Giving a Pass is Not Always Best

Dave served in the Air Force for 6 years and has a combat tour in Iraq. He struggles with his Post Traumatic Stress Disorder (PTSD) because of a roadside bomb that hit his convoy while in a supply convoy. Dave’s PTSD is well known throughout his family and his small town. Dave has been pulled over by the local police several times for a Driving under the Influence (DUI) but was given a pass because of his military service and PTSD. They would make him park his car and drive him home, there were no repercussions for his actions. Dave has been self-medicating for years, using alcohol while trying to live with his PTSD. Dave looks back at his time in the military and remembers the stigma in the military for seeking mental health help. Dave hangs on to the idea that it is more acceptable to drink than go see a “shrink”. Dave had support in the military from his buddies, they helped him hide the seriousness of his drinking while he was in. Dave understood the ramifications of a DUI in the military but seems to have forgotten them once he got out.  Dave felt like he was alone once he separated, he drank alone, and pushed his family away. Dave’s first DUI pass happened while on his way to get more alcohol. Dave saw his drinking as a way to deal with his PTSD. But self-medicating is not helping, it just caused a larger problem.   

Often, people feel they are doing the right thing by giving veterans a pass for their discretions thinking it would help. Self-Medicating is a huge issue in the veteran culture for those with PTSD. Self-medicating causes a host of issues people overlook because of their service to the country. Dave keeps getting passes for his actions because people feel “sorry for him” because of his combat PTSD. Dave’s spouse, Darlene even allows Dave to drink around the children, when Dave acts up, she blames the war, not Dave for his actions. Darlene is not alone. So many people give folks with PTSD a pass because of their own guilt of not sacrificing themselves. So often spouses feel they can’t leave the spouse with PTSD because they will be leaving a “war veteran” or leaving “a tortured soul”. Darlene feels stuck but continues to coddle him and make excuses for him even though Dave has become a danger to himself and others because of his drinking.

Others in society give Dave a pass, this includes the local police. This is especially true in a small town where everyone knows everyone. Dave could get the help he needed if people would just force his hand and hold him accountable for his actions. Dave should have spent a lot of time in jail because of his DUI stops, but he has gotten a pass by the police. Dave might have gotten help if Darlene had left with the children vowing to not come back until he is better. Dave keeps getting passes from his family, community, and police endangering himself and everyone in the community.

What so many people forget is the cost for giving a pass to someone who needs help. This cost can be the children in the home getting PTSD from domestic violence cause by substance abuse, to believing the parental relationship with alcohol is normal. It is also an issue because if the police or society give a pass for the DUI or the physical assault caused by the misuse of drugs or alcohol will make the person believe he/she will get a pass and keep doing the negative behavior.  By giving the pass they are being enabled making it ok to behave badly. In the end there is a larger cost to society. Your guilt or feelings of shame are not warranted and can cost yourself and society dearly. If Dave had not been given a pass for all his transgressions, he might be alive today. Dave was killed while driving while drunk. I did not know he was struggling, he lived in Ohio and we did not stay in constant contact. I had not talked to him in 2 years and found out we lost him after a phone call from another buddy. Darlene called me a couple of months after his death and told me his story and what happened. We lost Dave because no one held him accountable for his actions. It might be easier to let things slide. It might even make you feel better because you “cut someone a break” but in the end, giving a pass is not always best.

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For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

PTSD Is Not Always Combat Related

Johnathan came into session upset that his family feels his problems that brought on his Traumatic Stress Disorder (PTSD) is no different than anyone else’s issues and minimizes his fears. Johnathan struggles himself with is PTSD diagnosis because it was not caused by combat. Johnathan’s PTSD came from an incident that happened while he was in the Army but did not come from what everyone expects. Johnathan’s PTSD came from a vehicle accident that happened during training. Johnathan discussed how the Humvee he was riding in rolled down a mountain while he was serving at Ft. Wainwright Alaska. The accident occurred on the bombing range on the back side of Ft. Wainwright, they were alone while driving from one location to another and it took hours for someone to find them. Johnathan was stranded in the Humvee for hours beside his troop who was killed in the accident.    

