Monthly Archives: June 2011

June 27th is National #PTSD Awareness Day

Right, so these blog entries have been exhausting. Still, I have received such tremendous feedback that I am more excited than ever to keep writing. Thank you again for reading.

For those who don’t know, tomorrow is National PTSD awareness day. (Personally, I didn’t even know this day existed until this year. Seems like there is a national day for everything these days though, so in a world where every kid gets a trophy, this is no real shock.)

In any case, I want to share a quick story of a Sergeant I met while receiving out patient therapy from the in patient PTSD clinic at the VA. It was right around Valentines day a few years ago.

The Sergeant was a man a little older than me, at the time in his early 30’s. He served in Operation Iraqi Freedom and was a medic on the push up to Baghdad. Like the famous men who hoisted the Flag at Iwo Jima, this Sergeant graced the cover of most major newspapers carrying an Iraqi boy to safety. His name was Sergeant Joseph Dwyer and the demons of the thunder run to Baghdad never left him.

Our encounter was brief but poignant. I recognized him as I stood in the break room sipping some coffee. He had just finished writing a letter to his family. We exchanged the typical “who you with” and “where were you” pleasantries that service members often use to size each other up. He was exited to be heading home soon. I traded email addresses with him and I still have the scrap of paper he wrote it on. I remember thinking to myself, I have been so close to checking myself in here, I am glad that it is working for him.

Four months later on June 28th 2008 he killed himself in his home in North Carolina.

I can still see him sitting on the couch in Northport. His tentative smile and somber eyes convinced me when I met him that he was going to be alright. I think of him often and brood about what went wrong. I know from experience how easily a spiral can plunge downward. He was loved. He was in treatment. Yet it still wasn’t enough to save him. Tonight I reflect and wonder had his entire community made it their business to care for this Veteran, would he be here now?

On this Day of National #PTSD Awareness, one day short of the three year anniversary of his suicide, I ask that each and everyone of you who read this take some time to share his story.

You don’t have to wear a ribbon or bracelet. You don’t have to donate money. Just share his story and talk about how we as a community can care for our Veteran’s, and more specifically those who suffer in silence with PTSD.

Here is also a link to a great organization that organizes sponsorship of Veterans for re-integration: Team Red, White and Blue or @teamrwb.

Team Red, White & Blue’s vision is to transform the way wounded veterans are reintegrated into society when they return from combat and exit their position in the Active Duty force or National Guard.

I know many of these great men and women and all of their hard work is tremendous. Thanks again!

Managing Meds- the early days of #PTSD & how the Red Sox saved my life

As I have said once before, getting my sleep under control was the first place I started. As such, the first medications I came in contact with were sleep meds.

Here is a brief story of how I knew that there was really something was seriously wrong and the start of my prescribed sleep pills.

A Book in a Pile

I was near the end of my second tour and had been awake for three days. I was back at the Forward Operating Base (FOB) taking care of supply and maintenance paperwork. In an effort to fall asleep each night, I picked through the stacks of donated books and read whatever I felt was worth reading. The pickings were slim since they were mostly books libraries were going to throw away anyway. One book I came upon was the “Best American Sports Writing of 2005.” When I saw this one I snatched it up because at least it was about sports and I recognized the editor: NY sports writer Mike Lupica.

I started with a story about Eli Manning and his stats during rookie camp compared to his brother. (I’m so glad that story turned out to have merit.) Then I came to Tom Verducci’s article Sportsmen of the Year. The article chronicled the Red Sox faithful who had waited so long for a championship. As I sat and read about the elderly who died happy and had their headstones engraved with their allegiance to the Red Sox I began to cry. Uncontrollably. The emotions were too much for me to bear. I thought about my soldiers who were dead and how they would never experience the joy of being a fan of anything again. I envied the elderly who reached that ripe old age. I thought about how there were times I secretly wished I was dead so I wouldn’t have to suffer worrying about me or my own Soldiers dying or getting hurt. At least if I died over there it would be with my brothers in arms and honorable.

When I was done crying I knew that I needed help. I thought to myself, “What the hell is wrong with you? You hate the Red Sox.” The combination of that mess of thoughts was a epiphany for me and I consider it my defining moment to seek help for what I knew in my heart was PTSD.

