It's June 30th, the last day of National PTSD Awareness Month. It's also exactly one month out from the trauma anniversary that has, historically, been very challenging for me to cope with. It's with this in mind that I'm writing this blog post. I wanted to bring a little bit of tongue-in-cheek humor to a serious subject and help to inform loved ones of how pending anniversaries can impact the daily lives of our veterans. I also wanted to present how I cope with my PTSD anniversary in a way that would be immediately familiar and identifiable to anyone who has served in a combat zone. So, here goes...
Pre-Deployment Processing (PDP):
When soldiers are getting ready to deploy, they go through an exhaustive review of their readiness from physical fitness to ensuring all shots and vaccinations are updated to drawing weapons and equipment to updating their life-insurance beneficiaries and their wills. It is a focused and direct approach that ensures that each soldier is fully-equipped to confront the challenges they will face when deployed. When I am preparing for the emotional and physical buildup that stems from a pending anniversary, I take stock in much the same way - to ensure that I know the status of my resources and to shore up any weaknesses in my coping mechanism. I take stock of how well I've been sleeping. If I haven't been sleeping well recently, I make a point to go to bed earlier to try to compensate for this. If I haven't been active and exercising, I make a point of increasing my activity levels - it helps you sleep better and it has been proven that exercise improves your mood. I start paying particular attention to events that could potentially trigger my PTSD (the Fourth of July, for example) during the month leading up to and immediately following the anniversary. I do what I can to prepare my family for what could be a bumpy ride. Marshalling and evaluating the readiness of your resources is key to a 'successful deployment', whether into a combat zone or in preparation to confront and cope with your PTSD triggers. In the past, I have tried convincing myself that I don't have to do this and that believing that the anniversary won't impact me would see me through - Epic Fail. Don't fall victim to the Five P's (Piss Poor Proper Prior Planning).
Battle Damage Assessment (BDA):
After a battle, a unit goes through what is called a Battle Damage Assessment to evaluate the readiness of their troops and equipment. This is a critical process - after the BDA is complete, it allows the unit commander to redeploy his resources in the most effective way possible, given the readiness and condition of his assets. It is much the same after something has triggered your PTSD. It is vital that you evaluate how much of your emotional reserve has been depleted by coping with the trigger and fighting to regain control. It is also very important that you evaluate your physical condition. There is almost always a strong adrenalin response when I am triggered and it can disrupt my sleep and my physical energy reserves can become dangerously depleted. After I have re-stabilized, post-trigger, I perform a BDA so that I can redeploy my coping resources more effectively. Sometimes that means taking naps to catch up on lost sleep. Sometimes that means making sure I have time to decompress built into my day. Sometimes it just means staying in for a day to recover. I do whatever I have to do to ensure that my resources last as long as possible.
Make no mistake: Effectively coping with anniversaries is like fighting a campaign with each trigger event being an individual battle. Winning or losing an individual battle may not win or lose you the campaign, but without proper planning and resource allocation, you will lose out to attrition and loss of morale. Don't try to ignore the warning signs - you'll get blindsided. It would be like a convoy not sending out scout vehicles and being surprised when they get decimated by a near ambush with intersecting fields of fire...
Calling in Reinforcements:
Sometimes you will find yourself in a situation where you know you're about to be overrun. In the past, I have let my pride get in the way of asking for help and have paid dearly for it. Reinforcements are not unlimited so it is imperative that you know what reinforcements you have access to and how often.
After-Action Review (AAR):
After every campaign, commanding officers get their officers and their NCO cadres together to evaluate the performance of the unit over the course of the campaign, to better identify recurring weaknesses in strategy or to identify resources that were more rapidly depleted than planned and accounted for. This is a high level review that allows commander to respond and react to lessons learned and properly account for them in future deployments. It's important to do the same with PTSD after the anniversary has passed. Once things have returned to the status-quo, it's important to take a look at what you did right and where there's adjustments that need to be made. It's important to talk to your friends and family and get feedback, should it be necessary. If you don't incorporate lessons learned in preparation of the next anniversary, you're not doing yourself any favors. As a commander, if you knew that deploying your troops differently in response to a threat would save lives, you'd want to know it. Treat coping with your anniversary the same way.
So there you have it. I hope you find this helpful and humorous at the same time. If you have any questions or feedback, don't hesitate to comment on this!!
The Best TV Episode You've Probably Never Seen About Combat-Related PTSD, Suicide, and the Long Road Home.
