Tag Archives: depression

Low D

On a topographic map, there is a symbol marked by a closed loop representing a contour of equal elevation with hash marks inside. This is a depression, an area of land lower than all the land surrounding it.

One in ten older American Veterans suffers from depression (VA)http://www.va.gov/health/NewsFeatures/20110624a.asp

Last week at Dr. Hart’s Combat Veteran Aftercare Group, I heard him tell a brother that most Veterans with PTSD also have another condition and that his was depression.

Depression is like being lost in a cedar swamp on a moonless night in the fog. Pitfalls surround you between the roots of tall trees that shade you even from starlight. One wrong step could drop you into a hole in the bog, into cold, dark water. You know there is higher ground somewhere, but even your imagination has lost sight of it. There is no light, not even in your mind. Darkness enveopes you; purpose escapes you; hope echoes like a cruel joke.

NOTE: This blog series investigates twelve attributes I see as conducive to recovery from PTSD and other past stresses. May aspires to Hope.

Eleven (11) percent of our older Veterans suffer from depression. The number seems low to me, but I expect that is because a lot of Veterans do not live to be old. On an average day, twenty two (22) American Veterans commit suicide.

Depression kills.

It lies there, waiting, between the anger and acceptance of a grieving process.

But, there is Hope.

“Hope is a good thing, maybe the best of things…” (Shawshank Redemption)

A line from a movie, yes, a story written by an author of horror. I find that amusing in a way.

If you are a Veteran, or if you love a Veteran, please recognize anger as an alternative to depression. Anger is a lifeline to higher ground, to life, to rescue from depression.

Yes, acceptance is a goal, the state of conclusion of grief. Yes, acceptance is possible and desireable. But, it is over there, on the other side of that chasm or swamp of depression. Will we survive the journey?

Some of us will. Many, too many, of us will not. Like combat, itself, even the survival of PTSD carries a sense of survivor’s guilt. Now, ain’t that depressing?

Anger management in the customary sense is dangerous for combat Veterans because it makes us vulnerable to depression. It strips us of our lifeline. It casts us into the swamp of despair.

So, where is the Hope, already?

Here it is: Brotherhood. Nothing helps a Veteran like another Veteran. We don’t need to sit around and talk about our PTSD. We do need to sit around and talk. We need each other. I don’t know why, the psychology of it, but I know it works. And at some point one brother shares with another an experience of Hope, an improvement in conditions through application of strategies, a psychologist that can be trusted. Trusted, yeah, that’s it.

And service. There is a blessing to feeling useful in service to your brothers. You feel a purpose, again, to share your experience with the Veteran in pain. I have witnessed it, experienced it.

If there are tracks of depression in your heart, get help. Reach out to a brother and ask him how he does it. You will find them at Veteran’s organizations, VA hospital or clinic waiting rooms, or VA Centers dedicated to serving combat Veterans and their families.

May your tracks follow you to help.

Shades of Anger

Sometimes we have to be angry. We HAVE to be angry. Sometimes.

Still, anger is always a painful alternative to Faith.

Note: This blog series investigates twelve attributes I see as conducive to recovery from PTSD (and other past stress) which has become part of our ethos or basic belief system. April aspires to Faith.

Anger is a feeling, an intense, unpleasant, often painful feeling.

So, why do we have to be angry, sometimes?

Because the alternative to individuals with Post Traumatic Stress symptoms is depression, and depression kills.

Anger swallowed is guilt—which leads to depression.

Anger accepted from others is shame—which leads to depression.

Anger blamed on others is resentment—which is poison to the mind, body, and soul, but it may avoid depression, temporarily.

Anger fueled becomes rage—which leads to loss of control and prison (or worse).

Lest I rouse anger, allow me to remind you that I am neither psychologist nor sociologist. I’m just an old soldier trying to claw his way back to mental and spiritual health who has done a little research.

Okay, now, resentment fueled becomes war—which leads to anger, guilt, shame, resentment, rage, and more war. That is a positive feedback loop that defines disease.

Oh, and anger turned sideways is comedy (of a sort), especially satire and sarcasm.

