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Friday, December 5, 2008

PTSD:The difference between "secondary stressor" and "secondary PTSD"


by Chaplain Kathie

If you have PTSD or someone in your family does, you may have heard these two terms. There is a big difference between the two of them. In plain English without all the medical terms no one can understand this is what they are.

Post Traumatic Stress Disorder Secondary Stressor

First you need to understand there are different levels of PTSD. It's why the VA has different levels of compensation for it. Some can have mild PTSD. They are able to function. They are able to have relationships and work. While they still have nightmares, flashbacks and mood swings, they are able to cope to a certain extent.

They go on believing that "it's not that bad" and they don't seek treatment. They just bury it. They bury it with work and doing things. They stuff it in the back of their minds and focus on other things.

We know that the healing rate for PTSD is higher the sooner they get help but with mild PTSD, it's easier to avoid doing anything about it. It happened to Vietnam veterans.

Because they didn't know what PTSD was when they came home, they thought they would just have to get used to being the way they are. After all, bad things come into everyone's life. Considering they heard all the usual denials from the people they were surrounded by, avoiding it was easier than facing it.

They managed to get by. That is until another traumatic event hit them hard. In our case, I miscarried twins. It was a very traumatic day for me but it was catastrophic for my husband. He had been my best friend. He took time off of work to go to appointments with my doctor. He worried about what I ate, if I was getting enough rest and if my feet were swelling too much. We knew he had PTSD even though he wanted to deny it.

My father, a Korean war veteran was used to seeing veterans like him. My Dad was 100%, well known at the DAV and the VA regional office, as well as with other veterans. The day he met Jack, I asked him what he thought. He said, "He seems like a nice guy, but that guy has shell shock." I told my Dad the new term was PTSD. What I didn't know back then was that it would get worse without being treated.

I was still thinking that when they had PTSD, it was what it was and couldn't get worse. I thought we could just deal with the "quirks" of having to sit in a certain place in our favorite restaurant. That having to leave a party or get-together early because it got too much for him, was no real problem. His twitches didn't bother me or our friends. His memory lapses were not that hard to deal with. I could handle all of it. The problem was, Jack wasn't.

The day I lost the twins, Jack was right there with me. He saw it all and saw me falling apart. Later, after it was over, I had to call Jack to come back to the hospital because I needed him with me. He didn't want to come. I had to beg him to come back. The secondary stressor hit him that hard, that fast. The man I thought I knew as well as myself, was gone. A stranger showed up at the hospital.

The next day as the doctor was explaining the egg just separated wrong, Jack was twitching like crazy, couldn't hear what the doctor was saying and kept talking about Vietnam and Agent Orange.

Our lives fell apart after that. All the symptoms of PTSD grew stronger and I was watching him die inside. I couldn't get him to listen to me about PTSD or that he needed help. My Dad tried to get him to go to the VA but Jack said the VA was for veterans who couldn't work and the veterans without limbs. It was not what he needed. He just needed time to "get over it" and become what he used to be. He saw the changes in himself but was still in denial.

It didn't matter what I knew or how hard I tried to get him to go to the VA. He just didn't want to hear it.

That is what a "secondary stressor" does. It's PTSD on steroids. If they seek help as soon as symptoms begin, PTSD stops getting worse. If they don't, if they bury it, it is storing up the energy to hit them hard. We're seeing it in the older veterans as they reach retirement. When they have nothing to help them bury it with, it all comes seeping out. When they look back at their lives, they are able to see all the signs and how hard they worked at stuffing it all in their minds.


Secondary PTSD

Secondary PTSD is when you live with someone with PTSD.
The way they act.
The way they treat others.
The mood swings.
The unacceptable behavior making you feel as if you don't matter at all. Especially when they don't seem to care about accountability, showing up on time, saying hateful things and taking off for days at a time.
Causing arguments getting out of control.
Their disconnect from their families.
Self-medicating to kill off the feelings they don't want to feel.

The list goes on.

If a child acts like a child and is noisy, they snap. If a child drops a glass and it crashes, they overreact. Any kind of simple commotion sends them over the edge. Nothing a child can do will make the PTSD parent happy. The negativity is extreme. Often the child believes their parent hates them. In turn, the child will begin to hate the parent.

