Our Lives With Post Traumatic Stress Disorder and Traumatic Brain Injury

We are a community of various authors with different points of view on the PTSD/TBI landscape. Some suffer the effects of PTSD/TBI, others only PTSD, and you'll also hear from the family members who find themselves trying so valiantly to help us. These are our stories... These are our lives with PTSD/TBI.

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I Survived. My fight against PTSD.

I am a 40 year old mother, wife, and disabled veteran of the US Army. It has taken me a long time to get to the point where I could share this story. This may be triggering for some, and I apologize, but it is something I need to get out of my head.

 medcorpsI was a medic in the Army, as such, while I never had to pull the trigger; I had to see the aftermath of war. It didn’t matter what side they were on out there…once they came through the doors of our hospital, we had to treat them all the same. It didn’t matter whether they were combatants, innocent bystanders or children who were caught in the crossfire, when they came through our doors, they were a patient. Period.  It’s the children who stay with me. I can still see their sweet faces, along with all the medical accoutrements that were needed for their individual medical needs. They have never aged. In my mind they are still the same now as they were then…sweet, innocent, and in need of our help. For all the varying opinions of what we were doing in Iraq and why, the one thing I can say is that I made a positive difference. I did my best to harm none and other than one altercation (with another soldier), I never laid an angry hand on another person.

 

I have friendships that have lasted till this very day. We have become sisters. We have been through so much together and have helped each other become stronger in the process. They are the reason that I will never regret my service. It is the hardest thing I have ever done, the one accomplishment of which I am the most proud….but the one thing I will never do again (even if I were physically able).

 

The reason I would never serve again is simple…the culture which permeates throughout the entire military complex is one in which women are objects. If we are lucky, we are seen as “one of the guys”. We are told from day one that we are not “females”, we are “Soldiers/Marines/etc.”. This should have been my first clue, but I was too proud that I was continuing the family tradition of service. During my first enlistment, I had an NCO who would verbally berate me, wrote me up for the slightest infraction, and literally made my life hell. Within thirty minutes of arriving to work, this man would have me in tears. One day, I finally worked up the courage (or was pissed off enough) to ask him outright, “Why do you hate me so much?”  His reply was “Because you’re a female in that uniform!”. Needless to say, as soon as that day’s ass-chewing was over, I asked to take a break and instead of getting something to eat, I went straight to the Chief Wardmaster’s office and told them everything that had been happening. He was immediately escorted from the ward and received a 72 hour psych discharge. I had incidents with other male NCO’s but none as severe as this and all were seemingly karmic-ly returned to the perpetrator.

 

Unfortunately, my commander in the National Guard who was a problem as well. At first he was a little too friendly…when the level of friendliness was not reciprocated, his demeanor changed. By the time it was all said and done, I had the sworn statements of my entire squad, platoon sergeant, and several other members of my platoon stating that the commander had been singling me out for punitive reasons. I took all of these to the Battalion Commander. Since this was a very new unit, I was (in my opinion) nice enough to ask for an Honorable Discharge from the National Guard in exchange for not pressing Sexual Harassment charges against him. It was granted.

 

MSTAfter 9/11, I reenlisted in the US Army. I was stationed at Ft. Campbell, Ky. in the 86th Combat Support Hospital. Four months after I went back to active duty I was sexually assaulted by another NCO (not in my unit). I had met him online and had talked for several months. During an ice storm, he had even crashed in my barracks room and was a PERFECT gentleman (he even folded up his blankets after sleeping on the floor and left without waking me up). The night of the assault (Friday), I had been the designated driver for some new members of the unit. I ran into him at the club and he was obviously intoxicated. After ensuring that he was not driving, he said he had nowhere to crash. I told him if he couldn’t find anywhere safe to stay, he was welcome to crash in my room again. Thinking he would be the same gentleman who I had helped before, I foolishly left my door unlocked.

