PTSD and your mental health in a SHTF scenario

[cptd]

Some things to think about if you haven't already, which might save yours or someone else's life.

40% of soldiers coming out of Iraq and Afghanistan are diagnosed with either PTSD or depression, and for many it is a crippling ailment. We put guys in harms way for tour after tour, and while I disagree fundamentally with that practice (having seen first hand the effects of it) it does give us a reasonable way to predict what the effects of extended periods of time living under stressful circumstances and witnessing traumatic events might do.

It's not a function of how tough you are, and no one can ever really predict how they will react to prolonged exposure to traumatic stress until it happens. But I can say this for sure - no one is immune to these effects, and sooner or later they will catch up with anyone.

I didn't really start to suffer until after my fourth combat tour. I had episodes before that - flashbacks, sleepless nights, that kind of thing - but it really hit me when I got home from my second deployment in Afghanistan. I know guys who I thought would last longer than me who in fact lasted shorter, and some guys with whom the opposite was true. There doesn't really seem to be any rhyme or reason to it.

When guys arrived in country on deployments, I used to tell them that it was my thinking that everyone has sort of a built in "stress bucket". It's just something you are born with and everyone's is a different size. Some people get a shot glass, and then I've known guys who had a 55-gallon drum. Into that bucket our brain puts all of the trauma and stress that we experience, and as long as it stays in the bucket you're fine. The problem is that with enough exposure, even the largest buckets fill up and overflow, and you don't really know how big yours is until you've been in the s--- .

So, my question is, have you thought about what you'll do if your stress bucket overflows?

In terms of the profound effects of this ailment, it just can't be understated, but so far I've not heard much thought  put into it from a prepping standpoint.

These are my thoughts:

1. We know that the veteran suicide rate in the United States is 18 a day, with PTSD and depression being the driving force behind that statistic. Untreated PTSD and depression will kill you as easily as untreated pneumonia will.

2. Most people probably don't have access to pharmaceuticals that can help mititgate the symptoms, and can't squirrel them away - so are there other options for responding to this silent killer?

There are a few things you can do to help yourself if you start experiencing the symptoms of PTSD and/or depression and can't get quality medical care for whatever reason.

One thing you can have on hand is some St. John's Wort. It's an herbal supplement that has been used for hundreds of years to treat depression - and while it won't give you the same results that Prozac will, it might get you up and out of bed when you otherwise wouldn't have been able to do so.

Avoid alcohol. It's a depressant and even in small quantities it will make things worse.

You might also consider stashing some OTC sleeping pills. Again, it won't give you the same effect as prescription meds, but it might mean the difference between getting some sleep and getting none at all, and without sleep your problems will be compounded greatly.

You should read and thoroughly familiarize yourself with the symptoms of depression and PTSD. There's a ton of stuff out there and if you just google it you'll get good results right away, but if you have trouble just let me know and I'll research some sites and post them here.

I know this isn't a sexy topic compared to hunting wild boars with a spear, but it just could save your life if you find yourself in a prolonged period of strife.

[FreeLancer]

Good stuff.

I tried starting a similar conversation awhile back, but it didn't get too far, it's just not quite sexy enough.

[thefuzz1290]

From my brother-in-law who used to work with the mental health aspect of the military at the pentagon, and whom has a legit case of PTSD, many of that 40% you mentioned are "over-evaluated." The military doctors will tell soldiers that they can get a higher percentage if they are "diagnosed with PTSD," even if they don't have it.

However, great post!

[flippydidit]

From my brother-in-law who used to work with the mental health aspect of the military at the pentagon, and whom has a legit case of PTSD, many of that 40% you mentioned are "over-evaluated." The military doctors will tell soldiers that they can get a higher percentage if they are "diagnosed with PTSD," even if they don't have it.

However, great post!

There are quite a large number of PTSD cases submitted by veterans who have never been deployed or even seen combat.  Some have never left the U.S.

