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Post Traumatic Stress Disorder

What tours do you think were the highest for PTSD? (Max 2 votes)

  • Somolia

    Votes: 0 0.0%
  • Rwanda

    Votes: 0 0.0%
  • Bosnia

    Votes: 0 0.0%
  • Afghanistan

    Votes: 0 0.0%
  • Cyprus

    Votes: 0 0.0%
  • Golan Heights

    Votes: 0 0.0%
  • East Temor

    Votes: 0 0.0%
  • others

    Votes: 0 0.0%
  • think it is over played

    Votes: 0 0.0%

  • Total voters
    0
  • Poll closed .
I will just say this to Tess and HoM: You are not alone. Soldiers have an idea that they're tough and and can take it. Thanks to you both for sharing your stories, because it takes a huge amount of courage to write these things so people can read them. Just yesterday morning, an old Army buddy called me on the phone. We recruited together in Oceanside, CA a long time ago. Anyway, he just retired last year and found me on AKO. He served in OIF I and was relating to me some of what he went through. He said he'll never forget the first time somebody actually shot at him. What was funny to me was, he said right after it happened, he remembered one morning drinking a cup of coffee in our station and listening to me and another Desert  Storm guy talking about the exact same thing.

There are gates we go through in our lives and some of them you can't go back through. Combat is one. I don't know if there is any comfort in this, but many have made the transition back to what I'll call normal life for want of a better term. I encourage you to acknowledge the fact that you've changed by what you lived through, but don't forget that you're still the same person as you always were.

It takes time to sort out everything you experienced overseas. You have to give yourself the space to do that and understand that sometimes, the only answer is time. There are so many questions combat can leave you with and honestly, there just aren't any answers. It's so random and we're always looking for reasons trying to get to the "WHY". This is the hardest thing, but sometimes, you just have to let it go.

Combat stress is a normal reaction to the experience of war. You go through this kaleidescope of emotions and feelings and it all happens so fast. Plus, the whole world is moving 101 mph and you're living this roller coaster of ups and downs. When we get back home and have time to start decompressing, that's when things like what you've related start happening sometimes.

I will shoot you a PM, HoM.

Mark

 
the 48th regulator said:
Along with proper follow up after deployment, wouldn't you agree?

No argument there!  I see it as being in two parts though.  First, an official debrief needs to be done with all returning soldiers.  Ive seen it done for units, but a lot of individuals who were temporarily assigned to those units and then went back to their original units when the tour is complete arent included in this process.  Coming back to your unit and having no one give a damn about what you did or experienced is tremendously frustrating and aggravating.  Second is just as youve said, having available the resources and groups at a later time when you realize youve got some issues to deal with.

 
GreyMatter said:
No argument there!  I see it as being in two parts though.  First, an official debrief needs to be done with all returning soldiers.  Ive seen it done for units, but a lot of individuals who were temporarily assigned to those units and then went back to their original units when the tour is complete arent included in this process.  Coming back to your unit and having no one give a damn about what you did or experienced is tremendously frustrating and aggravating.  Second is just as youve said, having available the resources and groups at a later time when you realize youve got some issues to deal with.

I agree with this post completely.  I am in a CSS unit and while I haven't been overseas yet (although I am leaving in a few days to do so),I have seen quite a few people who were attached to units as individuals come back.  Almost all of these people are changed in one way or another.  I truly believe a large part of that is due to the lack of a support system (a regiment of peers) who have done the things they have done and seen the things they have seen.  Associated with that is of course the ability to discuss it after.

I understand that the military's outside support system (phyciatrists and such) has greatly improved in the last 10 years, but in my opinion the greatest thing we can do for soldiers minds is try to return th comraderie that was once felt, but now seems to be absent.
 
From my tour, I have since heard that some have their PTSD problems. In my opinion, each of us deal with trauma in a different way, and overall, it all effects each and every one of us differently. I do worry about this one person in particular, but at least the issue is being addressed thru the proper channels.

Since my return from my deployment I have some things I have noticed is at times. On occasion I find it hard to concentrate, have some sleeping problems, some anxiety issues, a little hard on the Canadian Club at times (more so when I first got back), rather intense night sweats (some serious sheet soakers - ha!), re-occuring dreams of reliving certain moments in those dreams both normal daily 'routine' shyte, and some of the rather twisted times. I can be impatient, easily bored, and at times moody, and even short fused and aggressive with strangers. As time goes on (it was 3 months yesterday I arrived home) these seem to deminish in their frequency, which is good. To top it all off, then there was my relationship issues too, as within 6 days of returning from the war, she was leaving. A well planned thought out thing, adn being honest, I was away for 11 months all up. So, this deployment did cost me a best friend and what i thought was a woman who understood me. i guess not. Seven years waisted, but it could have been worse, it could have been 27 yrs, as there are others whocopped it worse that I did.

