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| PTSD and Holidays |
| Home From War |
Australian Veterans
Information
United Kingdom Veterans Information
What is Posttraumatic Stress Disorder?A National Center for PTSD Fact SheetPosttraumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life. PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the person's ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting. Understanding PTSDPTSD is not a new disorder. There are written accounts of similar symptoms that go back to ancient times, and there is clear documentation in the historical medical literature starting with the Civil War, when a PTSD-like disorder was known as "Da Costa's Syndrome." There are particularly good descriptions of posttraumatic stress symptoms in the medical literature on combat veterans of World War II and on Holocaust survivors. Careful research and documentation of PTSD began in earnest after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% at that time and that 30% had experienced the disorder at some point since returning from Vietnam. PTSD has subsequently been observed in all veteran populations that have been studied, including World War II, Korean conflict, and Persian Gulf populations, and in United Nations peacekeeping forces deployed to other war zones around the world. There are remarkably similar findings of PTSD in military veterans in other countries. For example, Australian Vietnam veterans experience many of the same symptoms that American Vietnam veterans experience. PTSD is not only a problem for veterans, however. Although there are unique cultural- and gender-based aspects of the disorder, it occurs in men and women, adults and children, Western and non-Western cultural groups, and all socioeconomic strata. A national study of American civilians conducted in 1995 estimated that the lifetime prevalence of PTSD was 5% in men and 10% in women. How does PTSD develop?Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes. The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events). How is PTSD assessed?In recent years, a great deal of research has been aimed at developing and testing reliable assessment tools. It is generally thought that the best way to diagnose PTSD-or any psychiatric disorder, for that matter-is to combine findings from structured interviews and questionnaires with physiological assessments. A multi-method approach especially helps address concerns that some patients might be either denying or exaggerating their symptoms. How common is PTSD?An estimated 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse. About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high as 8 percent. Who is most likely to develop PTSD?1. Those who experience greater stressor magnitude and intensity, unpredictability, uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and betrayal 2. Those with prior vulnerability factors such as genetics, early age of onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events 3. Those who report greater perceived threat or danger, suffering, upset, terror, and horror or fear 4. Those with a social environment that produces shame, guilt, stigmatization, or self-hatred What are the consequences associated with PTSD?PTSD is associated with a number of distinctive neurobiological and physiological changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The amygdala has also been found to be involved in coordinating the body's fear response. Psychophysiological alterations associated with PTSD include hyper-arousal of the sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities. People with PTSD tend to have abnormal levels of key hormones involved in the body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in individuals who have both PTSD and depression. PTSD is associated with the increased likelihood of co-occurring psychiatric disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence (27.9 percent). PTSD also significantly impacts psychosocial functioning, independent of comorbid conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system. Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD. How is PTSD treated?PTSD is treated by a variety of forms of psychotherapy and drug therapy. There is no definitive treatment, and no cure, but some treatments appear to be quite promising, especially cognitive-behavioral therapy, group therapy, and exposure therapy. Exposure therapy involves having the patient repeatedly relive the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Prozac and Zoloft. At present, cognitive-behavioral therapy appears to be somewhat more effective than drug therapy. However, it would be premature to conclude that drug therapy is less effective overall since drug trials for PTSD are at a very early stage. Drug therapy appears to be highly effective for some individuals and is helpful for many more. In addition, the recent findings on the biological changes associated with PTSD have spurred new research into drugs that target these biological changes, which may lead to much increased efficacy.
PTSD and Holidays (The printed version of the first issue is available free. Simply fill out and send us the feedback form or write and send us your name and address at The Post-Traumatic Gazette, P. O. Box 2757, High Springs, FL 32655) Please visit Patiencepress.com Copyright Patience H. C, Mason, 1997. First published in The Post-Traumatic Gazette #16. All rights reserved, except that permission is hereby granted to freely reproduce and distribute this document, provided the text is reproduced unaltered and entire (including this notice) and is distributed free of charge. Most people do not realize that people with PTSD have anniversary reactions. Holidays may also be anniversaries of trauma and bring up a lot of pain. This is one of the most distressing forms of reexperiencing for survivors and their families. If the survivor doesn't recognize that this is one of the symptoms of PTSD, he or she may feel like Scrooge instead of like a normal human being who went through hell at that time of the year. If the family doesn't understand that this is a PTSD anniversary reaction, they may be very angry at the survivor. "What is wrong with you?" is a heart-rending, humiliating question when the survivor doesn't know why s/he reacts like this. If your veteran spent a particularly