[microdevil45]

First, thanks for the write up it was very informative.  Second PTSD is a condition that effects everyone everyday in different ways.  Some occurrences are more traumatic than others but it is there.  Military, EMT's, Fire Fighters, First responders, Police, are the known ones but also truck drivers delivering haz chemicals, you diving down the highway and watching a crash happen, loss of a loved one/pet, etc.  So I think finding a good balance in life helps with the bucket level so to speak.  Diet, exercise, sleep, are good ones now to help prep for the shtf scenario.  I like the St. Johns wart and the avoiding alcohol.  So thanks for bringing up this not so sexy topic again.

[prepgal]

I'm sorry, I know this is a bit off topic.  Does being diagnosed with PTSD effect a person's ability to buy and own guns? I ask because I have long suspectedI have this, but avoid doctors because I don't want it documented.

[cptd]

I'm sorry, I know this is a bit off topic.  Does being diagnosed with PTSD effect a person's ability to buy and own guns? I ask because I have long suspectedI have this, but avoid doctors because I don't want it documented.

I've never had a problem buying a gun and I have it bad. So for whatever that's worth.

[cptd]

From my brother-in-law who used to work with the mental health aspect of the military at the pentagon, and whom has a legit case of PTSD, many of that 40% you mentioned are "over-evaluated." The military doctors will tell soldiers that they can get a higher percentage if they are "diagnosed with PTSD," even if they don't have it.

However, great post!

It's not my place to claim other people are frauds when it comes to this thing. My personal experience with it is that if anything it goes underdiagnosed, not over. But I don't have a brother-in-law at the Pentagon. I just know what I see in my buddies.

Regardless, it would be smart to think about it before it becomes a debilitating and life-threatening problem, which was the purpose of my post - to stimulate thought about what to do to combat it.

[flippydidit]

Around 2006-2007 there was an "email" going around that scared people into thinking that the government was "closing a loophole" and making it so that anyone diagnosed with a mental illness (PTSD) would have their gun rights arbitrarily revoked.  It was a hoax and the actual bill that finally became a law (Veterans Second Amendment Protection Act).

http://www.freerepublic.com/focus/f-news/2797112/posts

Of course, just because it was a hoax, doesn't mean that it wasn't supported by people like the Brady Campaign or others.  For that reason I've personally avoided anything like PTSD anywhere near my medical records.  My livelihood involves working on firearms.  I'm not going to jeopardize that for some government subsidy (my opinion).

That's not to say that PTSD is not a valid or dangerous injury.  It is, and should not be discounted.  Cptd was right about starting this "unsexy" thread.  We have many service-members who suffer from this and are even more subjected to chaos when they get home.  There are a small few that defraud the system (enough to earn a bad reputation), "doctors" that aren't sure what the disorder truly is, and legislators who are poised to write laws based on zero solid medical findings.  This all creates a stigma about the disorder and fear/anxiety for the service-member who is truly in need of care.

[Morning Sunshine]

now, I have not served, and have not seen this first hand.  but I heard a theory once about PTSD, and I am honestly and humbly asking for thoughts on it, not assuming anything.

The theory was that WWII vets did not suffer from PTSD in the numbers we see from Vietnam forward, and the reason for that was not just an identification issue.  It was that after the fighting was over, the troops stayed in country until there was a way home - ie a large ship.  A large ship that took a few weeks to cross the ocean.  So, say a month or two after the fighting was over, but with a support group that knew EXACTLY what you were thinking/feeling/experiencing.  Two months to fight those demons in your head and talk/work/whatever it out with your buddies.  Then you got home and were expected to readjust to civilian life.
Now, your tour ends, and you are on an air transport within days, home to a civilian life in less than a week.  No time to decompress, no time to sort it out before you are supposed to be "normal."  Just, one day you are a soldier with people shooting at you and a week later you are supposed to know that it is your child waking you up in the middle of the night, not incoming missiles.

I know from personal experience of a very stressful college semester (nowhere near the stress of combat, I know, but what I have experienced), that when I took Amtrak home - a journey of 2 days - by myself to just relax and decompress from it, I was a whole lot nicer to my family than when I flew home. Just those 2 days of being able to relax before I had more/different responsibilities to take care of changed my behavior.  So, anyway, that is why this theory of PTSD makes sense to me.  Feel free to shoot me down

[cptd]

now, I have not served, and have not seen this first hand.  but I heard a theory once about PTSD, and I am honestly and humbly asking for thoughts on it, not assuming anything.

