What is Post-Traumatic Stress Disorder? PTSD has recently hit the news again as being used for the defense of murder. Those who live with PTSD find this defense effort insulting. PTSD is never and excuse. It is not something that the individual enjoys living with on a daily basis. PTSD may best be described as a daily war going on between the ears of the individual and the life he or she leads. PTSD is not a limited condition. It is not a condition that is limited to combat veterans. That is the most obvious event where PTSD is concerned. But PTSD is able to develop where any major personal threat event occurs or when a long duration of personal threat conditions is encountered. It is incorrect to always expect a single traumatic event to be behind PTSD. In many cases of PTSD it is the result of a ‘pressure cooker’ condition where the person lives under moderately high to high stress over a long period of time.
I have worked with combat veterans for over 20 years as a counselor. I also have my own issues of PTSD with which I live. When many of my veterans would get paperwork from the Department of Veteran Affairs for them to fill out so that they could get service connected disability benefits one of the consistent questions was for them to describe the event which was the precursor for their PTSD. This question proves the ignorance of the VA’s understanding of PTSD. In many cases the veteran could have responded with having landed in Vietnam on a particular date and then left Vietnam on such a date. Even this would not be a completely correct answer. This is also why so many veterans do not believe that they could have PTSD. Many believe that if they were not in direct combat that they could not have PTSD. But this is not true. One particular veteran that I worked with was with Naval Intelligence. He was not in combat but when I asked if he was ever in-country I also asked him if he had the same fears as everyone else. I asked him if he had the same fears regarding an unseen ‘charlie’. I asked him if he had the same fears regarding all the snakes and other living things over there that could kill as easily as an enemy’s bullet. I asked him if he knew who and where his enemy was at all times. He began to see that just because he was not in combat that he experienced many of the same fears.
PTSD is a physical condition created due to the long term exposure of the brain’s limbic system to heavy doses of the bodily chemical called cortisol which is the body’s reaction to stress. This flies directly in the face of classic belief of PTSD as an emotional or psychological condition. As the body is saturated with cortisol there eventually begins to be alterations in the limbic system such as the hippocampus and hypothalamus. These physical changes may be seen in imaging such as MRI. These changes create alterations in behavior. But these changes are never an excuse for bad behavior. Anyone who is a diabetic knows that they are responsible for their diet. Anyone who is diabetic knows that they must restrict their sugar intake otherwise they will have a negative reaction. Likewise anyone living with PTSD knows that they will have particular trigger events that they are responsible for avoiding or restricting. It is the individual who is responsible for their behavior and not some condition. It is my responsibility to assure that I eat properly. It is my responsibility to be watchful regarding any alcohol intake. It is my responsibility to make sure that I take my medications regularly. It is my responsibility to make sure I get my rest. It is my responsibility to make sure that if large crowds affect my nerves that I am mindful of those situations. My PTSD is my responsibility and is never an excuse.
PTSD is never something that is enjoyed and simply kept in the background to be pulled out whenever an excuse for bad behavior is needed. PTSD is not something that entitles the individual to a sense of uniqueness. If someone holds the view that unless a person has experienced there particular ‘brand’ of stress that they cannot understand their PTSD then there is a real question as to that person’s desire to truly get help in living with PTSD. Everyone has unique experiences. Five people could have experienced the same firefight and have five different reactions. It is not the event but the reactions of the body to the event. In many times it is the minds response to the ‘what ifs’ of the event rather than the event. A teller who lives through an armed robbery obviously has survived the robbery physically as if I never happened but it is the reliving the event in the mind and the ‘what if’ events that create actually more stress than the event itself. One of my men who lived through the USS Forrestal and the fire that broke out onboard told me that in many cases it was the ‘what if’ events that create more stress than the actual fire. What if the fire had made its way to the ammunition storage? What if the fire had made its way to the heave explosives? What if the fire could not be contained? These questions were able to cause more stress than the actual event. A person, who lives through a firefight physical unscathed, be it a foreign soil or local law enforcement, obvious lived through physically as if there had never been an encounter. But the event and all the elements of the event creates more stress than the actual event. It is also this element that creates the flashbacks of the event. Once a person experiences that level of total vulnerability they never feel quite as safe. Once the façade of personal safety is shattered and the reality of one’s mortality is revealed then that person can never go back to the false belief of personal ignorance regarding the evils which surrounds them. Once a person’s mortality is faced, life changes.
In many ways living with PTSD can be a blessing in disguise. Once a person’s façade of the world’s condition is broken then they can live in reality more easily. Once a person is able to accept that the world is not a nice or safe place then they are able to do what they need to do in order to make it safer. Once a person has faced their own mortality then they are more easily able to live. Too many people are so afraid of dying that they are too afraid to live. Those who have faced their own mortality have faced the reality of death. They have come to terms in many cases with death. Now all they have left to do is live. Mentally they have already died. Now all they have to do is to finish living. In many cases there is a sense of freedom. Death has been faced; personal mortality has been accepted, now for the rest of living. Often the person is left with not so much a death wish for life but a freedom to live life to the absolute fullest for that particular individual. PTSD is never an excuse for bad behavior. PTSD is never an absence of personal responsibility. PTSD is often a war between the ears and something that a person is constantly aware of on a daily basis. PTSD can also be an opening of life’s views to a door of absolute mental freedom.