I explained in the previous post that I was getting really amped up and didn't know how to shut it off.  Well, as the day and night unfolded yesterday, the reasons for this became abundantly clear.  My body was preparing me for action - action that had the potential to go on for a long time.  There was no saying how bad this storm was going to be in our area.  I didn't know if I was going to be taking my family on a flight to safety, if I was going to have to deal with potential looting, if my friends were going to need my help, etc.

What I realized is that I was amped up, not anxious or nervous.  I was just ready. When I say ready, I mean READY.  My body saw the potential threat in the coming storm and started priming the system for action days in advance.  If something would have happened yesterday, I would have acted immediately to resolve the situation, no hesitation, no fear.

This effect on my body was predominantly primal, physiological.  The docs at the VA and elsewhere have been talking about the 'battle brain' or 'fight or flight' and how that part of the brain taking over is what causes some of the issues we have with PTSD.  While I understood the argument intellectually, I didn't fully understand the depth of what that meant until my body started amping me up in preparation for this storm.

Many of us can turn this on, short term, when the need arises, but there is still a lag before the clarity of purpose sets in.  Getting amped up days in advance for what could happen reduced the lag created by needing to 'flip the switch' down to near zero.  Hence the pre-storm build-up.  I would have been ready for anything - running for cover, protecting my family from the elements, protecting my family from people, killing if the need arose to protect me and mine.  Morality and gray areas be damned.  Yet through it all, I knew what was happening this time.  I knew the necessity of it and I knew that it could scare people to see the side of me that allowed me to survive outside the wire in a hostile environment with just three other guys to watch my back.

It was surreal.  I was just along for the ride yesterday.  I could freak out in my head all I wanted to and still trust that instinct would direct my body to make the best choices to ensure my survival and those I choose to protect.

Today, the threat ended.  My body turned it all off and I crashed.  I slept almost 10 hours during the day AFTER I woke up to start the day.  The adrenalin dump was so extreme that my kidneys hurt and I felt like a junkie coming down off a high.

Then came the fear and anxiety, the anger at myself.  How could I lost control like that?  The thoughts of what I could have done yesterday (and the things I did have to do in Iraq) haunt me.  This one is going to take some time to work out.  I am just glad that it's over and I can start to work through the new wrinkles that this experience has introduced to the party.

I know a lot of my readers were in the path of this storm.  I hope this finds you all well and in good health.

So here I sit. It's 1:30AM and I am typing this on the computer, obsessing about this storm that's coming.  I have this horrible gut feeling that it's going to be worse than they think.  I can't shake it.  We live in eastern PA, 30 minutes from the New Jersey border.  According to the National Weather Service, we are smack dab in the center of the cone of possibility.  The projected path puts us squarely in the cross-hairs to get the full force of the storm.

Enter serious anxiety.  I was at work all day so distracted I could barely think straight.  Do we have everything we need?  What about a fully stocked first aid kit?  What about enough water?  Batteries? Emergency evac routes? If it gets really bad, what about potential looters?  Could this traumatize my daughter?  She's only two years old.  What about our apartment?  We have a lot of windows...

I could keep on going, but you get the idea.  The adrenalin is pumping and I am going into all go survival mode and I am scared shitless that entering into that mode (which my wife has only seen glimpses of) is going to do more to scare my family than the storm will.  My heart is pounding right now and I feel the blood pulsing through my hands as I try to type this.  I have to get up in five hours for work and I doubt I will go to sleep.

So where do I go from here?  I am standing on the precipice.  The air at work was charged with a certain energy...Does fear have a smell?  I am trying to talk myself down, but the adrenalin keeps getting in the way.  My hands won't stop shaking but I have to try to get some sleep.  I know I am not the only one out there losing sleep over this, but the waves of my adrenalin are isolating me in ways flooding waters never could.

Well, this was an interesting session.  I had just gotten out of individual treatment just a little bit before I headed out for CPT group.  When I got to group, I was agitated and emotionally raw, the anger oozing out of every pore.  It was obvious to everyone in group.

I talked with them all about my anger coming out a lot more since I have begun confronting the PTSD and they all understood.  The anger coming back out to the forefront is apparently part of the healing process.  Wish I would have known that in advance.  So is it any wonder that as my anger becomes less and less easy to control that my anxiety has ratcheted up proportionately?  Uh.....No?

The doc explained that phenomenon to all of us in group.  When the anger isn't tightly controlled, we become unsure of what is going to happen next - but whatever is going to happen next, it won't be good...