The theory was that WWII vets did not suffer from PTSD in the numbers we see from Vietnam forward, and the reason for that was not just an identification issue.  It was that after the fighting was over, the troops stayed in country until there was a way home - ie a large ship.  A large ship that took a few weeks to cross the ocean.  So, say a month or two after the fighting was over, but with a support group that knew EXACTLY what you were thinking/feeling/experiencing.  Two months to fight those demons in your head and talk/work/whatever it out with your buddies.  Then you got home and were expected to readjust to civilian life.
Now, your tour ends, and you are on an air transport within days, home to a civilian life in less than a week.  No time to decompress, no time to sort it out before you are supposed to be "normal."  Just, one day you are a soldier with people shooting at you and a week later you are supposed to know that it is your child waking you up in the middle of the night, not incoming missiles.

I know from personal experience of a very stressful college semester (nowhere near the stress of combat, I know, but what I have experienced), that when I took Amtrak home - a journey of 2 days - by myself to just relax and decompress from it, I was a whole lot nicer to my family than when I flew home. Just those 2 days of being able to relax before I had more/different responsibilities to take care of changed my behavior.  So, anyway, that is why this theory of PTSD makes sense to me.  Feel free to shoot me down

It probably has more to do with the duration of the current conflict. In WW2 most guys saw no more than a year of combat. There were guys who volunteered to do more, but as a rule of thumb, after one year on the front guys were rotated home to serve the rest of their time stateside and were replaced on the front with fresh recruits.

But, even if that weren't the case, we've been at it with Afghanistan/Iraq for ten years.  I personally spent five years in combat and I know guys who have gone longer than that. That's longer than the duration of the enitre second world war from the US point of view anyway.

Back then the government didn't call on the same handful of guys to go back into harms way again and again and again, ad nauseum, with no relief. It was unthinkable.

[thefuzz1290]

Interesting theory, though I know there is a debriefing period for soldiers coming back to the states which lasts a week or more. Another reason you're seeing PTSD more is that people in the military don't do a single tour and go home for several years. Now you do a tour, come back for a few months, get deployed again, come back for a few months. My brother-in-law was friends with a guy who was deployed 8 times in 10 years (he was in some Spec Ops division, single, and volunteered to go)....they eventually told him they weren't going to let him deploy again anytime soon.

Now this is paraphrasing from my conversations with my brother-in-law, whom confided a lot since being a cop is the closest thing in the family to being in the military, the problem with the military now is that the combat vets don't want to be perceived as weak. This is why many don't come forward at first. My brother-in-law's job in the Pentagon was to help soliders come forward with PTSD so they could get treatment. Same thing happens with cops in a shooting. If I shoot someone, I go see the shrink, get cleared, then come back to work in a few days. I know officers who have shot someone, or have been shot, who aren't ready to come back but don't want to be deemed a wimp by his peers (which he wouldn't be).

[thefuzz1290]

But, even if that weren't the case, we've been at it with Afghanistan/Iraq for ten years.  I personally spent five years in combat and I know guys who have gone longer than that. That's longer than the duration of the enitre second world war from the US point of view anyway.

Back then the government didn't call on the same handful of guys to go back into harms way again and again and again, ad nauseum, with no relief. It was unthinkable.

That's one reason I didn't join the reserves a few years ago. I always regretted not joining the military right out of high school and when I was 24-25 years old I thought about joining a reserve unit. I have a family and I knew reservists who were called up every other year, or close to it, and they were gone for 8 months+. I couldn't do that and leave my wife with our newborn....plus my wife basically told me, "Cop or soldier, not both, and you better not pick soldier."

[endurance]

I was a cop for three years, EMT for three years, did 11 seasons of firefighting, S&R, and law enforcement with the Forest Service, but it was a simple traffic accident (albeit serious) that caused me to have a spell of PTSD.  You certainly don't need combat or a law enforcement job to get PTSD. 

That said, I'd never really compare the three or four month spell I had of PTSD to what our vets are coming home with.  There's a point where layer upon layer just adds up to a shitstorm to unravel later vs. one tidy package to work through.