Have you ever heard of the TV Show, 'Hack'? I hadn't either, but it was available in Netflix and its premise sounded interesting. I cop that made a mistake, lost his badge, and started over as a cabbie or hack in Philadelphia. The show starts Andre Braugher and David Morse so I figured I'd like it.
I'm glad I gave it a chance. The show ran for two seasons in 2003 and 2004. It has excellent lessons in morality and it's massive scale of grey, love, hope, and family. Then I started watching Season 2, Episode 14, named "Fog of War". The main character's godson came home from Iraq after being wounded and they depicted PTSD, raw and unfiltered. They showed how he tried to numb his mind with pain killers and alcohol. They showed how corrosive the effects of survivor's guilt can be on the soul. They illustrated the particular way in which our anger can flare - by raging against inanimate objects and scaring the crap out of our loved ones. It illustrates moral injury and the cost of war upon the human condition. What gave me chills was the manner in which the actor playing the soldier depicted intrusive recollections. The unconscious twitch of the body, the quasi-nauseous shudder and the thousand yard stare.
It also shows how quickly dependency and depression, combined with survivor's guilt, can lead to suicidal ideation.
One thought kept on popping into my head: "This Could've Been Me."
PTSD didn't really reach mainstream awareness and acceptance as the signature wound of this conflict until 2006 and 2007. What really gave me goosebumps was the date that this episode aired: Feburary 7, 2004. Just five days after I returned home from overseas - I was one of the vanguard. One of the first to return home from Iraq. They didn't even have support services in place for the conflict in Iraq. My support group was comprised of veterans of previous conflicts, predominantly Vietnam.
I watched the episode four times in a row, with tears in my eyes every time. Every time I watched it, the more poignant I realized it was - and just how aware the writing team was of the enduring costs of war. I would warn against watching this episode if you are still learning to cope with triggers, but if you are in the right frame of mind - take the time to watch this episode. It will be particularly educational for family members. The show demonstrates just how important fidelity, unconditional support and love are to our returning veterans.
The veteran depicted in the show had a father who was a hard-nosed cop. Old-school. The show no weakness type of man who thought his son should just forget what happened and 'just move on' in his life. The main character, who over the course of one and a half seasons has found his compassion and his own code of morality, lights the way to a positive solution to the show - not with his virtues but with acceptance of his flaws. It is masterfully done and in such a way as to give hope to those who watch it that their loved ones with PTSD can learn to cope and live with their experiences.
I really didn't see this episode coming at all. It even depicted the politics of the time from both sides of the aisle in a way that showed the validity of both standpoints without being argumentative.
Take the time to watch this show if you have Netflix. You won't regret it. It is truly an episode for the ages.
As you may be aware, things have been going really well for me in recent months - new job, balanced work/personal lives, personal fulfillment, and more. I went into Memorial Day weekend and I was as happy as I can remember being in years.
Imagine my surprise when I woke up on Sunday that weekend and I felt like weeping. I weight of my sadness and my guilt for feeling happy was oppressive. It was unbearable. I had resolved, before the weekend started, to honor the memories of those that gave their lives in service by spending quality time with my family.
How I felt on Sunday was a kick in the nuts. I couldn't even enjoy the company of my wife and my daughter I was so morose. The following few weeks have been hard. Despite the fact that my duties at work have been incredibly fulfilling, I have not been motivated to do much of anything else and have had a lot of trouble sleeping.
Talk about feeling exceedingly frustrated. Even when things were going right, what happened over in Iraq stole some of that happiness from me. Unbelievable. I've thought a lot about this over the past few days, trying to figure out why the guilt is persisting. It wasn't until earlier today that I finally made a breakthrough.
After recovering from the burnout that was working in retail, I had taken a break from blogging and from advancing the cause of my non-profit. What I discovered was disconcerting - I was fearful of burning myself out again and had been unintentionally shying away from responding to emails, communicating with my board of directors, and even from blogging.
I should have known better. Working to help veterans had become a central tenant of my ability to cope with my PTSD. I also now know that my new job will not overwork me or keep me from being able to administer my non-profit. So here goes. I am going to start blogging again at least twice per week and am going to start moving the non-profit forward again, despite the government tax-exempt status backlog.
So here's to another fresh start. I hope I can finally find the right balance and stay true to myself.
As I continue my life with PTSD, I will share my challenges and discoveries on this blog.