I was still recovering from a pretty bad case of bronchitis and had taken some medication with Codine and fallen asleep. When I awoke, he was on top of me. Every time I protested, he would bite me. Eventually, he pinned my arms above my head with the pillow over my face. I was too petrified to scream anyway. I did not want everyone else in the barracks to know what was happening to me. I was ashamed and mortified. I don’t remember most of the rape. I do remember that when he was finished, he rolled over and fell asleep. I don’t know how long it was before I attempted to move. I was terrified. Eventually I was able to get out of my bed, but instead of going and telling someone, or simply calling the police myself, I fell asleep in the corner of my room on the floor.

On Monday I tried to go to work, teaching a combat lifesavers course. I couldn’t concentrate on what I was doing; I couldn’t focus on cidthe material I had known like the back of my hand. At lunch, I told one of the other soldiers that I was going to go talk to our platoon sergeant. He could tell something was terribly wrong, and eventually I told him I was raped. My platoon sergeant was a good man who always had my best interests in mind…the real definition of a leader. By regulations, he had to report the assault. I spent the next several hours at the ER and then at the CID office being interrogated. Yes, interrogated…as if I were the one who did something wrong. The next day, I was brought back to the CID offices and interrogated again. By the time it was all said and done, it was beyond obvious that they were not going to prosecute my rapist. Exhausted, exasperated, and defeated I uttered the words that I knew would make the interrogations end. I told them “Fine, he didn’t rape me. Can I go home now?” I was allowed to go. I was so humiliated that I couldn’t even look my platoon sergeant in the face. The way I was treated by the CID agents (male and female) made me feel far worse than my rapist

The next day my unit informed me that I was to report to JAG…CID wanted me prosecuted for attempting to make a “false sworn statement”. Thankfully, the JAG lawyer listened to my story and was immediately swayed to not only choose not to pursue charges against me, but to fight on my behalf. She was a bull dog! She went up her chain of command, which then went DOWN the CID chain of command. The soldier who raped me said it was consensual…but he was married. JAG wanted him charged with adultery (there are still regulations against adultery in the Uniform Code of Military Justice). However, CID and his unit did nothing. He wasn’t punished in any way. Needless to say, it shattered my faith in the military justice system. I tried attending the rape survivors group on base. Of the seven other women there, six were assaulted on base and every single one of them had the same exact experience with CID. None of our attackers were prosecuted.

I have since been through countless hours of “therapy”, numerous medications, diagnosed with PTSD, and now have a service dog. I have recently returned to college and I’m slowly gaining my life back, though it will never be the same. I still distrust authority, being questioned by them causes immediate flashbacks, and I still have intimacy issues. I am working on them, as best as I can.

Someday, I’ll share more about my life…but for now…this is something I’ve never shared publically. This is my fight against PTSD. Getting it out of my head and productively written out is a step for me. I am still proud to have served in the United States Army; I know I did good things that changed lives, even if I will never know the full outcome of those changes. But I will never forgive those in power who prey on the victims while rapists walk free in their ranks.

A New ‘Leash’ on Life for the Invisible Wounds of War

In a nation who has been at war for more than a decade, the rate of service members diagnosed with Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), and the frequency of suicide, has radically risen. The backlog of veterans waiting to receive benefits has also dramatically increased. This is leading to longer waiting times for diagnosis and treatment. To date, no authority seems able to find a viable and expedient solution to any of these problems. Yet, nationwide, some veterans are finding a solution. They have discovered the healing power of a service dog. While this is not a cure for PTSD or TBI, it is extremely beneficial to those who have chosen to utilize this tool in their recovery.

september-11th-photoSince the attacks on the World Trade Center and the Pentagon on September 11th, 2001, the United States has been at war. To date, approximately 1.64 million (Rand) U.S. service members have deployed in support of Operations Enduring Freedom (OEF, Afghanistan) and Iraqi Freedom (OIF, Iraq), many have deployed multiple times. Of the nearly 60,000 U.S. casualties, 6,778 have lost their lives (iCasualties.org).  This means approximately 50,000 have returned home with injuries from minor to catastrophic. Many of these casualties would not have survived in previous wars but thanks to better protective equipment, medical advances, and the ability to rapidly evacuate the injured to medical facilities both in country as well as in Europe and the United States, service members are routinely surviving wounds that would have formerly been fatal. This decrease in fatalities is leading to an increase in veterans returning with traumatic amputations of one or more limbs, TBI’s, and PTSD seeking compensation and treatment through the Veterans Administration.

