PTSD: One Size Does Not Fit All

So when someone says "PTSD", what's your first vision? The news headlines: "Soldier kills family, stranger, co-worker, etc--suffered from PTSD; family says he/she was never the same after war; Suicide rates are higher in soldiers suspected of having PTSD; Domestic violence levels dramatically increase in service members--PTSD culprit" etc.

But the fly off the handle, unable to cope, hiding at home, constantly anxious, dramatically different personality, alcohol dependent, violent tendencies, road raging, constantly irritated symptoms aren't the only defining symptoms of PTSD. In fact, a service member can have PTSD without obviously suffering from most of the symptoms listed above.

For example, The Husband.


The Husband has met with and been diagnosed with Chronic PTSD and yet he's still a productive (if not over-productive) member of society. *GASP* Yes, someone with PTSD can continue to function in society. I know, I know, according to most major media outlets, service members with Chronic PTSD are the crazy guys you see in fatigues at corners begging for food, beer, money, etc. They are the ones living on the street. They are the ones that America let down. They are the ones that the VA can't help. They are the ones that are the poster child for PTSD...if you have PTSD you have it like that. But see, that's not true. PTSD manifests differently for every person who might maybe have it. This week the VA denied funding for a program that matches soldiers who have PTSD with a therapy dog. And while I think it's incredibly wrong for the VA to deny funding, I also understand that it's INCREDIBLY difficult to set parameters on what qualifies your PTSD for a therapy dog. PTSD is this insane, highly individualized beast. It manifests in so many, many different ways. For one person, it may be a constant state of fear. For another, it's just a fear in certain environments. And because the VA is a government program, there has to be a set way of diagnosing and treatment and it must apply to everyone, even though PTSD doesn't affect anyone in the exact same way. Ever. Sure, there's a bunch of symptoms that are typical for someone who's been through a traumatic event, but that doesn't mean that a person will have all of those symptoms. So then you're basically looking at having to train each dog specific to each soldier. And if I have learned anything about Army, it's the there is no such thing as individual in Army. So, the VA effectively said "oh, it's too much work to do, so yah, sorry you have PTSD and yah, this whole dog thing has shown significant progress, but you're not worth the effort. Good luck!"

But I digress.

So The Husband took his mushy brain to get checked out and jumped through all of the hoops in Army Medical Land and was consequently diagnosed with TBI. At his first appointment, they told him "look as we treat this TBI, the PTSD that you have will come to the surface and you need to prepare to deal with that too". PTSD? What PTSD? Who said anything about PTSD? The Husband looked at me like "man, I'm glad I'm not *that* crazy" and we continued with his appointment. 4-8 weeks later, he's sitting in a psychologist office getting diagnosed as *that* crazy. The psychologist and psychiatrist were very good with explaining that not everyone has the typical PTSD symptoms, and that because he'd been dealing with the symptoms for the last 5 years, they were his new norm and consequently he no longer saw them as strange. And once they defined his symptoms, I came to realize his "quirks" were actually symptoms. Wife of the Year. The epic battle over seating at a restaurant isn't necessarily because the kids can't ever decide where they want to sit in the booth, as much as it is because The Husband needs to sit facing the exit. The crankiness in crowds isn't because he hates crowds as much as I do, it's more like he gets tired after having to visually scan every person of dark hair for wires. The lack of sleep isn't because he's an insomniac as much as it is because he keeps finding himself in nightmares that he has to be woke up out of. The inability to make friends isn't because he's anti-social, but because the friend he made today, might be the friend that gets blown up tomorrow. The inability to sit still isn't because he has ADD (which I still think he has...), but because the quiet brings the memories of death, IEDs, personnel recovery, smells, sounds, etc.

We have been very fortunate to not have the typical PTSD symptoms. When they came home from Iraq in 2007, the unit sent their psychiatrist home first and she briefed the spouses about what to expect from what she had seen. She gave the run down on PTSD: withdrawn, angry, drinking excessively, reckless driving, violent, only wants to spend time with the guys, insomniac, depressed, and suicidal. So when The Husband came home, I was prepped for those symptoms. I didn't let him drive for 2 weeks, which drove him NUTS. I carefully monitored his alcohol consumption, which I noticed as being strangely low. I tried to let him have quiet time without kids under foot all of the time. I watched him for temper flare ups. I watched him for depression. I watched and watched and watched. And what I saw was this guy who wasn't very different than the guy that had gone away 15 months ago.

But what I took notice of was a guy who didn't want to talk about it. At all. And I let him not talk about it. And I don't regret that decision. Some people will tell you the only way to deal with it is to talk about it and while I agree, I wholeheartedly believe it has to be on his terms. Making someone talk when they're not ready to talk can be beneficial to some, but to others (like The Husband), it's just an uphill battle that you will lose. I decided after the psychiatrist gave us her PTSD brief that when he was ready to talk, he'd talk. And 5 years later, he's talking. Not a whole lot, but some and it's literally baby steps. And he's explained that he's seen some horrific things and it's stuff that he wants to spare me from having a mental picture of, because it's a picture that he can't get out of his head. And his psychologist explained that because of the above mentioned childhood, his resiliency ability is through the roof and probably the only reason why he's been able to maintain the illusion of normalcy.

I've been a bit hesitant to write about this based on the stigma that goes along with PTSD. We've had a lot of different responses to his diagnosis. Most Army Guys have been "so what are your symptoms then? Hmmm...I've kind of had that too...I wonder if I'm crazy too?". Some have been stereotypical--"Well has he ever hit you? Do you and the kids feel safe with him? You know I watch the news, I know how those PTSD guys are". But a majority of the responses have been "wow, I would have never guessed.". It's actually somewhat therapeutic to be able to discuss it with others and if by discussing with others, we've encouraged even one person to think "oh hey, maybe I'm not just cranky, crabby, forgetful, exhausted, etc...maybe I should go get checked" it was completely worth it. I know Army does not encourage an environment of getting yourself helped, but if you've got the chance, go and get yourself checked out...even if it's 5 years later.