As I mentioned in the other thread, the important part is having others around you who know the signs and symptoms and can seek early counseling.  The longer you delay treatment, the worse your life is going to get.  While it seems that some of our WWII soldiers found a way to muscle through, knowing the kids of some of those vets, I would definitely say there is a multi-generational impact even if the vets survived.

[inbox485]

I was a cop for three years, EMT for three years, did 11 seasons of firefighting, S&R, and law enforcement with the Forest Service, but it was a simple traffic accident (albeit serious) that caused me to have a spell of PTSD.  You certainly don't need combat or a law enforcement job to get PTSD. 

That said, I'd never really compare the three or four month spell I had of PTSD to what our vets are coming home with.  There's a point where layer upon layer just adds up to a shitstorm to unravel later vs. one tidy package to work through.

As I mentioned in the other thread, the important part is having others around you who know the signs and symptoms and can seek early counseling.  The longer you delay treatment, the worse your life is going to get.  While it seems that some of our WWII soldiers found a way to muscle through, knowing the kids of some of those vets, I would definitely say there is a multi-generational impact even if the vets survived.

This. I never want to belittle a soldiers sacrifice, but there are a lot of things other than combat that people get PTSD from. And the exact triggers seem very random. Even with somebody who has dealt with combat, it has been my observation that it isn't necessarily the worst or most recent thing that tipped them over the edge, but rather one or more of the many that just stick out for whatever reason.

That all said, it is my theory that PTSD stems from a lack of reconciliation. Traumatic incidences that didn't have a reason or real explanation seem to stick out more. Fighting a war for 5+ years with a moral imperative that is flimsy at best seems to fit that. Also not having a decompression time stunts any reconciliation that could have happened there as well.

[inbox485]

More on topic since my last post was a bit off on a tangent:

To me the best way to mitigate this type of issue looking forward is to have a support network in place. A big part of it should be a group of well adjusted people that are outside the scope of the source of the stress. Every cop I've known was either screwed up in the head, or had a solid social group outside of any police force. I asked one that I knew well enough about that and he confirmed my observation. His explanation was that if you are a cop long enough you either surround yourself with non-cop people that are positive influences, or you become one of the cops that thinks anything that isn't blue is a turd. I think a lot of soldiers get to the point where they view the world the same way. The common thread in those that don't end up that way is some sort of social circle that constantly reminds them that normal people are still the norm. That seems to make a huge difference in mental health right there.

Another part of the support network is like situated people you can talk openly with. This is pretty self explanatory, but the instinct is to clam up when a mental issue is pervasive.

In a breakdown like the OP seems to be envisioning, some sort of clan community would likely be the most effective prevention to mental breakdown. It would have the common background to share, hopefully somebody you confide with, and hopefully a number of semi-normal people to keep you grounded.

[endurance]

...
Another part of the support network is like situated people you can talk openly with. This is pretty self explanatory, but the instinct is to clam up when a mental issue is pervasive.

In a breakdown like the OP seems to be envisioning, some sort of clan community would likely be the most effective prevention to mental breakdown. It would have the common background to share, hopefully somebody you confide with, and hopefully a number of semi-normal people to keep you grounded.

Hold it right there!  That's a direct assault on the Lone Wolf, invincible island, 100% self-sufficient survivalist mentality.  How dare you challenge years of deepening isolation with your liberal ideas of "community" and "networks".   That there reeks of commy-ism.  Next you'll be telling me you're a "community organizer." 

[inbox485]

Hold it right there!  That's a direct assault on the Lone Wolf, invincible island, 100% self-sufficient survivalist mentality.  How dare you challenge years of deepening isolation with your liberal ideas of "community" and "networks".   That there reeks of commy-ism.  Next you'll be telling me you're a "community organizer." 

If you want a chicken or the egg question, which comes first: the lone wolf or the nut job?

[flippydidit]

If you want a chicken or the egg question, which comes first: the lone wolf or the nut job?

Awww.....can't it be both?