PTSD and Traumatic Brain Injury (TBI) have been called the signature wound of the War on Terror. “Although these invisible wounds would appear less severe than the amputations inflicted by the IEDs, they affect many more service members and can have as much impact on the casualty’s future as the loss of limbs” (Kreisher). According to a recent report, nearly 30% of OEF and OIF veterans are being diagnosed with PTSD (Reno). Compare this number to The National Center for PTSD which has “estimated the lifetime prevalence of PTSD among adult Americans to be 6.8%” (Gradus). Part of this massive difference is likely due in part to many service members serving multiple combat tours in their careers.

PTSD is a condition that has been around since the invention of war. It has been called many names: Nostalgia, Homesickness, Soldier’s Heart, Neurasthenia, Shell Shock, Combat Stress, and finally in 1980 the American Psychiatric Association called it Post-Traumatic Stress Disorder and added it to the Diagnostic and Statistical Manual of Mental Disorders. PTSD is comprised of a set of symptoms which include re-experiencing the traumatic event, avoiding places, events, or objects that remind one of the trauma, and hyperarousal. Most people feel many of the symptoms of PTSD after a traumatic event, but those symptoms fade with time. To be diagnosed with PTSD, the symptoms must last longer than 6 months.

PTSD can be extremely debilitating, leaving veterans homebound and isolated, suffering from co-occurring mental health issues and symptomsaddictions (generally caused by self-medicating their symptoms). Add to these issues a Traumatic Brain Injury and you have a recipe for disaster. TBI’s can range from mild to severe, even resulting in death. The symptoms include loss of consciousness, memory or concentration problems, headache, dizziness, sensory problems, fatigue, convulsions, and emotional disturbances.  “According to a Rand study, about 19 percent of troops surveyed report a probable TBI during deployment” (Williamson). Many symptoms of PTSD and TBI mimic each other, making definitive diagnosis difficult for some patients. How much of the patients symptoms are related to PTSD and how much to TBI? Patients and doctors are often left in a guessing game as to whether the symptoms require therapy, medication, or both.

The great influx of veterans returning home from the current conflicts has caused a massive backlog for the Veterans Administration. Currently, “401,000 claims remain officially backlogged, meaning the applicants have been waiting at least four months” (Glantz). Many of these are waiting a year or more for appeals related to service connected disabilities. This means veterans, who are too injured to continue their military service and unable to achieve successful and meaningful employment in the civilian work force are waiting for their disability compensation for a year or more, putting them and their families in financial peril. The stress of dealing with gathering the enormous amount of information required to fill the claim, the aggravation of having your claim misplaced, delayed, or denied only adds to the problems already being endured by the veteran.

The stress of dealing with PTSD and fighting the VA’s red tape backlog is lending itself to the suicide epidemic plaguing our veterans. Senator Bernie Sanders said, “Without being overly dramatic, let me state that we are losing 22 veterans every day from suicide. This is a tragedy that we must address. I know that no one in the VA, no one on this committee, wants to add to that tragedy, because of unnecessary delays that could extenuate the problems that veterans express” (Johnson). In 2012, the suicide rate of active duty personnel outpaced combat fatalities. “Access to care appears to be a key factor, […] once a veteran is inside the VA care program, screening programs are in place to identify those with problems and special efforts are made to track those considered at high risk” (Maze). The veteran suicide rates are outpacing that of the civilian population. In reports from 48 states, the suicide rate among veterans is 30:100,000 compared to civilian rates of 14:100,000. This is more than twice the rate of the average American citizen and is increasing at double the rate (Hargarten). Traumatic Brain Injuries can increase the propensity toward suicide, as can the overwhelming symptoms of Post-Traumatic Stress Disorder. According to Hargarten, “concussions also are a chronic risk factor leading to suicidal thoughts, […] because head trauma makes people more vulnerable to suicidal thoughts” (Hargarten).

