PTSD The Face of WarAn Intimate Look Inside

By Honey Bonjour

Objectives

• Define PTSD• Discuss symptoms of PTSD• HELP• Discuss Treatment Options• How to Cope With PTSD• Support Systems –Importance of• Battling Bare Support Group • The story of…• How PTSD Relates to Alzheimer’s & Dementia• Suicide Rates Older Veterans and Younger Veterans• Older Veterans Now seeking Assistance for PTSD and other Related Issues• What you can do to help• Why this is important to me!

Goals

• To bring about awareness of PTSD and the effects it can have on veterans. To show an inside look to what someone who has PTSD goes through. To Show what a caregiver deals with when someone they love has PTSD. To enlighten the population on what they can do to help and

What is PTSD?

• You feel on edge. Nightmares keep coming back. Sudden noises make you jump. You’re staying at home more and more. Could you have PTSD?

• If you have experienced severe trauma or a life-threatening event, you may develop symptoms of posttraumatic stress, commonly known as posttraumatic stress disorder, PTSD, shell shock, or combat stress. Maybe you felt like your life or the lives of others were in danger, or that you had no control over what was happening. You may have witnessed people being injured or dying, or you may have been physically harmed yourself.

• Sometimes these symptoms don’t surface for months or years after the event or returning from deployment. They may also come and go. If these problems won’t go away or are getting worse—or you feel like they are disrupting your daily life—you may have PTSD.

Signs Signs Every Where Are Signs

• Feeling upset by things that remind you of what happened

• Having nightmares, vivid memories, or flashbacks of the event that make you feel like it’s happening all over again

• Feeling emotionally cut off from others

• Feeling numb or losing interest in things you used to care about

• Becoming depressed

• Thinking that you are always in danger

• Feeling anxious, jittery, or irritated

• Experiencing a sense of panic that something bad is about to happen

• Having difficulty sleeping

• Having trouble keeping your mind on one thing

• Having a hard time relating to and getting along with your spouse, family, or friends

Other Related Symptoms

• It’s not just the symptoms of PTSD but also how you may react to them that can disrupt your life. You may:

• Frequently avoid places or things that remind you of what happened

• Consistent drinking or use of drugs to numb your feelings

• Consider harming yourself or others• Start working all the time to occupy

your mind• Pull away from other people and be

come isolated

Why Get HELP

• Early treatment is better. Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.

• PTSD symptoms can change family life. PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.

• PTSD can be related to other health problems. PTSD symptoms can make physical health problems worse. For example, studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD you could also improve your physical health.

Treatment

• Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.

• Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.

• Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.

• EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

Other Treatment Options

• While there are a few treatment options that I spoke of just understand that with today’s technology there are many different treatment options available. It is up to the person afflicted with PTSD as to what works best for them.

HOW TO COPE POSITIVELY

•Learn about trauma and PTSD•Join a PTSD support group•Practice relaxation techniques•Pursue outdoor activities

•Confide in a person you trust•Spend time with positive people•Avoid alcohol and drugs•Enjoy the peace of nature

SUPPORT IS KEY

• http://www.brainlinemilitary.org/content/multimedia.php?id=8319

BATTLING BARE

• http://www.nbcnews.com/video/nbc-news-channel/49286851#49286851

PTSD AS I KNOW ITThis is my husband Arthur Bonjour who was deployed to Iraq in 2003-2004. I didn’t know him yet, but I soon would learn to call this man my best friend. Our world would change more than we knew.

2004: Where it all began!

• I met my husband in 2004, after he had completed a tour in Iraq. He seemed to be fine and our lives went on as normal as we started to date and get acquainted much better. Only when we moved in together did I start to notice something wasn’t right. At night, he would have vivid dreams and nightmares and awaken in sweat drenched clothes. Every time, I silenced his screams and held him till he fell back asleep. Over a period of time, I would realize quickly that waking him seemed to be a chore! He would not even know it and would awaken with fists flying and screams of jumbled jargon that I could barely make out. I did my best to deal with this, but knew deep down something was not right. I started looking up signs and symptoms of PTSD and there it was right in front of my eyes. The realization that my soon to be husband had this common disorder, but I had no clue just what was in store for our future.

2005: My Wedding Day

• I married my best friend in 2005, and we were the happiest we had ever been in our lives. But…Things were not getting any better and still we just tried to do our best on our own. We did not seek help until later when one fateful day a realization would hit us both that would make us stand up and take notice that we needed to get help soon.

