PTSD: a Marine vet on cure vs. management

I am posting this interesting note from a Marine veteran with his permission. I think there is something to consider here about his report of going through PTSD and coming out smarter, calmer and happier:

Regarding your new post on PTSD I’m glad that you posted the great link and, on a purely confidential basis, I believe the fairly common idea (certainly on the shrink side) that “PTSD…cannot be cured, only managed”, may turn out to be a pile of horse manure in the long run.

How society defines its illnesses has a huge impact on their treatment.

Society is telling PTSD patients that they are marked for life and can never hope to cure themselves. That leaves no room for hope. And on what basis? We’ve barely got a handle on PTSD – have barely scratched the surface in terms of its effects on brain structure and avenues for treatment – and we’re already calling quits on a cure? Why?

Recovery is possible. But as long as soldiers and Marines – often young, insufficiently skeptical, utterly reliant on authority – are told by everyone around them that the mind is like a bottle, and that once it breaks, you can piece it together again, but it’ll never be as strong – as long as that’s the social message, there’s little hope for full recovery. But the mind isn’t a bottle. It’s a bone. Once it heals, it grows stronger, more resilient. We need to change the message to reflect the possibility of being strengthened by PTSD in the long run.

The timing of your blog post is very fortuitous. Last night, I received a call from one of the Marines who handled my medical discharge – for PTSD – and who’s kept in touch with me since I left the Marines in ’07.

He asked me to call another Marine who’s been dealing with PTSD for years and is trying to move forward, because he wanted me to relate how I’ve not just come to terms with PTSD, but haven’t had any symptoms since roughly three months after my discharge. I’m calmer, smarter, happier than I’ve ever been in my life — and I’ve tested myself under very stressful circumstances. Next month I’m heading to [deleted] because I can still contribute as a civilian. And by next year I hope to be waived back into the military, as an officer; and I wouldn’t do so unless I was 100% confident that I will not jeopardize the men under my future command by re-enlisting with persistent symptoms or delusions that I’m fully healthy.

I cannot be the only one, because there’s nothing special about me. And I’m not going to dedicate my life to this issue because I just want to move on. But more prominent veterans can make a difference. Iris Adler made a documentary featuring your own Nate Fick talking about how he overcame PTSD, in so many words. I was about to email Nate to ask him whether he thinks he’s overcome it. Please ask him. If he’s symptom-free, it should mean he’s cured, not that it’s always just around the corner; because “you never know about tomorrow” isn’t a scientific benchmark. It’s a recipe for anxiety and fear.

Veterans and serving Marines need to finally hear success stories. They need hope, not life sentences. We just need to find and publicize these stories.

So, maybe one question worth looking into — and I’ve never heard of a journalist doing so — is whether veterans with PTSD ever re-enlist.

Surely, out of the tens of thousands with PTSD, there must be some who came back — in every sense of the words — to continue doing what they love, and inspire those around them to stare their demons in the face and walk away much stronger for it.

If you like, I can write more about what factors helped me overcome PTSD, why treating PTSD like alcoholism encourages us to give into our symptoms, and other factors, like distinguishing between regular strong emotions and PTSD-induced emotions, which seem to be overlooked at large. But I think I’ve written enough for now — I’m more interested in your thoughts in response.

Tom here: I think a better way of expressing the notion that PTSD cannot be cured but managed is to recognize that combat is often a life-changing experience. You can’t undo the past, but you can understand and adjust to it, and move on, somewhat. 

On the issue of resiliency, CNAS also has a project looking at “post-traumatic growth,” led by Army Capt. D.J. Skelton, a veteran of Second Fallujah. Here is a summary:

Post-traumatic stress disorder has hit the force particularly hard; however, some individuals also experience positive changes, a phenomenon referred to a post-traumatic growth. Indeed, service members may experience PTG along with PTSD or other mental of physical injury, and DOD and VA are increasing their efforts to understand PTG and resiliency. How might post-traumatic growth be incorporated into military mental health management?

You actually can listen to a presentation on this.

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