Saturday, June 25, 2016

To Honor: PTSD in Veterans and First Responders

by Dr Margaret Aranda


War Troopers were once considered "chickens" when they looked as if they were shirking from assignments. Much like the black sheep in a family, it is not hard to imagine how they were ostracized as "the weakest link in the chain" in mortal combat.

These emotionally-disturbed warriors became sufferers of the "Friendly Fire" of emotional proportions in that they may not have lost their lives, but they did lose the lives that they once had. And they lost them forever.

No one knew that the scenes of battle had scarred their brains, their emotions, rendering them paralyzed from bodily and emotional shock. But today, we know that this syndrome is multidimensional, called Post-Traumatic Stress Syndrome (PTSD).

In combat on the front lines, I propose a closer look at a scenario with two different and unique "Impending Veteran PTSDs." Look at the first image below, and evaluate the situation as best as you can, before reading the caption under the image. What do you think is going on here?


Image 1. Two Possible "Impending Veteran PTSD" Patients.  This is imperative for family and friends to understand, so SHARE and spread it wide. See the raw emotions. Hear the bombs, the screams, and see the blood and body parts fly. They aren't just body parts. Those were their buddies that they loved and lost.


Don't think that your life is seriously all that bad if you get this far to read this post, okay? Traumatized people are warriors who fight to live every day, and millions have "Invisible Disabilities" that stay with them day and night. Just be aware of this for starters and put yourself out of your insignificant complaints that are minuscule, in comparison. Image Courtesy of the Christian Youth Musicians' YouTube video, "NF" . Note: For those with warfare PTSD, the video will provoke your PTSD again. Some Veterans cannot and should not watch the video. Others will find great comfort in knowing that they aren't the only ones that know how they feel. Caregivers and significant others may glean an epiphany of understanding that makes them understand and have compassion.

Image Assessment: It is plain to see that the soldier with the helmet wants to go run to our right, perhaps to help another soldier. Equally easy to see is the soldier on the left, who is pulling him back, preventing him from running into a hopeless situation. To me, it's like a scenario that firemen regularly see in front of a burning house.
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Transpose it to the World: People in despair, some who literally want to run inside their burning building, have others that are holding them back, screaming some 'sense' into them, as if anything makes sense.
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There are two "Impending PTSD's:" (1) the Primary 'Patient' and (2) the First Responder. The 'Primary Patient' is in severe distress; the First Responder is pulling the Primary Patient back. Who suffers the most? Do they suffer equally? Are their responses to stress the same, or are there too many variables to differentiate?

How deep can these feelings of desperation be put into words? How does the world stop turning?


The "Primary Patient:" The body's 'Flight or Fight' reflex for survival has him wanting to "Fight." His adrenal glands are secreting adrenaline, or epinephrine into his blood stream. He wants to run. Every muscle and every bone in his body wants to move forward, and he does not care if that means that he will die, too. He wants to die trying to save his fellow warrior. He is noble, caring, loving, honorable, and so much more. This instant of time is forever etched in his brain. It is a MAXED OUT, intensely vivid high state of instinctual survival. The stress response is normal for survival.

The "First Responder:" Similarly to firemen, paramedics, Emergency Room (ER) doctors, ER nurses, and military Meddacs, there is no time to think of anything but 'saving' the Primary Patient. Charged with the professional Duty of saving the "Primary Patient," the "First Responder" puts aside her own emotions and visions of the scene, and is the logical, pragmatic operative who 'saves' the Primary Patient. Inside, the First Responder can be literally sickened inside, holding back her own gut-wrenching vomit longing to be expelled. But she can not, and she does not show it. She may actually even "gag." She "gets over it," and then continues with her Duty as if nothing happened inside her.

Now, look at the this image, taken just seconds later. Think about the two soldiers again, before reading the caption below. What is your assessment of the "Impending PTSD?"



Image 2. Realization of Defeat. After some time, the warrior is swayed by the First Responder. The "Primary Patient" listens to the external pleading, the screaming familiar voice that allows him, no, makes him hold himself back. In defeat to the loss of rescuing his comrade, he passionately cries without considering what anyone else thinks of him.


With PTSD, perhaps the warrior never stops crying and can hope that with proper treatment, he will be able to live a 'normal' life again. He may always have "triggers" like the smell of blood, or the sound of fireworks, that "set off" the PTSD, putting him back into Image 1. But he is changed forever. He can, and he must go on to live his life the way that his comrade would have wanted him to....perhaps to settle down, get married, and have children of his own that join the military. Just like his father did, and his father's father.

Image Assessment: Warrior #1 submits to defeat, as First Responder #2 realizes that he has succeeded in swaying Warrior #1's actions. Warrior #2 has probably saved the life of Warrior #1. 
Transpose it to the World: Firefighters, paramedics, Meddacs, ER doctors & nurses can suffer from the trauma of seeing others in extreme situations where difficult life-and-death choices had to be made. There may not be a "winning" Duty. There may be no sense of accomplishment on the one hand: although he saved the life of Warrior #1 today, it is the 100th time that he has done this.  

The "Primary Patient:" After the Fight or Flight reflex subsides, and the adrenaline stops flowing, Warrior #1 will BOTTOM OUT. There, in an instant of time, is no more cause to 'survive.' He has given in, saved his own life, and like Star Trek's Spock, it is the only logical thing to do. But he still has the scenes, the sounds, the echoes of his Buddy's memory, laughter, farts, and hangovers to hold on to. Someday, he will reach his own equilibrium, and there are many phase to go through: The Stages of Grief, and more. There are things that can help with the trauma. God heals. Time heals. Prayer heals, as does the family, friends, and even the dog. If everything seems to fail, there is always hope that a new/different approach will arise. Together with Lenkey Harrison and others, we're bringing you closer to equilibrium.

The "First Responder:" Undergoes PTSD as well, which is why firemen, ER doctors, and Trauma Surgeons get 'burnout' and problems with alcohol, family relationships, or other negative areas. Retired fireman Lenkey Harrison has a novel method of self-help tools to gather internal resources, de-stress, and heal PTSD without specifically focusing on it and drilling the stress back into the body and mind. The method is described here, at "Raise Your Resilience."


So, let us open a new door to talk about PTSD in both patients with trauma, and in the First Responders. Because "It's About Time."