What also came out is that anger manifests more strongly as I feel less in control at work.  Thus my cycle of quitting jobs every 6 to 8 months.  Well, it appears that cycle has taken longer to come to a head with my current employer, but I am there.  It's frustrating knowing that the cycle had continued over the past three years.  So what is my biggest priority right now?

Breaking the Cycle

I will not walk away from stability and employment, despite how draining my workdays can be.  I gotta break the cycle.  If I want to ensure stability and safety for my family, I can't give in to the urges to walk away from what distresses me.

Let's see how things go...

So today was the first individual therapy session with the clinician from Soldiers Project.  It laid the groundwork for what I am hopeful will be a very productive long-term therapy relationship.  It has been a long road and the past few years have been particularly tough to cope with.  That being said, I have written often about knowing a lot of the underlying issues I needed to work through - I just didn't know how or where to start.

Well, I found out today that I am going to have a very long road ahead of me as well.  All things being equal, my blog eventually circles back around to the fact that I am angry.  Not just angry...ANGRY.  When I feel that anger, I can feel the impulse control starting to slip away from me.  That lack of control causes me to clamp down on my anger so hard that I box it up and put it away.  Not a healthy way to deal with anger at all.

Well, we talked about this for a long time and what it comes down to is this:
Everything I Fell Stems From My Anger Issues

How about them apples?  She saw right through a lot of barriers I have put up to protect myself and others from my anger and got to the heart of it...and fast.  She asked if I thought that needing to clamp down on the anger all of the time is what was exhausting me and draining me of energy.  *smacks forehead*  How the hell did I miss that one?  That makes perfect sense.  It is also why going to work every day is so draining for me - shit at work always finds a way to trigger me, fair or not.

Ok, so underlying cause identified:  Anger.  Anger so profound it doesn't need a target.  I wake up angry, am angry all day long, and go to bed angry.  Angry at what?  Nothing in particular.  It's like having a pressure in the back of your head that won't go away.  It's always there.

So what the hell do I do now?  Not a clue.  The clinician wants to make a safety plan in place to ensure everyone's well-being in case my ability to cope goes south.  We're going to go over that next week.

All in all, a very draining session - but a good one.  It's nice to feel like I am headed somewhere with this.  Guess time will tell.

I met with my prospective clinician today at a local diner.  I wanted to meet on neutral ground first to see if we had compatible personalities.  As it turns out, we do.  I will be moving forward with individual therapy with this clinician that was provided, free of charge, by The Soldiers Project.

What an organization.  I was skeptical when I first heard about this organization.  They ask for no compensation.  They have a heartfelt desire to help veterans.  You can tell that the desire is genuine.  I have done more research on them and I found out that they require that all of their volunteers be trained on how to communicate and treat veterans.

I have spoken with my wife and I will be working with the clinician on a week-to-week basis.  I will do my best to schedule a time to meet with her once a week.  Her schedule is flexible and I look forward to finally receiving the intensive one-on-one treatment I think I have been in need of for a long time.

I need this.  I really do.  The PTSD symptoms I have been experiencing recently have been morphing into a new variation of intensity that I haven't had to contend with before.  There is one thing that she has brought up already that I am looking into and doing research on (yeah, you know me...gotta learn all I can):  The idea that the emotional/psychological/spiritual trauma I experienced may have diverted that natural development of the adult brain and arrested any further development.  At least that's the gist of what she was saying.  So needless to say, I am quickly drilling down into this subject matter.

I wanted to send out a special thank you to Rod Deaton (Blogger, Paving the Road Back) for informing me of this wonderful organization.  I appreciate all that you do, Rod.  I consider you a true friend, a man of limitless compassion.  Would that there were more like you.

I have been corresponding via email with Rod Deaton for a while now and occasionally by phone when our schedules permit.  He has been an amazing sounding board and gives me no bullshit guidance on PTSD.  While he is a doc and I am a veteran with PTSD, our relationship is not that of a clinician and a patient.  We have a deep abiding respect for one another and the work we do to advocate for veterans with PTSD.

In recent posts, I have talked about my struggles to cope with my low self-esteem and the absence of motivation to lead a healthier lifestyle.  Rod expressed concern about these issues.  While he doesn't think that I am in danger of hurting myself, he does believe that I would benefit from one-on-one therapy.  His opinion is that, being an introvert, I would find individualized treatment less draining.  He still recommends that I continue group therapy, but feels strongly that I should explore individualized treatment.