horrible Christmas seeing villagers lose all they had, seeing friends die, seeing the fat cats in the rear partying while the troops were suffering, he may have a hard time with Christmas. If your abusive father tore up the Christmas tree every year, if your uncle molested you at the family get together when you were eight, if you got mugged while out Christmas shopping, or date raped after an office party, or if your violent family pretended nothing was wrong during the holidays, these upcoming holidays may be a hard time for you. This is a normal reaction. Holidays are also a really stressful time for many trauma survivors because they seem to reinforce the outsiderness of being a survivor of trauma. Everyone else seems so happy while your guts are twisted into knots as you think about past events. For veterans and other survivors, this pain can be compounded by grief for lost friends and their families who now face the holidays without those loved ones who didn't survive. Guilt may also rear its painful head. Why did I survive? The financial difficulties many trauma survivors experience are highlighted by the commercialization of the holidays. There are a lot of pressures to conform. One of my first healthy actions in my marriage was to decide that Bob didn't have to celebrate Christmas after he came back from Vietnam. I loved it so I should celebrate it and let him be him. I have no idea where that idea came from but it saved me a lot of fights. Today I look back on it as a miracle, accepting Bob as he was, and detaching in a healthy way. I think this is an important point for all trauma survivors and their families: Let the people who love the holiday celebrate it, and the people for whom it brings pain don't have to. This may cause problems with the extended family or the kids, but treating the survivor with respect is one healing way to frame it: "We have to respect other people's feelings and limits," can be a healthy way to put it. We can also create our own ways of celebrating the holidays. We don't have to conform to a rigid commercial stereotype of piles of expensive gifts and big gatherings. As a matter of fact one thing that trauma can bring you face to face with is the value of people as opposed to things. We're starting a tradition in our crowd this year (a number of whom are trauma survivors and veterans) of homemade, recycled, or under $5 gifts. Ingenuity and fun! Many survivors are not comfortable in crowds or at parties, but a quiet meaningful celebration, say singing carols in the living room with just the tree lights on, may be something they can participate in. They may not want to trim the tree, but going out to cut it down or pick it out may be okay. I am mentioning Christmas traditions here because that is what I grew up with, but I'm sure that Hanukkah and Kwanzaa celebrations can be as low-keyed and spiritual as the survivor needs them to be. Survivors may need to create new rituals to help in their healing. For instance a veteran who lost friends in combat on Christmas may want to feed the homeless (many of whom are combat veterans) instead of participating in a big family dinner with people who may or may not appreciate his service. He may need to go to a special place and tell his lost buddies how much he misses them and wishes they had lived. Someone else may want to help provide Christmas presents for children of poor families or for other survivors of trauma. The range of possibilities is limited only by the imagination. If all you want to do is stay drunk or stoned through the holidays, it might be good to find help instead. No one wants to be providing traumatic memories for the next generation. What you do while drunk or stoned can be pretty unpleasant for others, and especially painful for family members of both the spouse variety and the small-fry variety. 12 step meetings happen even on holidays like Christmas and New Year's. I'm going to be at my ACOA meeting Christmas Eve. Sobriety is better than big presents. Harder, too. Crass commercialization and shop till you drop take the fun out of the holiday for me. So does having religion shoved down my throat, but I find that I can celebrate the birth of a child who represents all children to me and use it as an opportunity for me to do good in the world. Perhaps you and your family can do the same. Holiday Helps: Asking for input and creating family traditions: As I mentioned before, when Jack was a kid, he and I had our own Christmas without making Bob participate. This is called politeness, although my principal reason was selfishness, wanting my kind of Christmas. Selfishness created a healthy boundary in that case. Something I didn't think of at the time was asking for input, which is also polite. Rituals For Our Times, by Evan Imber-Black and Janine Roberts (Harper, 1992, $12.00) has a wonderful chapter on holidays and a whole section called "Making Meaningful Rituals." Among other things, they suggest that planning, discussing and getting input from family members can prevent disappointments. Planning small changes in existing family traditions instead of trying to change everything at once is also easier. Sometimes family traditions are out of balance and only please one side of the family or one spouse or whatever. To fix this, ask what the other person would like to do for the holidays. Say something like: "Maybe we could figure out some new things we could do that we would all like and could do together. Then the kids and I could do the stuff we like without pushing you to be involved." Your spouse may never have thought about what he or she would like to do. I suggest not expecting an answer right away-maybe not even till next year. Just let him or her know you are interested in discussing it and open to change. People resist doing things they haven't been involved in. Planning or contributing to an event can give them a sense of being valued and having some control. One final point, without them being aware of it, some traditional activities may clash with issues of safety for survivors. For instance, if Vince Veteran never puts up the Christmas lights despite endless nagging, perhaps it is because in Vietnam the night belonged to Charlie. By lighting up the house at night, he is attracting attention to his nearest and dearest, the kind of attention that could get you killed in Vietnam. Bringing