2008: FLASH FORWARD

• During the time of 2005-2008, we just tried to get used to married life. We had a new baby and my husband officially adopted my youngest son. Life was good but we also had bad days that would put strain on the family and our relationship. My husband was prone to fits of rage, angry outbursts, irritability, depression, insomnia and having difficulty sleeping, nightmares, flashbacks, anxiety, being jumpy or startled easily, crowd paranoia, just to name a few. He had so many emotions and just did not know how to deal with them. At times, I didn’t know what to do, but all I could do was just tell him I loved him and that I was there.

THAT FATEFUL EVENT

• One day in 2008, we decided we were going to go to Aggieville to have a few drinks with some friends, so we arranged for my husband’s sister to come watch the kids. We had planned to get a cab home if we had too much to drink. The night started out smoothly, but then in an instant that all changed. My husband and a friend( his battle buddy) were standing off to the side of the dance floor drinking and talking when all of a sudden as I made my way to them, a bouncer came out of nowhere and snatched some guy up by his throat and in doing so almost knocked me to the ground. I let out a scream and in an instant my husband was by my side with is friend seeing if I was ok. I assured him I was, but the look in his eyes told me he was not okay with what just happened. I told him to leave it be and let’s just go. That isn’t what happened. The two of them decided the bouncer needed to be talked to and headed that way. I managed to persuade them both into leaving and ensuring a brawl did not occur. It didn’t stop there…….

Emergency or Not That is the Question?

• My husband was angry and frustrated and kept telling me he was going to go have a nice chat with the bouncer. A few of our friends cane up and had asked what had happened as I explained what happened my husband became even more enraged and mad. We got him to eventually calm down and we decided we would just walk the short distance to our home so it would help him to calm down. We parted ways with friends and headed out to what I thought would be our next stop of our lovely home. As we walked along Poyntz Avenue, I could see my husband slowing down as the alcohol continued to seep into his veins and blood. Then he just stopped…just like that and laid down on the ground. I was like uh oh this is going to be bad. I tried every person I could to get a ride home, every cab company and then eventually 911. what was my emergency? How does one explain this type of situation. I tried best to explain to the 911 dispatcher who told me I was not to use this unless I had serious emergeny? Didn’t this constitute one? And she hung up on me….

What Now?

Someone I didn’t know?

• As she hung up on me, I just stared at the phone in disbelief. As I suddenly heard my husband calling out to me from the ground below, he uttered the words “ GO SAVE YOURSELF” “SAVE YOURSELF AND THE KIDS, JUST LEAVE ME BEHIND” No matter what I tried to say or do, he uttered those same words over and over again. He began to puke violently and then I knew I could not just sit on the side of the road with my husband no longer. I knew this man who lay on the ground next to me was now in dire need of assistance for he was not in his right mind. 911 again here we go…this time I got an apology and assistance sent to me right away..as the police showed up first, I spoke the words that would save him from ever having a criminal record due to his service at war. “ PLEASE HELP ME HELP MY HUSBAND, HE IS VERY DRUNK AND HAS SERVED IN IRAQ, I BELIVE HE THINKS HE IS BACK AT WAR BECAUSE HE KEEPS TELLING ME TO SAVE MYSELF” As the officers approached him he became very violent and then I was scared..scared he would go to jail, scared he was going to hurt himself, scared of what was going to happen next….

AND THEN….

• What happened next made me start to realize that what we as a couple were doing to help him deal with his post war emotions and actions. He started to swing his fists at the cops who were just there to help me and him out. I walked over to my husband and the cops yelled get back to me. I disregarded them and bent down to my husband’s level. I then grabbed him by his shirt and preceded to tell him he better look at me now, his eyes popped open and I yelled knock it off and let them help all they want to do is help so please let them help you! He calmed down and let the cops and EMT’s assist him onto the gurney to ride to the hospital. I asked to ride in the back but they feared too many people would just disorient him. So, I sat in the front as I heard a commotion going on in the back of the ambulance I just cried because I had no idea what was going on. Then I heard one if them say “ he ripped his IV out, let’s get going to the hospital so we can get some assistance. And away we went…

At the hospital….Emergency Entrance Early Morning Hours…I myself had a little too much to drink..I feared I wouldn’t be much help once the alcohol settled into me……There was nothing I could do they said go home and rest and when we get him awake in the morning after we sedate him, then we will call you to come get him. Then we can tell you where to get help from here. He really needs some assistance with this because he cant do it on his own and neither can you.

