I want to give you some helpful information by talking about PTSD, TBI and depression. I have all three. In the last six months I have made tremendous strides to take my life back.
I know a lot of friends and family members who have these issues. Hopefully, reading about them and sharing what I’ve learned will help those suffering.
My goals in this emails to be as honest as I can. Some of these issues are deeply personal and embarrassing, but If it helps only one person it will all be worth it.
The Black Cloud
I have an amazing life. I have a fiancé who loves me. I teach the future leaders of the army on my weekend drills. I write for a living, something I love to do.
Despite all these wonderful things I live with depression. Sometimes I am overwhelmed by overly negative feelings and thoughts.
Sometimes something brings it on like the loss of a loved one or a friend. Sometimes nothing whatsoever brings it on, a black cloud will form on the horizon of a happy day.
Living with depression is disabling and awful. All the pleasure is sucked out things I love to do. I start to leak confidence and become blind to the good things in my life.
I become forgetful. I can’t keep track of my finances, or remember simple appointments because I am overwhelmed by feelings of self-loathing and a loss of self-confidence.
I become a stranger to friends, family and myself. I tell people I am doing well. In reality I can’t bear to clean the house or simply do the dishes.
The worst thing is I lose all my compassion and become selfish. I feel like a useless, ugly, stupid blob. In this state I become unpredictable, afraid and lazy.
I miss the old me full of energy, brimming with confidence.
Over time I see glimpses of my old self. It becomes harder and harder to get up the in the morning and face the day.
The worst part is how I see myself. I feel like a bad person, a rotten, selfish human being.
I feel like I fell down a black hole. I quit taking care of myself and forget to bath and eat. I feel like I will be stuck here forever.
I lost track of time, each moment feels like forever. I’m completely alone on Depression Island. I am isolated, trapped and nothing will ever be the same again.
It becomes harder and harder to get out this frame of mind, to see any hope.
I am Italian and Catholic- we do guilt, not suicide.
I do know why people kill themselves when they feel this way. It is draining and leaves you so tired you don’t want to go on. You feel once you’re gone you don’t have feel these negative feelings anymore.
At some point I decide to fight back. I am determined to be strong and I remind myself I live through this. I usually do something fun to let my feelings flow.
I learned this state of mind has nothing to do with will power or attitude. It’s like being bald or short, it is what it is.
I have tried all sorts of remedies to relieve my depression: yoga, running, hiking, behavioral cognitive therapy, regression therapy, group therapy, religion and meditation.
Some helped and some made no difference at all.
Sometimes a good night’s sleep was helpful. Sometimes I stay stuck in the hole for a few days. I realized this last time I needed some professional help.
What I learned
Some depression is hereditary like male pattern baldness or brown eyes. I was probably born this way with a temperament towards depression. I think it has very little to do my experiences in the military.
It’s a well-known fact that some families have a disposition toward depression. I am reminded of the “Hemingway curse.” Ernest, his father, his brother, his sister and granddaughter all killed themselves after suffering from severe manic-depression.
Part of it may be a chemical imbalance in my brain.
The brain is a magnificent organ. It is the command and control of your body.
The brain is very soft. It is the texture of soft butter. Only thin layers of fluid-filled membranes cushion the brain from impact.
The brain sits in the skull- a hard helmet of bone that protects the brain. The skull is full of bony ridges and sharp points. When you hit your head, the brain hits these hard places. This causes Traumatic Brain Injury (TBI).
My real problems began about a few months after I got home from last tour in Afghanistan in 2012. I started to slip into a parallel world for minutes at a time. Instantly, I was back in Afghanistan, sometimes Iraq, but mostly Afghanistan.
Sometimes it was in dreams, other times it was when I was awake in flashbacks. I had the same feelings and sensations I felt there. It seemed very real.
Once in a while I would replay the explosion that killed Bruno. Other times it was stuff that happened in Iraq. I would snap back to a former reality during a deployment and exist in it for a period of time.
The war for all the things wrong with it became the defining experience of my life. There I was loved, and had purpose. I took part in the adventure of my generation.
I started to write down what was happening. It was a repetition that became a compulsion. I began to understand that my flashbacks were an overwhelming need to repeat the experience, to resolve it.
I was replaying the movie in my head to get a satisfactory ending. I just couldn’t let go of it. I was living both a nightmare and a dream. This was PTSD.
TBI is a physical injury. PTSD is the mental injury. The combination of PTSD, TBI and depression is a “perfect storm.” Symptoms of the three can be overpowering and destructive. Sometimes they overlap.
The rate of PTSD is much higher in veterans who have a brain injury.
In 2005 I was blown up in a small explosion in Iraq where I hit the side of head. It knocked me out for a minute or two. It was not that severe. It was early in the war.
Three years later I hit my forehead on the steering wheel in the initial explosion that killed Bruno.
I hit the side of my head on the door and the roof of the truck as the truck blew apart and into the air. I was knocked out for 10 minutes. I woke up and passed out twice before Jerry rescued me.
Surviving an Explosion
An explosion does horrible, violent things to the human body. A blast wave is like being hit with a tsunami, then an instant later you are pulled back into the ocean to drown. This all happens in an instant.
A complex pressure causes the explosion. A wall of heat, pressure and sound hits you at over 700 miles per hour. The blast wave passes through your eyes, nose and mouth.
Air filled organs like your lungs and gastrointestinal track lose all oxygen. A fraction of a second later, debris and fragments fly through the air.
