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Is This Even Ptsd??? Or Just Angry Depression?

Discussion in 'Military & Emergency Services' started by ldj, Jan 2, 2017.

  1. ldj

    ldj Active Member

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    I wonder if I can pick everyone's brain on something I've been pondering....

    My vet does NOT have any of the following symptoms:
    - flashbacks/nightmares
    - fear
    - hyper-vigilence
    He also doesn't seem to be particularly bothered/traumatised by stuff he's seen or done and can talk quite matter-of-factly about it (though, I appreciate, he might be keeping it hidden)

    He DOES, on the other hand, have severe anger issues and seems frustrated with life on civvy street. I'd say he's definitely depressed.

    Now obviously I'm not in a position to question medical professionals, but he hasn't actually met a therapist yet, his first appointment isn't until February. So this is still early days. He got 'diagnosed' in October, following a 30 minute phone call to Combat Stress. Is that pretty much the extent of the assessment process?? If you answer yes to most of the following symptoms, then you've got PTSD?? Seems a bit superficial to me.

    Anyway, my point is this:

    It's been shown that sufferers of PTSD whose trauma was caused by war/combat respond less well to treatment than sufferers who are survivors of sexual assault or domestic abuse, say. I know this is a generalisation, but it really interests me why this might be the case.

    How many of you out there, like my vet, DON'T suffer with flashbacks, nightmares, fear of certain noises, anxiety and hyper-vigilence in crowds??

    And of those of you who said you don't suffer these symptoms, how many of you feel like your treatment is going well, is working?? Anyone? Or are you the group of vets who are bringing the success rates down, because the treatment isn't really focusing on the true root of your problems?? Which, in my humble opinion, isn't the trauma you experienced in war, but the anger and frustration you feel about life in the civilian world. Is it less a case of PTSD and more a case of readjustment failure, perhaps? Am I on to something here??

    I know is might sound like I'm trying to call a spade a shovel - pretty much the same thing, doesn't matter what name you give it. At the end of the day, you're feeling what you're feeling, doesn't matter what it's called.

    And I'm sure therapists are skilled enough to recognise where they need to focus treatment and tailor it to the individual's needs. But what if that's only the few good ones??! What if not everyone gets this deal? This is still a relatively new illness, research is still happening, there are not loads of professionals trained to treat it yet.

    What if lots of you are being encouraged to revisit memories, process the trauma, resolve old emotions etc etc, when actually, it's NOT the past that is bothering you, but the PRESENT! The lack of fulfillment you feel, the loss of identity, the difficulty relating to civilians, the dissatisfaction with your job.

    Certainly in the case of my vet, I believe these are the big stressors for him. I'm not belittling what he experienced in combat and saying that it's had no effect, but I genuinely believe, if he had a job he enjoyed and felt challenged in, if his skills were valued and appreciated, then he wouldn't be suffering like he is now. And I'm just curious if that might be the case for a lot of you out there??

    So that leaves me sceptical as to how effective treatment will be for him. Yes, I'm sure it will help him address issues that need confronting, but will it really resolve the problem of his career?

    Trouble is, how DO you resolve that problem?? What will ever provide the same, unique experience of being in the military???? He'd love to go back, but can't because of his back.

    I think it's great that the taboo is now being lifted on mental illness and the army are looking to include training to try to prevent and lessen the risk of PTSD. Not sure if that would actually work, but it's a start. But they still seem reluctant to help soldiers at the other end of their careers. When you leave, you've left. The door is firmly shut. Thanks for serving your Queen and country so well, you're rubbish to us now. Goodbye.

    More needs to be done to establish careers for veterans, to set up links direct with potential employers, so soldiers leaving are basically guaranteed a new career. You should be supported if you need any extra training, and be given opportunities for top positions that might provide some of stimulation and satisfaction you had in the army. You guys have such incredible skills. Why are they, all too often, not being recognised and put to good use? My vet has had 6 jobs since he was MD-ed 5 years ago. That speaks volumes, eh?

    Anyway, think I've waffled on enough. Would be really interested to hear your opinions /personal experiences on this. And if someone wants to bring up this debate on the sister site, mycombatptsd, on my behalf, and then report back here, then I'd be grateful.
     