Seeking Help in Mosul

The next morning I scheduled a flight to Mosul to see psychiatric services.

Helicopter flights ran frequently from Tal’ Afar to Mosul and I hopped in with a group of Soldiers who were also struggling. Our unit had seen some serious fighting and a few of the guys were quietly getting help in theatre. They had seen the psychiatrist and were already on sleep meds. This was their follow up and my first appointment though we were all skeptical of our path forward with doctors in theater.

Mosul was nicer than our FOB. It had a movie theater and a big Post Exchange (PX). There was also a large field hospital with lots of resources for all types of treatments.

Once we got settled to our room, we made our way over to the psych buildings to check in. I was still hesitant to take myself away from my unit but I thought about the Red Sox and knew I was making the right choice.

There was a Master Sergeant with the Medical Service Corps who took my information, listened to my story and told me off the record that I had PTSD and that I would have to wait until I got back home to get real treatment. (I would later learn that the doctors were forbidden from making PTSD evaluations in theatre.) The doctor saw me, prescribed Ambien and Seroquel and sent me on my way. I went to the pharmacy and picked up my drugs. I went back to my room, popped the pills and felt my brain slow down. I woke up the next morning feeling good after the first solid nights sleep in months.

The group of us went back to the Psych buildings the next morning to pick up our evaluations. I felt a tremendous amount of anger and disappointment when I got my write up because my status indicated “acute workplace stress”. I chuckle now because what else is PTSD for an Infantryman than workplace stress?

More Guilt

As we walked back to our room it began to rain. We were scheduled to return to the FOB that night but we had flexibility. We settled in and set our alarm. When my alarm went off I was still feeling good from the meds. I leaned over to the ranking NCO who came with me and asked if he wanted to leave or wait another day and get some rest. We could hear the choppers coming in, but we could also hear the rain pounding the roof of our CHU. We skipped our flight and went back to bed, not wanting to wait in the rain.

That helicopter crashed into a hillside between our FOB and Mosul killing everyone aboard.

As a result we were stuck in Mosul while an investigation was conducted. After a few days I was able to get a DNVT call back the FOB and tell my wife I was ok, more guilt still piling up. I then called my parents and confessed I was not working a desk, but fighting with my line troop. (My Mother says she always knew, but I still had lied to her to that point)

And so my dependence on medication had begun. I experienced great success early on with the Ambien and Seroquel. But, as time wore on, those meds became less and less effective. I was about to step onto the carousel of medicine. I am still not off it today, but I am working on getting off.

As for the Red Sox, I gave them some credit for saving my life for a while, and I will never forget that story and the moment of clarity it brought, but after their second World Series win in three years, I have less of a soft spot than I used to… Ok, strike that, I’m a hater again…

The Gory Details and #PTSD part 2

Well, I apologize for not finishing this sooner. I have been grappling with the best way to communicate how I convey the details of my experiences without actually describing my experiences. It was a bit more of an internal debate than I anticipated.

Philosophical Differences

I kept asking myself: Can I describe in a meaningful way my experience if I do not let you in as a reader? Do I just dive into the details I said I wouldn’t share? If I do, how deep and graphic? Unfortunately, as I tried to think about these questions, I came smack in the face with those gory details. I revisited my old friends which I had spent the better part of Prolonged Exposure Therapy working through. The specific gory details have slowed me down a bit, and I have been trying to stay out of that place in my own head to prevent a spiral. I resorted to some avoidance (a post for another day) but I am back in the saddle. Ultimately, I have decided to share in the best, most concise but vaguest way I know how: bullet points. (Anyone who has made a pointless powerpoint can sympathize with this approach)

Imaginal Exposure

Prolonged Exposure Therapy Imaginal Exposure is pretty simple in it’s core objectives: address the images, take note of their emotional reaction, whittle away the areas that do not bring much baggage, and focus on the points that evoke the greatest emotions. I got to pick a day (12 hours actually) where a mass of crap was laid on me. I explored in greater and greater detail (using all five senses and my feelings) the events of that night into morning. I recorded my account of that day and listened to it each day. With each iteration of listening to myself I remembered more. I reflected more about what happened, and what has happened since. I stared at those gory details without blinking. It was the hardest therapy I have ever done and one of the harder things I have ever had to do in my life.