The next day… and then some…

• The next day seemed a blur to both me and my husband as I tried my best to console him as he asked me what had happened that he couldn’t remember anything from the night before. I explained best what had happened as he looked at me in a hazy eyed glare and confused as to had he really done that. Needless to say we were about to get the long awaited help we desperately needed. The state of Kansas called me a few days later and explained that they had been informed of the incident and that he needed to apply for benefits immediately. We did and within a month he started receiving full disability pay for the state of Kansas. I wish I could say it was that easy for the Veterans Affairs. However this would take me a long time to fully get what he deserved and I am currently still awaiting a review of his Army medical board and am still trying to apply for his Purple Heart.

The VA

• The VA hospital tried to place my husband on as many as 20 something medications to which I replied that there was no way he was ever going to be on that many medications at one time ever. During the course of his treatment we were dealt another blow when we found out he also had a traumatic brain injury that would likely explain his never remembering simple things most people do on a daily basis with no issues. He was in a terrible accident while deployed in Iraq when the HUMVEE he and his fellow comrades were in was hit by an explosive device. He never once had mentioned this to me until we found out for fear of worrying me. My husband has very hard time remembering lots of things and just to name one is that he always forgets to eat or take medicine. He needs constant reminders and his memory has taken quite a blow. He repeats himself a lot and at first I would try to tell him that he had already told me, but I would soon this would just make his PTSD worse so I just listen to him and hear what he has to say. We have been down a long road but eventually we got where he has been compensated and is unable to work. His rating is called 100% unemployable. He is 100% disabled and unemployable and that remains to be see whether he ever will work again.

As the years have passed

• As the years have gone on we have had our ups and downs with not only the VA system but within our family system and our relationship as a couple as well. We have almost divorced twice, but yet somehow we have remained together because of the deep love and devotion we have to one another. We have become more than best friends in the last few years and maybe that comes with educating yourself on how to manage injuries such as the ones my husband has, maybe it’s the fact that we have been bound and determined by our love for one another to stick together forever or as they say till death do us part.

Education

• It took many years for us to develop a routine and gain a sense of understanding on how we were to rearrange our lives as well as our children's and teach each other. We have had to work together as a family to teach each other how to go through this battle my husband deals with inside himself. He works very hard to fight through this and he knows he is not alone yet at times he feels he truly is. I have reminded him that everyday I continue to educate myself in order to help him through this. He is the reason I chose the degree I currently pursue and he has instilled in me a love for the soldiers, veterans, and their families. My passion now is to help others just like my husband, my kids, and me so that they know there is someone who truly cares.

How does this relate to the course??

• I have grown fascinated with not only the younger generation of veterans, but the older generation as well. While scrolling through articles over the years I have come across many that discuss the suicide rates among veterans young and old, but then I found an article that discussed the risk factors associated with Alzheimer's and dementia among veterans and was shocked at what I found.

What I found…

• A new study of nearly 200,000 older military veterans has found that those with traumatic brain injuries are 60% more likely to develop Alzheimer's disease or other forms of dementia.

• But the study did not answer the key question of whether the risk of dementia is elevated in cases of mild brain trauma — a common injury from roadside bombs in Afghanistan and Iraq as well as in football and other contact sports.

• "It's still controversial”

WOW

• The study was based on medical records of 188,764 veterans ages 55 and older who had been patients in the Veterans Affairs health system from 2000 to 2003 and did not have a diagnosis of dementia during that time.

• Of those, 1,229 had a TBI diagnosis.

• The researchers used medical records from 2003 to 2012 to compare the fates of the veterans with TBIs to the much larger group without brain injuries.

• Among the veterans with TBIs, 16% went on to develop various types of dementia. That figure was 10% in the comparison group.

• There is also growing evidence that repeated mild brain injuries can have a variety of long-term effects, including impaired cognitive ability and an increased risk of dying from neurodegenerative diseases.

Risk Factors

• Military risk factors for AD include both factors elevated in military personnel such as tobacco use, traumatic brain injury (TBI), depression, and post-traumatic stress disorder (PTSD) and other nonspecific risk factors for AD including, vascular risk factors such as obesity and obesity-related diseases (e.g., metabolic syndrome), education and physical fitness. The degree of combat exposure, Vietnam era Agent Orange exposure and Gulf War Illness may also influence risk for AD.

• Using available data on the association of AD and specific exposures and risk factors, the authors have conservatively estimated 423,000 new cases of AD in veterans by 2020, including 140,000 excess cases associated with specific military exposures. The cost associated with these excess cases is approximately $5.8 billion to $7.8 billion. Mitigation of the potential impact of military exposures on the cognitive function of veterans and management of modifiable risk factors through specifically designed programs will be instrumental in minimizing the impact of AD.