this to consciousness--the need to keep the family safe--may help him get such a natural need met in a more appropriate way--like buying new tires for the car or better locks for the doors. Examining your traditions with that in mind can be rewarding. Let go of outdated traditions or modify them to suit today. With our without the help of your survivor, you can sit down with whoever else in the family wants to celebrate. Have each person list what is fun for him or her. Do the things everyone likes doing. Let go of what has become a burden or what you think others should do or you should do. You can always go back to doing something if you miss it! Example: I like filling stockings for everyone and I thought they should fill mine. Now I get my own stocking stuffers. It is a lot of fun getting a stocking full of stuff I really like instead of an empty one full of hard feelings. I've also dropped creamed onions, cornbread dressing and mince pie! Discussing what the family might like to do can be empowering for your children because it gives them a chance to move on to more age appropriate activities as they grow up. This may be hard for the parents, but I suggest that you can hang your own stockings or have your own quiet holiday dinner. Some new family traditions you might try: Looking up at the stars can be a beautiful experience of the glory of nature. According to December's Discover magazine, this December [1997] the sky is going to be swarming with planets at twilight. "Every bright 'star' to the left of the sunset is a planet... This is a show that airs before prime time, so observe early. After 9 PM only Saturn remains... This year the natural holiday lights are on display for even the youngest of Earth's appreciative sky watchers." Get out of the house: Making snow angels is one of my favorite pastimes. There is nothing that helps me recreate the feeling of being a happy kid again like falling over backwards into the snow and waving my arms and legs. Too bad it never snows in Florida! Snow men, snowball fights (no ice balls, please), snow forts, snowy walks, cross country skiing, sledding, ice skating all can be family fun activities. In the south, walks in the woods, canoeing, kayaking, fishing, bicycle rides are still options. Decorating with natural materials is another thing I like to do. Grapevine wreaths with gold or silver pinecones, magnolia cones, acorns, berries and any weird seed pods I can find give me a sense of satisfaction no store bought wreath ever brought. Look around and be inventive. I also have a wreath made of rusty barbwire which my friend Marci gave me. As a survivor, she feels a little Scroogey at Christmas. I like it! Recycled and home made decorations (and gifts) bring family members together, minimize the wastage of natural resources, and increase our own resourcefulness and independence in a healthy creative way. For some of us it is important not to contribute to corporate profits. Paper chains and pomanders (oranges covered with cloves) are great home made decorations. Buying cloves in bulk at an oriental grocery store or a health food store makes pomanders affordable. They smell great! Doing stuff for others. One veteran I know has been feeding the homeless for the last nine years on holidays. I buy books to contribute to the local newspaper's Christmas book giving program for disadvantaged kids. This is a living amends to a poor little girl to whom Jack wanted to give one of his books when he was 5. I wouldn't let him. Battered women's shelters always need stuff as do homeless shelters, nursing homes, hospitals and churches. You can adopt a family if you are well off, or contribute a few cans of food or a toy if you are not. Whatever you give will benefit you as well as those you help. Altruistic people actually are healthier than those who are not! You can do any of these as a memorial to someone who was lost or abused. Doing stuff for yourself: Provide yourself with something you didn't get that you needed. Maybe this is a grown woman buying her inner child a Barbie doll, maybe it is a veteran presenting himself with a certificate of thanks for his service. Look inside. People who love you would like to do this for you, too. Let them know if they can help somehow. Ask people what you could get them within your price range. Tell people what you want. Talking about presents is hard for some of us. I thought I should be able to find the perfect present with no input. Now I ask. I used to expect Bob to know what I liked and wanted. Now I give him guidelines. Our crowd is having a homemade, recycled or under $5.00 Christmas again. We gave each other some really funny presents last year. If someone has given you something expensive you hated, this year you can recycle it to someone who might like it. I get wonderful containers at garage sales and fill them with cookies or rum balls or spiced pecans so it is homemade and recycled! Talk to each other: Go for the quiet evening at home together. Many of us never sit down and talk because we are so swept away in the demands of daily living. Make a date and simply talk. What about? About what the holidays and/or the family means to you. Accept the fact that kids are naturally self-centered and needy but can develop great kindness. A parents job is not to suppress these natural characteristics, but to encourage awareness of others and empathy. People used to think small children were little demons, but they are actually very kind and willing to give of themselves and help others. One great family tradition is to tell them that some little kids need toys and help them weed out ones they want to give away. Give each child something that will give him or her a feeling of specialness. It needn't be expensive. Magic markers and a pad of paper gave Jack many wonderful hours of fun. I still treasure his creations.¦ Happy Holidays Patience Mason, writer, editor and publisher and one man band. How to subscribe to the Post-Traumatic Gazette: To receive six issues (one year) send $12 (Payable to Patience Press) along with your name and address to: The Post-Traumatic Gazette, Dept WP1 P.O. Box 2757 High Springs, FL 32643 or subscribe by phone at 1-904-454-1651 To subscribe, send $12.00 for one year (six issues) to The Post-Traumatic Gazette, P. O. Box 2757, High Springs, FL 32655. Subscribe online in the Patience Press bookstore.