Getting depressed? Time to bring in the experts, a group of kindergarteners addressing the pain and remedy for anger in a short video called, “Just Breathe.”

Yes, I know, it is not that simple for those who have survived traumatic experiences, but it is good advice on two counts:
1. Anger does hurt; and,
2. Mindful breathing does help.

Here is the problem as I see it. The beast is chasing us toward the cliff and great chasm, a less than gorgeous gorge. If we leap, we will surely die. If we surrender to the beast, we will surely die. If we focus all of our energy by turning and fighting the beast, we just might survive for a little while—maybe.

Ah, but there is a bridge, flimsy ropes with a few rotting boards on the bottom, swinging in the wind; but, it crosses the chasm.

Are you afraid of heights?

Running across that bridge requires an act of faith, faith in the materials, the engineers, yourself, and maybe God Almighty.

And, there is our problem, a lack of Faith. It is hard to have faith in engineers you have never met (or, people at all) and a God that seems to have let you down, you know, back there in that ungodly experience of trauma.

No, I am not suggesting a leap of Faith. Your vulnerability is real and it can kill you. We will discuss that next week before we get to a way of escaping the beast.

In the meantime, you might take a brief look at the tracks of your anger, but be good to yourself.

Happy Tracking!

Sad Sorry

…A man carries one of these into battle and by the grace of God comes out in one piece; he carries a strange sense of guilt the rest of his life.   (Paraphrase of John Wayne in The Green Berets.)

This is from memory as I couldn’t find the quote, but I have seen the movie several times including 1969 before I had earned my own Green Beret. Perhaps one of you can post a quote and source.

Reminder: For the past few months, this blog has been dedicated to my reflections on a book by Ashley B. Hart II, PhD, called An Operators Manual for Combat PTSD: Essays for Coping.

“Frequently, combat veterans feel guilty about having survived their combat experience, and this affects their sense of self-esteem and self-worth.” (Hart, 2000, p. 141)

The first thing I did when I walked up to “The Wall” (Vietnam Memorial) was to read the first name. The second thing was to wonder where my name should be. The third thing was to find the panels of names of those killed during my tour in 69-70.

This is a healing wall and I felt the acceptance of my life and, unbelievably, of the loss of theirs. It is a spiritual place.

After my experience, I tried to encourage a good friend and fellow Vietnam combat Veteran to go to The Wall. He said he couldn’t do that until he had done something with his life.

We lost something in combat, too. My first wife said she always thought I had lost my soul. When another friend was asked by his psychologist what part of him died in Vietnam, he went after his doctor.

This is another dilemma of Post Traumatic Stress. We feel a sense of loss but deny it because we feel guilty for surviving. We didn’t lose as much as others so we have no right to feel that loss. We never grieved our own loss.

Psychologists describe several stages of grief (usually five or seven depending upon the source). When we refuse to allow ourselves to grieve (because we feel unworthy of the feeling), we get stuck, mired in the past and caught in unresolved grief.

We deny our loss and our right to feel the loss for a generation or two. When denial fails at a subconscious level, we proceed to bargaining. We try to relive the time and experiences, if only in our dreams, desperate to make it come out different, to finish this unfinished business. In our dreams, death is undone—our friends are still alive, a thing we regret did not happen.

More about sleep issues next week.

We spend our lives in denial and bargaining for so long, going back and forth between the two, that we sometimes forget it is not normal. We wonder what is wrong with the rest of the world.

And, the next stage is anger. Yes, this is about as far as most of us ever get. We are angry at ourselves for surviving but we do the sensible thing to protect ourselves. We focus our anger on others. You make the list. We blame. I’ll attempt to move past that stage.

Anger causes all kinds of physical and mental illness, family and social problems, even legal and moral issues. It is a tragedy, a genuine waste of life.

So, why do we not move on, into the light of acceptance? Of resolution? Of healing recovery?

Because there is a hazard between anger and acceptance. (Ooh, that would be a good title, “Between Anger and Acceptance”.)  The hazard is a gulf, a chasm, a gauntlet, and it kills (quickly or slowly) almost as many Veterans as combat. It is much more dangerous than anger.

