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How to be human: how can I get help for PTSD?

SSG Mary Junell/DVIDS

Leah Reich was one of the first internet advice columnists. Her column "Ask Leah" ran on IGN, where she gave advice to gamers for two and a half years. During the day, Leah is Slack’s user researcher, but her views here do not represent her employer. You can write to her at askleah@theverge.com.

Hey Leah,

I'm not sure what I'm looking for at this point in my life. I'm not even sure looking for anything is worth the endeavor, even just as a means to an end. I've been out of the military since September 2012, and I'm having a lot of trouble living life after my two combat tours as an infantryman. One of them took me to Basra, Iraq, and the other to the Korengal valley in the Kunar Province. The VA gave me a high disability rating for PTSD — both from the military experiences and latent from my being physically, emotionally, and mentally abused by my biological mother.

You know, I've tried to drill it in myself that I am okay with my life, that all the abuse was worth enduring in the end because I am a stronger person as a result, but that's the misdirect because that can't possibly be true. I'm tired of carrying all the rage and hatred for my family. I am tired of seeing my dead friends. I am tired of being able to live and they're not, but I feel like I don't even know them anymore at this point.

I've always somehow pushed through the hardest parts of my life because suicide has always felt like an abstract idea, as in something I couldn't or wouldn't be able to do. Now I find myself not one foot from a loaded handgun (I won't be so pedantic to say the world would be better off without me because it wouldn't matter if I was here or not. Nothing would change, no lives will be affected in the long term), and it's an idea I contemplate every single day. If it were not for Canines with a Cause, who gave me the most wonderful companion service dog anyone could ever ask for, I'm sure I would have shot myself in the head like two of my friends did. I've tried everything from medications that either don't work or do work but cause ridiculous side effects. I sold my car because I was too terrified to drive when I came home from Iraq in 2012, and I've been exclusively riding my bike to get around since September 2013 because the VA can't let you know enough that exercise will only do me well. I have tried to involve myself in the community here, I even help lead a really popular, previously established community bike ride every Thursday night. Everyone I meet feel like distant acquaintances hanging in an orbit around me that is just out of reach.

The only family I have left are my grandparents on my mother's side, and while I know they love me and want the best for me, they really cannot help me. All their answers revolve around religion, and religion is the last thing that I need to contend with because facts are more comforting than faith. I have my biological father not 10 miles from where I live now, and I have a younger brother, and sister. The thing is, that side of my family loathes my existence because my real father sees me as a mistake of his past before he met his current wife and started his current family. They want nothing to do with me, and that hurts so goddamn badly because I want nothing more than to be relative to someone, to have someone give a shit about my life other than me because even on my best days, I can barely muster the care about my own life. I would absolutely love to have to have a younger brother and sister in my life, but my real father poisoned their minds against me by telling them shit like I'm only back in the picture to collect all the child support he didn't pay for 18 years. I don't know where he got that idea from. The last time I talked to them was on my birthday in 2012.

I just recently got out of a volatile relationship with a woman that is bipolar, not medicated. I had to deal with her mood swings that were so heavy, they felt like different personalities entirely. I had to deal with her wanting to commit suicide twice. I had to call 911 on her twice because that is not a card you can play with me for attention (as I said, I've lost a few friends that way). Thankfully, I'm through with her, and she is out of my life. One thing she showed me though was that it wasn't empathy that I lack, but the ability to be a nurturing person. I was once told by a civilian psychologist that it was a miracle I didn't turn into a sociopath. It felt great hearing that, having to contend with that idea.

You know, I'm not without plans. I have plans for my future, and I want to accomplish many things, but every day it gets harder and harder. I am in school right now, but I am on track to burn out very soon. I've been going nonstop since January 2013 for at first a BS in psychology, but now in sociology. It is difficult being almost 32 at a university of most people in their late teens / early twenties.

I am not sure what to do anymore. I question everything, everyone. I can't make it through a single night of sleep. I don't have anyone I'd call a real friend. I don't have any more family that will be in my life for the long term. I feel lost and I want to feel found, and I feel like if I knew how to do that, I wouldn't feel lost.

Regards,

M.

Dear M,

I've been thinking about your letter for a while, turning it over in my head, holding it in my heart, wondering how to respond to it. This is a hard letter, and an upsetting letter, and a wildly complicated letter. I can't solve this. I can't just give you some thoughtful advice that will make things feel a lot better. But I can do one thing, which is let you know you are not alone. I don't mean in the "other people have experienced this" way but rather that someone out there cares about you and wants you to be okay. That's me.

I also want to tell you that, because I am not a medical doctor or a licensed therapist, I am not able to dig in like I might want to — to help you with your PTSD, your abusive mother, your friends' suicides, and everything that is tormenting you so deeply. It would be dangerous and stupid for me to try and help you with that specifically. I also realize that the sorts of "invisible" casualties many veterans have are devastating, and what I say may be useless in a situation like yours, tiny imperceptible drops into a vast, empty bucket. But I will do what I can.

