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Monday, April 7, 2008

PTSD signs in simple English

Not every traumatized person develops full-blown or even minor PTSD. Symptoms usually begin within 3 months of the incident but occasionally emerge years afterward. They must last more than a month to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic. (National Institute of Mental Health)



Post Traumatic Stress Disorder
Common Causes
War
Public services such as police and fire department incidences
Abuse/rape/assault and battery/violent crime
Terrorism
Natural disasters



Signs in English!

Physical and Interpersonal Symptoms
Physical effects (twitches or jumping nerves)
A lot of veterans will feel like they are loosing control of their insides. Nerves try to jump out of their skin. In a flashback, everything is as it was when the trauma hit them. Muscles are tense waiting for it to come. Their sense of smell is increased. Their eyes respond to every movement and detail. Their ears respond to every sound. They enter into an altered reality. A time trip back to the combat while they are sitting in the chair.

Fatigue, Exhaustion, Insomnia
(drained)
When they spend nights unable to sleep through the night, it leaves them feeling drained. When they have the nightmares, as real as the event itself, it is as if their life is being sucked out of them. Adrenaline pumps through them and they come down to "earth" feeling drained out.

Cardiovascular strain (fear)
There have been studies on the heart while someone is going through stress. We don't often think about what else is going on in our bodies during stress. If you pay attention you can feel your heart bump harder. You may feel a tightening of the chest. You can feel blood rushing into your head. As you get tense, your heart works harder to gear up the rest of your body in response to fear.

Startled response (enemy is coming)
Don't sneak up on a person with PTSD! They are always waiting for the enemy to come up on them and they will over react. If you drop a cup on the floor and it breaks, they will freak out. If there is an emergency in the house, like a kid getting cut and they scream or cry, the veteran will over react to this and most of the time react wrongly. They may begin to yell instead of trying to calm the child.

Hyper arousal (again waiting for the enemy)
They are always on guard. Many veterans will "patrol the perimeter" checking doors and windows over and over again. They may get to the point where their actions drive you up a wall. A lot of veterans will obsess about your safety. This comes from watching the backs of their brothers while in combat.

Increased physical pain
This one is easy to understand. They feel it more than they did before. What would have caused them to be "uncomfortable" in the past is translated into pain instead. They feel it more because they feel everything inside of them more.

Reduced immune response, Vulnerability to illnesses

Most of this comes from the above. The loss of sleep and true rest plays into this for all humans. When you go through anything that drains you, you are more likely to get sick.


Headaches, Gastrointestinal upset, Decreased appetite
Again, these are linked to the above. They are being worn down and worn out. Tension gives them headaches, upsets their digestive track and when that happens, they don't want to eat.

When they go on medication, a lot of veterans will gain weight. Some of this is caused by the medication itself and part is also caused by the change in the diet when the metabolism has been trained to survive on little food.

Decreased libido
This is one of the hardest things on them and their spouse. It is hard to connect to the body with passion when there is a barrier. Most marriages will suffer from this. Even when they do get aroused, they do not "feel" it. Passion goes out the door and they think they have to do it instead of wanting to do it. Let's put it this way, they have a lot of other things on their minds. They are dealing with all of the above and that also plays into this part.

Interpersonal Effects
Increased relational conflict (seems like they are looking for an argument)

Social withdrawal (wanting to stay home, not wanting to talk, not trusting anyone, thinking that someone will be out to get them)
Reduced relational intimacy (again, they don't feel it)

Alienation (they loose the connection they had with people they love)

Impaired work performance, Impaired school performance (this can come from short term memory loss and the sense of distrust) It's very hard to concentrate when you have all of the above going on.

Decreased satisfaction (can't feel happy over anything)

Distrust (everyone is out to get them) They will question irrationally and obsessively.

Externalization of blame (it's always someone else's fault)
Feeling abandoned or rejected (they cannot connect to others and they think it's because others are judging them)

Over protectiveness (gets back to the patrolling the parameter when they think they have to protect everyone from harm.

Emotional and cognitive
Emotional effects
Shock (while we feel startled)
Terror (while we may feel a little afraid)
Irritability (as if they are looking for a fight)
Blame (it's all their fault or it's all your fault)
Anger (will react as if it was the worst thing that could be done or said to them when we would have just let it go)
Guilt (they deserve to feel the way they do, they shouldn't have survived when someone else did not or God judged them)
Grief or sadness (always looking for what to feel bad about because nothing is worth feeling good about)
Emotional numbing (they cannot feel anything but pain and then they self medicate to stop feeling the pain)
Loss of pleasure (nothing makes them feel better, no longer able to feel joy or love)
Difficulty feeling happy (they really can't feel happy but they may often act as if they are, it shows in their eyes.)
Difficulty experiencing loving feelings (again, passion and intimacy is gone, they are not worth loving)



Cognitive effects
Impaired concentration (short term memory loss, zoning out and shutting down)
Impaired decision making ability (making bad decisions like buying things they cannot afford, driving too fast, not being able to deal rationally with choices they have to make)
Disbelief (they cannot trust easily)
Nightmares (more real than what we have, more vivid and intense)
Decreased self-esteem (they can't do anything right or they deserve to be going through what they are going through)
Decreased self-efficacy (cannot fight for themselves and one of the biggest reasons they need help to file a claim for their treatment with the VA. They want to give up because the fight has gone out of them.)
Intrusive thoughts and memories (flashbacks, feeling as if someone is out to get them and not trusting what they are told, looking for what you are not saying and thinking the worst)
Worry (if they do not have something to worry about, they'll find something)
Dissociation (cannot feel connected to the people around them)
Dreamlike or spacey feeling (zoning out)

These are what happens to most of them but they will not all experience the same symptoms at the same level. If the "out of character" signs go on for more than 3 months without showing any signs of easing up, or getting more intense instead, they should think about getting professional help. If this lasts 6 months, get them to go for help, no if, ands or buts about it. Get them to go for help. Help them to understand that these are normal reactions for any human who has been in an abnormal event. I've said it before and will keep saying it until everyone understands this, "Combat is not normal but they are!" It is not a sign they are weak, lack courage or are "defective" individuals. They are strong because they endured it. They are courageous because they were willing to go into combat. They are not defective and because they are feeling what comes after all they live through, they are capable of feeling. There is nothing defective about not being able to walk away the same way after going through what they go through. Even those who do not develop PTSD will change. No one walks away from trauma untouched if they are able to feel anything.

Over the years most veterans I've come into contact with or read reports about all indicate they have the capacity to feel things very strongly. Being sensitive is not a defect and has nothing to do with bravery. It just makes them more human.

We all forget these are men and women when we use the term "troops" and some of us get the impression they are "soldiers" and should be like some kind of killing machines instead of humans. We need to see them all as humans exposed to abnormal events and help them to heal from the events most of us will never know because they were willing to put their lives on the line.

Chaplain Kathie Costos
Namguardianangel@aol.com
http://www.namguardianangel.org/
http://www.namguardianangel.blogspot.com/
http://www.woundedtimes.blogspot.com/
"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." - George Washington

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