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anthony
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I have been thinking about this post for the last 24 hours now, trying to gather my thoughts on how to best present it. A few things come to mind, but basically you will have to read the entire post, because there are certain phases, certain means and methods to the other side of PTSD, and variances / tolerances most certainly play a major role in recovery from PTSD on a person by person basis. Only you, the sufferer, will know exactly what fits you best, what you may be going through now[PRBREAK][/PRBREAK], or what could be adapted to suit you better.
This is by no means definitive, and by no means appropriate for every person, but most should fit within this scope to some point. Basically, it is long winded, and details most of my own personal accounts with PTSD, and then some other peoples' thrown in for good measure, because I believe their parts of healing are very appropriate to be known.
Timeline to Recovery - Assertive Approach
Why did I headline "assertive approach?" Well, this is how I took on my recovery from PTSD. When I say recovery, I am not saying you will be cured, but you should get to a point where your life and personal relationships are certainly back to some normalcy compared to PTSD. Relationships are always an ongoing work effort, regardless of whether one has PTSD or not, so don't discredit yourself too much.
A Quick Synopsis of the Timeline to Recovery
- Exposure to severe trauma over periods from 1997 - 2002 from multiple operations around the world.
- Developed PTSD, as a catalyst of concerns, International Force East Timor (INTERFET) 1999.
- Life turned upside down from 1999 - 2000. PTSD was in full uncontrolled flight, with no idea what was wrong with me.
- Sorted myself out to a functional level, still with no knowledge of PTSD, in 2001. What I perceived as okay, others did not.
- Redeployed on UN operations Jan - May 2002, fell apart immediately after.
- Was sent to get help beginning 2003 or get divorced, again.
- Was diagnosed with PTSD mid 2003.
- Continued working for approximately 3 months, at which point I took all my leave because I wasn't coping, being about 4 months worth in lieu.
- Returned Jan 2004 for about one week, fell apart, sent home.
- Approximately Mar 2004 it was conclusive that my medical discharge was now moving for PTSD.
- I spent all of 2004 basically at home on full-time medical leave, in which I attended counselling and physicians for help and support.
- End of 2004 officially discharged, and little was happening with the counselling and doctors, apart from being medicated highly and telling all my trauma to a counsellor, none of which was really understood at the level I required.
- Learnt about PTSD and my symptoms in 2005, and attended the National PTSD course using CBT. The particular location had the highest success rate for all of Australia.
- PTSD Forum was born during that course for a sheer lack of ability to chat with others directly affected by PTSD as a whole, and not military orientated.
- Got much worse after that course, and after the intense trauma sessions, though the storm passed by end 2005, and I felt much better.
- I repressed early 2006, to only pull myself out of the hole I had gone back into, now being near symptom free.
- Total time from diagnosis to near symptom free - 3 Years.
Exposed to Trauma
Here we are at the beginning, your exposure to trauma. Regardless what sort of trauma you have been exposed to, the end result is PTSD. Whilst other disorders or illnesses may be present from your trauma, you may need to seek appropriate advice from qualified persons within those areas, or persons who are educated in those disorders. Let's just keep things to PTSD here.
At some point after your trauma, PTSD is now present. Chances are you have no idea about it, just as I did. We the sufferers may now be going through endless relationships, divorce, separation, anxiety, depression, social withdrawal, anger, fear, drugs, alcoholism and so the list goes on.
Suppression and Denial
At this point in your life, you have changed drastically. You may have separated from previous partner/s, continuing to have partners and attempt relationships, but none of them work and everything is the other person's fault in your eyes.
You could actually be using cigarettes, dope or alcohol to suppress PTSD. This means, that whilst these factors are a part of your current life, your PTSD may be quite pushed down, and you're still working, still socialising, still living what you consider to be "normal." The difference here is that your life contains facets that are also just as dangerous, or addictive, to ensure you continue maintaining your current life structure. This is part of denial.
Denial is not about not knowing, but instead even though you don't know what PTSD is, or that you have it, you deny the fact that you can exist without alcohol, without cigarettes, without drugs possibly, and your life will still be the same. Denial is about people telling you that you have changed, and dismissing those statements from family, friends or relatives; all of which generally know you the best. You continue partying; continue a self-destructive lifestyle, unbeknownst to you that PTSD is actually part of your life.