Johnathan states his spouse; Evelin and his family don’t understand or want to understand what he is going through. Johnathan disclosed that he feels his family looks at his issues as no reason to have PTSD because people have automobile accidents every day.  Johnathan’s family don’t see his PTSD as anything different, they struggle to understand why Johnathan suffers and others don’t who have been in an auto accident. Johnathan’s family makes him feel invisible and refuses to make concessions for his PTSD and just looks at him as being weird. Johnathan was not married or have children while he was in the Army and struggled the rest of the time he was in; he has been dealing with the loss of his troop since the incident. Johnathan began to drink heavily causing him to fall out of favor with his command causing more issues. Johnathan’s family did not know him before the accident and never knew him without his PTSD.

Johnathan recently realized through counseling that he has been going throughout life accommodating his PTSD. Johnathan found job’s that allow him to feel safe with his PTSD which helped hide the PTSD symptoms. But his family continues to not understand. Johnathan feels the sacrifices he has gone through has been unnoticed because his family feels his PTSD is not valid because it was not due to combat. He believes his family looks at his incident as just another automobile accident. Not the fact that he was stuck for an extended time with a dead troop beside him in the Humvee. Johnathan has stopped talking to his family about his triggers because they blow them off and don’t take it seriously. With his family blowing off his triggers Johnathan feels invisible.

One of the biggest things I see in our veteran population is people discounting the sacrifices of those who’s military service’s PTSD did not involve combat. It appears to most people, even combat veterans, that those who did not deploy should not look at their PTSD as the same as a combat veteran’s. The people around Johnathan discount his experiences because they believe Johnathan’s automobile accident is no different than the thousands of accidents that happen in the country every day. What his family does not understand is auto accidents cause more PTSD than combat… it just not talked about. Johnathan continues to struggle with his PTSD because his family discounts his experiences casing him to feel invisible and helpless.

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For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Veterans Can Fall Victim to the Failed Mental Health System

I was talking to a client the other day and she brought up the shooting in Thousand Oaks CA. Jamie had trouble understanding why a person like the shooter was able to purchase a weapon. She did not understand that the shooting was a product of our failed mental health system. The shooter’s PTSD might have played a part in the shooting, but if the mental health system was not so difficult to navigate, the shooter might have been able to get help or be stopped.  The shooter could legally purchase a weapon because he had not been committed to a mental hospital. The shooter understood the mental health system and knew what to do and say when approached about his PTSD by family members and authorities. According to the newspaper, the shooter’s mother tried to get him help but he refused. The way the laws are written around mental health, there is nothing that can be done unless the right situation arises. It is tough to take away someone’s civil rights but in California, if the shooter had been committed to a mental hospital, he would not be able to possess a weapon for 5 years. Because the shooter was never committed to a mental health hospital, he was legally allowed to purchase the weapon.

The Thousand Oaks shooting puts a negative light on veterans again. The shooting is a reminder of our broken mental health system in the United States, not just the VA but the entire mental health system. Part of the problem with the broken mental health system is the rules are different throughout the country. Every State, County, or local Municipality has different rules around who can commit someone to a mental hospital when it’s necessary. There are no national laws that cover committing someone to a psych ward. The mental health system is too controversial for politicians to take on. Fixing the broken mental health system would entail taking away some civil rights of people with mental issues, including their second amendment rights. Politicians will not touch this issue; therefore, the mental health system will probably stay broken.   

As time passes we find out more about the shooter, it was known he had issues and refused to get help. It is also important to know that the shooters track coach at his high school told school administrators that the shooter had assaulted her while the shooter was in high school and before he went into the Marines. The track coach was told to let it go because the shooter was going into the Marines and they would straighten him out. It is now obvious the Marines did not straighten him out.  In the end, the shooter had anger issues before he went into the Marines.

I have seen firsthand how difficult it is to get someone with a mental issue help if they refuse it. I have also been told by several parents, family members, and friends of suicidal and PTSD victims that they tried to get their loved ones help, and the mental health system got in their way for whatever reason. OUR MENTAL HEALTH SYSTEM IS BROKEN!  This shooting appears to not have anything to do with weapons, gun laws, or the political climate. It was caused by a failed mental health system.