[joeinwv]

There are ways to boost your serotonin levels without medication - get more clean protein in your diet, take a fish oil pill, limit caffeine / tobacco / alcohol / refined sugar, exercise, spend time with friends and get some counseling.

I think anyone returning from combat can likely benefit from some short term SSRI prescription medications. These fight depression and anxiety and should be combined with counseling.

Getting up in the morning and drinking a huge coffee or a couple red bulls, smoking all day, eating crap food, gaining weight, then knocking back a 12 pack every night - your neurotransmitters are going to be way out of whack.

[Joe_Nobody]

I think this is an excellent post and worthy of consideration by every prepper. Regardless of the cause, the biggest issue I see is that we can't treat many aspects of this situation now. Even with all of our medical capabilities, many still suffer. What will it be like without any meds, services or treatment being available? I know PTSD is debilitating and serious, and like any medical issue pre-event, things aren't likely to get better afterwards.

This may sound a bit silly, but I've always envisioned life post-SHTF as less stressful, and in some ways healthier than how many live today. Unless we devolve into constant strife and in-fighting, there is an argument to be made that life will be simpler and of higher quality in some regards.

For example, I would expect manual labor to become more of a requirement in daily life. My experience has been exercise reduces stress.
I would also think that having preservative free, natural foods might be better for all of us.
Not having to worry about a mortgage, electric bill or how much time your kids are spending on the xbox might be welcomed in some homes.

It's obviously impossible to predict any of this, but I think education about stress management and treatment is just as important as dental care, first aid and other medical based preps.

Great post cptd.   

[cptd]

Obviously you're right, we don't know what the picture will really be like after a bad collapse of some sort. Maybe it gets better for some people, but probably one form of stress will replace another.

My plan to deal with it is to avoid triggers. I know, for example, that if I was in a gunfight again, there is a good change that it would end with me suffering a debilitaing flashback, hallucination, or worse. That's not cowardice, mind you (I've stood my ground in combat a few times, which is why I have these issues in the first place), it's just the way for me now, and I'm not willing to stake my life on my ability to win a firefight.

So, as a consequence of that, guns and ammo (GASP!) are not a central theme in my survival plan. There are an absolute, no mistake about it, last resort, which I only get out of the locker in the back of the boat if there is positively no other alternative.

Survival for me will mean staying away from the dudes with guns who mean to rob/rape/murder and staying in places where there is some semblance of order and security.

Another example of why there is no such thing as a ready-made survival plan. Everyone has to take into account their own skills as well as their own limitations.

[nelson96]

So besides staying away from guns/ammo/fights, what works for you cptd, or have you not figured that out yet?  You may very well be the expert here (given that you stated you have it bad) and I would truly like to know.  This would prove to be something to prep for in any kind of life, given the various triggers (no pun intended).

[sdcharger]

The only "prep" for PTSD is educating yourself about the signs and symptoms so you can help yourself or your family/friend when it happens.

Some quick information here:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/

[CrunchDog]

I did two tours in Iraq and one in Afghanistan. Reading through this thread has opened my eyes to more then the computer based training and web based post medical treatment has.

I've been down a lot but don't really bring it up. I work in a fire house so it's kind of hard to express your feelings here without getting some jokes or something. I really don't know what to do. I don't feel comfortable with Mental Health, and I don't feel comfortable with the doctors here.

All I can say is that being on this forum, and prepping in general has helped me channel a lot of my feelings. I also loose myself in tv shows and video games, that helps me a lot. Especially in controlling my anger.

This is a big reason for me wanting to seperate from the military, I really do not want to deploy anymore. The stress it causes on not only myself, but my family is overwhelming, and I can see how a large percentage of people can be diagonsed with it. I don't have flashbacks or anything though, so I think I'm good. I'm just really down sometimes.

[sdcharger]

I've been down a lot but don't really bring it up. I work in a fire house so it's kind of hard to express your feelings here without getting some jokes or something. I really don't know what to do. I don't feel comfortable with Mental Health, and I don't feel comfortable with the doctors here.

I'm just a layperson not a counselor or psychologist but I can tell you the worst hangup is just deciding to go and talk to someone.  After you have talked to a couple people you will know if it helps you or not.  You may surprise yourself and like it or at least find some tools to deal with stuff more effectively on your own.

