Managing Traumatic Stress and Combat PTSD Through The R-E-C-O-V-E-R Approach*
PTSD AND COPING WITH THE HOLIDAYS (PART 2)
Being Easily Startled or Hypervigilant During the Holidays
Surprises and being startled are not things that vets with post-traumatic stress disorder (PTSD) welcome. Even simple things like crowds (even of family members and friends) become problematic for the veteran who is trying to scan the room with their eyes to avoid being surprised by someone intending to do them harm.
This suspiciousness is frequently misunderstood as the vet being paranoid or crazy. The title of our book, I Always Sit with my back to the Wall is indicative of this need to know who is there and to be aware in case someone intending to do harm (such as a suicide bomber in the combat zone) might come in.
As might be expected this constant vigilance (hypervigilance) and scanning makes for poor interaction with others at a get together and results in extreme anxiety when there is a crowded situation.
In addition, the sound, sight or feel of an unexpected loud noise, seeing a package that might be a reminder of an explosive device, or even being touched by someone unexpectedly might result in a severe startle response. One veteran told me of the embarrassment he experienced at a holiday get together when he was touched on the back by a family member he did not know was there, resulting in his “hitting the ground.” When he looked up and found others staring at him he vowed never to put himself into that same situation.
The Holidays and Difficulty Experiencing Positive Emotions
Veterans with PTSD report a difficulty in experiencing positive emotions, often feeling emotionally numb to positive event. And it is often far too easy to easy to experience negative ones such as depression, anger and irritability.
Those who love someone with PTSD will recognize the problems with temper and seeming inability to control anger. Simple remarks or actions of others may provoke unexpected negative behavior, with the veteran raging in anger. In the presence of alcohol it may be impossible to control anger, but even in the absence of alcohol, the veterans fuse is too short, or their explosion too big over even minor matters. At a holiday get-together with family and friends, the expression of this anger can be both frustrating and embarrassing to the veteran and those around him.
Other Symptoms and Problems of PTSD around the Holidays
Although not part of what are called the core symptoms of PTSD, the following behaviors and feelings are frequently found in those suffering from PTSD.
Depression, PTSD and the Holidays
A veteran suffering from PTSD may experience depression. Sometimes it is due to the combat-related memories, sometimes it is from childhood trauma, sometimes it is the result of being unable to control the symptoms of PTSD and sometimes it’s the notion that the veteran is disappointing or letting down those who love him. Depression becomes even more difficult during the holidays when the expectation is that we should be happy and grateful.
Substance abuse, PTSD and the Holidays
In order to treat some of the symptoms of PTSD – especially the unwanted recollections and desire to avoid socializing – the vet with PTSD may turn to alcohol or drugs. Rather than helping to deal with the symptom positively, the substance use generally worsens the symptoms and the situation. It becomes more difficult to control anger, hypervigilance and socialization
Financial concerns, PTSD and the Holidays
Tragically many veterans with PTSD have found it difficult to find or keep a good job. As a result, many find themselves financially strapped during a season where the expectation of many is giving. This lack of financial means to afford what the veteran may expect to give to the family may further worsen the anger, irritability or sense of inadequacy that many veterans experience – especially during the holidays. For many the only way to provide what the veteran desires for their family is to go into debt, posing even further problems down the road.
Spirituality, PTSD and the Holidays
In addition to the above, many veterans with PTSD have lost interest and faith in “religion and spirituality.” During the holiday season, where these beliefs come to the forefront for most, it can be very difficult for the veteran with the condition to get involved in the meaning of the season at all, even if religious belief was very important prior to going to combat.
Results of the Symptoms and Problems of PTSD around the Holidays
The results of the symptoms and problems of PTSD around the holidays is that for the veteran the holiday season becomes one of anxiety and dread. The more years this pattern persists, the move difficult is seems to deal with it. As a result, for many the anxiety provoked by the holiday season may begin months ahead of time.
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