11 Things

1. You don’t have to be a veteran to have PTSD.

The disorder can develop after a traumatic event, like witnessing or experiencing sexual assault, violence or death. It is estimated that 60 percent of men and 50 percent of women will experience one traumatic event at some point in their lives, although that doesn’t necessarily mean they will develop PTSD.

The condition is most commonly linked with war veterans, who while active were likely surrounded by scarring situations quite regularly. It is expected that between11 and 20 percent of vets who served in operations Iraqi Freedom and Enduring Freedom suffer from PTSD in a given year.

2. The time it takes for the condition to develop varies.

Sometimes symptoms don’t show up right away. There are two types of PTSD, according to researchers. There’s short-term or acute, from which a person can recover after a few months, and chronic or ongoing, where symptoms tend to persist throughout a longer period of time.

3. At its worst, PTSD can lead to suicide.

One of the horrible side effects of any mental illness is a risk for harmful or suicidal thoughts. It is believed that both deployed and non-deployed veterans have a higher risk for suicide than the general U.S. population.

If you or someone you know needs help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., visit the International Association for Suicide Prevention for a database of international resources.

4. It’s not totally unheard of to have PTSD.

Nearly 8 million American adults suffer from PTSD in a given year, according to the U.S. Department of Veterans Affairs. Additionally, about 8 percent of the population will experience PTSD at some point in their lives.

5. The symptoms are all-consuming.

The effects of PTSD aren’t just emotional. The condition been associated with physical issues, like poor cardiovascular health and gastrointestinal problems. It’s also classified by paralyzing episodes of fear, avoidance of situations that trigger those fears and mood changes like extreme guilt, worry or loss of motivation.

6. There’s a huge stigma surrounding the condition.

Like most mental illnesses, people with PTSD are often plagued by negative stereotypes. According to the U.S. Centers for Disease Control, only 25 percent of people with mental illness feel like others are understanding about their condition. This is a huge problem since stigma often prevents people from seeking proper treatment.

7. It’s not a punchline.

Using mental illnesses in a colloquial manner or as a joke only perpetuates incorrect perceptions. Think twice before you claim a stressful day at work or an uncomfortable argument “gave you PTSD.”

8. Remedies for PTSD vary depending on the person.

Mental illness isn’t one-size-fits-all, and neither is the treatment. People with PTSD will likely have to try different therapies, medications or other techniques in order to find what works best for them.

9. It’s not “all in their head.”

The mind is the most complex organ in the body, and related illnesses should be treated as such. Research shows that traumatic stress impacts regions in the brain. In other words, the condition is not something a person can just “get over” or an attitude they adopt just to seek attention.

10. The triggers aren’t universal.

Because PTSD stems from different traumatic experiences, the triggers that aggravate the condition and prompt flashbacks to the event aren’t going to be the same for everyone. While the condition is manageable, there’s always a chance that a person on the street, a sound in the grocery store or even a comment from a relative can provoke a paralyzing fear. It’s a hard reality to deal with on a regular basis.

11. It’s possible to live a healthy, productive life with PTSD.

Just because someone has PTSD doesn’t mean they’re unable to function or live fulfilling lives. Once again, the right treatment is necessary. Like cancer or the flu, an illness is just an aspect of someone’s reality; a piece to a whole puzzle. Their illness does not define them — and that’s the most important thing to remember.


16 Things

1. Get Educated. If you see the signs and symptoms of PTSD in someone you care about, learn more about what PTSD is, and what it isn’t, as it relates to your loved one’s experience.

2. PTSD: a Chronic or Curable Condition? According to the National Institute of Mental Health, PTSD is a chronic condition that can be managed through various modalities of treatment. With treatment, the effects of PTSD can be reduced and even eliminated, however, memories of the event cannot be erased.

Treatment can help someone regain control over their life from the symptoms of PTSD. It can also help reduce the extent to which symptoms of PTSD interfere with a number of different areas in their life such as work, school, or relationships. That said, it is important to remember that symptoms of PTSD can come back again. Once a person has successfully completed treatment, it does not mean the work is done. It is important that they continue to practice the healthy coping skills they learned in treatment.

3. PTSD is not a choice. Just like other mental illnesses or addictions, it is not something that you “choose” to have or to do to yourself. Use kindness and compassion when someone you know is coping with the PTSD.

4. Let the professionals treat your loved ones. Mental health experts are trained and equipped to handle mental illnesses such as PTSD. They will be able to talk with your loved one with an objective perspective and can utilize the best tools at hand for treating their PTSD. Your job is simply to love them best you can each day.