Over the years, countless studies have been published promoting the health benefits of owning a pet. Pets can, lower blood pressure, encourage exercise and socialization, improve mood and reduce stress. Is it any wonder they are being trained to assist disabled veterans struggling with the effects of PTSD and TBI?  Training dogs to assist with disabilities is not a new concept. Most people are quite familiar with service dogs for blind or wheelchair bound individuals. However, those with invisible disabilities can also benefit from a service dog.

Psychiatric Service Dogs can be trained to assist their handlers in many ways. They can be trained to retrieve assistance during a disabling episode, either a nearby person or by using a special K-9 rescue phone to dial 911. They can be trained to answer the door and lead first responders to their handler. They can provide balance during episodes that potentially cause dizziness and help their handlers up off the floor. These dogs can be trained to alert to increasing anxiety levels so their handler can more effectively handle the symptoms before they become overwhelming and disabling. They can pull their handlers from dissociative episodes, or flashbacks, wake their handlers from nightmares, provide deep pressure therapy during panic attacks, and give their handlers a sense of ‘crowd control’. In short, these animals are giving back to veterans something they lost when they left the service…a battle buddy – someone who has their back twenty-four hours a day.

The legal definition of a service dog, according to the Americans with Disabilities Act, is a dog that is “individually trained to do work or perform tasks for people with disabilities” (ADA). These dogs and their handlers are granted public access by federal law, meaning they must be allowed wherever the handler would normally be allowed without the presence of their dog. There are some restrictions such as sterile environments, such as operating rooms or burn units, and private property. They are allowed in stores, restaurants, hospitals, and anywhere else the general public goes. This protection enables veterans who had previously been home bound to return to the world without the crushing effects of PTSD plaguing their every movement.

Jason axle 2United States Marine Corps Captain Jason Haag, credits his service dog Axel with saving his life. “I’ve led 150 Marines into combat three times. I couldn’t walk out of my […] house to buy a pack of gum. I couldn’t go to sleep without a gun underneath my pillow. That’s how bad my PTSD was” (HLN). Captain Haag states that after returning from Afghanistan he began drinking heavily, having angry outbursts at his family, unable to leave his basement and on 32 different medications. “Axel hit the reset button for me” (HLN). Since graduating from K9s for Warriors more than a year ago, Captain Haag has radically decreased his medications – to 2 per day, he now regularly participates in family activities, and has even been to Capitol Hill, advocating for service dogs for veterans with PTSD (Haag).

Captain Haag’s story is not an anomaly. Most graduates have returned to a new ‘normal’ of doing the everyday things that most take for granted, such as walking through the grocery store or visiting their children’s school.

K9s for Warriors is just one of many non-profit organizations who are training service dogs for veterans with PTSD and TBI. These organizations train and place service dogs with disabled veterans, often at little to no cost. They are filling a gap left by the Veterans Administration, when they discontinued a congressionally mandated study on the efficacy of service dogs for veterans with PTSD.

There is still reason for optimism, though. Two bills have been introduced into the House of Representatives this year with the intent of expanding the availability of service dogs for disabled veterans.  H.R. 183 – “Veterans Dog Training Therapy Act”, introduced on January 4th, 2013 directs the VA to begin a pilot program to research the efficacy of service dog training and handling in the treatment of PTSD. H.R. 2847 – “Wounded Warrior Service Dog Act” would direct the “Department of Defense and the Veterans Affairs to jointly establish the K-9s Companion Corps program for the awarding of grants to assist nonprofit organizations in establishing, planning, designing and/or operating programs to provide assistance dogs” (govtrack.us). Should these bills pass, perhaps in time the studies will confirm what those veterans who already have service dogs know.