Diagnostic
Criteria
A. The person has been
exposed to a traumatic event in which both of
3. acting or
feeling as if the traumatic event were recurring
2. Irritability
or outbursts of anger 4. Hypervigilance 5. Exaggerate startle response
E. Duration of the
disturbance (symptoms in Criteria B, C, and D) is more than 1 month.The
disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of
functioning
(The printed version of the first issue is available free. Simply fill out and send us the feedback form or write and send us your name and address at The Post-Traumatic Gazette, P. O. Box 2757, High Springs, FL 32655) Copyright Patience H. C, Mason, 1997. First published in The Post-Traumatic Gazette #16. All rights reserved, except that permission is hereby granted to freely reproduce and distribute this document, provided the text is reproduced unaltered and entire (including this notice) and is distributed free of charge. Most people do not realize that people with PTSD have anniversary reactions. Holidays may also be anniversaries of trauma and bring up a lot of pain. This is one of the most distressing forms of reexperiencing for survivors and their families. If the survivor doesn't recognize that this is one of the symptoms of PTSD, he or she may feel like Scrooge instead of like a normal human being who went through hell at that time of the year. If the family doesn't understand that this is a PTSD anniversary reaction, they may be very angry at the survivor. "What is wrong with you?" is a heart-rending, humiliating question when the survivor doesn't know why s/he reacts like this. If your veteran spent a particularly horrible Christmas seeing villagers lose all they had, seeing friends die, seeing the fat cats in the rear partying while the troops were suffering, he may have a hard time with Christmas. If your abusive father tore up the Christmas tree every year, if your uncle molested you at the family get together when you were eight, if you got mugged while out Christmas shopping, or date raped after an office party, or if your violent family pretended nothing was wrong during the holidays, these upcoming holidays may be a hard time for you. This is a normal reaction. Holidays are also a really stressful time for many trauma survivors because they seem to reinforce the outsiderness of being a survivor of trauma. Everyone else seems so happy while your guts are twisted into knots as you think about past events. For veterans and other survivors, this pain can be compounded by grief for lost friends and their families who now face the holidays without those loved ones who didn't survive. Guilt may also rear its painful head. Why did I survive? The financial difficulties many trauma survivors experience are highlighted by the commercialization of the holidays. There are a lot of pressures to conform. One of my first healthy actions in my marriage was to decide that Bob didn't have to celebrate Christmas after he came back from Vietnam. I loved it so I should celebrate it and let him be him. I have no idea where that idea came from but it saved me a lot of fights. Today I look back on it as a miracle, accepting Bob as he was, and detaching in a healthy way. I think this is an important point for all trauma survivors and their families: Let the people who love the holiday celebrate it, and the people for whom it brings pain don't have to. This may cause problems with the extended family or the kids, but treating the survivor with respect is one healing way to frame it: "We have to respect other people's feelings and limits," can be a healthy way to put it. We can also create our own ways of celebrating the holidays. We don't have to conform to a rigid commercial stereotype of piles of expensive gifts and big gatherings. As a matter of fact one thing that trauma can bring you face to face with is the value of people as opposed to things. We're starting a tradition in our crowd this year (a number of whom are trauma survivors and veterans) of homemade, recycled, or under $5 gifts. Ingenuity and fun! Many survivors are not comfortable in crowds or at parties, but a quiet meaningful celebration, say singing carols in the living room with just the tree lights on, may be something they can participate in. They may not want to trim the tree, but going out to cut it down or pick it out may be okay. I am mentioning Christmas traditions here because that is what I grew up with, but I'm sure that Hanukkah and Kwanzaa celebrations can be as low-keyed and spiritual as the survivor needs them to be. Survivors may need to create new rituals to help in their healing. For instance a veteran who lost friends in combat on Christmas may want to feed the homeless (many of whom are combat veterans) instead of participating in a big family dinner with people who may or may not appreciate his service. He may need to go to a special place and tell his lost buddies how much he misses them and wishes they had lived. Someone else may want to help provide Christmas presents for children of poor families or for other survivors of trauma. The range of possibilities is limited only by the imagination. If all you want to do is stay drunk or stoned through the holidays, it might be good to find help instead. No one wants to be providing traumatic memories for the next generation. What you do while drunk or stoned can be pretty unpleasant for others, and especially painful for family members of both the spouse variety and the small-fry variety. 12 step meetings happen even on holidays like Christmas and New Year's. I'm going to be at my ACOA meeting Christmas Eve. Sobriety is better than big presents. Harder, too. Crass commercialization and shop till you drop take the fun out of the holiday for me. So does having religion shoved down my throat, but I find that I can celebrate the birth of a child who represents all children to me and use it as an opportunity for me to do good in the world. Perhaps you and your family can do the same. Holiday Helps: Asking for input and creating family traditions: As I mentioned before, when Jack was a kid, he and I had our own Christmas without making Bob participate. This is called politeness, although my principal reason was selfishness, wanting my kind of Christmas. Selfishness created a healthy boundary in that case. Something I didn't think of at the time was asking for input, which is also polite. Rituals For Our Times, by Evan Imber-Black and Janine Roberts (Harper, 1992, $12.00) has a wonderful chapter on holidays and a whole section called "Making Meaningful Rituals." Among other things, they suggest that planning, discussing and getting input from family members can prevent disappointments. Planning small changes in existing family traditions instead of trying to change everything at once is also easier. Sometimes family traditions are out of balance and only please one side of the family or one spouse or whatever. To fix this, ask what the other person would like to do for the holidays. Say something like: "Maybe we could figure out some new things we could do that we would all like and could do together. Then the kids and I could do the stuff we like without pushing you to be involved." Your