5. You can’t push, coax, or cajole someone into treatment. This is especially hard for those who are watching folks who are dealing with PTSD. While you can make a suggestion to get treatment or even help them find the resources they need, they have to seek treatment for themselves. We’ve all heard the saying, “You can lead a horse to water but you can’t make them drink…”

6. Understand your loved one’s symptoms and the impact of those symptoms on his or her behavior. What might not seem like a “big deal” to you could be a trigger for your loved one. The more you know about these triggers, the more effectively you can modify routines and avoid them.

7. Recognize if they’re having trouble sleeping. Those trauma survivors who get PTSD are even more likely to suffer from insomnia and nightmares. According to the Department of Veterans Affairs, of those coping with PTSD, 71% to 96% may have nightmares. If your loved one experiences insomnia or bad dreams, reduce the feelings of stress they experience especially before bed (ex. don’t watch the news before going to bed), reduce or eliminate caffeine in the late afternoon and evening, don’t eat too much before going to bed, and create an environment in which they can sleep well and feel safe.

8. Consider getting a therapy dog. A therapy dog can provide a sense of security, calming effects, and physical exercise that can make a positive difference in the life of those that suffer with PTSD. A therapy dog can also help them  sleep better, as the dog can be on guard for them, and wake them up if there is a problem.

9. Don’t ask insensitive questions. Questions about their trauma such as what happened, why it happened or how it happened, can trigger unwanted memories. If a friend or loved one wants to share the experience with you, he or she will do so when the time is right.

10. Honor individual choices. It is important to understand that your loved one’s behavior does not necessarily indicate his or her true feelings. That is, he may want to go out with friends and family but he is too afraid of bringing up upsetting thoughts and memories. If your loved one says no to participating in some event or going somewhere, honor this answer.

11. Anxiety has many faces. Especially for kids, but also for adults, anxiety can look like irritability, and it’s much harder to see it for what it is when that happens, according to Dr. Ruth Hoffman. Rather than responding to their crabbiness with “Where are your manners?” or “You don’t have to be such a grouch about it…” try taking a more compassionate route such as, “Wow, you really seem unsettled, is there something I can do?”

12. Just because you can’t see it, doesn’t mean it’s not real. Each person deals with trauma in their his or her own unique way. Let go of your judgment, and reach for compassion instead as you never know what someone has been through or what they’re dealing with on the inside.

13. Meet them where they are. A person with PTSD still has a range of feelings, she just may not be expressed in the same way or fashion as she did before the traumatic experience. This may look like utilizing different coping mechanisms to operate effectively in the world, mechanisms which aren’t as familiar to you. When you can meet her where she is and rather than “where she used to be,” you can lower your stress and hers.

14. Let them be in control of their choices as much as possible. i.e. Don’t make all the choices for them. Conversely, asking them, “What do you want for dinner?” or “What do you want to wear?” (for kids) etc., can be overwhelming because it presents too many choices to think about.   If there is an obvious thing, like wanting to wear the same outfit over and over (some clothes feel safer than others), or wanting to sleep in the other room, etc., those are not things to argue about. Another approach might be “What can you wear that will feel safe enough, while I wash this other favorite outfit you’ve had on for three days?”

15. Get the support you need. Support groups and/or couples counseling may be a good way to learn how to communicate with your loved one, as well as cope with his or her PTSD symptoms. They may also help you find the best way to encourage your loved one to get help if he hasn’t already.

16. Treat them normally. If your family member or loved one is getting the treatment she needs, great. The best way you can support her as she goes through the healing process is to treat her normally, i.e. don’t walk on eggshells around her or use PTSD as an excuse to coddle her. Listen and love her as she learn how to effectively manage symptoms of PTSD.

Dealing with the effects a friend or loved one with PTSD can bring many tests and trials to even the best of relationships.  It requires learning new things and making changes to old patterns and habits.

The more you know, the better equipped you’ll be to offer emotional support, understanding, patience and encouragement to your loved one on his or her road to recovery.

5 Things


Civilians Don’t Understand What PTSD Really Is

Spencer Platt/Getty Images News/Getty Images

So you probably want the exciting story of how Warren got injured in Iraq. A big firefight? A roadside bomb? The restless spirits of an ancient tomb? Well, he … uh … fell off a wall. Yeah, he’s probably not getting a dramatic action movie about his experiences.

Okay, there was more to it than that. Earlier, he had been around a few I.E.D.s when they lived up to the “E” part of the acronym (close enough to get concussed, but not maimed). He also managed to break both legs and an arm in basic training, and he got shot at a party when he and his friends intervened in a fight. But it was a wall that finally ended his tour — he took a nasty fall while climbing over it. And that’s it. Thanks to what sounds like a deleted scene from Larry the Cable Guy’s Delta Farce, Warren was sent home with a spinal brace. Add that to everything else he’s been through, along with the general stress of getting shot at for a living, and it’s not hard to see how Post-Traumatic Stress Disorder emerged.