I'm not military so I don't know all the resources available to you, but you can also find help from groups like wounded warrior project and other non profits.

All I can say is that being on this forum, and prepping in general has helped me channel a lot of my feelings. I also loose myself in tv shows and video games, that helps me a lot. Especially in controlling my anger.

Prepping has helped me feel more in control and gardening has been very therapeutic as well.

This is a big reason for me wanting to seperate from the military, I really do not want to deploy anymore. The stress it causes on not only myself, but my family is overwhelming, and I can see how a large percentage of people can be diagonsed with it. I don't have flashbacks or anything though, so I think I'm good. I'm just really down sometimes.

People have different levels of ptsd or maybe you have something else going on?  It wouldn't hurt to try and figure out what the root cause of your "feeling down" (depression) is.  Either way, depression is insidious so don't discount it.  Learn to recognize the triggers and be proactive.  Your family will thank you.

Don't let any macho crap get in the way of learning about possible issues you may or may not have.

[flippydidit]

I don't know if this is a problem you have, but one of the things I realized is that I didn't have any real friends where I lived.  I had kids I grew up with back in Oregon and my wife had her friends that she grew up with where we lived in Florida.  All my Army buddies were scattered across the U.S. and some still overseas.  So I made it a point to go and make new friends.  Let me tell you, when you're starting from scratch and you get to pick your friends, it is awesome (well can be).

First I thought about which common interests I might have with others, and which interests were of no interest to me.  That search lead me almost directly to my local gun forum and readiness forum (a local version of TSP).  From there I have made the best friends I've ever known and people who have the same interests (sometimes the same combat stresses).  We're able to come together and work through things together much better than any session with a shrink.  So I'm in total agreement with the power of networking with friends and family to get through any tough places in your life.

For anyone considering suicide, just remember that it's a permanent solution to a temporary problem.  It's not always going to suck.  There's really good times ahead if you're willing to talk to the right people that can point you in the happier direction.

[CrunchDog]

I've talked to Doctors, Mental Health workers, and Clergymen about feeling off, but not really about depression. In all those situations there were numerous times I could have brought it up but didn't feel comfortable with them. The only person who I talk to about it is my wife, and even then I give her a watered down version.

I may have to talk to someone about it eventually, but it's just not the right time I think. I'm the type of person that doesn't really express much unless its a joke or something, so I feel the need to take it slow. It's been a year since my last deployment and I was on a secondary team this time around and we were canceled, so I felt good about that.

You might be right flippydidit. I have some fairweather friends but no real friends. It's hard to make friends in the Fire Dept though, I mean with people outside of it. My schedule is hecktic and people I usually click with don't work in my career field or they're on the other shift. And when I do make plans with anyone it gets set aside because of my work schedule and they eventually get tired of trying to hang out with me.

I seperate in 7-10 months, I say 7 because I have 90 days of leave saved up, so I'll make a greater effort once I get out to make some friends. I do feel good talking about it with you guys, even though I feel a little weird about it.

[flippydidit]

What area do you live in?  I'd start out with the local preparedness community.  While you're waiting to find the right people, you are more than welcome to talk to me offline.  I'm no shrink and I have a security clearance because I can keep secrets.  It's not the best choice (I'm sure), but I'm free and I don't judge.  Hope it works out for the best.  I know that the decompression is the hardest, but one of the more critical things a person needs to do.

[endurance]

Increasing the breadth and depth of one's pool of friends takes years, but what most folks don't know is just how much effort it takes, too.  I've found that if you don't put in the time and effort to have both positive experience and down time for sharing the serious stuff, things don't happen on their own.  Personally, I'd focus on folks that do things that you enjoy, whether that's shooting, running, hiking, fishing, biking, RC stuff, photography, whatever.  It's a lot easier to form a new friendship around something you have in common than just trying to make it happen with someone more random in your life. 

In 2004 I started screwing around on a foreign mountain biking website.  One thing led to another and in 2005 I flew to England to meet several of the guys.  That's led to several trips there and them coming back and despite the distance, a couple of those folks are people that I'll probably be friends for life with.