You may be pressured to give up alcohol, cigarettes or drugs if you use them, in a new relationship that you actually do care for this person deeper than what PTSD can push them away. Generally, the fight or flight syndrome has simply pushed you into flight from relationships, but now you're discovering you have to fight to keep something you may just love more than anything else within this world. You may have a child that for years you could have neglected or rejected, and now your mental state is actually fighting, not flighting, and pushing you to want to be with your children, or to have children even. Regardless what it is, something is worth more than just coping with day to day life with uncontrolled PTSD.
Here is a point in your life that produces the full results of PTSD, all of which will generally suddenly cause your life to take major direction shifts, and changes to your personal circumstances. For me, it was when I gave up smoking to have a child with my current wife, for the health of the baby, and not my selfishness. Cigarettes, one of my main suppressants in conjunction with alcohol, were now gone. PTSD was then no longer suppressed, so I attempted to increase my alcohol consumption to counteract the effects - these same effects that I still had no idea they were occurring, or why they where occurring, within my body.
I didn't increase alcohol volume as such; I increased the alcohol strength, from purchased spirits, to now homemade spirits, which where on average 70% alcohol volume compared to the standard 30 - 40% sold commercially.
At one point when I left my first wife, I moved to drinking a standard bottle of spirits per night, which I think is about 700ml, and then working each day. My system was so used to the alcohol; I actually could function quite normally during the day in my job...I was alcohol dependent at that stage within my life. It was nothing to go and spend $300 a weekend on alcohol in nightclubs, bars and clubs.
Some of this may sound familiar to those with military backgrounds, because the military basically forces alcohol upon you, as a suppression and social tool. They make compulsory boozer attendances, functions and events based very much around alcohol. At the end of the day though, it is still an individual decision whether to drink it or not, though one could often be ridiculed within the military for not drinking and being "social."
During all this, I deployed again for another 4 months to East Timor, though this time it was just UN operations, peace keeping - much less stressful than the previous war zone I had been in. East Timor was rebuilding itself, and even though we had weapons and a threat still existed, it was by no means as stressful. Regardless of all this, my progressive getting better over the year before this deployment all fell apart when I returned home, because you still have so much more that goes with deployments than just the stress and threats. The things you see and do, and the way your life is lived, all of which is vastly different from the usual civilian lifestyle that you're used to when home.
You live in your house, you have safe passage everywhere, guns are not in every person's hands (though America is another story, Australia is not like that), civilian life is very relaxed, peaceful and less stressful. You go to bed each night, have a good night's sleep, then wake up, go to work, finish work, and come home to your life again. None of which occurs during operations. You are at work 24/7, in a strange environment which becomes home to you; eat, sleep, go to the toilet, etc. with your weapon, at all of those times in the back of your mind, a sniper or incident could occur. The unknown stresses of conflict I put it down to.
So, returned home a mess, my wife and I actually had back to back deployments, being that I came home and she was deployed, and we got to see one another in country for two weeks before I returned home. So that was nearly one year apart, which under normal circumstance would strain a relationship. I returned home, heavy on the alcohol and cigarettes, slowly watching my life fall apart around me. I had a breakdown during this time; I also had a car pull out in front of me when I was on the motorbike, and cleaned me up, breaking most of the left side of my body. It was this point, nearly at the end of Kerrie-Ann's first deployment, that she was returned home. Her deployment stressors are another story, and let's just say, they played a significant impact on my breakdown, though the accident got her home a few weeks earlier. I was basically bed ridden for some time.
Welcome to PTSD
At this point, you have been told you could have PTSD, you could have taken yourself off to get help, and you could have been given an ultimatum as I was, "Get counselling or get divorced - again!" I loved my wife, then fiance, far too much to go through another divorce, and wanted to spend the rest of my life with this person. So, off I went to counselling with the Vietnam Veterans Counselling Service (VVCS), which was provided free to all veterans of any conflict, their partners and immediate family.
It was at this point my counsellor said to me, near immediately from looking at me, "I think you have PTSD!" I said, "PTS what?" At this point I was given a book to read, a short Vietnam Veteran's experience from military to civilian life, and having PTSD. I returned a week later and said, "Someone wrote a book on me." My counsellor, who was an expert counsellor in PTSD, looked in dismay, because she actually didn't think I could be that bad, as bad as a person who was significant enough to have a short book written on them. She was wrong...so she discovered.