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  3. heyheyhey

    heyheyhey Well-Known Member

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    Sorry, someone correct me if I'm wrong, but I am pretty sure you cannot be diagnosed with PTSD without having fear and hyper vigilance. That is the essence of PTSD, that terror, the emotional re-experiencing. PTSD is about re-experiencing your trauma in the present (through fear, flashbacks, and nightmares), if that isn't present then he doesn't likely have PTSD. I can't say for sure, because I'm not a doctor or therapist - has he ever had a diagnosis? Rage is a common symptom, but can be common in lots of things, and arise from lots of experiences - I'm sure a lot of VETs may struggle with this. Just because someone doesn't have PTSD though, does not mean that they haven't been traumatised. So I think that you can still treat those things in the same way, even if you don't have the same label. Standard treatments are likely to be helpful - EMDR, CBT etc.

    VETs generally have a worse profile and are harder to treat, than others because their trauma is more severe, more varied, and extends over a longer period of time. These things make trauma worse in all scenarios, but tend to give VETs a worse 'trauma profile' comparatively and generally speaking, due to these factors.

    Yeah, I think that's a good insight - honestly, if you don't have a job or any meaning and joy in the present - anyone would be depressed. But for a VET it's probably like "here is everything that was taken from me, and now I have nothing", so who wouldn't be f*cking angry? I think for me, it was about trying to see how trauma and PTSD wasn't the end of my life, and it was also about finding what else gives me meaning now... what else is he good at? What else could he enjoy? For me these things are dancing, friendship, nature, animals, friends - community, volunteering, reading, philosophy - it's going to be different for everyone. I know when people are depressed, it's hard to build these things and find meaning in things - so you aren't likely to do them, but it also works the other way - in behavioural therapy, putting these things in place, even when you don't feel like it, will begin to resolve the depression someway.

    Sorry, i hope this isn't insensitive, but I think part of healing from trauma - is moving on from it to some degree - not putting all your meaning and passion and existence within the army experience. My old counsellor was an army veteran, he counsels people with PTSD who served, so it's all very much still apart of him and i know how proud he is of it, and how much it means to him - yet helping veterans now means his life has morphed beyond the past, even though he's still connected to it - does that make sense? At the same time he has and does other things that make him feel alive, motorbiking is a big thing for him - and i can see the attraction and the thrill of that, as a result of his army days.
     
    Amack, leelee and ldj like this.
  4. joeylittle

    joeylittle ˁ˚ᴥ˚ˀ All howl, no bite Administrator Generous $250+

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    I'm curious where you got this from.
    All due respect, but how do you know? All you can know is what you observe, and what you are told. But you may not be completely clued in to what it's like in his head.

    No - those are two different issues. But addressing one may bring a kind of closure on the other, or an ability to re-focus. It's hard to say in the early days.

    Mental health is still a baby science. There's more that is not understood, than is understood. Not everyone who experiences trauma even develops PTSD - so of course, it's possible that's not what's going on with your vet. Yes, assessments can be bizarrely short - certainly initial ones. Most mental health diagnoses depend on self-reporting, which makes it far from an exact science.

    The flip side of that is, mental health treatment has lots and lots of overlapping boundaries. Much of what you do for PTSD will also help your overall mental health, even if you don't actually have PTSD.
     
  5. ldj

    ldj Active Member

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    Hi joeylittle, thanks for your reply!

    Oh, I read it in a book "When Someone you love suffers with PTSD" by Claudia Zayfert. And I'm sure I saw it somewhere else too. So it just sparked my curiosity.

    Yes, I agree I don't know what's happening in his head, but I can only go on what he's told me and what I see. He says he doesn't get flashbacks or nightmares - and from what I observe, that seems to be the case - and also doesn't feel scared or guilty about what happened - again, from what I see, that seems to be true, but I appreciate he might be hiding his true feelings.

    As you say, whatever is really going on in his head, whether it's PTSD or depression or a mixture of both, treatment will hopefully help him start making sense of it all.