Let me begin by saying I cannot for one moment begin to imagine all you have been through. I am grateful for your service, and I am deeply saddened by the fact that it has cost you so much. You have lost friends, your mental well-being, your sense of direction in life, even your sense of place in your own generation or cohort — by which I mean you are finishing college rather than being able to think, "I am at a similar place as my peers, people my own age." On top of this, you have the abuse you endured from your mother and the awfulness coming from your father and his family.

M., I do not want you to commit suicide. I am worried that you will, so please, if you read this, email me and tell me you're okay. I also want you to know that I do not think considering suicide means you're a coward. I do not think people would kill themselves if they truly did not feel lost, if they felt they had any other option available to them to relieve the torture and pain they endure every single day. I do not say this to hurt those who have lost loved ones to suicide — which includes you — but to acknowledge that the pain you feel is real. Suicide is not about trying to hurt your loved ones. It's about feeling as if there is no light at the end of a single tunnel in your life, and there's no way to imagine feel any other way than the terrible way you do.

So let's talk about ways you can find a toehold or two that allows you to climb out of this very bad hole. I want you to feel like there is another option, even if that option is the same hard, long road toward something better that you've been on.

Of all the things that jumped out at me in your letter, the idea that somehow the abuse was worth it is where I feel like we can start to untangle this knot. Abuse and loss are never "worth it." I know that you know it, because you tell me how tired you are. You tell me you are angry and hurt and full of rage; and frankly you have every reason to be. This is what I want you to focus on for a minute: It is okay for you to be angry. It is okay for you to be tired. It is okay for you to feel lost and scared. It is okay for you to want someone to be close to — to want someone who can understand you.

It is okay.

By okay I don't mean, "it's good you feel these things." I mean you should listen to that voice that is telling you, "I am tired and I need to stop pretending this is okay." You don't need to be tough and strong, telling yourself somehow everything has been for the best. Give yourself permission to feel all these things, as bad as they are. It seems counterintuitive, I know. "I want to feel better — not all these terrible things!" But admitting those feelings are real and having someone validate you — yes, they are real! — can be a huge relief. Not struggling against them anymore will give you more energy to actually address them.

I want you to be able to accomplish all you've set out to do, I don't want you to burn out, and I certainly want you to be able to sleep. You mentioned a civilian psychologist. Do you still have a therapist, one who specializes in veterans and PTSD? I imagine you do, but if not, I want you to promise me you'll look for one where you are. Someone like these women who live in the Pacific Northwest. If you are seeing a therapist, please be honest with him or her about just how bad things are. It's not your suffering that has made you strong — you are strong, which is how you've managed to survive all of this. You're carrying the mental equivalent of a great whale on your shoulders, against the tide. No wonder you're burning out.

Are you involved with an organization that provides support to veterans? Again, I assume you are, so please let them know you need extra support. Ask them about other resources where you live. Have you spoken to anyone at your university about resources for supporting older students? There may be someone who can help you with burnout, and also with connecting you to other older students.

Here's something I also want to suggest: have you considered talking to a therapist about finding somewhere to volunteer? The reason I want you to talk your therapist is I want you to find somewhere that won't trigger your PTSD. The reason I want you to volunteer is that I want you to find a way to get out of your head, if only for a little while each week. This is valuable and necessary even if — heck, especially if — you're a loner. I'm not asking you to make friends or suddenly start depending people. I'm asking you to do something that has nothing to do with you, your life, your school, your traumas. For example: visit the elderly, who often have no one visit them for months or even years at a time. Is there a Little Brothers Friends of the Elderly group where you are? You can visit them in their homes, help throw holiday parties for them, spend time with people who will tell you stories and give you a chance to forget about your own.

M., the thing I want you to do most of all is know that you don't have to be strong and tough. You know, when I think about being strong and tough, here's what I think about: I do a lot of yoga. (I know, nothing is more boring than hearing someone talk about yoga except hearing someone talk about her dreams, but bear with me.) One time, some years ago, my teacher said: "An advanced yogi is someone who will use props." I remember thinking, "What! That seems so backwards!" But as I continued in my practice I understood what she meant. An advanced yogi knows where her body is. She knows where she is and how far she can push herself. She knows that in order to keep practicing she has to keep breathing, so she shouldn't push herself so hard or tangle herself up so much that a deep breath becomes impossible. If she needs a prop, she uses it, because that's, oddly enough, how she will get stronger and better for real.

I know you feel alone. Hell, I know in many ways you are alone. And maybe, by nature or by circumstance, you're kind of a loner. You know what? It's okay to be a loner, but being a loner doesn't mean doing everything on your own. Be an advanced loner: find resources to lean on so you can get stronger in a way that isn't your brain trying to carry this unnecessary weight.

You aren't alone. One person is out here cheering her goddamn lungs out. If you take nothing else from this letter, take that, and lean on it.

Lx

A note from Leah: If you or a loved one are experiencing similar issues, there are resources available to you. If you are in a crisis situation, there are multiple hotlines you can call to speak with someone immediately. Other valuable resources include the Palo Alto VA center, which has some of the world's leading researchers and clinicians in PTSD. You can look specifically at the Men's Trauma Recovery Program (MTRP). There's also The Coming Home Project. If you are suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-8255.