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Editor's Note: The story in this website tells about Clark Dyrud's time in Vietnam. He has spent much of his life since then helping hundreds of veterans deal with PTSD and other problems. This letter
addresses what he has learned in the 30 plus years since the war.
Post traumatic stress disorder (PTSD) is a strange critter. It creeps into your life without you even noticing and hangs
around in your shadows, sometimes for the rest of your life. It nips at you in many ways, often in ways you're not aware of. However, once you become aware of its existence, it's a great relief, because
it explains many behaviors and actions that may have been troubling you for years. And there is hope. Once you recognize it, there are many avenues of help.
PTSD enters your life once you have been
exposed to situations in which your life or safety is threatened in ways which make you feel very fearful or helpless. That's all. When faced with life-threatening experiences you simply react in the
best possible way to save yourself: You either fight back very hard or run away very fast (the old fight-or-flight reaction).
Our brains were hardwired so we could survive. People who could either
run away from saber-toothed tigers, or kill them before becoming their lunch, survived to fight or flee another day. And they survived because of a couple of little glands in their brain stems.
When
we see or hear something, most of the incoming information gets routed by the first gland (the thalamus) to the main area of the brain (the neocortex) to be identified. But it takes time to see something
like a tiger leaping out from a bush, recognize it, and send messages to the appropriate organs and muscles to respond. Not a lot of time, but enough to make us the tiger's blue-plate special of the day.
Therefore, that first little gland sends a little bit of that incoming information to another tiny gland (the amygdala, for those of you keeping score), which instantly fires off commands all over
your body. You leap out of the way, or hurl your spear, or run like the dickens before you're totally conscious of what just happened. If you live, your heart is pounding; you're probably sweating a lot;
your stomach has flipped, flopped, or tightened like a fist; your mouth is dry, but you've survived. Meanwhile, your brain has fired off chemicals (endorphins), which act like morphine. Your feelings are
numbed, you have an increased tolerance for pain, and, when things calm down, you may even feel like you're a little high. After a battle, there's often a lot of laughing, joking, and you may have had a
temporary sense of well-being. You may have actually felt quite good.
This worked so well back when tigers chased us, and the system still functions flawlessly today. And here's the kicker. If that
system (fight-or-flight) is activated too many times over a relatively short period of time, or super-activated by a major, one-time event, that second little gland treats almost everything it receives
as dangerous or dastardly, and a routine trip to the mall can cause your fight-or-flight system to be continuously activated. But at a low level so it's hard to recognize it. (Not like when a car
back-fires and you find yourself peering sheepishly over the edge of a curb.) But it keeps happily firing away, just under your radar, thinking it's doing a wonderful job. Meanwhile, your quality of life
keeps going south, and it keeps affecting the lives of the people around you.
So what are some of the ways your life may be affected? Let's start a partial list and see if any of these fit:
--You jump at loud noises.
--You have nightmares about war. (I'm going to keep referring to war. Please remember that it could be any kind of trauma, so, non-veterans, keep reading. This could apply
to you.)
--You can sure get angry, but you have a hard time expressing other emotions. In fact, you often feel sort of numb—other people seem to be reacting certain ways, but you don't really feel
like them. You learn to sort of fake your emotions so you can fit in.
--You have night sweats for no apparent medical reason.
--You sleep poorly, often waking up during the night and not being able
to fall back asleep. Or you can't fall asleep. Or you wake up several times during the night.
--You avoid people or places. You feel best when in quiet situations, such as in nature or in your
basement recliner.
--You avoid large gatherings. If you have to go, you have learned that having a few stiff drinks before you go, or shortly after arriving, makes the event easier to attend.
--The only time you really feel comfortable around others is when you've had a few knoopers.
--You lose yourself in your work, at the expense of your family or social life.
--You are unable to
work in "normal" settings, and find you can only function in jobs where you're by yourself.
--There are things about your experiences that you don't remember. Sometimes a fairly large block of time
such as several hours or even days.
--You get irritated very easily: By other people, the events on the news, the guy in the next car, the way your co-worker talks. A drink or four will make that
irritation go away. You feel better about everything—unless you drink too much, in which case you may go bonkers and feel like knocking the crap out of anyone who has a vowel in their last name.
--You
talk very little, or never, about your experiences. You are vaguely embarrassed or ashamed of things you did (or didn't).
--You don't like to be reminded of the war. War movies, a certain sound or
smell, or any number of things can make you remember your experiences, and so you find yourself avoiding more and more activities.
--If you survived and others didn't, you feel guilty. Why did you
survive? Why didn't they?
--You withdraw from friends and family more and more over time. They don't know why; you don't know why.
--You can't seem to make relationships work. You've gone through a
couple of divorces, and, as your kids get older, you lose the ability to connect with them or to keep them in your life in any meaningful way, even if you love them very much.
The list can go on.
There are so many ways that PTSD can affect your life. But you don't connect the dots. All you know is your quality of life sucks and others seem to be able to be happy, joyful, or contented (at least
some of the time), but you can't. That is why you don't realize that PTSD has affected you until years after the traumatic event, and why it is an incredible relief to discover what PTSD is, since it
helps explain many of your odd, unpleasant, or unfulfilling behaviors over the years.
Here's the thing about alcohol or other drugs. They can calm down that state of high alert that PTSD puts you in.
Therefore, your life feels better when you're drunk or high. (Unless you're a "mean" drunk, in which case you'll go through life knocking others down, or getting knocked down. What's very sad is if the
victim of your foul, alcohol-enhanced temper is a family member.)