More of what I found…

• Veterans who have survived traumatic brain injuries are 60 percent more likely to develop Alzheimer’s disease and other forms of dementia later in life, a new study found. Those who developed dementia also tended to develop it about two years earlier than veterans who hadn’t had brain injuries, the study found.

• The findings add to growing evidence that serious head injuries may contribute to brain problems like Alzheimer’s years down the road.

• “These findings suggest that a history of traumatic brain injury contributes risk for dementia in later life in veterans,” said study author Deborah E. Barnes of the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center.

Older veterans now seeking care>>>>

• http://online.wsj.com/articles/vets-seek-help-for-ptsd-decades-after-war-1417203812

Suicide Rates

• Veteran suicide numbers have gone up in recent years with much of the attention focused on veterans of the wars in Iraq and Afghanistan killing themselves. However, almost seven out of 10 veterans who have committed suicide were over the age of 50, according to a Department of Veterans Affairs study.

Scary News..

• The fact that our heroes of this great nation are dying at alarming rates and that there are links to veterans with TBI developing AD at an earlier rate is quite alarming. I was shocked that this was something I had never heard before. I now had a choice?

• A. Worry myself to death and stress over the fact that my husband could eventually develop AD

• B. Continue to be proactive in his care and continue to research new information and wait for technology to catch up and help find a cure for AD.

What did I choose?

• BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB

• OF COURSE WHY WOULD I CHOOSE AAAAAAAAAAAAAAAAAAAAAAAA

• I WOULD JUST WORRY AND STRESS OVER SOMETHING THAT MAY NEVER BE! I CHOSE TO LIVE MY LIFE AND DEAL WITH WHATEVER COMES MY WAY WHEN IT FINALLY DOES.

Our lives today

• Today we have been married for nine years and are the best of friends. We both have had a rough life growing up and when I say rough I mean it has been an uphill battle for us both. How did these two kids from rough backgrounds and upbringings continue to push forward and strive on up that hill…it’s a little thing called resilience.

What was is not what is today..

• MY HUSBAND: beaten and starved as a young child, yanked back and forth between divorced parents, dropped out of school, got addicted to drugs and alcohol and moved to Oregon to escape the bad path he was headed down, to become a loving husband and father who is a true American hero.

What was then will not be today

• ME: a military brat who became pregnant at 15 years old, drug addicted to cocaine by age 18 years, a full blown alcoholic by the time I was 21 years old, who survived a suicide attempt…to a loving doting mother and wife who has been sober since the age of 25, who finished high school and continues on in college to inspire her young children to reach for their goals.

What can you do to help

Educate yourselves on the issues that pertain to our heroes.

Know the signs of PTSD and when to get someone help or for yourself.

Say “Thank You” to a veteran, soldier, or family caregiver…a simple thank you goes a long way.

Show your support

Why this matters to me!

• This matters to me so much because when I see the alarming suicide rates and the veterans afflicted with AD and many other issues, I ask myself how this can even happen to the ones who were brave enough to fight for our freedoms we have here today in America. I want people to be aware of what it is like not just on the outside, but on the inside as well. I have only given you a brief glimpse into my daily life with a wounded veteran, so that maybe you will start to become more proactive in helping our nations heroes. I want to make a difference in a soldier, veteran, or even a family member’s life just so they know that they are truly not alone in this battle here on the home front. I hope that I have helped you to understand a little bit about what is happening to our military members today and yesterday and still tomorrow.

Thank You!

• Thank you for listening to our story and I hope that you learned something today.

References

• http://maketheconnection.net/conditions/ptsd?gclid=Cj0KEQiAneujBRDcvL6f5uybhdABEiQA_ojMgil0-4-utg9OYB7-pTb-rv6jgjTyZJe0EhBJ0gF2yNgaAkDE8P8HAQ

• http://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp

• http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm

• http://online.wsj.com/articles/vets-seek-help-for-ptsd-decades-after-war-1417203812

• http://www.brainlinemilitary.org/content/multimedia.php?id=8319

• http://www.nbcnews.com/video/nbc-news-channel/49286851#49286851

• http://www.latimes.com/local/la-me-0626-veterans-dementia-20140627-story.html

• http://www.eurekaselect.com/113942/article

• http://www.alzinfo.org/09/articles/diagnosis-and-causes/veterans-with-brain-injuries-at-increased-alzheimers-risk

• http://www.military.com/daily-news/2014/08/31/older-vets-committing-suicide-at-alarming-rate.html