spouse may never have thought about what he or she would like to do. I suggest not expecting an answer right away-maybe not even till next year. Just let him or her know you are interested in discussing it and open to change. People resist doing things they haven't been involved in. Planning or contributing to an event can give them a sense of being valued and having some control. One final point, without them being aware of it, some traditional activities may clash with issues of safety for survivors. For instance, if Vince Veteran never puts up the Christmas lights despite endless nagging, perhaps it is because in Vietnam the night belonged to Charlie. By lighting up the house at night, he is attracting attention to his nearest and dearest, the kind of attention that could get you killed in Vietnam. Bringing this to consciousness--the need to keep the family safe--may help him get such a natural need met in a more appropriate way--like buying new tires for the car or better locks for the doors. Examining your traditions with that in mind can be rewarding. Let go of outdated traditions or modify them to suit today. With our without the help of your survivor, you can sit down with whoever else in the family wants to celebrate. Have each person list what is fun for him or her. Do the things everyone likes doing. Let go of what has become a burden or what you think others should do or you should do. You can always go back to doing something if you miss it! Example: I like filling stockings for everyone and I thought they should fill mine. Now I get my own stocking stuffers. It is a lot of fun getting a stocking full of stuff I really like instead of an empty one full of hard feelings. I've also dropped creamed onions, cornbread dressing and mince pie! Discussing what the family might like to do can be empowering for your children because it gives them a chance to move on to more age appropriate activities as they grow up. This may be hard for the parents, but I suggest that you can hang your own stockings or have your own quiet holiday dinner. Some new family traditions you might try: Looking up at the stars can be a beautiful experience of the glory of nature. According to December's Discover magazine, this December [1997] the sky is going to be swarming with planets at twilight. "Every bright 'star' to the left of the sunset is a planet... This is a show that airs before prime time, so observe early. After 9 PM only Saturn remains... This year the natural holiday lights are on display for even the youngest of Earth's appreciative sky watchers." Get out of the house: Making snow angels is one of my favorite pastimes. There is nothing that helps me recreate the feeling of being a happy kid again like falling over backwards into the snow and waving my arms and legs. Too bad it never snows in Florida! Snow men, snowball fights (no ice balls, please), snow forts, snowy walks, cross country skiing, sledding, ice skating all can be family fun activities. In the south, walks in the woods, canoeing, kayaking, fishing, bicycle rides are still options. Decorating with natural materials is another thing I like to do. Grapevine wreaths with gold or silver pinecones, magnolia cones, acorns, berries and any weird seed pods I can find give me a sense of satisfaction no store bought wreath ever brought. Look around and be inventive. I also have a wreath made of rusty barbwire which my friend Marci gave me. As a survivor, she feels a little Scroogey at Christmas. I like it! Recycled and home made decorations (and gifts) bring family members together, minimize the wastage of natural resources, and increase our own resourcefulness and independence in a healthy creative way. For some of us it is important not to contribute to corporate profits. Paper chains and pomanders (oranges covered with cloves) are great home made decorations. Buying cloves in bulk at an oriental grocery store or a health food store makes pomanders affordable. They smell great! Doing stuff for others. One veteran I know has been feeding the homeless for the last nine years on holidays. I buy books to contribute to the local newspaper's Christmas book giving program for disadvantaged kids. This is a living amends to a poor little girl to whom Jack wanted to give one of his books when he was 5. I wouldn't let him. Battered women's shelters always need stuff as do homeless shelters, nursing homes, hospitals and churches. You can adopt a family if you are well off, or contribute a few cans of food or a toy if you are not. Whatever you give will benefit you as well as those you help. Altruistic people actually are healthier than those who are not! You can do any of these as a memorial to someone who was lost or abused. Doing stuff for yourself: Provide yourself with something you didn't get that you needed. Maybe this is a grown woman buying her inner child a Barbie doll, maybe it is a veteran presenting himself with a certificate of thanks for his service. Look inside. People who love you would like to do this for you, too. Let them know if they can help somehow. Ask people what you could get them within your price range. Tell people what you want. Talking about presents is hard for some of us. I thought I should be able to find the perfect present with no input. Now I ask. I used to expect Bob to know what I liked and wanted. Now I give him guidelines. Our crowd is having a homemade, recycled or under $5.00 Christmas again. We gave each other some really funny presents last year. If someone has given you something expensive you hated, this year you can recycle it to someone who might like it. I get wonderful containers at garage sales and fill them with cookies or rum balls or spiced pecans so it is homemade and recycled! Talk to each other: Go for the quiet evening at home together. Many of us never sit down and talk because we are so swept away in the demands of daily living. Make a date and simply talk. What about? About what the holidays and/or the family means to you. Accept the fact that kids are naturally self-centered and needy but can develop great kindness. A parents job is not to suppress these natural characteristics, but to encourage awareness of others and empathy. People used to think small children were little demons, but they are actually very kind and willing to give of themselves and help others. One great family tradition is to tell them that some little kids need toys and help them weed out ones they want to give away. Give each child something that will give him or her a feeling of specialness. It needn't be expensive. Magic markers and a pad of paper gave Jack many wonderful hours of fun. I still treasure his creations.¦ Happy Holidays Patience Mason, writer, editor and publisher and one man band. How to subscribe to the Post-Traumatic Gazette: To receive six issues (one year) send $12 (Payable to Patience Press) along with your name and address to: The Post-Traumatic Gazette, Dept WP1 P.O. Box 2757 High Springs, FL 32643 or subscribe by phone at 1-904-454-1651 To subscribe, send $12.00 for one year (six issues) to The Post-Traumatic Gazette, P. O. Box 2757, High Springs, FL 32655. Subscribe online in the Patience Press bookstore.
