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Military Think I am making my PTSD worse

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Cypress

Confident
I'm not sure if this is the right prefix. If not, maybe one of the mods can make a change.

I am a civilian working in an operational environment for the next year. My original trauma had nothing to do with combat and I am not a veteran. I do have decades of civilian emergency medicine under my belt and don't seem to have PTSD from that, but who knows. Anyway, I worked on/off in this type of setting before I went into therapy for PTSD and thought I did OK.

Well now that I am back in theatre and trying to continue treatment with tele-therapy, the PTSD triggering is 10x worse. There have been a couple of IEDs and some small arms fire recently and each time it sent me into a completely numbed out state which was followed by such an intense adrenalin rush I vomited. Now every time I hear a helicopter overhead my heart pounds - which is bad because this happens multiple times a day/night.

As long as I am at work I am fine, but when I come back to my room I fall apart and secretly drink. I am going to the gym, eating right, playing board games with my colleagues so I'm not sure what else I can do on the self-care end. I can't take sleep medication because I have to be able to react at night.

My therapist is a pdoc and he is recommending propranolol which I started yesterday.

Not sure what else I can do besides quit this job which at this point is not an option for many financial and logistical reasons related to my divorce. My T thinks I should cut the contract short and get out as soon as I can even if that leaves the people here short-handed. I am hoping that I will adjust with time.

Any advice for getting through this from the vets out there?
 
Tricky situation @Cypress....that’s not helpful I know, but just want to indicate that I have a level of understanding. I have been in similar situations after being diagnosed and completely make sense of the ability to function at a high level while working and then collapse when you have privacy. I also turn to drinking. Have also been prescribed propranolol. I typically defer to drinking. All that to say, I get it. And I hide it all...if you do that too, then you know it just adds to things.

Advice? Well, you serve others correct? When that starts to degrade or function is affected, for myself...I search for a way to recover that. If I really really can’t find a way, then yes....pulling myself from the fray becomes a reality.

Support here in the forums? Outstanding. But not always enough. Pdoc? Yes. Again, tele-health is challenging and not always enough. Decompression in the field is nearly impossible but focusing on the smallest of wins can help.

What’s there that you can capitalize on? If you like the gym, is there one piece of equipment that’s your favourite/not available at home? When you use it, hone in on that. Maybe not the best example but I know there’s always gym stuff in the AOR.

Can you sign out books or movies? Download stuff? Visual distraction when you’re in your ‘pod’ after work?

As always with my words, take what’s useful to you & discard what isn’t.
 
@Warrior Chicken Everything you have shared with me is helpful. I really appreciate hearing from someone who gets it. I most definitely hide it all and defer to drinking. My function at work has not been affected and hopefully it won't be but I agree that if it were to slip and I couldn't get back to good, I would have to leave.

I tend to be highly symptomatic and highly functional at the same time but I plan to decompensate into a puddle at my T's feet during my next R&R.

You make an excellent point about distraction. There are volleyball or softball games that I can start doing. Social and physical at the same time. I can sign out movies and download stuff so I will start doing that. Maybe watch an entire TV series or something. My "pod" is the only privacy I have so I need to make it feel like a home too. I have some new ideas now. Thanks.
 
Well, you falling apart when at home... is also exactly where one should be doing that, if falling apart. The right place & time for it, you know? So you could see how well you're functioning and a win in that, instead of a loss and something that needs a fix-or-out.

Do you have a way to talk to your T about the meds / monitor you for effects?

My T thinks I should cut the contract short and get out as soon as I can

... and they're sure you wouldn't fall apart harder with that return, for the transition itself, return to all the relational drama & hardness left at home, financial isssues, and everything unfinished you left behind, not even starting on having to deal with everything you are pushing to side now?

Shrug, ok, my stick of Finish the job & deal with all the rest later ain't necessarily your stick, but still think its two cents worth of consideration, that you might not be better out of there, but worse, for many more reasons.
 
but when I come back to my room I fall apart and secretly drink. I am going to the gym, eating right, playing board games with my colleagues so I'm not sure what else I can do on the self-care end.
Can you see these statements don’t agree with each other?