It was at this point that she sent me off to a veteran General Practitioner (GP) to get preliminary diagnosis and referral to a psychiatrist for further review. The GP took one look at me, without even speaking to me, and said, "So, you have PTSD!" He had over 30 years experience as a GP dealing with veterans and PTSD, and could tell without even talking with me. I was a mess as a person. He referred me to my psychiatrist, Dr. Michael Likely, who was the most experienced psychiatrist in Townsville with veterans, and is a very good doctor. It only took him minutes to derive the severity of my PTSD, and I was diagnosed with this disorder that I knew little to nothing really about, nor understood the implications it has played on my life previous to diagnosis, nor after.
I got medicated in the trial of Lexapro, as it wasn't available at that time on the prescription list. I was told to take 10mg, then a few weeks later, 20mg, then a month later 30mg. I was told if I had to take 40mg I was getting locked up in the hospital, because basically I would be a danger to myself and others. I already was, now that I look back on it, because I ended up having to self medicate myself with 40mg without telling the doctors. Very dangerous times I led for myself, and others around me, but I am a very strong minded person, and was not going to kill myself over PTSD. Instead I knew I was going to beat an illness I was just diagnosed with, and told wasn't curable.
At this point, I was still working. I was told by both doctors to get rid of the alcohol, because at the end of the day, whilst it was a suppressant for me, alcohol is also a depressant, which was a significant player in my constant thoughts about suicide, and ending the pain that I suffered. I took myself off alcohol for the most part, though I was still binge drinking as such, at work functions and social events, but the majority of time, no alcohol.
My doctors told me pretty straight that I would not be able to remain within the military with PTSD because basically the symptoms, pressure and stress associated with the military role, my responsibilities and job aspects, would never allow me to get any better from this debilitating illness. Me being me, I didn't listen, and so I continued with my job. I told one of my immediate superiors that I trusted about being diagnosed with PTSD, because I actually did all this around the military medical system, because I thought it wouldn't affect my job, and didn't want it to affect my job. I knew if the military medical knew, then it would only get worse, being that I would be restricted to certain duties, tasks, no weapons, etc., etc., etc...safety aspects, all of which I was aware, though I knew I was in control to some point, and to not do anything silly. I really didn't need extra stress, and didn't want to be humiliated within my duties, especially as a SGT who was soon to be promoted to Warrant Officer.
Well, it didn't take long and my life got worse, just as the doctors told me. I couldn't concentrate on a task for very long, I couldn't remember tasks that were given to me. I started to get things wrong, often, which was not very like me at all. As a senior soldier, I was lucky in that aspect, because I earned a little more leniency than I guess a private soldier would get under the same circumstances. I took myself to the military doctors this time, and told them I had been diagnosed with PTSD. The civilian doctor, female, actually didn't even know what PTSD was, nor had she dealt with it before. I told her my mental state of mind, and she sent me home to rest for a few days, whilst she educated herself with PTSD. I came back, told her that I was no different; she sent me back home for a couple of weeks.
I returned to work, a little less stressed and anxious, and thought I would be okay by this point. How wrong I was. Stress, anxiety, etc. all came flooding back within days. Back to the doctors; huge restrictions placed upon me, then sent back home for another few weeks. After this went on for a while, she sat me down and spoke pretty frankly about this. She said that I should be able to remain within the military, though my mental state was telling me much differently. So I said that it wouldn't be an option at this point in my life, so she proceeded to start the medical discharge rolling. During this time, I was sent home permanently for nearly twelve months, until my discharge date was effective.
So, here I was, now a civilian again. Money was a concern for a short period, though that soon sorted itself out from compensation, some hard work done previously and investments. Money was no longer a problem. That took a huge stress from my shoulders. The problem with this though, is some of my friends with PTSD; most aren't as lucky, as most certainly do have financial issues, all of which just add to making PTSD much more stressful. When I look back and review things that others with PTSD and their financial situations face, finance plays a significant role in whether the person begins to seriously contemplate suicide or not; regardless of all other factors, it is a huge contributor to the decision.