The Bullet List

Without further ado, here is the chronological event list:

  • in my unit for two weeks, get a radio call in the middle of the night to go pick up dead Iraqi’s shot by my unit
  • drive through some treacherous terrain at 1AM to reach the bodies
  • start loading dead guys onto the truck when one of the “dead” guys starts screaming, suddenly not dead
  • treat the screaming guy and take him to the Aid Station where he later died
  • get back in time to get up for pre-dawn Raid for a weapons smuggler
  • get to the Raid site and drive up to Iraqi’s forming an ambush near Raid house
  • suppress and kill the Iraqi’s setting up the ambush
  • don’t find any extra weapons other than the ones on the ambushers
  • stay until daybreak to notify the family
  • notify the family only to have the women of the ambushed ambushers start screaming, crying, scratching and throwing dirt on them
  • drive away exhausted and conflicted

The Gory Details

So, that story was recounted and recorded in a first person description with the gory details. Each day I listened to my own story, and each week I recorded an updated recount. As I progressed, I was able to really focus on the feelings, and eventually, to distinguish between the types of feelings that overlapped.

The bullet list happened in my first deployment. I carried it around for a while in silence before I even thought about talking about it. Guilt, fear, adrenaline rushes, sadness, anger, frustration; they were all bundled into an intense twelve hours. By the time I started PET the day I recounted had happened so long ago that I had to really think about it to get my facts straight. I explored every detail I could remember. I described every sight, sound, smell, and touch in the first person.

I left therapy every week exhausted. I would close my eyes and just talk about that day like I was actually back there. My therapist would take count of my self described stress level. With every passing week as I talked and listened my stress level went down. It did not go away. Not by a long shot. But I feel like with preparation and the right environment, I can talk about that day with more people now than I ever could before. The ability to talk about my experience in Iraq without a complete meltdown was one of my goals going into treatment. I consider it a success that I can at least talk about it a little now and I will continue to work on it.

Prolonged Exposure Therapy is hard. It gets harder before it gets easier, but I recommend it because it works. I’m pretty sure most things worth doing are not easy.

A quick admin point, I am now on a self-hosted site: http://www.ptsdsurvivordaily.com, please update your browser as necessary. I ported all the old posts, and you can still find the archives at the old site for now. The feedback has been more than I could have ever hoped for! Please continue to share! Thanks again!

The Gory Details and #PTSD part 1

Two part blogpost starts here. I mentioned in my last post that my wife knows the gory details. You can read that post here. I can never thank her enough.

The gory details are the pieces of our trauma that often leave us Veterans the lasting nightmares. It doesn’t take any gore to develop PTSD. Getting mortared, shot at or losing a friend is more than enough to leave a Veteran with the feelings that trouble us for a lifetime. But, if you are so graced by those gory scenes (Band of Brothers, Saving Private Ryan and The Pacific all do a too close for comfort job) I can assure you they haunt you with the lights on.

I’m going to visit some issues that I have struggled with about gory details, but I will not be gracing this page with specifics. (disappointed? SEO marketing at it’s finest.) I will talk about two aspects. First, if you know a Veteran who has seen “action” there are some of our apprehensions about sharing those scenes, even to our therapists. I will explore why I feel that way. Second, how using Prolong Exposure therapy forced me to use Imaginal Exposure to revisit those days and how it helped. For me, addressing these scenes and facing the onslaught of emotions head on has worked. They are not gone, but I can put them on a shelf in my mind and I know what to expect when I visit them.

When I came home the first time I ignored all of my symptoms and kept right on slugging. I knew I was probably going back to Iraq. I told myself to suck it up. I used the years of lessons about duty and selfless service to justify neglecting my own well being. Strap on the boots and go again. I remember having a long talk with my cousin before I went back my second time. “Why does it have to be you?” she asked. I told her that with the experience I already had that I could prevent more soldiers getting hurt or killed. In my mind, my experience made it my duty to go back. The rest and relaxation was for another time. Our country needed us. Little did I know that I would burn the candle too low and our enemies were getting smarter.