What if you think
you might be among those who have PTSD from your combat experiences? (I
understand that your unit went through some highly stressful combat.) How can
you recognize it? Perhaps the best sign is
combat-related nightmares. However, these nightmares don't need to be exact replays of the actual combat experiences. Often they're weird take-offs on those experiences, and may involve, for example, the presence of family members or acquaintances you didn't even know in the war you fought in. But nightmares aren't essential. Unwanted, intrusive daydreams often signal PTSD. At their most severe, these may involve a sense of loss of contact with reality, in which case they're called flashbacks.
Other PTSD features
include becoming very emotionally or physically upset when reminded of combat
experiences, trying to put such memories out of ones mind, and trying to avoid
being reminded of combat experiences. There are also other features that a
qualified diagnostician can explain to you.The good news about PTSD is that the
natural course in most cases is progressive improvement. However, relapses are
possible indefinitely, and it's not uncommon that veterans who initially had
PTSD but then http://www.brothersboundbyhonor.com/ptsd.html ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ What should you do if
you think you might have PTSD related to your Vietnam or other war service? The
first thing I recommend is filing a claim with the Department of Veterans
Benefits. Persons who do this are usually helped by the DVA, VFW, American
Legion, or other veterans' service organizations. One important reason to file
a claim is to stand up and be counted. It's important that society recognize
the detrimental effects, both physical and psychological, of war on people's
health. (This is not to say that war is always bad. It's only to say that a
nation that is contemplating war, and persons who are thinking of
What if you have filed
for service connection and been turned down, and you continue to think your case
is legitimate? The answer here is persistence. In some VA Regional Offices, turning down a first
application is almost a knee-jerk reaction, and meritorious cases may need to be
appealed once, twice, or even more before they
are
If you can't stomach the thought of going to a VA Medical Center for treatment, and some vets who are not very fond of the Federal Government can't, you might consider trying a Vet Center near you (formerly called Vietnam Veterans Outreach Centers, these are now open to vets of all wars.) The environment is often more friendly there. Most Vet Centers provide their own treatment and are even authorized to pay for private treatment in certain circumstances.
Finding good
psychiatric treatment isn't always easy. Like all other walks of life, some
therapists and doctors are more competent than others. If you need treatment,
don't settle for a therapist or a setting that doesn't feel right to you. Ask
for a change. Keep trying until you get what you need. Again, in dealing with
the VA, patience and persistence
Finally, if the above information doesn't apply to you, count your blessings, and support those among you who are less fortunate.
Roger K. Pitman,
M.D. According to the Department of Defense (DoD), 11% of those serving in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are women. Officially, they are restricted to non-combat roles; however, in wars such as that being waged in Iraq, there are no front lines. Danger lurks at every turn. Find out how they're faring. And learn of their unique experience with combat-related post-traumatic stress disorder [PTSD]...
No Going
Back
"If you tried to pull women out of the equation, this country could not fight a war." -- Lory Manning, a retired Navy captain and director of the Women's Research and Education Institute
Although women have served in one capacity or another in every major war in U.S. history, Iraq has easily become the largest deployment of women to a combat zone: one out of every seven is female. As their numbers have increased, so have their responsibilities. No longer relegated to being spies or nurses, they now find themselves in the heat of battle. As Retired Air Force Brig. Gen. Wilma L. Vaught puts it:
"You've got more women carrying weapons with the possibility that they'll use them to fight or defend themselves," Vaught said in a phone interview. "That's one of the big differences between this war and others. Women haven't done this type of war before."
They are serving admirably and proving their metal daily. Because of the nature of the Iraq war, the policy preventing women from serving in combat positions doesn't shield them from stressful combat situations. For example, in the opening days of the war:
1st Lt. Adrien Thom prepared for the journey toward Baghdad.
Current federal law is meant to shield women
from armed conflict. As such, females are technically banned from serving in any
of the following groups:
Althought President Bush has determinedly stated, "no women in combat," the Pentagon has begun relaxing their ban, placing women in more dangerous roles in the combat zone.
In February, the Army's 3rd Infantry Division acknowledged it has assigned women to units in Iraq that directly support combat troops by providing food, equipment maintenance and other services. The process, called "collocation" - literally to place side by side - is at odds with an 11-year-old Army policy that bans women from serving in front-line support groups.
