Thursday, March 27, 2014

Married to a man with PTSD

Originally posted in the Santa Monica Daily Press on March 5, 2014


Dear Life Matters,
I recently remarried and I am hoping you can help me help my new husband. Years ago he was diagnosed with post-traumatic stress disorder. He had counseling, but it doesn’t seem to have helped him. And something that I really do not understand is that his experience from the war is years ago; he is a Vietnam veteran!
About once a week he wakes up from some nightmare, screaming and tossing around with a crazed look in his eyes. It’s very frightening. I actually am worried for my own safety. In those few minutes I am not sure that he even knows that I am there.
I not only feel sorry for him, I worry for myself because it feels so dangerous at those times. I never realized this before we married and began living together, which is almost a year ago now. He also seems really isolated and seems to have pushed most of his friends away.
So I have three concerns: how to deal with my own fear, the effect on our marriage and his pain.
It really has become a problem for me and any suggestions you have would be most appreciated.
Signed,
Scared

Dear Scared,
This definitely sounds frightening. I would like to start with your specific problem and then move to the issue of post-traumatic stress disorder (PTSD) in general.
This has got to be really scary for you because it is new to you and apparently not something you really noticed or knew about during your courtship.
The good news is that he has not hurt you or mistaken you for an enemy for the year that you have been living together and while I cannot promise you anything, it looks like you are going to be safe and that it is a matter of managing your own fear and then, with any luck at all, getting him some treatment that is more appropriate for him and his condition.
Not all PTSD is alike; it does not always come from the same kind of thing as in war nor does it manifest itself in the same way for everyone.
He probably would tell you that the counseling he got was helpful to him and it probably was, but it just did not go far enough.
Your husband sounds as if he may disassociate, a condition where he splits off from himself and in a surreal way he is reliving the trauma just like you describe it.
This kind of experience requires a very specific type of help with a trauma specialist. These are licensed psychotherapists, but they have specialized training to help someone like your husband. Look for someone who is certified in EMDR and/or specializes in trauma and disassociation. Make sure that the therapist has the right credentials. Do not take their word for it, look it up or ask to see the licenses and certification.
PTSD from war is horrible. Can you even imagine being in a war zone, every day having to worry for your life and actually not only losing, but also seeing some of your friends die? I think it is really too much to even contemplate, but while war veterans are definitely traumatized, not all develop PTSD. For those that do, there are new and very effective treatments.
Also, war is not the only source of trauma to cause PTSD. Anyone who has experienced a life-threatening event, either to himself or herself or a loved one, is at risk. Physical and/or emotional trauma can cause it as well.
Adults who grew up as children of alcoholics or in homes with domestic violence are at high risk for developing it. Also survivors of sexual abuse, rape or incest will almost always have some aftermath in the form of PTSD.
Some of the more common symptoms of it are: hypervigilance, an exaggerated startle response and avoidance of people, places or things, even conversations that might be a reminder of the trauma, or extreme distress at anything that reminds him or her of the trauma; persistent exaggerated negative beliefs about themselves and others; feelings of estrangement or detachment from others (you mentioned this about your husband with his friends); reckless or self-destructive behavior; substance abuse, problems with concentration and sleep disturbance and an overall depressed mood.
Those who are fortunate have immediate debriefing and counseling and are less likely to develop PTSD. But while we now know to do this with school-aged children, for example counselors rush in after a school shooting, with most traumas, like war, there is no time for something like this. In the cases of childhood abuse, domestic violence or sexual abuse, often the victims are afraid to speak up or have no one to turn to. It is often years later that it comes to light when the victim finally feels safe.
Getting help is better late than never.

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