Our society looks down on those who suffer from a mental issue. The stigma associated with mental health is especially relevant in the veteran community. Veterans often fail to get help for their mental health because of the stigma. Veterans are taught violence; which can be a problem for someone like the shooter who had anger issues before he joined the military. My guess is there was someone who knew this shooting was possible and might have tried to help, but the STIGMA and the system got in the way. I understand it’s hard to take the rights away from someone who fought for your rights but sometimes it is necessary. This appears to be one of those times. Our thoughts are with those families who lost a loved one, even the shooter, he was let down by the system too. The only ones who can truly fix the problem are our politicians. Please press all politicians to do something about our broken mental health system.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Comparing Trauma Can Be Harmful

Kevin and Katrina have been married for 10 years. Kevin is a medically retired Army veteran with 3 tours in Iraq. According to Kevin and Katrina, Kevin appeared to be doing OK until he was medically discharged from the Army for his Post Traumatic Stress (PTSD) and Traumatic Brain Injury (TBI) and lost his purpose and identity. Kevin has struggled to maintain any kind of employment and feels the pressure to keep a job from Katrina. Kevin also feels the pressure from her family because he is not “providing” for his wife. Katrina is a few years older than Kevin and was raised by a Vietnam veteran, William, who she adores and feels can do no wrong.

After discussing Kevin’s situation with him and his medical retirement I started to dig into the issues he is having concerning his PTSD, TBI, and family. Kevin feels Katrina is being too hard on him because of his PTSD and not understanding his struggles. Kevin feels Katrina is comparing his experiences with her father’s because he was in war too. Kevin suspects William has PTSD and has been hiding it for years because he has seen some of the signs of in William but Katrina refuses to see it and always changes the subject. Kevin believes William is playing a part in Katrina’s hard-core feelings about Kevin’s PTSD and his inability to hold down a job.

Kevin describes how Katrina continually calls him out for not wanting to go anywhere or do anything. She continually tells Kevin to get over it and move on. Katrina believes her dads wartime experiences are comparable to Kevin’s. She reminds Kevin that her dad had been through Vietnam and was ok and that Kevin should be OK also. Kevin struggles to visit Katrina’s family with her because he feels he is being judged because of his PTSD & TBI by them.

William talks down to Kevin every time he sees him. Kevin stated that the tension can be felt as soon as he walked into the room with William. William has even told Kevin, I’ve seen combat too, I was able to get on with my life, not become a victim, and depend on the Veterans Administration (VA) for a paycheck. William reminds Kevin every chance he gets that he came home and was treated like crap by society, but he refused to let it bother him and moved on, and Kevin should do the same. William had gotten a good job as a heavy equipment operator and had made a decent living. William admitted to Kevin that he does struggle with his own issues but found a way around them and Kevin needed to do the same.

What William does not understand is Kevin’s PTSD goes back to his childhood. Kevin went into the military to escape the abuse he took in the foster care system as a child. Kevin went into the Army with PTSD and his service exacerbated his symptoms. William appears to not care about Kevin’s background and feels he should grow up and be a “man” and take care of his daughter. It is interesting that Katrina does not like the way her father is talking about Kevin, but she continues to harp on Kevin about not being able to get past his PTSD.

What Katrina cannot understand is she was drawn to Kevin because of his PTSD. Katrina can live with Kevin’s PTSD because she sees the same things in her father - the outburst, the secrecy, the triggers, the lack of empathy, and the signs of narcissism. Katrina has seen all of it before and believes if her father could get past it, so should Kevin. What Katrina does not understand is she is doing more harm than good to Kevin’s psychologically. Katrina is what we call a “bootstrapper” She believes Kevin should just pull himself up by his bootstraps and move on just like her father did. Katrina is making a big mistake because she is comparing Kevin’s PTSD to her father’s. The problem is they are a lot different and she can’t see it.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

The Importance of Spouses in the Recovery Process of TBI & PTSD

I see a lot of spouses who do not understand the VA system. Judy was frustrated that the VA has so little support for spouses to help with their loved one’s recovery. As a Licensed Marriage and Family Therapist (LMFT) I have discovered the importance of a spouse’s role in the recovery of Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). Spouses are the key to the recovery of our combat troops who have the signature issues of the recent wars, PTSD and TBI. Part of the problem is the VA will not allow spouses to get therapy from the VA on how to understand and work through PTSD and TBI in their loved one. The lack of support for spouses from the VA is measurable if you look at the divorce rate.

A study conducted by a professor at Brigham Young University found that combat veterans relationships were 62% more likely to end in separation or divorce than their civilian counterpoints. Often the combat experience is a risk factor in ending a relationship. Combat trauma seems to be an issue when people are trying to maintain a successful relationship. PTSD causes a veteran to act irrationally when they are triggered. It appears combat is especially an issue if the couple was married before deployment. The non-combat spouse to needs time to mourn the loss of what they had and accept the new normal. This takes therapy, something the VA is not providing for spouses. If the VA was willing to work with spouses one on one to explain PTSD and TBI to them, the divorce rate might decrease along with the suicide rate. If the marriage starts after deployment, it is more likely the relationship can survive because you don’t have the past to mourn. 