Are you able to embrace that the alcohol is most certainly making it harder for your body and mind to manage the stressors of your environment? Is there an alternative way you can manage returning to your room?
 
Shrug, ok, my stick of Finish the job & deal with all the rest later ain't necessarily your stick, b

I think we are on the same page. I feel like in some ways I would be worse back home right now. I need to make some money here so that I can get a new place to live when I get back and I get a break from the relational drama/trauma/mutually abusive misery that was my long-term marriage. I'm 1000% conflict avoidant and don't want to go back until after the divorce is final.

The propranolol is making my body less reactive so that is helping too - a little and hopefully I will have good enough wifi for a therapy session this week. Not ideal but it is what it is. My T is a psychiatrist too so I will ask him if he can recommend anything else.

Are you able to embrace that the alcohol is most certainly making it harder for your body and mind to manage the stressors of your environment? Is there an alternative way you can manage returning to your room?

Yes, you are absolutely correct, this is maladaptive coping all the way and I'm sure I'm making it worse down the line even though it doesn't feel that way right now. Using Etoh as a crutch is an old habit. I know it's disinhibiting and makes the parts more likely to come out but I have had a quiet inside so far here. I guess I am in the contemplative phase as they say.

I appreciate the help from everyone. Makes me feel less alone out here.
 
I'm not sure if this is the right prefix. If not, maybe one of the mods can make a change.

I am a civilian working in an operational environment for the next year. My original trauma had nothing to do with combat and I am not a veteran. I do have decades of civilian emergency medicine under my belt and don't seem to have PTSD from that, but who knows. Anyway, I worked on/off in this type of setting before I went into therapy for PTSD and thought I did OK.

Well now that I am back in theatre and trying to continue treatment with tele-therapy, the PTSD triggering is 10x worse. There have been a couple of IEDs and some small arms fire recently and each time it sent me into a completely numbed out state which was followed by such an intense adrenalin rush I vomited. Now every time I hear a helicopter overhead my heart pounds - which is bad because this happens multiple times a day/night.

As long as I am at work I am fine, but when I come back to my room I fall apart and secretly drink. I am going to the gym, eating right, playing board games with my colleagues so I'm not sure what else I can do on the self-care end. I can't take sleep medication because I have to be able to react at night.

My therapist is a pdoc and he is recommending propranolol which I started yesterday.

Not sure what else I can do besides quit this job which at this point is not an option for many financial and logistical reasons related to my divorce. My T thinks I should cut the contract short and get out as soon as I can even if that leaves the people here short-handed. I am hoping that I will adjust with time.

Any advice for getting through this from the vets out there?
I served but not for the full coarse, so I don't consider myself a vet. It would better you with medication and not booze. Booze gets you in trouble and makes you feel like shit. Go to your reg doc and have him find you something for the day, everyday. Tell him you've become hypersensitive about your job but have to work.
 
Isnt that the same as saying, practically, Im unable to do this job, return me home earliest opportunity?

Honest question. Not sure how much of disclosure and of what is doable for Cy, both for practical reasons / availability of other medical personnel, and contract terms & demands on health alike.
My regular doc put me on anti-depressants a long time ago. First one was Lexapro. They can do all of that. Not sure about your question. My response is drinking makes one go down the rabbit hole and makes others stay there, indefinitely.
 
Go to your reg doc and have him find you something for the day, everyday. Tell him you've become hypersensitive about your job but have to work.

I wish I could go to a reg doc. Unfortunately I am in an austere environment and I am the reg doc and heal thyself is just not something I am so good at. I get what you mean though, maybe an SSRI would help too.

I guess the reason I have avoided dealing with drinking for so long is that I have an internal stop gap. I get a sick, screaming migraine after 3 drinks. It's like built-in antabuse. So while the desire to escape and reach for the bottle is definitely there I can't get sloppy drunk because I'll be vomiting into the toilet long before I get there. I was drinking less back home but here, its a daily, carefully titrated 2.5 drinks/day.

@The Albatross I have never heard of Smart Recovery but I will look into it.
 
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