Barbara Van Dahlen
Ph.D.Founder and president, Give an Hour
Despite the diversity of the U.S. military members who have served in Afghanistan and Iraq, there still exists a popular misconception of the returning vet as the Marlboro man, a stoic figure wrestling alone with the after-effects of combat. After nearly a decade of providing mental health services to veterans, service members and their families, I know nothing is farther from the truth. Our returning service members are a reflection of the society they serve -- male, female, young, old, representing every profession, personality type and ethnic group imaginable. They are us.
And their mental health struggles are ours as well. Of the 2.6 million men and women who have served in Iraq and Afghanistan since 2001, some 20-35 percent will suffer some form of post-traumatic stress (PTS). In treating this population and their affected family members, we must also work from facts and avoid misconceptions. It is also important to differentiate between post-traumatic stress and the more commonly-known disorder PTSD. Post-traumatic stress is an understandable reaction to the horror of war or rape or surviving a natural disaster. It develops into a disorder if those suffering don't get the support and assistance they need. While we have all read headlines about returning veterans who have "snapped," it is critical to understand that violence is not a symptom of post-traumatic stress. Those who make national news, or any news at all, are the extreme minority. With post-traumatic stress, there is most commonly the wish to get away from stimulation, to numb, to shut down, to avoid others. There may be depression, anxiety, listlessness, an inability to concentrate, and bad dreams, all of which can interfere with healthy relationships, enjoying kids and partners and engaging in the workplace.
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Thank you for writing about how rare violence and PTSD is. Veterans are a greater risk to themselves than anyone else. Also thank you for creating Give An Hour. Too many do not seek help. Recent report said that 47% of the veterans committing suicide did not seek help, so having options is vital. The issue is, 53% did seek help and still committed suicide. That says a lot right there. We've been at this for over 40 years and with hundreds of millions of dollars spent, these results frankly are deplorable, especially when families are left out of all of this. They don't know what it is or how they can help their veteran heal.
They are also not aware of what their reactions can lead to. I've been married since 1984 when no one was talking about Vietnam veterans or their families, so I made a lot of mistakes. When the way my reactions to my husband's actions were adjusted life got better for my family. I was no longer fighting him but fighting for him. I just disagree with the PTS and PTSD difference. PTSD does not make them violent.
The mood-swings they go through can be nerve-wracking. One minute they are quiet, almost as if they are not even there in the room with you, and the next, act like you just attacked them. In the morning they may be "themselves" but in the afternoon, the stranger walks through the door again. Sooner or later, when we understand "why" they are the way they are, we also understand how we can sooth things over.
If I had a dollar for every time I asked my husband "What the hell is wrong with you?" my mortgage would have been paid off ten years ago and I would have bought a new car every year. That is with even knowing what PTSD is and what it was doing to him. I still let those words come out of my mouth but most of the time it follows his forgetfulness with short-term memory loss. That part is really frustrating. He also worries way too much about things he shouldn't have to be concerned about.
There are so many things that we just don't talk about so the impression of a PTSD veteran being dangerous lives on. So let's take a look at a few missed facts.
My ex-husband, not a veteran, tried to kill me. My second and current husband is a Vietnam veteran with PTSD but didn't try to kill me. Yes, he does overreact to situations but is not violent. Almost every report I've read among the over 18,000 post on this blog about violence and PTSD were connected to medications, so it is not a far reach to connect violence and substance abuse the same way we connect them to civilians and domestic violence. We need to remember they are just like everyone else even without Combat PTSD.
My Dad, a Korean War veteran, was violent but did not have PTSD, or what they called "shell shock." He was an alcoholic. Today many veterans are treated for addiction to drugs and alcohol. The problem comes when doctors don't know if it is addiction or using them to get numb because of PTSD. Sometimes the doctors are treating both conditions and it gets really complicated for them. If they are not experts on PTSD, then most of the time they get it wrong, treat them for addictions only to discover the treatment isn't working. If they treat them for PTSD and do not address the addiction, it won't work either. Usually if they are treated for PTSD and were only using the substances to numb, they use less and live better as they heal. My Dad ended up getting sober with AA and helping other alcoholics. My husband finds a lot of strength by helping other veterans and having connections with other veterans. He feels understood and cared about by them almost as much as he cares for them.
There is something else on domestic violence that needs to be pointed out. When they have a nightmare, many wives make the mistake of yelling at them to wake up or shaking them because they do not understand what that nightmare involves. They are being attacked and their lives are being threatened. To them, their partner is the enemy attacking them and they lash out. Wives have had bloody noses and black eyes because they woke them up the wrong way, called 911 and the veteran was arrested for it. Had the wife removed herself from the bed or at least got out of striking range, it wouldn't have happened. A normally non-violent husband ended up being charged with domestic violence needlessly.
There are rare times when the veteran is in fact violent and the spouse has to leave for their own safety. Each case is different but if you don't know what is involved, nothing gets better.