The second tour got really bad. We faced a more organized enemy and that made being alert all the more important. We lost good Soldiers. I stopped sleeping for days on end. I was angry at everyone and everything. By the end of my second tour, with much trepidation, I made my mind up that I was done. I came home in March of 2006.

Three months later I was out of the Army. The things I saw and did were all that greeted me when I closed my eyes. I could see the dead in my dreams. Hell it got to the point where I thought I saw them in crowds. I started sleep meds in theater at the end of OIF3. I heavily medicated just to get the images to go away.

I found a therapist at Fort Carson who was willing to see me because I was now an Army spouse. (Though that opened up a whole new bag of issues. More on that for another day). Even though this therapist was a retiree from the Army, I still had trouble telling him the details. I was ashamed of things that happened. I was scared of revisiting those images for fear of tearing open old wounds. I also wrongly assumed that I would be judged.

Tales of blood and guts were a selective treat I used if I got pissed or wanted to get a rise out of civilians. As I am sure it has happened to all of us at some point, some jerk off asked me if I ever killed anyone. My reply made him pale and I loved it. I then told his boss what an asshole he was and he was fired a week later.

But, I was still just skirting around really dealing with those gory details. Another difficult aspect of the gory details came around family. They were very concerned for my well being and I always got the hand on the shoulder combined with an intense gaze and “How are you doing?” I would sheepishly tell them fine and try to convince them with words what my eyes said otherwise. I would tell a select circle the real deal and even share some gory details, but those sharing sessions were few and far between.

It was not until I completed Cognitive Processing therapy and started Prolonged Exposure therapy that the real work flushing out the gory scenes would begin. Four years of carrying them around made me eager to tone them down, but skeptical of the impact the therapy would have.

I will chronicle the deep dive of Imaginal exercises in my next post.

In summary, I am still on the fence about sharing scenes of war. I am more likely to share with another Veteran so long as it doesn’t turn into a pissing contest of “I have seen more blood than you”. Us grunt types can sometimes wear our hardships like badges. I have found it is easier for me to talk about the feelings and the actual experiences rather than one or the other. For any readers out there, I am open to listening or talking. If anyone wants to chat, please hit me up.

My Old Lady and #PTSD

I am a jerk. My wife lovingly tells me this often, yet I will still write this next blog post. Dealing with me, especially post Army and full swing into PTSD treatment, is a drain and requires a special woman to see and understand.

I am a lucky son of a bitch in that my wife was deployed as much as I was (ok, she has three more months in Iraq but I have a year in Korea, that counts right? No? K.). There were times that her being in theater added stress and there were times that her being on the same operating base reduced stress. (Big Cat knows)

All in all, now that all of the Army stuff is done, her knowledge of the gory details is a trait of our relationship that I would never trade.

I talk with a lot of other Veterans who have PTSD and are still married. They need their wives to keep them straight. But, that is not what I am going to write about here.

I have been diving into this treatment and so focused at times that I lose sight of the impact it has on my family and my wife. Everyday is a struggle and sometimes I take for granted that my wife is being strong and she is doing it for our family. This fact becomes more troublesome because the effects of PTSD on family members is direct.

Here is a link to the VA Website on PTSD and the family.

And here is a link that references the studies done with PTSD, the family and children.

So whats that mean? We, as PTSD survivors, can be real downers. If you are not properly communicating, not emphasizing the important recovery habits, the road goes from bumpy to cratered.

Take the time to thank your support group. Take the time to reflect on what your PTSD is doing to those around you. Depending on where you are on this road back, just continuing to give great effort may be enough. Again, communication is the key.

I have said to my therapist and continue to say that I want to raise my kids on my terms. If something is going to fuck them up, it is going to be all me and none of the PTSD crap. I am closer to this goal today, but not nearly as close if my wife did not support me as much as she does.

Use it, don’t abuse it. With fathers day coming based on where I was a few years ago and how close I came to the edge, it is I who should be thanking her.