Depression. We cannot get from anger to acceptance without depression. That is why Dr. Hart counsels us to hold a low level of anger, to hold onto that “Edge” as we walk our recovery into acceptance. Few of us can survive the journey without help. So, we stay angry.

Are you depressed, now? Feeling guilty? “It is important to remember only good people feel guilty.” Thank you, Dr. Hart, for that reminder.

 

Good Grief

“Any war is testament to the proposition that human life is expendable.” (Barnes, 2011, p. 2 in Beyond the Blood Chit) We each leave a part of us on the battlefield and grief is the consequence. The quality of life after combat depends upon how that grief is resolved.

Reminder: For the next few months, this blog is dedicated to my reflections on a book by Ashley B. Hart II, PhD, called An Operators Manual for Combat PTSD: Essays for Coping.

When my first wife told me she thought I lost my soul in Vietnam, she was not completely wrong, for a part of my self did die in the jungle—not my soul, however, but an important part of me, nevertheless: my innocence. Recovery is a process of healthy grieving.

I expect most of us have some acquaintance with stages of the grieving process, perhaps five or seven steps. This may suggest that recovery is inevitable, that we naturally progress through the steps to a positive outcome. Sadly, no. Many times, we get stuck and may stay stuck. PTSD is like that.

We begin with a stage of denial, a form of disbelief that a loss has even occurred. Even if we know subconsciously that something died, we fail to articulate the loss cognitively. The idea that our experience has changed us or has taken something from us is so shocking that we reject it as not possibly true.

At some point, at least a part of our psyche develops an irritation, often in the form of a focused anger. We blame Nixon, Kissinger, Congress, North Vietnam, Russia, Jane Fonda…. Is it any wonder so many Vietnam Veterans hold anti-government or anti-liberal sentiments? We get stuck in this stage. Why?

We may progress, at least off and on at times, to a bargaining stage, especially subconsciously. We replay (or, relive) events of our past, ever trying to make things come out differently. We trick ourselves into living an illusion in which our comrades, and our own youthful innocence, still live.

Stage four is the reason we get stuck. Depression sucks. As the loss becomes clearer, it gets more difficult to deny the reality of our grief. We sink into a rut of learned helplessness, a feeling of being forever doomed, damned to suffer through eternity. Anger is preferable.

Anger is the alternative to depression, and many Combat Veterans become fixated at this stage of grief. We fail or refuse to struggle through the stage of our depression. My personal opinion is that the helplessness of step four makes us feel vulnerable, and vulnerability is not healthy for us—it threatens our survival. So, we stay angry.

If you learned five stages of grief, you might expect acceptance, now. If you learned seven steps, you might expect an upward turn at this point. That would be a good grief outcome. It’s not that simple.

If there is a key to healthy grief for battlefield losses, and it might be the key to all of Combat PTSD, it is right here. We may make some kind of turn toward reconstruction and acceptance (what I call recovery) or not.

We do get stuck. It is sort of like a broken thermostat, a positive feedback loop in homeostasis terms, or a do loop in computer vernacular. Depression leads not to an upward turn but back to anger—again and again—frequently for forty or fifty years.

The good news is that people do recover. We learn coping skills (BREATHE) that help lower the level of anger to a socially acceptable edge. That potentiates the journey through the depression toward acceptance.

I would like to offer two cautions, here. First, the journey into the stage of depression is dangerous and demands professional help. Certain conditions such as addiction will require resolution, and the issues of combat memories that encourage the journey also trigger major limbic system dysregulation (dinosaur dumps). It is also a lot of hard work for the Veteran. It takes commitment.

Here is where you come in. You can help a Veteran you love, even those you do not know. Validation of our experiences, our losses, and our emotional conditions can provide support for this commitment of hard work. We can all help our Veterans by learning about Combat PTSD, supporting treatment programs and VA services, and caring for the Veterans. It all starts with social awareness.

I do not have the answers. But, I do have some questions. Are you willing to participate with groups in your community to Support Troops After Return? I am willing to speak to community groups on behalf of Combat Veterans. See http://www.ErvBarnes.com for details.