Listen to an NPR interview to hear another female veteran's experience on the front lines here. :: The First Female Casualty of War
In the end, policy or no policy, women are in the thick of things, right along with our men. Of the ambush, the military later described it as a "torrent of fire" that had rained down on the unsuspecting unit of clerks, cooks, and repairmen. [For more on this incident, please read the excellent Rolling Stone piece, A Wrong Turn in the Desert by Osha Gray Davidson.] :: Women and PTSD PTSD affects women at twice the rate of men. Furthermore, studies show that their symptoms are more striking and incapacitating. In a July 2005 article, Newsweek reported
that:
To better understand how to successfully treat deployed women returning with combat-related PTSD, the VA has launched a first-ever $6 million study focusing on female veteran PTSD.
"PTSD is a very real problem for women who serve in the military," said Paula Schnurr, one of the study's lead researchers and the deputy executive director of the VA's National Center for PTSD in White River Junction, Vt. "This study is specifically addressing that, and we hope it will not only help us treat women coming home from Iraq, but all those who have ever served and struggled with PTSD in any conflict before."
Male and female physiology being what is it, not surprisingly each has a unique way of coping with the demons they may have brought back with them from war. Men, for example, are more prone to pick up drinking or drugs as a way of self-medicating themselves, attempting to numb their pain. Women, conversely, are more likely to seek help. This difference may be one reason for the larger percentage of women who have been identified suffering with PTSD; however it's not the only factor. From a March, 2005 piece in the Chicago Tribune:
"[D]ata indicate that female military personnel are far more likely than their male counterparts to have been exposed to some kind of trauma or multiple traumas before joining the military or being deployed in combat. That may include physical assault, sexual abuse or rape.
An additional factor that has some bearing on female veteran PTSD is the added reality of rape and sexual intimidation from her fellow troops. Since PTSD is slow to show itself, we have no way of knowing how grave a problem this will be for our soldiers, their families, their communities, and our nation. Only time will tell. :: Resources for Women Dealing with PTSD To cope with PTSD, female soldiers have formed Internet support groups (MSN Group Sisters Bound by Honor, for example). They've also begun using a book on PTSD called Why Is Mommy Like She Is? to help them when they transition back to family life after being deployed. See also:
Join the fun and get yourself a FREE Cortex member account (if you haven't already). It's fast. And it'll allow you to take advantage of all this site's great features! Hysterical Republicans hit new low in Washington State. Hysterical Republicans think Iraq moved WMD's to Syria. Infinity Publishing National Center for PTSD MSN Groups THRIVEnet Department of Veterans Affairs (VA) Vietnam Veterans of America Veterans for Common Sense National Gulf War Resource Center US Marine Corps Deployment Health Clinical Center Patience Press
Frequently Asked Quesions1.What is PTSD?Post-Traumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, abuse (sexual, physical, emotional, ritual), and violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the personís daily life. PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the personís ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting. For a further definition, please go to What Is Post-Traumatic Stress Disorder. 2.What treatments are available for PTSD?Elements common to many treatment modalities for PTSD include education, exposure, exploration of feelings and beliefs, and coping skills training. Additionally, the most common treatment modalities include cognitive-behavioral treatment, pharmacotherapy, EMDR, group treatment, and psychodynamic treatment. For a further discussion, please go to Treatment of PTSD 3.How do I locate specialists or support groups for PTSD?You can contact any of the following organizations. They all have referral capabilities: the Sidran Foundation 410-825-8888, Anxiety Disorders Association of America 240-485-1001; American Psychological Association 800-964-2000; NAMI 800-950-6264 Also, your local Mental Health Services office (found in the Yellow Pages of your telephone book) should be able to assist you. To locate help online, please click on Seeking Help for PTSD. 4. I am an American Veteran. Who do I contact for help with PTSD?You can contact your local VA Hospital or Veterans Center or call the VA Health Benefits Service Center toll free at 1-877-222-VETS! For online help, please go to Specialized PTSD Treatment Programs in the U.S. Department of Veterans Affairs. 5. As an American Veteran, how do I file a claim for disability due to PTSD?A determination of "service-connected" disability for PTSD is made by the Compensation and Pension Service -- an arm of VA's Veterans Benefits Administration. The clinicians who provide care for veterans in VA's specialized PTSD clinics and Vet Centers do not make this decision. A formal request ("claim") must be filed by the veteran using forms provided by the VA's Veterans Benefits Administration. After the forms are completely submitted, the veteran must complete interviews concerning her or his "social history" (a review of family, work, and educational experiences before, during, and after military service) and "psychiatric status" (a review of past and current psychological symptoms, and of traumatic experiences during military service). The forms and information about the application process can be obtained by Benefits Officers at any VA Medical Center, Outpatient Clinic, or Regional Office. The process of applying for a VA disability for PTSD can take several months, and can be both complicated and quite stressful. The Veteran's Service Organizations provide "Service Officers" at no cost to help veterans and family members pursue VA disability claims. Service Officers are familiar with every step in the application and interview process, and can provide both technical guidance and moral support. In addition, some Service Officers particularly specialize in assisting veterans with PTSD disability claims. Even if a veteran has not been a member of a specific Veterans Service Organization, the veteran still can request the assistance of a Service Officer working for that organization. In order to get representation by a qualified and helpful Service Officer, you can directly contact the local office of any Veterans Service Organization -- or ask for recommendations from other veterans who have applied for VA disability, or from a PTSD specialist at a VA PTSD clinic or a Vet Center. For online information, please click on Help for Veterans and Their Families.
by Patience Mason Author of Recovering from the War: A Guide for all Veterans, Family Members, Friends,and Therapists http://www.patiencepress.com/ ©2007 Patience H. C. Mason All rights reserved. No portion of this publication may be reprinted without expresswritten permission of the author, which you have if you are a veteran, family member, friend or therapist. Please print, copy, and give to anyone it will help. .
