Tuesday, April 14, 2009

The Real Battle - Post Traumatic Stress Disorder(PTSD) and Traumatic Brain Injury(TBI) Part 1 of 2 PTSD

This is part 1 of a 2 part blog dealing with Post Traumatic Stress Disorder(PTSD), and Traumatic Brain Injury(TBI). Two seperate medical issues, but are often dealt with the same by an uncaring & inept Army Medical Evaluation Board(MEB) and Physical Evaluation Board(PEB). First I will give a definition and symptons from Wikipedia.

Post Traumatic Stress Disorder (PTSD) Is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused grave physical harm. It is a severe and ongoing emotional reaction to an extreme psychological trauma. This stressor may involve someone's actual death, a threat to the patient's or someone else's life, serious physical injury, an unwanted sexual act, or a threat to physical or psychological integrity, overwhelming psychological defenses.

In some cases it can also be from profound psychological and emotional trauma, apart from any actual physical harm. Often, however, incidents involving both things are found to be the cause.

PTSD is a condition distinct from traumatic stress, which has less intensity and duration, and combat stress reaction, which is transitory. PTSD has also been recognized in the past as railway spine, stress syndrome, shell shock, battle fatigue, traumatic war neurosis, or post-traumatic stress syndrome (PTSS).

Diagnostic symptoms include reexperience such as flashbacks and nightmares, avoidance of stimuli associated with the trauma, increased arousal such as difficulty falling or staying asleep, anger and hypervigilance. Per definition, the symptoms last more than 6 months and cause significant impairment in social, occupational, or other important areas of fuctioning (e.g. problems with work and relationships.)

The above was taken from Wikipedia, for more info gp to wikipedia.com and type in Post Traumatic Stress Disorder or PTSD. I felt it was important, to put a description and symptoms for readers who do not know what PTSD or who have never suffered from PTSD. Now I will go into how the Army medical systems deal with PTSD(or avoids the issue), and I will describe how the MEB/PEB also avoids the issues of PTSD, and in second part on TBI, I wll show the similarities, in the handling of these to very real but unseen war wounds.

In the military, there is still a stigmatism associated with PTSD, soldiers are often looked upon as being weak, and are expected to "Suck it up & drive on", I know, I was an Infantry Fire Team Leader, and I at times feel ashamed of myself for not being able to overcome my PTSD issues. In previous wars, PTSD was known as Shell Shock, Battle Fatigue, Combat Fatigue & Post Traumatic Stress Syndrome(PTSS). Often, soldiers suffering from these disorders, were thought of as "Gold Brickers", weak, cowards, etc. When in fact, they were suffering from very real and very hard to deal with mental and physical issues. Because it is an unseen war wound, it has a potential to be exploited, so naturally the Army assumes everyone is faking it.

While I was at Walter Reed Army Medical Center, recovering, rehabilitating and fighting the corrupt & inept MEB/PEB process. I was witness to many soldiers being misdiagnosed and discredited, in order to save the Army money. It is hard enough for a soldier to come forward about PTSD or the symptoms. At Walter Reed, the psychiatrists there would often diagnose these brave men and women with Bi-polar disorder(a pre-existing condition so the Army does not have to rate or compensate the soldiers for), or my personal favorite other psychological disorders with PTSD like conditions, also not rated, anxiety disorders, depression, PMS(yes I am serious about this), genetic disorders, substance abuse, the list goes on. Because if the shrinks diagnose you with PTSD, then it has to be rated on your MEB/PEB boards.

The Wounded Warriors at Walter Reed and other Army medical centers across the nation, are often frustrated and disheartened by this corrupt process. Suicides are way up for these Vets, I am researching that now, when I have exact figues I will put in future blog. The Army does not deal with the severe guilt, that medevac'd soldiers feel for leaving their brothers and sisters in arms, back still in harm's way. It can lead to a deep depression or suicide, more should be done for these brave combat Vets who get medevac'd out early.

I myself went through this process, it was the most humiliating experience I have ever gone through. When I finally went for help at Walter Reed, I was diagnosed with anxiety and other psychological disorders with PTSD like conditions, I asked the doctor, isn't that PTSD and he said no. Strange, I never had these disorders or problems before I went to Iraq. I suffer daily with having trouble getting to sleep, and when I do I keep waking through night jumping out of my bed, I suffer from night sweats, nightmares, severe anxiety attacks, & chest pains. I avoid friends and family, at times I don't leave my apartment, I have trouble working and going to work, I am on verge of losing my job. i have to fight of a depression everyday, I have had flashbacks, I have to sleep with a light on in next room, so when I wake up I know where I am. My relationships with my fiancee and friends and family suffers, I avoid crowds and do my shopping at 2am to avoid dealing with strangers. I have severe road rage when I am stuck in traffic(In Iraq if u get boxed in u are dead). Once the Army puts u out, they want nothing to do with u, my old unit B Company 1/69 Infantry wants nothing to do with me, I call for help with my benefits, and can not even get the time of day. Ok, enough rambling about me, just wanted to give u an idea of want Vets go through, it is different from person to person.