I had some difficulty accepting 'thunder' from my first lightening storm, as I had no doubt become conditioned somewhat overthere, as IDF and bombings were frequent every day. No I was not diiving for cover, or freaking out, but the first thing that came to mind was mild adrenaline rush, and in my mind I said 'holy phuck'! ha!  I have spoke about this to other Vets, and they all felt the same, and we all laughed about it.

For me personally, I think I have the basic issues many Vets have, and if my Uncles can survive D-Day thru to Holland, then I can handle 207 days I spent in Baghdad. I do tend to down play the dangerous times, and blow it off with some good jokes. The humour was ever present, and I miss the mateship in a big way.

You know the best thing about it all is I am not alone, and thats a fact!

Every single one of us that comes back has a story.

My 2 cents,

Wes

 
Here's my .02...

I think a big help in regards to my own mental health has been the fact that I had an interest in PTSD and CSR before I had deployed. I picked up On Killing and had read it beforehand, and I had On Combat waiting at home when I returned. One of the biggest points I get out of Grossman's work is that to be forewarned is to be forearmed. Instead of playing "catch up" in the aftermath of critical incidents I found myself saying "Oooohhhh.. So THATs what he was talking about". I had understood that a Combat Stress Injury is just that - an injury - and I accepted it as another risk of the job. I know that in our line of work a soldier can lose his life, a limb, take a bullet, or get hit with combat stress. Knowing that it could happen to me just as easily as the next guy could step on an IED really helped to set my mind at ease. In hindsight, knowing that it could happen and mentally preparing myself for that eventuality probably went a long way.

I also had the benefit of mechanical distance. I spent most critical incidents inside a LAV turret, feeling insulated from the chaos outside. I saw the world through a thermal viewer, feeling calm and detatched while others dealt with combat more intimatly. While I still felt the effects of combat stress reaction, they were not as intrusive as others have had to deal with.

The other key I've found is leadership. To have someone you respect slap you on the back and say "Good Job" makes a HUGE difference. It helps to wash away any self-doubt after the fact, making it clear that you did the right thing. On the flip side of the coin, I believe that poor leadership can pre-dispose a soldier to a combat stress injury. Everyone makes mistakes, but to emphasize mistakes made by a soldier during a critical incident leads to all sorts of second-guessing. I understand there must be an honest after action and lessons learned, but good leadership understands the difference between constructive criticism and destructive criticism. If the soldier can make a mistake but come out feeling confidant that he knows what to do next time, its much better then him thinking he's just a shit-pump who couldn't handle the pressure. A leader needs to be able to know when to praise, know how to communicate faults, and have the good judgement to know when an incompetant soldier really needs to be replaced.

Just my own observations...
 
Veryt true Wonder, I had read On Killing before I left (Defence Library copy), ended up buying while in theatre (thanks to the US APO, ha) a copy off ebay, along with On Combat, which tended to be more police related. These books aided in educating myself on the feelings and answered heaps of questions in my mind. I identified with them both, but more on ON Killing than the other. Still both make a good reference set to have.

All the best,

Wes
 
Wonderbread said:
The other key I've found is leadership. To have someone you respect slap you on the back and say "Good Job" makes a HUGE difference. It helps to wash away any self-doubt after the fact, making it clear that you did the right thing. On the flip side of the coin, I believe that poor leadership can pre-dispose a soldier to a combat stress injury. Everyone makes mistakes, but to emphasize mistakes made by a soldier during a critical incident leads to all sorts of second-guessing. I understand there must be an honest after action and lessons learned, but good leadership understands the difference between constructive criticism and destructive criticism. If the soldier can make a mistake but come out feeling confidant that he knows what to do next time, its much better then him thinking he's just a crap-pump who couldn't handle the pressure. A leader needs to be able to know when to praise, know how to communicate faults, and have the good judgement to know when an incompetant soldier really needs to be replaced.

Good post and I agree 100%.  I had a good boss who did this for me after my last big tour, helped put me back on my tracks when the train was setting up for derailment.  It certainly helped that he had gone throgh the same process a few times so he knew what I was going through.
 
There is a ton of ancedotal evidence (can't really study it because leadership is not a qualiative thing science can study) that says this is correct.