The Snipers Never Go Away with #PTSD

Ok, so, I’m editing this post and renaming it. I will start with what I wrote prior and fill in the during and after:

I’m currently preparing to march in a parade. I have been actively mentally preparing for this since Thursday.

I drove with my family down to DC Thursday. No issue. Some fireworks last night and my two kids, my wife and I in asleep in a Queen sized bed left me a bit on edge this morning.

The Metro ride was uncomfortable but manageable. I struck up a conversation with a rider and it seemed to help.

So, here is the the challenge in front of me:

A crowd of people, most of whom I do not know.

Heat. Muggy, hot. Yuck.

Punchy. No sleep, plus the other two equals Angry Mike closer to the surface.

So, here are my steps to keeping it cool:

1. Remind myself that I am in a safe environment. Be on guard but not combative.

2. I have done this before and succeeded.

I will update this more later, but just wanted to capture my before state of being: anxious, nervous and punchy.

Talk to you later!

The parade was packed. It was seven people deep at the most crowded parts and had people lining the streets for the miles we walked. As we started, I was on high alert.

Actual thoughts that crossed through my mind:

Someone is going to blow themselves up.

Someone is going to run into our group and start a fight.

I looked for snipers on buildings and in the windows.

There are more, but for the sake of space, you get the picture. All of these thoughts and the subsequent memories of my experiences with them resulted in me being on edge. For the first ten minutes into the march I was very overwhelmed. But, I was there, committed to my friends and myself, and there was no turning back. I had to keep telling myself I was safe, and to relax.

The thoughts above cover scenarios I was taught to identify in Cognitive Processing Therapy. More specifically the therapy helped to identify the difference between low probability and high probability. I utilized my skills from Prolonged Exposure therapy by immersing myself into an In Vivo Exposure. I tested those feelings of safety and anxiety. Given the nature and length of the parade it was a very good assignment.

Low Probability v High Probability

Is there a chance a Sniper was on a building? Yes. But that probability was very low. In my own brain, just because it had happened in the past I over emphasized and addressed the scenario as though it were highly probable. Snipers and mortars are things that keep many Veterans awake at night. Chaos surrounds their intervention. One minute calm, the next all hell is breaking loose and to make matters worse, most of the time you have no idea where the hell they came from.

I think most Vets will agree that getting punched in the face is far better because at least you can see who is giving you the black eye. The canyons of building surrounding the parade route and gaggle we walked in were enough to remind me of a patrol on the mean streets.

Still, we were in Washington Freaking D.C. I am fairly certain that city has air defense missile systems now, let alone a slew of plain clothes cops… So, acknowledge the probability, but don’t let is consume you.

In Vivo Exposure

Again my summary of In Vivo Exposure: Don’t like doing it? Do it, and do it some more. Ok, maybe that is a bit too simplified. There are some instructions that go a long with the therapy: Take notes on how uncomfortable the situation is. Stay in the situation long enough for the comfort level to increase. Pay attention to the thoughts and specifics. As I stated earlier, I was hard up for comfort as the parade began. It was very loud and there were thousands of people all focused on the parade. After the parade I hung out on the streets for a bit to keep the exposure going. I was selective where we stood and watched the rest of the parade with no incident.

All in all I had a good time. I made it home late that night after another Metro ride and I was mentally and physically exhausted Sunday and into today.

The therapy works but it requires sharpening the edges constantly to remain effective. Shooting is a perishable skill. So is your own mental health.

Moral of the story: Keep at it. Attack the PTSD just as you had attacked other things in other times. Be smart about it and you will see results!

Feedback welcome!

The Sleep Game and #PTSD

Oh sleep, how I miss you.

I’m not talking about a medicine induced coma (I can eat Ambien like tic tac). Or exhaustion from being awake for three days (it’s amazing how many TV series you can get through on Netflix). Or won’t get out of bed from depression sleep (see the Anniversary post).

I mean normal, wholesome, lazy Sunday afternoon sleep.

All sleep is not created equal. Getting to normal sleep was the first thing I tackled managing and is a constant battle. My mind and body need it. Given the complexity of PTSD and the issues deeply tied to anxiety and safety, weaving through the dozens of variables that contribute to a good nights sleep can be tricky.