    We're not together anymore. He left me just before Christmas. But I still feel involved in all this, because I've invested too much to just suddenly let it all go. But I'm respecting his wishes of no contact. Still want to do what I can in the meantime to continue educating myself about this condition. And maybe one day, he might want me back.

    This forum is a God send!

    :)
     
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  6. Friday

    Friday Raise Hell Moderator

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    Yep. Wrong. Not everyone experiences every symptom of PTSD, and fear is not a requirement at all. Some people have anger. Some people have no emotions whatsoever. Beyond not actually having a symptom it's both possible to lock some symptoms down, hide them, or only experience them intermittently.
     
  7. joeylittle

    joeylittle ˁ˚ᴥ˚ˀ All howl, no bite Administrator Generous $250+

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    Also, possible to lie about not having them.
     
  8. Richie

    Richie Active Member

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    this may seem like a strange question, especially on this forum but do you know many serving or post-service personnel?

    the reason i ask is that there is a lot of common issues within the military community that do include anxiety in crowds and even more so, hyper-vigilence! i am exactly the same with both of them and i have never been in combat (or any real traumatic situation). my eyes and ears are always scanning when i am outside and i hate crowded areas.
    frustration and distancing yourself from civilians is also very normal behaviour for a vet. most of us hate it out here because of the lack of discipline and dedication from colleagues. we have standards and we find it hard to deal with those who do not match those standards so again, this is normal for veterans. just yesterday i put in my application for a BSc psychology course because i want to work with the military again but as a clinical psychologist. even when he sees a therapist, there may be problems because most of them are civilians and do not talk our language and that really does cause frustration.

    there is one thing in particular that you mentioned that is not normal behaviour. combat veterans do not normally discuss what they have seen or done in combat.

    i suggest you point him in the direction of a guy called Rob Paxman on facebook. he runs a charity helping PTSD sufferers and he is ex SAS so he talks the language too. he can certainly point your vet in the right direction or he can dig around for other fb pages which relate to soldiers and ex soldiers. a lot of us look at these pages to maintain our military connections and it really does help with the transition into civvy street and beyond.
     
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  9. Zoogal

    Zoogal I'm a VIP

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    Do you know how much easier it is to just say (even go yourself as my husband pointed out to me the other day) that "I'm fine" as in "leave me the hell alone?"

    Not everybody wants to or is ready to deal with their stuff.
     
  10. ldj

    ldj Active Member

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    @Richie Thanks so much for the Rob Paxman contact, looks like it could be very useful

    (oh and I'm not sure what you meant by something I mentioned not being normal behaviour - the fact it's not normal for vets to talk about what they've seen or done in combat. Yeah, mine doesn't either. Did I imply he did?? Didn't mean to.)

    :)
     
    Richie likes this.
  11. Richie

    Richie Active Member

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    I am not sure why I mentioned that. It now seems irrelevant but still true.

    there is one thing that does stand out though. I know it is a symptom of PTSD but that aside, hyper-vigilance is very common with vets in general. I know quite a few vets from all branches of HM Forces and each one (including myself) does observe their surroundings intricately in public. Maybe it is nothing more than a deep rooted habit (suffering is definitely not a fair description) from our time in uniform but is more unusual to not do it if that makes sense. I am not suggesting that it is wrong in any way, it is unusual though at least for vets
     
  12. Richie

    Richie Active Member

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    I have read your first post again. While there may be some combat trauma behind it, frustration and anger in civvy street is a common problem with the transition. This is my 15th year out here and I still hate working with them sometimes. I am guessing he is old school which means a form of discipline was a slap somewhere quiet and this USED to be ok. If I am right, he will want to do that now but obviously cant in civvy street. It gets very frustrating and he will have to accept that eventually. He does not have to lower his standards but he will need to accept the fact that very few civvys will meet his standards. He can only find a way to channel his frustrations into something other than anger. A hobby or talking to friends (military love to moan). Anything that relieves that pent up aggression
     
  13. Friday

    Friday Raise Hell Moderator

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    I've had to draw a really hard line between vigilance & hypervigilance in recent years.

    It's an easy line, though; Vigilance / Situational Awareness is useful, Hypervigilance is not.