PhongsakM/iStock/Getty ImagesTraumatic injury is enough to inspire PTSD for one in five people. So yes, this really is enough.

In the long term, PTSD tends to be self-correcting, because we wouldn’t be here today if our distant ancestors had huddled into balls and waited to die the first time a wolf tried to eat them. But 20 percent of traumatized people end up with long-term PTSD, and an inordinate number of them are soldiers. Unlike other traumatic experiences, soldiering produces mixed emotions. Unless the car that put you in a wheelchair for a year was driven by your future spouse, you generally simply want to put traumatic events behind you. But soldiers are usually proud of what they do, and they make good friends while they do it. So you have some of the best moments of your life melded with some of the worst; it’s not as simple as “moving on.”

Oh, and I should point out that soldiers who served in Iraq and Afghanistan are less likely to commit suicide than soldiers who never deployed. This is because, and this might shock you, the army tends to not deploy unstable people into stressful, gunfire-filled situations. (And the overall suicide rate for soldiers, while tragic, is generally no higher than the national average.) The real PTSD warning signs are pre-existing mental conditions, past trauma, being less educated, and having a vagina — women tend to be more susceptible than men.

Scott Olson/Getty Images News/Getty ImagesThey get to deal with more causes than gunfire.

So then why are violent, suicidal, male veterans such a cliche? Most of the sociopathic villains in the FX drama Justified are veterans, as are many of the violent bikers in Sons Of Anarchy. Even freaking Happy Tree Friends features Flippy, the soldier character who, wait for it, violently flips out at the slightest provocation. I could go on, but others already have. If you need a character to be ridiculously violent and emotionally unstable, then slap a service badge on him and call it a day.

Gramercy Pictures“Come on. Fuck it, man. Let’s go bowling to much-needed therapy sessions.”

So in some cases, PTSD is a self-fulfilling prophecy. We think soldiers with it are dangerous, so we don’t interact with them and invent creative ways to legally avoid hiring them. Then, shockingly, they start to believe that they’re worthless and will never recover (even though the research says otherwise). And then some of them kill themselves and we treat it as a mysterious tragedy. Well, it doesn’t seem that mysterious to me. We go from treating them as heroes to treating them as ticking time bombs.

Speaking of which …


Marriage Is Difficult (But Not In The Ways People Assume)

Luke Sharrett/Getty Images News/Getty Images

I love my husband, but even if your marriage is so strong that it makes the eternal love of Disney characters look like festering garbage, years of sporadically supported PTSD puts a serious strain on it. For starters, if you think sex is the most intimate physical act a couple can engage in, try being a small woman doing her best to prevent her gigantic husband from choking during a seizure while he loses control of his body and shits himself. While that does earn me a lot of relationship karma (“Oh, you don’t feel like doing the dishes tonight? Well maybe I won’t feel like keeping you from biting your tongue off”), I’d rather spend our nights watching Netflix.

Ingram Publishing/Ingram Publishing/Getty ImagesIdeally, something without shots or explosions.

What, you didn’t know that seizures could go hand-in-hand with PTSD? You’re not the only one. You can imagine our surprise. Other times, he doesn’t remember who I am. Sometimes he freaks out at imaginary mortar fire. Between the seizures and panic attacks, our constant frustration with the US government (more on that later), and the fact that we’ve moved more than bank robbers on the run from the FBI, our marriage is a tad more stressed than one in which the couple’s greatest concern is which bespoke diaper bag to buy. It’s not easy for Warren, either. He’s said that he wants a divorce several times — not because he no longer loves me, but because PTSD can put you in a place where you feel like nothing but a burden (he’s not, by a long shot).

He’s thrice tried to, let’s say, “unilaterally enact” a divorce with extreme prejudice. The first time, he tried to hang himself, and I was able to get him down. Then he tried to shoot himself but failed. Twice. Outsiders don’t see these challenges, so instead they make a very different assumption. Once, I was visiting Warren during his stay in the psych ward, and when I had to leave, I cried because I wanted more time. A nurse walked me to the elevator and said “I know what you’re going through. Abuse is very hard to deal with. If you ever need help, there’s a group for battered women like you.” In a moment of what I think is truly heroic self-restraint, I didn’t growl, “You want to see abuse?” before spin-kicking her down the elevator shaft.

alex_u/iStock/Getty Images“The fact that we’re on the first floor saved your life.”