While at Walter Reed, a group of us tried to get changes made to the Medical Evaluation Board(MEB)/ Physical Evaluation Board(PEB). Basically we were stone walled by the Commanding General, in fact we were ordered not to bring it up in the townhall meetings, that he would have, to talk about everything but the real issues and problems facing the Wounded Warriors at Walter Reed.

While doing research for this blog, I found an interesting paper, written by Kathy A. Debar at the University Of Illinois at Springfield, which u may find interesting. Titled "To Hell And Back: Wounded Warriors Return Home to Fight Yet Another Battle". http://www.csuchico.edu/cjhp/5/2/058-066-debarr.pdf It is a real good read. It was published in the California Journal of Health Promotion 2007, Vol 5, Issue 2, 58-66. Kathy A. DeBarr, M.S., Ph.D., Associate Professor, University of Illinois at Springfield.

I hope u found this blog interesting, please feel free to sign up as a follower and leave your comments. "Courage is being scared to death, but saddling up anyway." John Wayne.

Sgt Patrick M. McNally, U.S. Army, Medically Retired.


  1. Really terrific post - both clinical and personal, a great combo!

    To add on to the discussion: I read an article this week that discussed the issue of military suicide as linked to PTSD treatment. Specifically, the most used treatment is the prescription of SSRIs, which have as a side effect increased suicidal tendencies.

    The article posited that the military's 'help' for PTSD was actually hurting soldiers. Made me feel like you're damned if they diagnose you and damned if they don't. Do you agree??

  2. Great post, Sarge. I don't know if you read Blackfive, but they had an interesting item about a year and a half ago on PTSD. The upshot was that PTSD isn't an illness, but a normal human reaction to the stress of combat and witnessing the horrors committed by a barbaric enemy. In other words, if you're exposed to all that and you're feeling just fine after, then you really might be sick.

    It's an interesting take, and might even help some PTSD sufferers (and their loved ones) realize that it's a normal reaction to that level of stress, which helps remove the stigma, but it seems to let the Army off the hook as far as treating the condition.

    Maybe it should be regarded as an injury rather than an illness.

  3. Mac...

    Well Done, as usual your looking out for the rest of us Dogfaces.

  4. My husband suffers from PTSD. It has taken him over 20 years to get 100% disability. He has nightmares every night. He sleeps poorly. He hates fireworks. When he first came home no one understood what his "problem" was. His parents thought he was 'nuts'. One day he's getting shot at, the next he's back in the States. How is he supposed to deal with that? According to everyone here it was as if he hadn't gone through anything. He was just the same guy who left. But he wasn't.
    He got into some heavy duty drinking, just to get the images out of his head. He did drugs...anything to forget. And no one understood. He was afraid to tell his Marine buddies for fear they would think he was a wuss, and he had no support from his family. The VA was no help. He was admitted 2 times for help with alcohol and drug addiction and almost killed himself by driving into a tree at 60 MPH.
    He tried to drink himself to death, staying in a hotel room for 4 days drinking and doing coke. He was depressed and at the end of his rope. It took him 5 years from the time he got out of the service to get sober (thank God) and has been sober for almost 20 years now. But those dreams still haunt him and he still gets jittery when he hears fireworks. His parents still don't understand what he went through,but that is what he went through. You don't have to go through that, if you just got out of the service.
    It's going to take time, but don't give up. Go to your local Vet Center. Get a Vet Rep. He/She will know all the ins and outs of how to go about applying for disability. Remember what the article said about PTSD not being your fault, it isn't. It is your RIGHT to be treated for PTSD. Keep plugging along, even if you've been denied.
    My husband tells me that there are PTSD clinics all over the country. In his experience the VA has been doing better with PTSD. He is not saying they are doing a good job, but they are getting better. Please, Please DON'T GIVE UP! We understand! My husband UNDERSTANDS. and a lot of other vets understand what you are going through.

  5. Hi,

    It is very hard breaking to see the effects of war.

    We CAMMMO - Citizens against Military Mass Marketing Objectives have a dedicated page to show how the Soldiers are effected by PTSD - please visit us at - http://www.cammmo.org/post_traumatic_stress_disorder/index.html

    Please support us by joining our Newsletter - http://www.cammmo.org/newsletter_subscription.html


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  8. So I have been diagnosed with mood swings and ptsd, I was a IED hunter 12b during the 2007 surge. I was blown up in my vehicle a few times and most were not documented because our company was getting hit daily. After the deployment I find myself losing temper and when me and my wife fight I lose it.and sometimes black out and cant remember what I said and did. I find myself stealing or doing risky things to get a rush, I dont do it to do it. But more of an addiction. After my first few IED blasts I would intentionally look to get blown up for the rush. Do I sound like a candidate for a MEB. I am being.seen at behavior health, and diagnosed with ptsd and kleptomania. my wife knew me before the army and says I have changed alot. So my question is do I qualify, and what steps should I take. My stealing has got me in trouble in the army, ive been in trouble before for it. I have been demoted because of it. My first problem was after my first deployment, was smoking pot because I wanted to get kicked out. Anyways any help would be greatly appreciated.

  9. Great blog post. I am dead tired thinking about the whole mess... Nice to see a concise and informational observation.