I agree with his assessment 100%.  The issue had always been finding a clinician at the VA with the time to meet 2-4 times per month for intensive therapy.  As we all know, searching for this at the VA is an exercise in futility.  Through no fault of their own, the VA doesn't have the resources available for that to be possible. 

In one of his recent email correspondences, Rod passed along information about a group of private clinicians who provide individualized treatment for free.  That organization, The Soldiers Project, intrigued me.  I looked into it, contacted the PA branch of the organization and was contacted back the same day.  They had found me a clinician within a week of first reaching out to them.  While I was lucky that they could find someone so close, they are continually expanding their network of volunteers.  I contacted the clinician today and hope to meet with her informally today to see if we are a good fit.

So far, I have been very impressed with how passionate the administration of this organization has been.  I am hopeful that this will end up being a great experience.  I will keep you all updated as I move forward with this.  It would be nice to be able to recommend a viable supplement to the insufficient treatment most veterans with PTSD receive from the VA.  Please keep in mind, I am not blaming the VA.  This is not their fault.  The fault lies with the government for not adequately providing for the needs of the warriors who have selflessly volunteered to protect the ideals this country stands for.  The reality is that the VA doesn't receive the funding and doesn't have the staffing necessary to adequately handle the sheer volume of veterans that have entered the system in the past decade.

Let's hope we can add another additional resource for combat veterans with PTSD.

I had a reader ask me about my anxiety that I experienced over the past few days.  I had commented on Facebook that I was having a rough day with it.  Here's the cut and dry of it.  I take three extra anxiety pills with me to work every day, just in case.  I felt jittery when I got up on Friday.  I got to work and the anxiety got exponentially worse almost immediately.  I got a glass of water and my hands were shaking so hard that I almost couldn't get the pill out of my pill case.

About an hour later, I felt a noticeable down-tick in my anxiety levels.  It lasted for about two hours.  I had to take another pill.  Same deal.  I held on for as long as I could but I could feel the tangible tension in my shoulders and what I can only describe as a pressure in the back of my head.  I immediately went to my boss and asked if he minded if I went home early.  He said it was fine and I headed out.

My first instinct was to 'suck it up'.  I was almost through the whole workday.  Aside from the anxiety ratcheting up, I have no concrete reason for why I asked to go home.  I guess I just knew my limits that day.

I got home and I zonked...hard.

My kidneys hurt when I woke up.  I knew that the adrenalin had been coursing through my body in massive quantities but I didn't know why.  I still am confounded by the intensity of the anxiety I experienced.  There was no conscious trigger that I can identify and that scares me.

But back to the matter at hand:  How do you know when it's time to call it a workday?  I haven't a clue.  I just listened to my body.  I paid close attention to the clues my body was leaving me along the way.  Each one of us is different.  We all have different limits when it comes to dealing with anxiety.  I have a high threshold, but when the threshold is reached....watch out.  My reactions can be volatile and scare the uninitiated.  So listen to your body, the cues it gives you.  It's better to lose a few hours pay than lose a job.

How do you deal with anxiety?  I'd love to hear from you all on this.

A good friend of mine asked me to address this question.  He recently made the realization that he may have crossed over from acceptance to giving up on himself and having a good life.  As a result of this, I wanted to very carefully address this (unfortunately) all too common occurrence.

One of the most important steps we, as veterans with PTSD, have to make is accepting that what happened was not something we could have prevented or changed the outcome of.  As Rod Deaton says, we veterans are 'intensely intense'.  Most, if not all of us, feel that accepting what happened means that we stop fighting the guilt that it is our fault.  Here's the hard part:

The instinct to fight is what also keeps us motivated to continue fighting for a better life.

Many of us (myself included) have tried to accept what happened.  What we were really doing was feeling guilty that what happened was out of our control.  We end up surrendering to the guilt.  It can feel a lot like acceptance, but it is not.  It's insidious.  What has really happened is that by surrendering to the guilt, we have given up fighting and we convince ourselves that giving up on having a good life - it's just something else we have to 'accept'.

When I made this realization about myself, I felt even worse about myself, knowing that the last thing that I wanted was to give up on myself.  It was back to square one with the idea of acceptance.  In short, I hadn't actually accepted anything.  I just gave in.  That's what made me feel worse about myself.

So there you have it.  I hope this makes sense.

I recently asked on my Facebook Page if there were any issues that my readers would like me to discuss in my blog.  My fellow advocate, Uncle Sam's Mistress, asked if I could discuss the following issue:

How do spouses and loved ones of service members with PTSD balance the celebrating events (like birthdays, anniversaries, holidays) with the needs of the suffering service member to have alone time - a safe harbor in the storm?