According to Sandi Capra, the Director of Development for K9s for Warriors, of their more than 100 graduated teams, 92% of graduates had reduced or eliminated their need for medications, and 94% have reported reduced symptoms of PTSD (according to the Harvard PTSD standards). At one year from graduation, 95% of teams recertify successfully. These achievements are not an isolated occurrence. A simple online search of service dogs for PTSD returns more than 286,000 results. You will find countless news stories about homegrown veterans reclaiming their lives thanks to their new ‘battle-buddy’, veterans attesting to the lifesaving partnerships they’ve found in a service dog and web pages for scores of organizations who train these dogs for our disabled veterans.

These stories are not the ‘too good to be true’ paid endorsements for the latest fly-by-night “cure” for PTSD. They are not random coincidences. They are the stories of recovery from a devastating and debilitating invisible injury. These dogs are not a cure. They are a tool in their handler’s arsenal for coping with and overcoming some of the obstacles associated with PTSD and TBI. There is a reason they are referred to as “man’s best friend”. They are the heroes on four legs and they are giving a new ‘leash’ on life to veterans who suffer from the invisible wounds of war.

Works Cited

Capra, Sandi. K9s for Warriors. Director of Development. Personal interview. 13 November 2013

Glantz, Aaron. “Overtime, New Computer System Put Sizable Dent in VA Benefits Backlog”. The Center for Investigative Reporting. 11 November 2013. Web.

Gradus, Jaimie L., “Epidemiology of PTSD.” National Center for PTSD. n.d. Web. 24 November 2013.

Haag, Jason. Personal Interview. 13 November 2013.

Hargarten, Jeff, et.al. “Suicide Rate for Veterans Far Exceeds That of Civilian Population”. Center for Public Integrity. Web. 30 August 2013.

“HLN Stories of Courage – K9s for Warriors”. Headline News. Television. 11 November 2013.

iCasualties.org, Coalition Casualties by Year, n.d. Web. 24 November 2013

Johnson, Bridget. “Sanders: VA’s Massive Claims Backlog Could be Contributing to Vet Suicides”. PJ Tatler. PJ Media. Web. 13 March 2013.

Kreisher, Otto. “Biding the ‘Invisible Wounds’.” Brainlinemilitary Brainline.org. n.d. Web. 24 November 2013.

Maze, Rick. “18 Veterans commit suicide each day” Army Times. Web. 22 April 2010.

Reno, Jamie. “Nearly 30% of Vets Treated by V.A. Have PTSD.” The Daily Beast Presents: The Hero Project. The Daily Beast. 10 October 2013. Web. 24 November 2013.

“Service Dogs.” ADA.gov. Web. 12 July 2011

Williamson, Vanessa and Mulhall, Erin. “Invisible Wounds – Psychological and Neurological Injuries Confront a New Generation of Veterans”. Iraq and Afghanistan Veterans of America. Issue Report, January 2009. Web.

Theme Song – “Why?” Soldier Hard

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Recovery

For many veterans with post-traumatic stress disorder, recovery feels like an unachievable concept. Realizing that there is no ‘cure’ for PTSD can make recovery seem even more daunting. There are no concrete A-B-C steps, and each one’s journey is just as different as the trauma’s that put us here.

Once we accept that we will never be the person we were before, and mourn that loss, we can begin to take the steps we need to take to find out who we are now. For some, that is enough; others require medications, therapies, etc. There is no right or wrong, stronger or weaker, super -hooah or soup-sandwich. Each of us has to define what recovery means. Does it mean simply being able to go to the grocery store, or reclaiming more areas of our lives? Does it include therapy? Medications? A service dog?

Personally, recovery has meant having the ability to return to college and join a local Toastmasters club. I have gone from having a stutter when asking the drug store clerk for Tylenol to placing third in a district speech contest.