It is all traumatic growing up with a parent and untreated PTSD. Much like the children of alcoholics have to heal from growing up with a "drunk" as a parent, children of PTSD parents also have to heal so they lead happier lives. They also need to have the help of mental health professionals just as their parent does.

When it is a spouse, it is the same because they treat everyone in the family the same way.

My Dad was an alcoholic and I grew up in a household that was under attack. He came home drunk most of the time. My oldest brother was usually his favorite target. He was beaten until he got bigger than our Dad. Then the fights were a two way street. There was a lot of smashing, breaking and punching. When I was 13, my Dad stopped drinking and joined AA. It took a long time for him to begin to change, but the damage was done to my family.

I understood what it was and that helped me to forgive him and come to terms with the way he treated us. There are still issues I have with feeling unloved at times because of the way my Mom ended reacting. She held a lot resentment and so did my two brothers. When it comes to me, nothing is ever good enough. I have a hard time dealing with any acclaim, people appreciating what I do and do not take compliments very well. I get uneasy with any kind of attention finding it more comfortable to sit in the back of the room.

When I was writing without my married name, I excused it by saying my husband wanted to remain private. The stigma of PTSD was still with him. The truth is that I wanted to remain anonymous as well. I wanted to just do what I do and then go sit in the back of the room letting everyone else get attention. I thought they deserved it more than I did anyway. I fight against the way I have been conditioned to respond. I still get sick to my stomach when I have to be the "center of attention" even though part of me believes I've worked very hard to get where I am in all of this, part of me remains the little kid that wanted to be invisible.

Living with my husband and PTSD, it's the same way. I understood what it was and was able to forgive him for the way he acted and sometimes still does. I know when the dark days are overshadowing his character. When those days come, I know when to pretty much stay away from him. I hesitate to say some things to him because I know he will not react appropriately. I stopped feeling attractive, stopped wearing makeup and dress plainly to avoid any attention. That is unless I have to wear the Chaplain's attire to be taken seriously. It is all a constant process and a growing experience but my faith has sustained me. Spiritual connection has been vital to me in all of this.

While I've had traumatic events happen in my life, plus almost dying 5 times, (I'll tell you about that some other time) it has all gone into what I deal with inside of me. I do not have PTSD but it has all gone into the way I feel inside about myself and other people. I think my life has helped me to understand how some people can develop PTSD at a rate of one out of three. Everything in our lives becomes a part of us. The good as well as the bad. We have to fight to overcome the bad and we have to sometimes force ourselves to focus on the good. That's all human nature.

I believe in a way we all have pieces of traumatic events in our lives if we really take an honest look at ourselves. I don't know anyone that has escaped trauma totally. When you lose a job, that's traumatic and the next job you have, you end up acting different until you feel comfortable on the new job. When you have a traumatic relationship, you act differently than you did in that relationship because deep inside you blame yourself for the way it went. Yet when it is a parent, you cannot get new parents to act differently with. When it's a spouse, you can find a new one but again, you will not be the same.

The thing is, in all of this the choice is your's to hang onto the bad, or grab the good. Focus on what is wrong or reach for what is good. I have a hard time trusting people. This goes into my amazement when I meet someone I can trust, when I see the actions that restore my faith in humanity. I may doubt, but I'm willing to believe when I see "fruits of their deeds" and believe in what I see with my own eyes. People can say anything they want but who they are inside, comes out in what they do. I saw my Dad overcome the alcoholism. I saw my Jack fight to heal and keeps fighting to stay level. Both of them could have become enemies in my heart but I saw what was good in them instead. They have made me stronger and gave me the ability to look at the cause of the pain they had within themselves so that I could come to terms with the pain they caused in me.

I hope you have a better understanding now of what the difference is between secondary stressor and secondary PTSD. More, I hope you can forgive the people in your life causing you pain. You need to see what caused the pain within them so that you can forgive them for your own pain.



Senior Chaplain Kathie "Costos" DiCesare
International Fellowship of Chaplains
Namguardianangel@aol.com
http://www.namguardianangel.org/
http://www.woundedtimes.blogspot.com/
www.youtube.com/NamGuardianAngel
"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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