I hit the steering wheel with my forehead, the roof and cab of my truck. I hit my head three times in less than five seconds. Each hit was like getting whacked with a baseball bat. I had major problems.
I smacked my forehead where my prefrontal cortex (PFC) is. The PFC is the part of the brain handles decision-making, planning and impulse control mixed in with depression and TBI. I was a perfect cocktail for a disaster.
My brain injury gave me a lot of problems in the years after the accident.
I can tell you from personal experience, having issues mentally like impulsiveness or memory problems is not lack of will power or a bad attitude.
Compulsiveness is not about rigid people who are over controlling. Understanding and optimizing your brain is sometimes the missing link to being successful in getting better.
A Brain Injury
My problems came from a brain injury. There was no “getting over it” with willpower or a positive mental outlook. A high performance car doesn’t run with a busted engine and a cripple can’t walk with a spinal injury.
When the command and control center of the body is injured everything else is broken.
I had no patience over trivial things like waiting in line or being struck in traffic. I was anxious or frigidity. I couldn’t talk about happened without getting angry.
I was dealing with the physical and mental scars of war, things had changed while I was away. I lived in four places in two years unable to settle down.
I knew I had to understand what happened to get better.
The Human Brain
The brain is the most complex organ in the human body. It is made of billions and billions of nerve cells. It is estimated there are mores nerve cells in the brain than stars in the known galaxy.
A single piece of brain tissue the size of a grain of sand contains a hundred thousand nerve cells. These nerve cells make up your personality, character and intelligence. It’s what makes us who we are.
Dopamine, the pleasure and motivation brain chemical, and serotonin, the happy and anti-worry chemical, help with anxiety, depression and obsessive thinking. When there’s too much or too little of these chemicals between connections with nerve cells things get out of whack.
Anti-depressants get things back on track. They can help to regulate, generate and control the flow of chemicals in the brain. I have seen them help some patients and hurt others.
The brain and body connection is amazing. In Iraq after my buddy Phil died, I started to lose my hair. After getting blown up in Afghanistan what was left of my hair turned white, and I had an unhealthy skin tone.
In three months after getting home I put on 20 pounds. The mountain of physical and emotional stress took a negative toll.
When you have chronic physical and emotional pain life is a struggle mix in depression and life can be become unbearable. Everything gets mixed up and seen through the prism of pain and jumbled thoughts.
Pain, both physical and emotional, is a very personal thing. Pain is a monument to wartime trauma. Pain makes you divide time into two parts: before the pain and after.
Bruno died in September, I went to my buddy Bruno’s funeral in October- where I told his loving parents how their brave son died, while I lived- and I watched Phil’s murderer be acquitted in December.
In the last three months of 2008 I aged ten years.
From that day on I grew weary and worn out. The experiences drove me like a stolen car. I was run too far, too fast and never maintained. I was broken.
My own combat experience is what baseball players call a “cup of coffee.” It’s a slang term for a minor player getting in one game of major league of baseball.
I saw enough combat for a “cup of coffee.” I’ve been shot at and mortared but never anything serious. A few frantic, scared seconds with a couple of rounds. It was over before it started.
My issues came from PTSD and TBI. It wasn’t about the duration of the experience, but the intensity. My problems were chronic pain, flashbacks, nightmares and depression.
My worst symptoms were memory problems. Negative thoughts and images lived in my subconscious.
I would be having a normal day and a damaging thought or image would invade my brain. I’d forget where I was and what I was doing. It was ruining my life.
Last fall, with the love and support of my fiancé, Muna, I decided to get professional help.
Over the past couple of years, but more so in the past 6 months, I really had some problems- physically (knee/shoulder/back pain and balance issues), mentally (lack of sleep, memory and concentration issues), and emotionally (withdrawing, loss of interest in formerly fun activities).
My issues snuck up on me. They were cumulative. Being a soldier is a hard life. Physically, mentally and emotionally it can be draining. The physical pounding of over 20 years in the army started to add up.
My real problems were sleep issues. At first I didn’t see it. Over the years, five hours turned into four hours turned into three hours and 45 minutes.
Good health begins with a good night’s sleep.
Having chronic pain, with PTSD, TBI and sleep issues is like living in a dumpy third world country with a strange language and unfamiliar culture- everything is hard and crappy.
It was ruining my life. Mix in all the fun of anxiety and depression and you have a perfect cocktail that drained my well-being. All of it makes you feel worn out and far too old.
In the past five months I did one-on-one and group therapy. I started eating right, taking fish oil and vitamins, exercising for 30 minutes a day, sleeping for at least 6 hours a night and got better at handling the stress in my life.
I feel younger, clearer and vibrant. The best thing I did was start to write again. It’s what I love to do most. It gives me joy to help others. I can’t draw, so I write.
It is important to re-enter the world when you feel strong. I feel like I can cope and work through life’s surprises.
Depression is tricky. It can be a one-time event or it can be long haul, lasting days or months. Either way you’ll have to wrestle with it or hide it when you have to.
Sometimes being positive makes you end up feeling positive.
Getting through depression and my other issues is a big struggle. It’s a victory when you start to come of out it. It’s like winning a title bout.
You may be a little battered and bruised but you’ve learned a few things about yourself and maybe you can help others because who have been there.
Slowly things change. Little things start to have meaning again. You survive a little at a time. Things gradually start to get easier. Maybe you’ll want to help others. Maybe you’ll even learn to love parts of yourself.
I hope this email helps by talking about it. It helps by talking about depression. Maybe you’ll have some tools for when it shows up again.