldiers with it are dangerous, so we don't interact with them and invent creative ways to legally avoid hiring them. Then, shockingly, they start to believe that they're worthless and will never recover (even though the research says otherwise). And then some of them kill themselves and we treat it as a mysterious tragedy. Well, it doesn't seem that mysterious to me. We go from treating them as heroes to treating them as ticking time bombs.
Speaking of which ...
Marriage Is Difficult (But Not In The Ways People Assume)
I love my husband, but even if your marriage is so strong that it makes the eternal love of Disney characters look like festering garbage, years of sporadically supported PTSD puts a serious strain on it. For starters, if you think sex is the most intimate physical act a couple can engage in, try being a small woman doing her best to prevent her gigantic husband from choking during a seizure while he loses control of his body and shits himself. While that does earn me a lot of relationship karma ("Oh, you don't feel like doing the dishes tonight? Well maybe I won't feel like keeping you from biting your tongue off"), I'd rather spend our nights watching Netflix.
Ideally, something without shots or explosions.
What, you didn't know that seizures could go hand-in-hand with PTSD? You're not the only one. You can imagine our surprise. Other times, he doesn't remember who I am. Sometimes he freaks out at imaginary mortar fire. Between the seizures and panic attacks, our constant frustration with the US government (more on that later), and the fact that we've moved more than bank robbers on the run from the FBI, our marriage is a tad more stressed than one in which the couple's greatest concern is which bespoke diaper bag to buy. It's not easy for Warren, either. He's said that he wants a divorce several times -- not because he no longer loves me, but because PTSD can put you in a place where you feel like nothing but a burden (he's not, by a long shot).
He's thrice tried to, let's say, "unilaterally enact" a divorce with extreme prejudice. The first time, he tried to hang himself, and I was able to get him down. Then he tried to shoot himself but failed. Twice. Outsiders don't see these challenges, so instead they make a very different assumption. Once, I was visiting Warren during his stay in the psych ward, and when I had to leave, I cried because I wanted more time. A nurse walked me to the elevator and said "I know what you're going through. Abuse is very hard to deal with. If you ever need help, there's a group for battered women like you." In a moment of what I think is truly heroic self-restraint, I didn't growl, "You want to see abuse?" before spin-kicking her down the elevator shaft.
"The fact that we're on the first floor saved your life."
Warren has never laid a finger on me, and I have no bruises to even suggest otherwise, but she's far from the first person to have suggested it. Because that's what traumatized soldiers do, right? They go home and beat their wives because violence has been fundamentally ingrained in them? Yeah, or they try to put a bullet in their own head specifically because they're terrified of hurting the people they love.
Even Other Soldiers Don't Get It
The way our society handles soldiers is ... complicated. We revere them for their service, but sometimes we take it to the point where we barely view them as regular human beings. After all, movie action heroes can suffer literally hundreds of near-death experiences and still make glib one-liners about it hours, days, or years later. Even that movie in which Tom Cruise actually dies 300 times still ends with him giggling at the camera. If they're ever shown as vulnerable, it's always in a way that makes them even more dashing and heroic.
So it's no surprise that mental illness is stigmatized within the military. It makes you look weak, and the lack of guaranteed confidentially with military therapists makes soldiers terrified that something they say will get them in trouble. Would you talk to a therapist if you knew there was a chance your boss would learn all the details?
As we've noted before, the military isn't always great at dealing with sensitive personnel matters.
Older veterans aren't much help, either. Far from being sympathetic to their struggles, some older vets view today's soldiers as having it way easier than they did when they were slogging through the jungles of Vietnam. Of course, Vietnam vets were looked down on by some WWII and Korea vets, the WWI vets thought fighting fascism sounded like a vacation, and so on down the line to some caveman telling a young caveman that back in his day, bashing in the skulls of rival tribesmen was a real struggle because they didn't get hunks of wood to attach their sharp rocks to.
"Rocks!? That must have been nice." -- Early Neanderthal
It's hard to talk about PTSD when every generation treats mental illness differently and everyone is more interested in swapping stories of the glory days without any downer vibes. That's the thing; society holds up soldiers as invincible heroes, and the soldiers themselves want to embrace that. Everyone wants to conform to an ideal, even if it slowly eats you alive.
That, unfortunately, serves nicely as a segue to ...
Dealing With The VA Can Be A Nightmare
As I've mentioned, we've lived in several different states. That's because we're searching for a Veterans Administration hospital that can give Warren proper treatment instead of shrugging and saying "Maybe try this? Okay, see ya!" Warren has been on more drugs than everyone at Burning Man combined: morphine, oxycodone, methadone, suboxone, fentanyl, Xanax ... Every hospital has their own theory on how to treat him, which has put him on a drug-fueled roller coaster of emotional and physical reactions. Methadone made him brutally sick, and fentanyl didn't treat him well either. Suboxone was working, but when we moved to Maine, they took him off of it, despite assurances from the previous hospital that the state could keep him hooked up.
But hey, it's not like you can experience life-threatening side effects by mixing pills like prescription trail mix, right?
Why the mix-up? Well, each of the many hospitals we've visited started from scratch. We were constantly told that Warren's records would be transferred, but that appears to be nothing but a hilarious prank they pull on people like us. And because hospitals can't take "Please gimme some suboxone, I swear it's good for me" at face value, we went through long periods in which Warren had no medication. That was terrifying, because a lack of medication tended to cause seizures.