One example know personally to me is from 2 Fd Ambs deployment to Rwanda. 2 medical sections worked side by side in the wards post genocide, so they seen many of the same horrorfying experiences.

1 section of eight, all diagnosised with PTSD, the other section, not a single one.... The difference was the attitude and leadership qualitites of the MCpls pre, during and post mission.

One told his troop to prepare for the worst having seen the news reporting from the area. He allowed them to use black humour, made them buddy up and talk to each other, highlighted the good things and positively corrected any breaches in conduct immediately because the job was not done until the end. This sect talked evenly about both good and bad things....

The other, the MCpl did not allow black humour, allowed his troops to miss shifts because they wanted to avoid doing something bad, and did not provide any positives to his subordinates at the end of a shift, and just went an hung out by himself.

Of the second section...I know of only one that is still in the CF.

Again, it is also a case of mental preparation before the events that help as well.
 
Wesley  Down Under said:
Veryt true Wonder, I had read On Killing before I left (Defence Library copy), ended up buying while in theatre (thanks to the US APO, ha) a copy off ebay, along with On Combat, which tended to be more police related. These books aided in educating myself on the feelings and answered heaps of questions in my mind. I identified with them both, but more on ON Killing than the other. Still both make a good reference set to have.

All the best,

Wes

Ditto
 
the 48th regulator said:
Don't know, are there detailed facts on these statistics?

dileas

tess

The US has good detailed statistics, there is nothing available yet in Canada for public consumption.  And the studies that have been done in Canada do not have a big enough test base. Although that seems to be changing. Part I think due to military members being more educated than past generations therefore realizing something is wrong. Secondly, a demand to have what is wrong fixed. But here is the key, those in the world of mental health have had their heads in the sand for so long we are "new". This argument I do not really buy either as VAC facilities were filled with two wars worth of "test subjects". As for the root cause I kind of like the work coming out on a actual chemical change within the brain itself.

Edit to add:

NCPTSD website is down so the US will have to wait .

So I found this;

"An early neurological study tested 654 Army veterans before deployment to Iraq in 2003 and again after returning in 2005, finding mild impairments in memory and attention lapses, but significantly faster reaction times when compared to other veterans not deployed to the theater.  These warrant further investigation.  VA also will analyze combat veterans' deaths from diseases in hopes of publishing mortality studies in the future.

"One early scientific study indicated the estimated risk for PTSD from service in the Iraq war was 18 percent, while the estimated risk for PTSD from the Afghanistan mission was 11 percent.  Data from multiple sources now indicate that approximately 10 to 15 percent of soldiers develop PTSD after deployment to Iraq and another 10 percent have significant symptoms of PTSD, depression or anxiety and may benefit from care.  Alcohol misuse and relationship problems add to these rates.  Combat veterans are at higher risk for psychiatric problems than military personnel serving in noncombat locations, and more frequent and more intensive combat is associated with higher risk"(http://www1.va.gov/OPA/fact/returning_vets.asp)

"Approximately 317,000 veterans with a primary or secondary diagnosis of PTSD received treatment at VA medical centers and clinics in FY 2005.  More than 50,000 veterans received PTSD-related services at Vet Centers during FY 2005. Nearly 16,000 Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) veterans were seen for PTSD at VA medical centers from fiscal year 2002 to 2005.  Another 3,000 OIF/OEF veterans were seen in VA’s Vet Centers during that period."(http://www1.va.gov/opa/fact/docs/ptsd.doc)

Veterans Being Compensated for PTSD

Period Sept. 05
Pre-WWII     -
WWII 25,278
Korea 10,944
Vietnam 179,713
Gulf War 19,356
Peacetime 9,087
Total 244,846

As for those down under it seems that the University of Melbourne has eithier completed but results not released or not completed a couple of interesting studies on both the sleep loss and nightmare issue.
http://www.acpmh.unimelb.edu.au/research/currentProjects/sleepDisturbance.html
http://www.acpmh.unimelb.edu.au/research/currentProjects/nightmares.html




 
Very good post 3rd,

However, my response was directed towards this question;

St. Micheals Medical Team said:
But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?

Any firm numbers or stats to back this up?

dileas

tess
 
Do you have a theory? Maybe lack of a certain mindset that combat arms types have? 
 
Being where we were in Baghdad, we all had equal exposure to the routine nastiness, however the basic LAV black hatted crews were out in it more, as in the RZ, and so were we, but not as often.

As for exposure to harassing SAF, and IDF, it was all equal for everyone in the FOB.

Cheers,

Wes
 
GreyMatter said:
Do you have a theory? Maybe lack of a certain mindset that combat arms types have? 