None of this would have been possible without me first taking a proactive approach to my treatment. Meds alone weren’t working for more than a few months at a time. The final medication combination had me gaining forty pounds in 4 months. Shortly afterwards, I was partnered with my service dog Chauncey. Because of Chauncey, I finally had the courage to begin therapy. I have returned to college full time, majoring in Social Work. Eventually, I hope to work with other veterans. I have tried several therapies, some of helped, others have been a train wreck.

The most important thing is to keep trying. Not everything is going to work the same (if at all) for everyone else. We can’t ever give up! Not on ourselves, and not on each other. We would never have left a buddy behind while we were over there… we risk the same cost if we leave them here.

23 veterans commit suicide every day. It is up to us to take care of each other. We had our buddies backs then, we should have them now. Find your buddy….make a new buddy. Take the Spartan Pledge together.

“I will not take my own life by my own hand without talking to my battle buddy first. My mission is to find a mission to help my warfighter family.”

Never leave a brother or sister behind. Never allow yourself to be left behind. If you need help, ask. If no one answers, yell! Keep yelling until someone hears you. Failure is not an option and suicide should never be one either. We need each other. We need you!

Our Family Toolbox…

lightingBOOM!

A flash of lightening and an instantaneous clap of thunder sent me into a dissociative flashback. My 18 year old daughter was sitting just feet from me on our screened in patio. We had been enjoying listening to the rain when the lightening sent me back to Iraq.

Vaguely, I could hear her asking if I was alright, but I was unable to process the question, let alone answer her. She knows I have PTSD. She has had to deal with my symptoms as she grew into the wonderful young woman who sits beside me now.

My service dog, Chauncey, had gone inside…following one of my younger children into the house. When my episode hit, I could see him staring at me through the door, but I couldn’t move. My daughter stood, went to the door and opened it, telling Chauncey to come to me. After Chauncey brought me out of my terror, I was able to thank my daughter.

In our battles with PTSD, we tend to alienate our biggest allies. Our family members can be the best tools in our arsenal, but we have to allow them to be so. Too often, whether consciously or not, we push them away…perhaps to protect them from our inner demons, but we push them away nonetheless.

As Warriors, we must learn to use the weapons and tools we have before us. Just as we relied on our training and weapons, we must learn to allow ourselves to be vulnerable to our family members so that we can rely on them in our times of need. This is not an easy thing to do. We often see ourselves in the ‘protector’ role when it comes to our spouses and children. Many have children who we see as too young to burden with our cares. It has been my experience that even my three year old can tell when I’m having a rough time and will start to be silly, or climb up and give me a big hug. She is just starting to get big enough that her weight can provide some level of deep pressure just by snuggling. My older girls are beginning to know when I just need some quiet time…now that doesn’t always mean they give it to me because they also seem to mimic my stress levels (and every kid knows where their parents buttons are located); but I have come to realize this and have put it in my tool box…recognizing more clearly when *I* need a time-out.

Our spouses, parents, siblings and other family members can also be extremely useful in our battle. I can’t count the times that family members have made themselves a buffer for me when I needed it most, or stood up to uneducated business owners who would try to exclude me because of my service dog.

helpinghandLong story short…we need to embrace those who love us and ALLOW them to help us. We didn’t face battle alone in uniform, we don’t have to face it alone now. We have our fellow warriors that will always stand up for us, but they are not always available face to face…our family is with us every day. We must learn how to embrace them and not push them away. Yes, there will be some who will walk away and we must learn how to let them go. In the absence of abuse, we must realize that they choose to leave because THEY are weak…and we will lose those we love, it’s a fact of life. Its learning to trust those who choose to remain, who choose to walk beside us in our darkest hours…it is our choice to allow ourselves to utilize the tools that they willingly present. We must realize that their gift just might tip the battle in our favor.

Nancy and Service Dogs

Nancy and Service Dogs, by Guy Gilcrest

I am beyond flattered. There are no words to express to Guy what this gesture means to me. Beyond that, I want to thank him, from the bottom of my heart, for helping to bring awareness to how much our four-pawed, furry friends help in the fight against PTSD. THANK YOU!!!

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