Paradise Lost: Opening The Gates Of Hell
Soldiers And Post-Traumatic Stress Disorder – UPDATED AGAIN
by Michael Maynard
December 21, 2013

myfathersmedal

Because of his PTSD, my father wanted no more reminders of the war he could never forget.

A mind not to be changed by place or time.
The mind is its own place, and in itself
Can make a heav’n of hell, a hell of heav’n.
John Milton, Paradise Lost

A right-wing minister recently claimed that veterans can pray away post-traumatic stress disorder (PTSD). The televangelist minister, Kenneth Copeland, stated in his BVOV.TV  network’s broadcast with his guest, historian David Barton, “Any of you suffering from PTSD right now, you listen to me. You get rid of that right now. You don’t take drugs to get rid of it, it doesn’t take psychology; that promise right there [in the Bible] will get rid of it.”

If only getting rid of PTSD was that easy.

I take great personal offense to Copeland’s and Barton’s statements. My father, Private First Class Lloyd Maynard, was one of the first Army soldiers to hit the beach at Anzio, Italy, during World War II. During the water landing, my father pulled one of his fallen comrades to shore, as my father was hit by shrapnel in his stomach and leg. He could have received many other medals for his heroism, including a Purple Heart. He never applied for them. He didn’t want any more reminders of his war experiences. My father did not “suffer from guilt”, I believe  he suffered from post traumatic stress disorder. He volunteered for combat, paid the price for his service to his country and the world, and could never be rid of the pain and horrors he experienced. For the rest of his post-service life, my father lived in his own private hell.

My father was a good and gentle man. But when he exhibited the effects of PTSD, he changed. I could hear him yelling during his sleep for his comrades to get down. My mother said that his legs would start thrashing and he start sweating profusely. He also suffered from severe headaches, during which his personality would become dark and frightening, scaring my mother and me. He never sought or received help. My father’s periodic headaches and pain lasted until he died. He did not want to be known as being “shell-shocked” or “battle-fatigued”, the common terms for PTSD at that time. Those were words of personal failure and weakness; his manlihood was being questioned.

My father was alone in his mental misery, but his having PSTD is not unusual. In this video, a Vietnam War veteran describes what he’s feeling while doing a routine matter, driving across a bridge. He feels that he is still under attack from the Viet Cong, though rationally, he knows otherwise because he’s home in Canada. This veteran cannot hold down a job because he can’t sleep and has to go to a food pantry for assistance. He, like my father did, becomes hijacked by his brain.

ptsdincidents

What is post traumatic stress disorder?

“Bottom line, PTSD is now described as a disorder of persistent reactivity in all of the domains of self-regulation, and not just troubling memories and chronic anxiety [1]. Distressing memories of past traumatic events and intense stress reactions to reminders that occur in current life continue to serve as the cornerstone of PTSD.

Now, however, these forms of “intrusive re-experiencing” of traumatization are understood as playing out across the full range of ways in which we regulate ourselves: emotions, body functions and health, thinking, motivation, behavior, relationships, and ultimately our sense of self or identity.” In effect, your brain is hijacked.

There are twelve steps in developing PTSD:

12-steps_PTSD_chart

There are four recognized levels of PTSD:

Acute Stress Disorder: symptoms occurring within four weeks of the trauma.
Acute PTSD: symptoms lasting three months or less.
Delayed Onset PTSD: symptoms appear six months or more after the trauma.
Chronic PTSD: symptoms lasting more than three months.

My father would have been diagnosed to have levels 3 and 4:  Chronic Delayed Onset PTSD.

The new DSM-5 definition of PSTD

The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5) changes the definition of PTSD to include the effects of it on living your daily life, functioning, not just your state of mind.

(Note: Having PTSD does not require serving in the military or adulthood. Not all events that cause the onset of PTSD need to be physically life-threatening. For example: being betrayed by your mate or constant verbal bullying by playmates could invoke the “fight or flight “ response central to PTSD).

The criteria for PTSD include specifying qualifying experiences of traumatic events, four sets of symptom clusters, and two subtypes. There are also requirements around duration of symptoms, how it impacts one’s functioning, and ruling out substance use and medical illnesses. Also, there is now a pre-school diagnosis for PTSD, so the following description is for people ages 7 and older. DSM also introduces a subtype of PTSD for children age 6 and younger.

Here are the major diagnostic criteria for PTSD and whether my father met each one:

PTSDSymptimschart

By my layman standards, my father met all of the specified criteria.

How do you treat PTSD?

“Our cure, to be no more; sad cure! ”
John Milton, Paradise Lost

Various forms of psychotherapy and medications are helpful in PTSD.

Cognitive behavioral therapy (CBT) helps a person learn behavioral techniques for relaxation and restructure patterns of thinking that foster anxiety.

Exposure therapy involves systematically exposing someone to the memories and events associated with a trauma and reducing the fear response to these events, under the guidance of a trained therapist.

EMDR (Eye Movement Desensitization and Reprocessing) involves presenting the patient with various visual and tactile stimuli meant to release emotional experiences and free the mind of blockages.

In addition, support groups help people with PTSD work through their feelings with others who have had similar experiences.

The goal of therapy is to encourage the patient to recall all details of the event, express grief, complete the mourning process, and get on with life. For children, this may involve play therapy.

Benzodiazepines, such as Valium, Xanax, and Ativan, are often useful for short-term, immediate relief of anxiety symptoms associated with PTSD. Long-term use of these medications is strongly discouraged.

A class of antidepressants known as selective-serotonin reuptake inhibitors (SSRIs), such as Celexa, Paxil, Prozac, Lexapro, and Zoloft, help modify levels of neurotransmitters (chemicals) that foster appropriate communication between nerve cells, and can improve PTSD.