The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.

dileas

tess
 
the 48th regulator said:
The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.

dileas

tess

You hit the nail on the head!

+1 Tess!

Cheers,

Wes
 
the 48th regulator said:
The only theory I have is proper follow up.  Regardless of what trade or work you do, if proper attention is paid in helping the soldier to return back to his normal routine, having help available, and properly trained individuals to help him acheive that goal, PTSD can be minimized to the point where the soldier returns back to where he was before the traumatic incident.

dileas

tess

I've been skimming this thread for a while, and I didn't really want to post anything, as it hits a little close to home for me... and I have mixed feelings about a lot of what has been discussed here.  But, I just wanted to give a quick sum up of the issues I've been having with returning from tour, problems and the “help available".

Keep in mind, this may not be the case with all soldiers returning, or even just reservists.. It may just be me, and I really hope this is the worst of it, and I'm the only one, 'cause I don't think my psychological problems are that out of control, and it would kill me if someone with real problems (PTSD) was going through this.
Anyway, here it is;

I'm not going to go into the details of my tour... I have already else where, and I've said enough... When I first came home, I didn't have too many issues as I was either heavily medicated (Morphine for pain), sedated (sleeping pills to get me to sleep 'cause of pain) or just happy to be alive.  Then came dreams and flashbacks... which is why I started writing crap and posting it here (I know some of you are sick of it... sorry).  After a few months of that, I finally figured out a way to control it so that I could get some sleep (about 3-4 hours a night) without constantly waking up. This method involved over-the-counter sleeping pills, anxiety medications prescribed by the MIR and the home nursing docs and “meditation” (don’t ask).

I don't like taking pills... not even Tylenol for pain.  Just a personal thing. So I stopped the meds and just forced my self to sleep.

I had been home for almost 5 months before any contact with the OSI (Operational Stress Injury) Clinic, and even that came with a fight. While in hospital, it seemed as though the docs were more concerned with my physical health than my mental health... which, to me, at the time, seemed reasonable.  But even in Hospital I was having sleep issues (especially when my room mate died from congestive heart failure, which is very loud and disturbing, the last night I spent in hospital... they left him in the room till morning... rough night.) 

The doc at the MIR wanted me to see someone as soon as I had come home from the hospital, but even that was fraught with problems.  At that time, I was under the care of everyone (LFCA, 31 CBG, Local hospital, etc.) and none of them communicated… so none of them organized any kind of psychological help.  In the end, I had to contact the OSI clinic myself. Which, in itself, took a month as I was bounced from contact to contact, left messages and received no reply’s.  This caused a lot of stress.  As all this was going on, I was also dealing with contract and pay issues, all of which I’ve had to solve myself… but that’s another issue, which caused even more stress… for both me and my wife, which cause more stress for me (from the wife).

Once I started appointments with the OSI clinic, I started feeling better, as if a weight had been relieved, but it was short lived.  After 3 sessions, my contact with the social worker at the OSI clinic ended.  The stress began again as I tried to renew contact, as well as contract issues, pay issues, issues with my home unit as well as family related stress.  This time, I wasn’t able to control the stress well.  I began feeling angry and bitter all the time.  Even when I was happy, there was that dark cloud, and it didn’t take much to set me off. I was having increasingly violent mood swings, and my wife started getting more and more concerned.

Then it came to a point.  The MIR was having no luck contacting the OSI clinic, and nether was I.  All the other issues kept compounding… then one day, while trying to hang a gate on my fence in my back yard, it all came apart.  I couldn’t get the latch to fit right, and I snapped.  I hurled my drill across my back yard, punched the gate, breaking a board and tearing open my hand, and then tried to rip the gate, and the fence down.  If my wife hadn’t been there, I probably would have… she calmed me down enough to get me back in the house. But it didn’t end there. I completely broke down; All the feelings I’ve had bottled up erupted again and I found myself completely shut down and shaking… this lasted a few days.

My wife contacted the OSI clinic and tore their heads off.  Then I had an appointment.
She came with me to keep me calm.  I begged these people for help and got no response. All I could think about the whole ride to London (2 hour drive) was how hard it was going to be to talk to someone I already don’t trust. And it was.  How am I supposed to reach out for help when there’s no hand reaching back?

After 2 hours of discussion, it all came together; the social worker I had been seeing was a student… I had no problem with that, ‘cause she was helping.  She had finished her term with the clinic and had left.  The clinic informed me that she should have contacted me, and then insinuated that she had and that I was over reacting or was responsible (this may not have been their intent, but it sure felt that way).