Warren has never laid a finger on me, and I have no bruises to even suggest otherwise, but she’s far from the first person to have suggested it. Because that’s what traumatized soldiers do, right? They go home and beat their wives because violence has been fundamentally ingrained in them? Yeah, or they try to put a bullet in their own head specifically because they’re terrified of hurting the people they love.

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Even Other Soldiers Don’t Get It

Scott Olson/Getty Images News/Getty Image

The way our society handles soldiers is … complicated. We revere them for their service, but sometimes we take it to the point where we barely view them as regular human beings. After all, movie action heroes can suffer literally hundreds of near-death experiences and still make glib one-liners about it hours, days, or years later. Even that movie in which Tom Cruise actually dies 300 times still ends with him giggling at the camera. If they’re ever shown as vulnerable, it’s always in a way that makes them even more dashing and heroic.

So it’s no surprise that mental illness is stigmatized within the military. It makes you look weak, and the lack of guaranteed confidentially with military therapists makes soldiers terrified that something they say will get them in trouble. Would you talk to a therapist if you knew there was a chance your boss would learn all the details?

Chip Somodevilla/Getty Images News/Getty ImagesAs we’ve noted before, the military isn’t always great at dealing with sensitive personnel matters.

Older veterans aren’t much help, either. Far from being sympathetic to their struggles, some older vets view today’s soldiers as having it way easier than they did when they were slogging through the jungles of Vietnam. Of course, Vietnam vets were looked down on by some WWII and Korea vets, the WWI vets thought fighting fascism sounded like a vacation, and so on down the line to some caveman telling a young caveman that back in his day, bashing in the skulls of rival tribesmen was a real struggle because they didn’t get hunks of wood to attach their sharp rocks to.

jarino47/iStock/Getty Images“Rocks!? That must have been nice.” — Early Neanderthal

10 Things

What People with PTSD Want You to Understand about PTSD

  1. We are not weak. Suffering from PTSD as a result of trauma is not a mental weaknessor moral failing. Rather, it is a result of some traumatic thing that happened to us. The fact that some people develop PTSD after a traumatic event, and some people don’t, really has no correlation to the person’s physical, mental, or emotional strength.
  2. We are not all combat veterans. PTSD can be caused by any type of trauma, not just the horrors of war. Physical, sexual, emotional, or any other kind of abuse, can cause it as well as things like car accidents, natural disasters, and illnesses. PTSD is hard to understand even when you have it. Learn some of the facts that PTSD sufferers would like for you to know about the disorder. Take a look.
  3. We don’t always look like the people with PTSD on TV and in movies. People with PTSD are often portrayed in TV and films as rage-filled, flashback-having, anxiety-riddled lunatics. While anger,flashbacks, and anxiety are certainly symptoms of PTSD, many of us have learned how to deal with those things through therapy, medication, and support.
  4. We did not ask for the trauma that caused our PTSD. Someone suffering from PTSD is not to blame for having the disorder. We were victims of trauma who developed the disorder as a result. The trauma wasn’t our fault, and having PTSD isn’t our fault either.
  5. We don’t always know what will trigger us and why. Because being triggered can be caused by just about anything — a sight, smell, sound, movie, television show, place, picture, and the list goes on — we don’t always know which things are going to have a negative effect on us. It is also true that something we encounter may trigger us one time, but not the next. At times, it’s like dodging bullets and you have no idea which direction they are coming from.
  6. We have scars, but they are often invisible. The scars left by PTSD-inducing trauma aren’t always observable. Many times the wounds left by trauma are emotional, spiritual, and mental. Just because you can’t see it, doesn’t mean it’s not there.
  7. We know that sometimes our reactions and feelings are illogical, but knowing that doesn’t always help. Being triggered, anxious, or depressed as a result of PTSD is sometimes quite irrational in relation to the situation. Many times, we know this, intellectually. That knowledge, though, doesn’t make the irrational feelings go away.
  8. We cannot just “get over it.” PTSD has physical symptoms; it affects our bodies, not just our minds. Telling someone with PTSD to “get over it” is like telling someone with epilepsy to “get over” having seizures. It doesn’t work.
  9. We want you around, even when we don’t act like it. Sometimes we want to isolate and withdraw from daily life. That doesn’t always mean that we want to be alone, though. We may feel comforted by just being in the same room with you, even if there is no interaction.
  10. We need for you to believe in our recovery. Recovery from, or at least management of, PTSD is possible, but it doesn’t always feel that way to us. Having support from you and seeing that you believe we can recover is the best thing you can do for us.

I’m sure that those of you out there with PTSD can think of many more things that you would like others to understand about PTSD and the effects it has on you. I would love for you to share some of your ideas in the comments below.

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