Time to Get Serious
During the time off awaiting discharge, I was slowly learning some pieces about PTSD, though most of the time was merely based around me just trying to relax and ground myself again. Once discharged officially from the military, it was at that time I could release that part of stress from me, being around military that is, and move on with getting myself better. So, I found out about the PTSD course that uses CBT to treat patients, and apparently had the best reputation for success in the entirety of Australia...so my wife began finding out the details, went through preliminary administration matters and got myself upon a course in the latter of 2005. From that point, I continued onto the course, learning for myself all the way up until the course, then being given expert knowledge, advice and counselling sessions. Whilst some things were useful, most content had little purpose or intention relevant to help sufferers of PTSD - tools and techniques, with little that had any sort of high success rate compared to other important information given within that course. What I discovered at this point though, was that by using the information they gave us, and the techniques they taught us, with discussion among the sufferers and spouses, pieces started to fall into place.
By the end of the course, I was feeling better, though it was the calm before the storm, because a good portion of the course contained trauma therapy and counselling. Once I finished the course and left to fend for myself, as I was told, it will now get worse to only get better. It got worse, especially with a move from one State to another thrown in at Christmas time. After that move, things began to get better for me near immediately, and so I have continued to evolve and sustain pretty good stature into 2006. Had my moments, but more ups than downs, and the downs are getting less and less every day.
One thing I discovered during a return to Townsville in early January 2006 is that the sheer relevance of that location had an impact on my mental state. This was the city in which all my deployments had occurred, military activity was high, helicopters flying on the roof tops most weeks, and the usual scenarios based around military cities and towns. I will not be returning to Townsville again, as it put me about 10 steps backwards in my progress.
The Calm After the Storm
I am now at a point, finally, where the storm has passed in regard to my PTSD, and I can now function more appropriately within society once again. During the past three years, I have learnt my limitations, I have learnt my triggers, and I know what to avoid vs. what to push upon myself for constant improvement to minor ailments.
When I was told that what I had was not curable, I really did shrug it off for some time, until such a point where I got to know people who have had it for 30+ years, and their in-depth experiences with PTSD during their lifetimes. They have been in and out of hospitals, done just about every known course to help them in each and every aspect of symptoms available; they have had times off up to 10 years with no symptoms what so ever, to suddenly be back in the hospital near overnight. Here are people who had nothing for 10 years, then bam, all their traumas came flooding back in again. Why? Basically, because during the entire 30+ years, they had never really gotten their trauma out; they still carried secrets which they all assumed were buried, though know much better now, have gotten those secrets out of them, and are now at a more relaxed state within their lives once more.
What this demonstrated to me, is that PTSD really isn't curable, and even though these people have now rid themselves of all their secrets and traumas, they still have mild bouts of symptoms pop up occasionally. This is basically what I experience myself now, with little to no long term effects, nor hiccups to my life whilst I remain cognisant of my triggers and known trouble spots. This most certainly doesn't mean that everything is rosy, because I still have issues to deal with constantly; some PTSD related, some are merely over emphasizing normal human reactions, because of the presence of PTSD within me. Whist I went to a crowded event two nights ago with over 53,000 people, and had no repercussions because of it, I was also mentally prepared to cope with such idea of such large crowds. Compare with an impromptu trip to the shopping centre, where suddenly it is very crowded; I can become anxious very rapidly because I have had no significant mental preparedness to cope with the situation.
Anyway, that is a rough outline of my PTSD timeline, with some others' experiences tacked within, and hopefully will provide some outlook to all other sufferers who cannot currently see an end to this battle. There is another side to PTSD, and it is most certainly much brighter than the uncontrolled PTSD aspects. Three years is approximately what my doctors originally told me it would take to get to where I am, if I wanted it bad enough, and was prepared to work hard at it. I say that, because I still have friends with uncontrolled PTSD, who were diagnosed before myself, and around the same time as myself, who have still done little to help themselves, are still self destructive, still highly medicated, still in denial and self pity about their life situation.
Getting better is really a full-time choice with PTSD. Either you commit to getting yourself better, or you think you are doing yourself a favour by ignoring the fact you're sick. One friend who is still in denial, and has been now for five years, has suffered two heart attacks from his PTSD, is still self destructive, and still won't help himself.
An active choice you have to make. Either you want help, you want to get better, and you are willing to commit yourself to this decision; otherwise you're wasting your time, and everyone else's time, whilst you continue to fool yourself that you will get better with all your secrets and traumas in check.