The VA states they prioritize their work with spouses for those of veterans who have died or have serious injury incurred in the line of duty, but isn’t PTSD and TBI a serious injury? The biggest difference is you cannot see PTSD or internal TBI. Congress does not want to add services for spouses because of the cost. It appears that the VA’s fear is the general population does not want to pay for serving spouses at the VA. There are people in the civilian community who would squawk about the costs if the VA started taking on the spouses too. The problem is, especially when it comes to mental health, it takes a toll on a spouse living with someone who has PTSD. The demands of being married to someone with PTSD can and does cause its own set of issues in the spouse.

Wouldn’t it be less expensive to allow spouses to have individual counseling? I believe it would. If the spouse understands what they are seeing they might have the ability to head off some of the issues the veterans goes to the VA for. It is possible the spouse could spot triggers in the veteran decreasing triggers. It is also possible the spouse could spot suicidality of their spouse decreasing the 20 to 22 a day veterans’ suicide rates. The VA does offer couples counseling but that can be an issue for the veteran. The spouse needs to be free to discuss what their living with and it is more likely the spouse would be apprehensive to discuss their feelings in couples counseling. Some of the conversations can be problematic for a combat veteran if they get triggered by the discussion of their issues by their spouses. Spouses need individual counseling to help them understand what their seeing in their spouse. Spouses don’t know how to help because no one is teaching them what they need to do.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Can Cannabis Help with Pain Management & PTSD?

Veterans have been using marijuana for decades to help with pain management and Post Traumatic Stress (PTSD) symptoms. The problem is the Veterans Administration (VA) follows governmental, not state guidelines concerning marijuana. Since marijuana is a schedule 1 drug according to the federal government, the VA is not allowed to help veterans attain, suggest, or prescribe marijuana. A schedule 1 drug is defined by the Drug Enforcement Agency (DEA) as a drug with no currently accepted medical use and a high potential for abuse. Sounds a little antiquated with it being considered equal to heroin, LSD, and ecstasy.

I have worked with and known hundreds of veterans with PTSD, I can honestly say it appears that cannabis helps them. With so many states now allowing the use of medical and recreational marijuana the federal government appears to be unwilling to authorize or extensively study cannabis even though it appears to be helpful to so many veterans. From what I can tell, there have been, or are doing limited studies on marijuana but not the extent that is needed. It is also possible the VA is studying it in secret because of the stigma. The only reason I can see for the government’s unwillingness to de-criminalize marijuana is because of how it looks and the stigma. To the government, marijuana is worse than opioids because opioids can be and are prescribed, therefore controlled. People are going to use pot if they want, it makes no sense in trying to stop it, it has and always will fail, and it is a waste of resources and money. I have seen where several veterans have used marijuana instead of opioids, and it has worked for them. Marijuana is often called a gateway drug. If you want to talk about a gateway drug… prescription opioids it is. Just ask someone who has beaten the opioid addiction.

I know some will disagree with me, but I honestly believe marijuana is better than alcohol or opioids. If you look at it from a logical point, allowing the legal use and distribution of marijuana makes sense. How many bar fights have been caused by using marijuana?  How many domestic violence cases have you heard of from marijuana use? There are very few if any. How much damage has marijuana done to families compared to alcohol or opioids? In my opinion pot appears to be a better than either.

The VA states on their website that they encourage veterans to tell their primary care physician that they use marijuana, and by telling their primary care physician it will not cause the veteran to lose their benefits. The VA will put the information in the veteran’s medical records, and it will remain confidential and protected by Health Insurance Portability and Accountability Act (HIPAA).  The VA also states that VA providers can talk about marijuana use with clients as a part of their planning and adjust treatment, but may not recommend its use. It is possible that the use of marijuana could interfere in the effectiveness of prescribed medications. The VA doctors are not allowed to write prescriptions for medical marijuana even if it is legal in the residing state.

I can see where having marijuana use in medical records could cause an issue for the veteran. The VA is always changing the rules, I don’t think I would want marijuana use in my medical records for fear of it being used against me in the future. Even though possessing marijuana in some states is legal, it is not allowed on VA property. You can be arrested for possession of a controlled substance if you’re caught with it on VA grounds, even if it’s prescribed by a civilian doctor. VA grounds are federal property, and marijuana is still a schedule 1 drug to them.