I wouldn't wish a seizure upon my worst enemy. And every time we've moved, we've gambled that the new treatment he'll get will be worth the seizures he potentially suffers on the way there. Sometimes it pays off, and sometimes the doctors we talk to have never heard of a connection between PTSD and seizures, despite the VA's own website discussing it. "Oh man, really? That's messed up!" are not words you want to hear from a professional you moved across state lines to visit.
"Hang on. I need to go WebMD this."
So each hospital is happy to treat Warren like an experiment, waffling between throwing drugs at him and then putting him in a psych ward to detox because they're worried about addiction. (The VA treats drugs the same way Homer Simpson treats beer -- the cause of, and solution to, all of life's problems.) Take medical marijuana, which is legal in our state, but still illegal federally. The VA performs routine drug tests, and will cut off your pain medication if they find any trace of weed, despite one of Warren's doctors being so convinced that it would help that he gave Warren clinic info off the record.
I can go on. One doctor said that she didn't believe people needed medication to get better, which at best makes her horribly unqualified and at worst is evidence that Scientologists have infiltrated the government again. Another doctor simply said that she didn't think there was any kind of medication that could help Warren, at which point she left to presumably smoke a cigarette, stare at the rain, and contemplate the fundamental meaninglessness of life. But the woman who really struck a chord with me walked up to one of her c-oworkers and, in front of everyone in their little coffee area, openly complained, "Whenever they come into my office, I just zone out because I'm so tired of listening to them all the time."
"It's all 'Hurting my family' this, and 'Abandoned by the country I love' that, and blah blah blah."
I realize that our experience is probably one symptom of a much bigger problem. In the last three years, VAs have seen their patient load jump 50 percent, while their overall staff levels only increased 9 percent (probably something to do with the multiple wars we've been fighting for the last decade and a half). As a result, the average VA doctor now sees 800 more patients than he or she can reasonably expect to care for. Terrible pay and a nightmarish workload mean that 40 percent of doctors will quit within five years, and a chronic doctor shortage means that nurses are often tasked with doing the work of doctors.
Maybe, just maybe, a disorder that can cause suicidal thoughts and
violent hallucinations isn't something that should be delegated downward.
The psychologists are in no better shape -- the VA failing to meet the mental health demands of modern soldiers is an unfortunately well-documented problem. Demand exceeds supply, and the supply is often doctors fresh from med school who don't understand veterans. I've seen the look on my husband's face when he comes home after yet another appointment with someone who doesn't know how to talk about what's going on inside his head.
I'm very aware that we're not alone in this. You can read about case after case after case of bureaucratic problems, if you'd like. We know a number of veterans who have encountered similar problems, including a woman who was raped while serving. She's found it especially problematic to get treatment, as the VA is completely unequipped to treat women. Female soldiers, at least on the scale we're seeing them now, are new to a system that for decades was used to only treating men. There are currently 635,000 women in the VA system, but many VA hospitals lack the relevant facilities to handle their needs. I could go on and on about this until long after all of you have stopped reading.
Family And Friends Are Supportive, But It Doesn't Always Help
Most of our friends and family don't assume that Warren is a wife-beating rage monster. But with so much misinformation about PTSD floating around, their help often resembles the messy but well-meaning assistance a little kid gives their parents in the kitchen. For example, while Warren's parents love him dearly, they don't believe in mental illness. (Yes, PTSD deniers are totally a thing.)
When you've been told your whole life that PTSD is a figment of your imagination that you need to overcome through sheer force of will, and then you painfully and abruptly discover reality, you don't reconcile those viewpoints overnight. He's afraid to talk about it with his family for fear of how they'd react ("Son, we love you, but have you ever considered that you're a huge pussy?"), and he thinks that there's something fundamentally wrong with him for having an illness his family doesn't think exists.
The people around us also believe what many civilians do, which is that Warren gets amazing free healthcare and is therefore in no position to complain. While it's true that Uncle Sam foots Warren's treatment and disability payments, that's no replacement for steady work (we get by, but we're not living in the lap of luxury so much as we're in luxury's ass crack). Occasionally, this attitude gets ugly. One of Warren's old friends half-jokingly, half-seriously suggested that because his taxes went toward Warren's healthcare, Warren owed him money and could settle the debt with a bottle of vodka. Let's just say that night didn't end well.
"Sure, I'll buy. Then you head off to war for a few years too, and we'll be totally square."
I'm happy to report that my own family doesn't believe in either the "get your shit together" approach to mental health or the "buy us stuff" method of fair taxation, but their presence around Warren can still be difficult. Not because my dad is really into yodeling or anything; it's just that being around other people makes Warren anxious and upset. And therein lies the dick-punching contradiction that is PTSD: Spending time with friends and family is one of the best ways to treat it, but when you're buying into the stereotype that you could go crazy at any minute, you feel the need to avoid loved ones out of concern that you could hurt them. The scary part is that fear isn't entirely without merit -- trauma is contagious, in the sense that it negatively affects people who have close contact with someone experiencing it.
I would know that as well as anyone. My husband's sure as hell worth the risk, though.
You can read more from Mark at his website.
For more insider perspectives, check out 5 Shockingly Outdated Problems Women In The Military Face and 6 Things You Learn Detonating Roadside Bombs For A Living.
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