Homecoming Problems: Sleep was just the beginning

I was pretty much terrified to close my eyes when I got home from my second tour. Either I was worried about someone coming into my house, or the nightmares took me right back to a firefight. (Cue story about attacking my wife in my sleep…) What I quickly discovered was that I needed the meds, and because of the meds I needed a routine.

Sleep Journal

I put myself on as strict a routine as I could but, finding the data points was tricky. If you don’t keep a log, I would highly recommend it. I kept med dosages, time to bed, time up, and a few notes and lined up anniversaries and non-Army stressors. The better I kept the journal, the more trends I could find. (we are not talking statistical significance here, it just felt like I was identifying trends)

Probably the biggest significant data point I recognized from the early days was the impact alcohol had on me and my routine. In the beginning I was on trazodone, citalopram, quetiepam and prazosin. Everyday. I hate medicine. My temptation to suck things up gave me serious misgivings about all meds. When avoiding meds was not an option, my soul mission in life was to get the sleep under control so I could get under way with real work. I was also desperate to get away from all the drugs filling up my medicine cabinet and more importantly, my veins.

The labels on those bottles did not lie. Even with small bits of alcohol, I was completely out of whack with my sleep patterns. It was a heavy sleep and a long fog after I woke up. As a result, joblessness or working from home was my only option early on.

One day, I just made up my mind and stopped drinking entirely, and besides saving me a few bucks, I have never looked back (ok, maybe I look back occasionally, and I may have slammed a shot and a beer when they killed OBL… it tastes so good when it touches your lips)

Still, getting sleep to be manageable is in my opinion the best first step on the PTSD treatment road. Sleep makes me happy. Sleep helps me think rationally. Too much sleep and being unproductive gets me down. Finding that balance of sleep and medication helps.

Alternatives to Medicine

I am at a stage now where I need less medicine. Using the lessons from therapy as well as some visualization techniques, I rely on a relaxation exercise to help me when meds are to too much and I am too wound up to get to sleep quickly.

I am including a link to the Army Center for Enhanced Performance site. They have tools there for a variety of stuff, but I will point you to the relaxation MP3. Everyone has an MP3 player now right? Good. Go download it and give it a try. ACEP Resources

In summary: sleep is the gateway to getting to the real work. Understand the labels and the restrictions sleep meds put on you. Be disciplined in your approach to sleep. Try relaxtion techniques to assist with getting to sleep. I hope it helps you.

The VA: Nightmare Bureaucracy, Healing Savior, #PTSD and #DDay

On the anniversary of D-Day I cannot help but think about the role the VA has played in the lives of generations of Americans and their service to this country. We do not live with a draft, more people vote for American Idol than the Presidency, and the greatest generation is dying off at a rapid rate. As a result, the Service Men and Women abroad affect the national consciousness with significantly less impact today than they did 67 years ago.

I specifically think about what the greatest generation went through to earn benefits from the VA. Claims written by hand. Eventually typewriters. Computers? Not until 30 plus years after the war ended. PTSD was not even formally accepted as a diagnosis until 1980. We have it easy. Still, frustrations with the VA are at every turn.

Each time I engage the VA there are very distinct mental adjustments I have to make depending on the “branch” I am contacting. The VA essentially has two companies that rarely talk to each other and have diametrically opposing missions housed under the same roof. One scrutinizes, interrogates and ensures validity, the other embraces the individual to provide world class health care. I cannot get to one without going through the other.

The bureaucracy that is a lynchpin of the VA will continue to frustrate Veterans for the foreseeable future. I, like others, waited what seemed like an eternity to hear back on my claims. It adds stress and is at times so convoluted that there almost needs to be (and in some cases are) a mental health group just for people dealing with waiting.

But, once you are accepted and into the system the healing places like the Northport VA Medical Facility and the practitioners cannot be commended enough for the tireless work that is done daily. If you are waiting, hang in there.

Listen, I am not a fan boy. I am trying to tell it like I see it. But, because of the unique job Service Members have, there is not another medical institution that comes close to understanding Veterans the way the VA does. Try and find a PTSD center with the experience the VA has. We are kinda stuck… With the good and the bad. I am not going to make it my mission to point out the injustices of the system (in this blog or elsewhere). Plenty of people and groups do that already. I will however, listen and help whomever I can through this blog and other social media.