The excuse they offered next was that, at the time she left, I was showing improvement, and they weren’t concerned.  This sent me off the handle again.  I received no contact from her after our last session, and as much as I was feeling better, I had just begun to trust her, and hadn’t had the opportunity to discuss what was really causing problems.

The rest of the meeting went well, and it left my wife and I feeling a little better, but then the question came up; “what do you want us to do for you, exactly?”
This shocked me… how am I supposed to answer this?  I don’t know what I need. I don’t even know if there’s anything wrong with me.  So I told them; “I don’t know.  I just know that I’m angry, frustrated, confused, depressed, I don’t sleep and I hate everything... I don’t want to feel this way anymore.  Work your magic.”
Their reply gave me a bigger shock; “These problems aren’t directly related to the incident, are they?”  I had no answer… just rage.

So now I’m taking anti-anxiety meds, suggested by the OSI clinic and prescribed by the MIR.  I’m still angry, and frustrated, but now I calm about it, which make me more confused and frustrated.  The meds are chalked full of some kind of stimulant, which keeps me up, and they don’t get rid of the pain or the dreams, so I sleep even less, which leaves me tired and even more confused.  All this make me depressed… which I hate. 

The OSI clinic has provided yet another social worker, which I am to see regularly and I’m back to work half days at the armoury, and everything seems to be getting better… for now.  But it took screaming, yelling, breakdowns and contact with personnel from Brigade, Area and NDHQ.  And every time something else comes up, no matter how small, all I can think is; “I don’t need this.”

As it stands, there is very little keeping me in the forces… I’m trapped by my wounds and lock in by my financial and medical needs.  The wife doesn’t want to move or change jobs as her career is just beginning, and I don’t blame her… This rules out the regular force.  I can’t do what I did before the injury and I’m not going to be on contract by the time I can go back to school to change careers.  I’m in a grey area hell.
They say the worst thing is never knowing what’s going to happen next… that’s my life.

Just a little note; all of this has been passed up the chain of command in multiple direction, actions have been taken to fix “problems”, but in my mind it still feels like a band-aid on a broken arm or “too little, too late.” 
I can only hope that those of greater tactical importance have learned from all this, and no one else who needs help has to go through what I’ve been through.

Sorry again for the long rant about nothing.
 
St. Micheals Medical Team said:
Perhaps she does...

Medicine is not an absolute, and understanding mental illness....

But I ask: Why, by percentage, do persons in support trades (in US and Cdn militaries) report higher incedences of PTSD then do cbt arms soldiers?

the 48th regulator said:
Please realize that I am not being facetious, as these answers are helping me.

At what point would you then recommend OSI or OSISS representatives to step in?  What criteria would be used in recognizing that a stress injury is present? 

dileas

tess

Just wondering if anyone was able to come up with answers for my questions.

Any help would be great

cheers

dileas

tess
 
Apologies Tess,

First for not getting that report out to you n a  timely fashion.  I actually was on call last Sunday with one of the coauthors and we had a short chat about that.

As for getting the mental health gurus involved, I err on the side of caution when it ocmes to alot of those things - if the resources are available, I encourage and or outright refer people to use them at the slightest inkling of trouble.  If I can't right away, I make do with what I have, be it an MO, mental health nurse or social worker, me and a sat phone, until proper care can be reached.


PM inbound.

MM
 
RHFC_piper said:
So I told them; “I don’t know.  I just know that I’m angry, frustrated, confused, depressed, I don’t sleep and I hate everything..."

Hang in there, brother!  I know the feeling...

I believe the best therapy out there is a site like this where you can connect with others who have had the same difficulties... 

 
the 48th regulator said:
Just wondering if anyone was able to come up with answers for my questions. 

Tess, I found your post a bit confusing... Piper posted his message on 30 June, you posted yours 'today', but you refer to two posts in between that arent here? 

But to bash on... reference the OSISS reps, I dont see any point where they should 'step in' (unless you are meaning they are asked to assist with a case).  I believe this should be initiated by one or more of three triggers:

a) individual self-declares a need for OSISS assistance;
b) supervisor or higher recommends a need for OSISS assistance;
c) or, medical, social or mental health worker recommends a need for OSISS assistance.

Assistance needs to be immediate - not in months, but in days and preferably within a week.  If OSISS cant do this, then they need to get their act together and stop acting like an external specialist. 

At this point it gets a bit blurry - 48th says he had a good experience with OSISS (if i recall correctly), Piper says he had a bad experience with OSISS.  Should we at this point take a poll and see what others think of OSISS services?
 
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