Post-Traumatic Stress Disorder (PTSD)
It's All in Your Head
Chief Petty Officer Tracey Duke Putney doesn't sleep well at night and she ends up taking a nap most afternoons. She loses focus quickly and she finds it nearly impossible to complete the simplest tasks that aren't work-related.
Putney knew something wasn't right and people at work were beginning to notice. She was good at hiding the emotional scars of the sexual abuse and domestic violence she'd endured for years, until last year. It wasn't until a corpsman friend recommended counseling that Putney began to suspect post- traumatic stress as her problem.
Experts say that post-traumatic stress disorder occurs in the range of 11-20 percent of veterans who served in Operations Iraqi and Enduring Freedom. In fact, the Rand Corporation published a study in 2008 that estimates as many as one in five service members return from deployment with significant psychological health or traumatic brain injury symptoms. What most people don't realize is that trauma isn't only caused by combat.
According to the American Psychological Association, trauma is an emotional response to a terrible event.
"[Trauma] really emerges in response to some significant threat," said Capt. (Dr.) Anthony Arita, who specializes in clinical neuropsychology, at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. "In those kinds of scenarios, the body prepares us to make some sort of survival response, (fight or flight) our body mobilizes in all of those physiological ways ... PTSD is a similar reaction; there's an activation in the body, and it's just not appropriate to the situation anymore. It's misplaced."
Arita said PTSD has a variety of symptoms and side effects including emotional numbness, difficulty concentrating, anxiety, felt stress and irritability. Arita also said that the magnitude and persistence of these symptoms are what help to characterize PTSD from something else.
Petty Officer 1st Class Jeffrey Ballge, was working in the Pentagon in 2001 when he left the building on an errand to the local personnel support detachment. Ballge said that's when he saw the news reports of a plane hitting the World Trade Center in New York. His thoughts raced.
"I can remember looking at that and thinking 'Okay. One plane. It could happen...Commercial plane? That's far-fetched. Two? It was surreal.'"
The clerk at PSD told Ballge the Pentagon was hit. The plane impacted on the side where Ballge's work center was.
"All I wanted to do was to go to that scene," said Ballge. "I had basic damage control in my head the entire time. The repetitive training; the stuff that was not always the most comfortable to do... I knew I could have assisted in some fashion. Not being able to utilize my training in the most basic response- it hurt."
Since Ballge couldn't get anywhere near the Pentagon, he and his leading petty officer set out to account for personnel.
"I remember my good friend, in particular, knocking on his door. Pounding on that door, until my hand hurt and hearing the phone ringing on the other side," said Ballge. "It just kept ringing and his voicemail would pick up and [I could hear] his mother's voice."
In the end, Ballge lost 42 friends and coworkers in the attack that day. He stayed close with fellow survivors and did get some counseling, but he mostly kept to himself.
Putney said that it was having a corpsman as a friend that made it easier to get help and follow through with the treatment process.
"I attended the outpatient Crisis Intervention Program at the naval hospital. It's a five-day cognitive behavioral therapy class with some group sessions."
Since she wasn't stationed on a base that had behavioral health services, Putney had to take time away from work to make her weekly appointments.
"My commute was more than five hours for the round trip for a 45 to 60-minute appointment," said Putney. "I'm fortunate to be at a command that is supportive, but I am sure it is difficult for other Sailors to be able to get the time off work to go. That, coupled with the stigma associated with mental health disorders, doesn't make it any more attractive to ask for help."
Putney's trauma spanned years as she endured physical, sexual and emotional abuse at the hands of different people. In 2005, she was held at gunpoint by her boyfriend.
"I remember making a phone call and being told something along the lines of 'God has something for you to learn; you just need to pray and figure out what it is'," said Putney. "It was like being told
that it was God's will [that] I have a bruise the size of the barrel of a .40 caliber on my forehead. It was my fault I wasn't Christian enough, faithful enough, to not be assaulted."
Putney is going through the process of formally being diagnosed with PTSD and like the trauma she experienced, the treatment process is long-term. She follows up with individual counseling and will get a new counselor once she transfers to her new duty station. One of the major focuses in her treatment is changing her thought process.
"It's a slow process; very slow. I have to learn techniques and then practice them," said Putney. "But you won't get good at it without practicing. The hard part is that I also have to unlearn what I've already become accustomed to doing; like calling myself names and belittling myself."
Immediately following the traumatic events of 9/11, Ballge was able to suppress much of his emotion. He was assigned to the Blue Angels and then USS Essex (LHD 2) where he was able to drown himself in work. He said it all caught up with him in 2009, when he found himself working less.
"I didn't have to work on weekends and that's when it really started catching up, is when I had all that downtime," said Ballge. "My chain of command helped me out. They recognized it. My quality of [work] was starting to be noticeable to the chain of command and they set me aside and they asked: 'Hey are you having suicidal thoughts? What's going on?' They kept at it. I told them I'd already had it planned but wasn't to that point yet. They pushed me to get help and I was hospitalized for inpatient treatment."
Arita acknowledged the stigma attached to seeking treatment for mental health and the Department of Defense is taking steps to remove that stigma and get troops access to the help they need sooner.
"We recognize when people have concerns about their psychological symptoms, there is a reluctance to step forward and seek care," Arita said. "We know that the people who are most symptomatic, the people that need it the most, those are the folks who often express the most reluctances seeking care. We do know people will visit their primary care setting within the year. With mental healthcare providers in the same places as primary care providers, we can address issues as they arise, sooner rather than later."
Ballge said he wouldn't want the stigma to stop a shipmate from seeking treatment.
"I think about Vietnam vets, when there wasn't an acronym for what was wrong with them and they just drank themselves to death, or they're in prison or they're homeless; because they didn't get that treatment," said Ballge. "I don't ever want that to happen to my generation or any future generation. As awkward as it may feel and as embarrassing as it may feel to you at the time, say something. If the command's not listening, be the squeaky wheel they cannot ignore. They don't want to ignore. They want to help you."