As stated earlier, today marks the 67th anniversary of D-Day. I ask that today you think not only about the sacrifices made that day, but the sacrifices of those who lived on and carried or carry their burdens (One in my family in particular comes to mind). I hope the effort of our current Service Members are never forgotten. I will do my part to honor the brave men and women of World War II, DDay, Korea, Vietnam, and all the others. I hope when you read this, you will at least give pause.

“First at Normandy!”

Crowds, a baseball game and #PTSD

I am going to a baseball game tonight. Since coming back from Iraq, I have generally not had good times at baseball games and not because I am a New York Mets fan. I don’t like crowds and in general the traffic (public trains or the LIE) gets me anxious and I don’t have panic attacks so much as angry attacks.

(I have had exceptions, I saw Endy Chavez make the catch from Row V in Shea. Even though the Metsies lost that was a magical night and I was on a hell of a lot of meds..)

In any case, tonight is an opportunity for me to succeed. I recently completed Prolonged Exposure therapy at the Northport VA. PEt has two parts: imaginal exercises and in vivo exposures.

Imaginal Exposure: To summarize in my own words, you sit with your eyes closed and talk in the first person about really crappy traumatic experiences, record it, listen to it all week, then do it over and over. With each iteration the experience uncovers more thoughtful reflection as well as a greater perspective on the traumatic events. It sucks. Like all therapies related to PTSD, it gets harder before it gets easier.

In Vivo Exposure: Then there are homework assignments for in vivo exposure. This is the fun summary: pick out a mess of things you avoid like the plague, rate them from one (in bed about to fall asleep) to one hundred (In the shit bullets flying). Then go do them.

Avoiding public transit? Go ride the subway. Don’t like war movies anymore? Watch Restrepo… Twice. Hate crowds? Go to a Ballgame!

(When my wife heard that one she rolled her eyes, but I can assure you, this is legit.)

As I was immersed in each homework assignment, I was tasked with keeping tack my feelings and mood. It is sort of like embracing the mental suck. But, as advertised, things get easier and easier.

So, tonight is another opportunity to succeed. Let’s Go Mets!

Anniversaries for a Veteran with #PTSD

Most people mark anniversaries with thoughts of joy and celebration. A card, out to dinner, a gift. You can even look at Wikipedia for traditional anniversary gifts by year. For me, and other Veterans, anniversaries carry a special weight. An alive day, the loss of a friend, the time where you treated a civilian casualty, I have them all in my mental calendar. I had deployments that overlapped during the calendar year and anniversaries from both deployments speckle my brain.

IED blows up. Complex Ambush. Mortar attack. My subconscious seemingly sends out messages in the form of depression, extra anxiety,anger, you name it.

I kept a journal both deployments and have specific dates for many of the big events, or a span of time when a collection of events went down. To this day, my mood is affected by those “traumatic” experiences.

Last October my wife and I were chatting and trying to keep each other in check. She turned to me and bluntly asked, “What is your deal these past couple of days? You have been acting like a complete dick.” I took the hint and adjusted my attitude.

Both my deployments to Iraq were shitty for different but similar reasons. When I looked back in my second Iraq journal i figured that since it was closer in dates, those experience would be stronger. But, I could not find a date in my last deployment that matched up. Then I found my first journal and there it was: a week from hell of mortar attacks and close calls.

Now, I am not trying to blame away acting like a dick. I very often do that of my own volition. Also, I am not claiming any scientific support for this, just my own feelings. But, the longer I do this therapy and the more data points I collect, the better I am at avoiding spiraling depression or angry outbursts related to the ghosts of my past. Life often dictates other things to try and focus on, but being conscious of the past stressors is at least helpful to me in heading off destructive behavior. I try now to not let those issues impact my relationships. It’s not easy, and I’m not always successful.

With each passing anniversary, or holiday, I get better at preparing and bracing for what has yet to be anything but a roller coaster of emotions.

This year marks seven years from the end of my first deployment and five from my second. I guess I owe myself a desk and pen set and some silverware…