This is an issue that my wife and I have struggled with greatly, especially when the PTSD started getting out of control a few years ago.  I would want to go out to an event or social occasion and I would reach my threshold for being around people I didn't know WELL before the event was over.  It ruined more than one night out for us.  As we discussed these issues, we determined that the house (or at least, part of it) should be closed off from other people.  Here's how we attacked this issue as a team.

Separate Vehicles:
More often than not, I will reach my energy threshold for being out in public way before my wife and will be ready to leave a function or social gathering.  We found that taking two vehicles has really worked for us.  If I was ready to leave, I didn't have to wait to head out.  I would communicate to my wife that I was reaching critical mass and I would go home to relax.  My wife could stay as long as she wanted.  While she would love to be able to spend the whole evening or day out and about with me, it's just not possible most days.

In-Home Events:
There are times when events are held at home (children's birthdays is a great example).  These events are the hardest for me to handle because people (yes, that includes family) are invading my safe space.  If the I don't have a safe place to retreat to away from everyone, I get snippy and irritable with everyone.  It can ruin the day.  My wife and I decided to make our bedroom and bathroom completely off-limits in our apartment when other people are over.  If I feel the need to retreat to safety, I can do so.  Sometimes I am even able to return to the event in small doses.

Don't Talk Religion, Politics, or Any Emotionally Charged Issue:
This may seem like a no-brainer, but people like to talk about what they are most passionate about - often that can lead to a really nasty situation with a veteran suffering from PTSD.  For many of us, our opinions have a tendency to be set in stone and sacrosanct when it comes to these types of issues.  Anyone challenging their ideals can trigger the PTSD.

No Surprises...Ever:
Veterans with PTSD do not take kindly to being surprised, especially in the place they retreat to to decompress.  If you want to make a veteran retreat into himself faster than you can blink, surprise him at home with a birthday party.  Not only can this lead to outbursts of anger, but it can also destroy the veteran's sense of security.  This is crucial.  If we don't have a place to go to unwind, it can cause us to regress substantially.

Sometimes We Need a Reminder:
More often than not, if I have a choice, I am staying at home on my couch watching a movie or playing a game or just kicking my feet up.  Sometimes we need someone to remind us that socializing is necessary for us as much as we hate to admit it.  Connecting with people gives us a sense of inclusion and belonging to society.  We just need that interaction to be on our terms - not anyone else's.

I think that covers all of the major points that resonate for me.  I urge you to discuss this with me and your loved ones.  If you have any questions or need clarification, please ask!

This question was a serious gut check this past weekend.  After my last blog post where I explained my struggle to stay motivated to get healthy, I talked with my mom about it.  She said that one of the things she has always loved about me is my gentleness.  I only become a fighter when absolutely necessary.  While I don't entirely agree with her assessment, it did turn a different light on:

I can fight for a cause.  I can fight for my loved ones.  I will fight for ideals worth fighting for.  But me?  Am I worth fighting for?


Yeah...as is said, gut check.  I realized immediately that survivor's guilt had a big role to play in this story.  The guilt eroded my self-confidence and self-esteem.  I have a very low opinion of my self-worth.  On top of that, I have stumbled and fallen down a lot as I learn to effectively cope with my PTSD.  I think that I am afraid to even try most of the time because I am afraid of failing again.  My lack of confidence turn this fear into a self-fulfilling prophecy.

So how do I get past this?  How does a person learn how to value himself again?  I should have a better opinion of myself.  The PTSD has tried very hard to destroy my life and my family.  Yet, I have persevered and held it all together.  What I realized is that I thought THEY were worth fighting for despite my inability to fight for me.

What a mess.  I literally hate the image I see when I look in the mirror and I wonder how much of that hatred stems from my guilt for having come home from Iraq when other I knew didn't.  Am I punishing myself?  Is that what's going on here?  I don't know.  I do intend to figure it out.  This may take more hand-holding than I thought, though.  The only way a person can truly improve their self-image is by having their worth validated regularly by those who love and care for him.

I don't want empty compliments and platitudes.  I need the people that love me to demonstrate to me why I am a good person.  Maybe I should talk to my parents, my sister, my wife, and others about having them write letters to me.  The idea would be explaining to me why they love me.  What they love about me.  That way, on a down day, I could pull out the letters and remind myself of how my family views me each and every day.  Hmm...