Although drugs and alcohol can ease some of the tensions of PTSD, they can take over your life so that PTSD is not your main
problem—your addiction is. And your addiction can cause far greater problems in your life than PTSD. The bottom line? Your usage needs to be dealt with before you can receive any meaningful help for
PTSD. (Note to Vietnam vets: You were exposed to Agent Orange. Wasn't that enough? Do you have to keep filling your bodies with more chemicals for the rest of your lives?)
So far I've talked about
PTSD as it develops over the years. Recently we have had more wars, and with them, newly-discharged combat veterans. If you stay in the military after being in combat, your life continues to have a
clear-cut structure, and you will probably receive information or counseling about PTSD. The military has become much more savvy about PTSD. But if you leave the service shortly after experiencing war,
your life can look a balloon that's been blown up and let go: You zoom through life bouncing off walls, ceilings, or anything that gets in your way.
Here's why. Your heightened fight-or-flight system
is screaming, "feed me!" and that's what you try to do. You've come from an experience where your life had a clearly defined goal: staying alive. Your senses were so much sharper in combat. There was an
intensity that civilian life can't match (unless you go into law enforcement, fire-fighting, or other careers where PTSD is an occupational hazard). So you find yourself drinking too much, partying too
much, driving too fast, developing dangerous pastimes (hunting grizzlies with a knife—okay, I made that one up, but you get the picture). You have a hard time tolerating the petty "crap" that you face in
a routine job or in the classroom. So you may leave jobs or school for no good reason.
My suggestion is to have fun. You've been through a lot. Now it's time to unwind. But, learn about PTSD and how
it can affect your life. You're not crazy; war is crazy. What you're feeling is a normal reaction to an abnormal situation. You've seen things that no one should see; you've done things that no one
should do. And now you're supposed to just pick up your old life as if nothing has happened. Another thing. Please don't expect other people to understand what you've been through and say the "right"
things. They can't; they haven't been through what you've been through. But it's very helpful to try to talk.
Try to find other vets who've been in war and talk to them. They'll understand. The
experience of war is the same whether it's fought in cold or heat or sand or sea. Women who have given birth can relate to each other regardless of race, status, language, or age; men will never
understand what that's about. The same is true for combat: If you've experienced it, you have something in common with other combat veterans, regardless of age or which war they fought in. So talk to
them.
Now it's time to talk to your WWII, Korean, and Vietnam combat vets. Fer chrissakes! Stop the BS about never talking about your experiences. That's the worst thing anyone with PTSD can do. Not
talking allows PTSD to fester and grow and take over your life. Talking about your experiences is like lancing a boil: it's messy at first—you may have strong emotions that surface—but you can't get
better until you grab that needle and…okay, enough about boils. But talk. Please talk. It will help you and it will help younger vets.
The effects of PTSD can be so minor as to be barely noticeable,
or they can be so great that you can hardly function.
After WWI and WWII, many veterans were classified as "shell-shocked" and spent much of their lives in a VA hospital. But veterans who didn't need hospitalization often ignored their own problems. They "shut up and took it like a man." Most likely, their problems were not recognized by the medical profession. (How can you help someone who won't talk?)
Studies have shown that the greater your sense of helplessness during a time of trauma, the greater you may be effected by PTSD. Therefore, a veteran who was raped while in service may have more
problems with PTSD than some combat veterans who were terrified, but felt they were somewhat in control of a situation.
But there is no "standard" reaction to war or trauma, and it's dangerous to
generalize. In fact many people, including veterans of other wars, were very skeptical of PTSD when it was first "invented," often thinking it was just some sort of weakness or character flaw. Yet
veterans from all wars have suffered from it. The reason it seemed to happen to Vietnam veterans was that extensive research into PTSD was done in the 1970s. A lot of the early research was done on
holocaust survivors, as well as veterans. By the late seventies, the group of symptoms that can happen to people exposed to war, and other trauma, was given the name Post Traumatic Stress Disorder, and
psychiatrists and psychologists were given the tools to diagnose and treat it.
The VA first recognized PTSD as a condition for which a veteran could receive compensation in the early 1980s; however,
it was very hard to get the VA to grant those cases in the beginning. Therefore, many veterans had unpleasant experiences with the VA and never returned. However, much of the ongoing research about PTSD
has been done in the VA system, and now the VA does an excellent job of recognizing and treating PTSD. And WWII and Korean veterans have learned that PTSD is something they also suffer from, and get help
for.
Okay. So you suspect that you may be bothered by your experiences, and that there may be something to this PTSD thing. Now what?
Here's where it gets hopeful. There are several ways to get
help. VAs have professionals, and sometimes entire departments, that help veterans with PTSD. The VA established Vet Centers many years ago to help Vietnam veterans who didn't feel comfortable going to
VA Medical Centers. Their role has expanded over the years, and now they help all veterans who have problems with PTSD.
It's really important to start talking about your experiences: To a doctor or
counselor, to a support group, to somebody.
Maybe you need some medication for a while. Something to help you sleep, or help with depression, or anxiety. Maybe you need to look at treatment for
a drug or alcohol problem.
Where do you start? Every county has a County Veterans Service Office. They know what resources are available in your area and are the best place to begin your process. Or
contact a VA or Vet Center.
And start talking. Eventually that is what can heal not only you, but your relationships with your loved ones. It's never too late to start. And it's never too severe to
be treated. So come in out of the cold—or maybe it feels like the heat.
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