Research also suggests that other medications, such as beta-blockers and corticosteroids, may help diminish the likelihood for forming strong negative emotional memories when given soon after experiencing a highly traumatic event.

Anti-epileptic drugs with mood stabilizing properties, such as Depakote or Tegretol, may lessen mood swings and explosive anger.

Anti-psychotic drugs may help people with PTSD who have persistent paranoia.

A recent “60 Minutes” episode. “The War Within: Treating PTSD” indicates that Cognitive Behavior Therapy and Exposure Therapy (and combinations thereof) are more effective than the more traditional forms of psychotherapy.

60 Minutes “The War Within: Treating PTSD”

While it is more beneficial to receive therapy as soon as possible after the onset of PTSD, because it is easier to change thinking patterns, getting treatment many years later can be effective in mitigating its effects. The Veterans Administration is taking steps to increase availability of treatment.

In July, the Department of Veterans Affairs (VA) changed the regulations about PTSD so that veterans of all wars will find it easier to receive disability benefits. The new benefits will include free physical and mental health care at VA hospitals and monthly payments of a few hundred dollars to $2,000, depending upon the severity of the symptoms The estimated cost of the new regulations are $5 billion over several years.

“This nation has a solemn obligation to the men and women who have honorably served this country and suffer from the emotional and often devastating hidden wounds of war,” the secretary of veterans affairs, Eric K. Shinseki, said in a statement to The New York Times. “This final regulation goes a long way to ensure that veterans receive the benefits and services they need.”

Even the strongest of men, Hercules, was believed to have suffered from post-traumatic stress disorder.  If the strongest immortal experienced PTSD from his battles, we mere mortals can, too.

barglow-treat-ptsd-hercules

“Me miserable! Which way shall I fly
Infinite wrath and infinite despair?
Which way I fly is hell; myself am hell;
And in the lowest deep a lower deep,
Still threat’ning to devour me, opens wide,
To which the hell I suffer seems a heaven.”

John Milton, Paradise Lost

Please support the charities that support our injured servicemen and women, such as The Wounded Warrior Project and The Iraq and Afghanistan Veterans of America.

UPDATE: 12/10/2013:

My friend and veteran suffering with PTSD wrote this Facebook response to this article:

Tom Barbeau  Operation Home Base also Michael. Mass General leads the world in PTSD research. The team there has helped me tremendously.

Operation Home Base:
The Red Sox Foundation and Massachusetts General Hospital Home Base Program provides clinical care and support services to service members, veterans, and family members throughout New England, who are affected by combat or deployment-related stress (also known as Post Traumatic Stress or PTSD) and Traumatic Brain Injury (TBI). These signature “invisible wounds of war” are estimated to affect one in three returning Iraq and Afghanistan veterans.

The Home Base Program offers a multidisciplinary clinical staff of psychiatrists, psychologists, physical medicine and rehabilitation specialists, nurses, social workers and other clinicians from Mass General Hospital. All understand the military culture, and are experienced in caring for service members, veterans and families. The Home Base Veteran Outreach Team, composed of Iraq and Afghanistan combat veterans, is part of the clinical team. Home Base also works with the U.S. Department of Veterans Affairs Healthcare System, Department of Defense Military Health System and other providers to offer individualized care for veterans and families and to develop a tailored treatment plan to address the needs of each patient.

The Home Base Program gives veterans access to the most advanced care currently available as well as the opportunity, if they wish, to participate in cutting-edge research aimed at improving treatment and understanding of PTSD and Traumatic Brain Injury.

Massachusetts General Hospital Post Traumatic Stress Disorder and Psychophysiology Lab:

The PTSD Research laboratory performs research into the assessment, pathophysiology, prevention, and treatment of post-traumatic stress disorder (PTSD). It is a part of the MGH Psychiatric Neuroscience Division and occupies laboratory space on the fourth floor of MGH-East at the Charlestown Navy Yard. The laboratory does not provide treatment services itself but can make appropriate referrals to providers within and outside MGH. In particular, the MGH Center for Anxiety and Traumatic Stress Disorders conducts clinical services and conducts complementary clinical research in this domain.

UPDATE – September 19, 2014

After the assassination of her husband in Dallas, Jacqueline Kennedy suffered from post-traumatic stress disorder. This month’s Vanity Fair discusses her ordeal.

During the long winter of 1963, during the lonely nights that seemed to never end, the wakeful nights that no quantity of vodka could assuage, Jackie Kennedy would relive the sliver of time between the first gunshot, which had missed the car, and the second, which hit both the president and Texas governor John Connally. Those three and a half seconds became of cardinal importance to her. In the course of her marriage, she had constructed herself as Jack Kennedy’s one-woman Praetorian Guard—against the doctors, against the political antagonists, against the journalists, even against anyone in his own circle who, to her perception, would do him harm. So, again and again that winter of 1963-64, she rehearsed the same brief sequence. If only she had been looking to the right, she told herself, she might have saved her husband. If only she had recognized the sound of the first shot, she could have pulled him down in time.

How to support someone with PTSD.

Columnist/Journalist/Writer/Book Editor Co-Founder/CEO of Azimuth Partners, high tech consulting firm for 30+ years. Former columnist for the Washington Post/Newsweek syndicate.

2 Comment on “Paradise Lost: Opening The Gates Of Hell Soldiers And Post-Traumatic Stress Disorder – UPDATED

  1. Pingback: What exactly is PTSD? | Facing the Predator

  2. Pingback: Killology | lisaleaks

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