    Vigilance/Situational Awareness? Is actually relaxing. I don't have to think about it. My mind automatically notes, categorizes, & dismisses... Everything. Anything out of the ordinary, or that I'm specifically looking for, will "Pop", but nothing else will. If I'm in a crowd of 1,000 people? I can easily bob & weave through it, finding holes or making them, and I'm very alert, which can be tiring after a long while, and irritating as hell if people are doing things I don't agree with -because I have no choice but to pay attention to it- but that's about it. However, if anything in that crowd is "wrong"? Sweating guy in the cold, long zipped up jacket in the heat, micro flashes of fear or guilt, hands half going for weapons when someone bumps them, signs of distress with no obvious cause, pebble falls from roofline, a bag left all by itself by a lamp post, etc.? ZING! Person (or thing/area) is practically lit up like neon. Every sense just snaps to, and locks on both it, and the immediate surroundings. At which point I can either investigate, or dismiss. Okay. Sweating guy has jogging clothes on, flashes of fear are directed at spouse beside them not law enforcement, coat guy just bent awkwardly and there's no weapon imprint (that's my knee-jerk, I never worked around suicide bomber risk, but a helluva lot of concealed long arms) or has no eyebrows so it's probably chemo-cold poor guy freezing in this heat, birds are landing on the roof no sniper, someone just grabbed the "lone bag" (and exhale), etc.

    Hypervigilance? That ZING! The things that pop as Danger! Warning! Achtung!...are...everything. Literally. Everything. It's not one person, or even five people, but every single damn person. It's every noise. Every movement. Every object. All of them. All at once. At increasing frequency. If you've ever gotten that Spike! from an unattended bag? Or near miss on the road? Can you imagine every box of breakfast cereal in the shop creating that same response? >.<. Every footstep, every reflection, every moving car, every person, every bird. Every Everything. It's f*cking blinding. When everything pops? Nothing pops. If someone tried to play "Bang I'm dead!" (Aka where are we? Location & SitRep) I wouldn't be able to tell them. Because the whole dang world is a kaleidoscope of make-it-stop eye-crossing impossibility. And what's worse is that my mind is so busy flagging every pregnant mom, smiling granny, brick, manhole cover, car, piece of gum on the street... That a man could be holding a knife in front of my face and I wouldn't see them. <<< Has actually happened. Had to blink several times and dazedly go "Whaaaa? Oh. Hello knife." (At which point everything crystallized, & clarified, & :sneaky: Wheeee! Yes! Now we're cooking!) but if he'd been trying to kill me, instead of rob me, I'd be dead. Because I couldn't tell real threats from all the -everything- else that assaulting my eyes/ears/heart/mind.

    At lower levels of HyperVig, I can still assess & dismiss... But I have to do it manually. Person by person. Object by object. Sound by sound. I can't rely on my instincts. It doesn't happen automatically, anymore. Which is one of the single most exhausting things I know of. But it's also the only way I know of to retrain my vigilance. At higher levels of hyper-vig, it doesn't matter how many times I dismiss a person/place/thing. It still registers as ACT! :banghead: <<< I think that's an upside, though, all things considered. It's not fear. I'm not afraid of every person/ place/ thing. A lot of people with PTSD, especially victim-related PTSD, those alarm bells, the Danger! Warning! Achtung!, spell terror ...instead of action-required or rage. I'm not afraid of crowds. I'm either exhausted or enraged by them. I don't avoid out of fear, I avoid out of "I don't wanna have to deal with that bullshit."

    Shrug. Anyhow. There are some things the military trains, like vigilance & there's some hypervig as fallout to that. But it seems like the little bit of hypervig just washes away over time for most people. Hell. Even the vigilance, for some (but then some people never seemed to have any situational awareness to speak of :mad: ). But while vigilance & hypervig might sound the same on paper (jumping at every noise, etc,)? At least my experience is that in practice, they're wildly different things. Vigilance can be irritating, exquisite attention to detail, but is useful. Hypervigilance, is infuriating, blinding, and is not. Not useful one bit.
     
    Last edited: Jan 18, 2017
    leehalf, eloc, tiredtexan and 2 others like this.
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