There have been several civilian studies that show marijuana can replace opioids for some pain management. A study done in 2014 shows that one state that legalized cannabis has had a decrease in opioid overdose deaths by 25%. The VA says their scientists may conduct research on marijuana benefits, risks, and potential for abuse under regulatory approval but the funding needed is not available. The limited funding for marijuana research mainly comes from the government, yes, the same government that has labeled marijuana a schedule 1 drug. Most of this research focuses on addiction, abuse, and other potentially detrimental effects of marijuana. Little research focuses on the positive aspects of marijuana causing the research to be skewed toward the negative. 

Marijuana acts differently in everyone, what works for one might be a problem for another, just like prescription medication. I also would like to point out that over use of marijuana can cause problems just like any drug.  I’m not going to suggest you quit your medication and use marijuana. If you want to try cannabis, talk to your doctor to see if it is an option. I believe the VA should be doing an extensive research study to see if marijuana works as a replacement for some prescription medication applications for pain management and PTSD symptoms. If the study finds marijuana works, it will save millions of dollars of tax money spent on opioids. If you feel marijuana should be studied by the VA, contact your congressman and demand an unbiased study.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.

Veterans Among Heroes in Las Vegas

Photo credits to: Prayitno (Flicker) License: https://creativecommons.org/licenses/by/2.0/legalcode

Teaching psychology in college opens a lot of doors for conversation. After the events in Las Vegas we discussed the aftermath. One of my students had two friends shot at the concert in Las Vegas. As I talked to her you could see the shock in her eyes and the concern for her friends. In Southern California Las Vegas is one of the key places to go for entertainment. Many people in California like to visit "sin city" and let their hair down and have a good time. Las Vegas is known worldwide for its ability to put on good shows, and handle huge crowds that come for the gambling and entertainment. This was not the case a few weeks back when over 2200 descended upon Las Vegas to see a country music festival. These 2200 + concert goers are now cemented in history for being a part of the largest mass shooting in recent American history. No city could prepare for the events of October 1, 2017, not even Las Vegas. It was helpful to the concert goers and Las Vegas that there were a lot of veterans and off duty first responders in attendance or the situation would have been a lot worse.

Veterans continue to be a staple of helping during a crisis, and Las Vegas was another example. According to multiple witnesses some veterans stepped up showed their ability to act heroically and do what it takes to get the job done. During the terrorist attack at the Las Vegas music festival veterans sprang into action and provided help where they could, at times risking their own lives, or the possibility of going to jail. The horrific events in Las Vegas continues to remind us that there's evil everywhere, even in the United States. There were 2 veterans among the 58 killed, one was a veteran who survived a tour in Afghanistan. He is not the first, and probably will not be the last veteran to survive a war to be shot and killed at home. It is bothersome when someone survives a war and is killed at home where he should have been safe.       

All veterans, not just war veterans are trained in first aid and how to handle a stressful situation. Putting skills that were taught in the military to good use, more than likely saved a lot of lives. Veterans and first responders understood the need to provide help quickly and they did in mass. Once the veterans and first responders realized the noise from the shots were not a part of the show, and were actual bullets, they sprang into action, helping where they could. Veterans, first responders, and regular citizens started giving first aid while the shots were still being fired, putting themselves at risk, some people even lost their lives rendering aid to the fallen.   

Knowing what to do and how to handle stressful situations is what saved lives during the attack. Also doing what you “have to do” even if it is illegal, also saved multiple lives. The Veteran who “stole” the truck in Las Vegas to take the injured to the hospital is an example of how veterans think outside the box to make things happen. He took a chance that stealing a truck for a good reason would be ok with the owner, he was right. Thinking quick is a key to saving lives and many veterans have been in stressful situations and know what to do and how to respond when under attack.  

Continuing to serve the community is what many veterans do. Whether it is becoming a volunteer, first responder, police officer, nurse, doctor, or mental health clinician like myself it is done to help the public. If you look at any of the tragic situations that happens, there’s usually a veteran there to help, putting their skills to work and their lives on the line. When a crisis occurs, I can only hope there are veterans around to help, bringing their training to the forefront and saving lives. Veterans are trained to handle stressful situations and usually step up to the challenge when faced with a stressful life changing event. I would like to give a shout out to those veterans and first responders who continue to serve. By acting on their training, skills, and not running from stressful situations, makes us all proud to be veterans.

For questions or comments, I can be reached at afterdutyvets@gmail.com or visit our website at marriedtoptsdpro.com and like us on Facebook at Married to PTSD Pro.