My husband, Bob, spent the second year of our marriage flying a Huey slick in the First Cavalry Division in Vietnam 1965-66. His book, Chickenhawk, tells the story of that year. When he got back, I saw how skinny he was, but I was so glad to have him back, I didn’t notice the thousand yard stare. I had no idea what he had been through. I was just so glad he was alive. Neither of us had any idea that the war was, quite naturally and normally, going to affect both of us for the rest of our lives. We didn’t know any of what you will read in this pamphlet. They told Bob he would be fine in a few weeks. When he wasn’t, he thought he was nuts. I thought I was a bad wife, or he would not be having problems. He often agreed. Our life was not very happy for the next fifteen years, until we found out about Post-Traumatic Stress Disorder. We still deal with it, but today our dealings are informed, which makes things easier. Stages you may go through when you get home: Stage 1: I’m fine: Most soldiers come back believing it’s all over. Young, strong, proud, even if you are having some odd moments, you are not about to tell the doctors because you will be kept from going home. The changes that helped you survive war don’t seem that big a deal, and who is going to tell some guy in a white coat that you are seeing dead people? You may not know how much you have changed till you’re home. Life here is flat. People have petty problems. You can’t sleep, have bad dreams, get furious at everything, and keep looking for roadside bombs. When a car backfires, you hit the dirt. Still, you probably think the people around you have problems. Not you. Any comments about how you’ve changed may really piss you off. You’re fine! You survived a war! What kind of help could you possibly need after that? If you don’t know that it is normal to be affected, what else can you do but deny that you are? That’s what everyone else does. Denial can make your family feel nuts. You may be telling them they are nuts. This usually does not improve relationships. Furthermore, in today’s military, you probably will have to go back, so denial may seem necessary..
Stage 2: I’m not fine, but I’m not telling you: You notice some problems. You get angry too fast, you are yelling at people instead of talking to them, you keep seeing your friends die. When civilian things go wrong, you don’t care. (Is anyone shooting?) You may be shocked to feel nothing when a beloved relative gets sick or dies, or you may think you don’t love your spouse anymore because you can’t feel it. You hate civilians or Arabs. You are not fine, but you are not going to tell anyone, especially not anyone who wasn’t there and has been telling you that you have problems. You start to think that you can’t talk to anyone who wasn’t there. You begin isolating so no one will see how nuts you feel. You are pissed off about being affected. You also fear going for help because it may dull your edge, which you will need when you go back. It might also affect your career, and you don’t want people to think you are nuts. You exclude your spouse. He or she gets angry at you a lot. Stage 3: I can’t talk to people who weren’t there: Since you can talk to other vets, you feel that no one understands unless they were there. This unfortunately is true. Most people make this clear by saying insensitive things like, “So what’s your problem? Get over it!” “Did you kill anyone?” “You’re a hero.” and the inevitable, “But why aren’t you over it?” So you increase your isolation from family and friends. This however tends to make spouses angry, because we are supposed to be understanding. Your sense of humor has become very black, and you laugh at things that would have horrified you once. You may even wonder if your spouse would still love you if they knew what happened over there. You might feel that everyone around you is spoiled and insensitive and it pisses you off. You have to stay so numb that your spouse feels you don’t love him or her anymore.
Stage 4: What’s wrong with me? The term “Post-Traumatic Stress Disorder” is a good description of the effects of war on normal people. The skills of war create a lot of disorder in your life. Shrinks and family members tend to see the symptoms of PTSD as the problem. Not me. I see war as the problem and the symptoms of PTSD as solutions to the problem of war, something right with you, not something wrong with you. Each symptom begins as part of your body’s hard-wired survival responses to danger, which your training has been designed to intensify and strengthen. They worked. You are alive. That is the bottom line. You have been through something that killed others. Having PTSD is proof of survival. I also believe that the people who get PTSD are the ones who care the most. You may feel like you don’t care, but if you didn’t care, you would not have to develop the symptom of emotional numbing to survive. Although PTSD symptoms originate in hard-wired survival skills built into all of us, unhealed, they can become your biggest problems over time.
Stage 5: I’m screwed up and no one can help. Deciding that no one can help is pretty human, but it is not true. I don’t think you are screwed up, either. You are in survival mode. What helped you survive one deployment will probably help yo |
Although the names Jessica Lynch and Soshanna Johnson are more
commonly recognized in most homes across the country, their friend who perished
that day in Nasiriyah is not.