Tuesday, September 12, 2006

Post Traumatic Stress Disorder Highlighted During 9/11 Anniversary

By John E. Carey

The tragedy of September 11, 2001 and other horrific events, remind us both of the resiliency and frailty of the human mind.

After an extremely emotional and gut wrenching event, some people’s minds seem to totally erase the bad memories. The mind seems to heal itself by discarding agony.

Other people relive the difficulties over and over again in flashbacks and in dreams. These people suffer from what is now called Post Traumatic Stress Disorder or PTSD.

The National Mental Health Association defines PTSD as, "an extremely debilitating condition that can occur after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened."

PTSD became a common clinical term when doctors began dealing with thousands of men suffering the ill effects of the disease during the Vietnam war.

Today, there is something of a surge in PTSD patients in treatment because of the wars in Iraq and Afghanistan, 9/11 survivors, Hurricane Katrina victims and others.

"It can be pretty scary and hard to deal with, especially if they witnessed some death and violent behavior," said Paddy Kutz, executive director of the Mental Health Association of Licking County, Ohio. "We're in a different kind of world and the stress is enormous."

Many PTSD sufferers do not seek medical treatment because they fear the stigma of being labeled crazy. But without treatment, PTSD can become a life-long, debilitating and chronic problem leading to drug and alcohol abuse or addiction, marital difficulties and divorce, and violent behavior leading to criminal prosecution.

In the Vietnam era, finding adequate PTSD treatment wasn’t easy, in part because of this stigma, peer pressure and the macho ethos of the infantryman.

"Post Traumatic Stress Disorder is not a dirty word," said Vietnam veteran Dale Bradshaw. "It doesn't mean you're nuts."

Another Vietnam veteran, Russ Clark said, "It took me a long time to even recognize I had some issues -- 25 years. I put on a good front, and I'm grateful I was able to do that because it kept my career going, but I knew inside things weren't right."

Today, the Veterans Administration and a host of help and support groups encourage sufferers to come forward as soon as symptoms are noticed.

PTSD symptoms are usually categorized as intrusive, avoidant or hyperarousal.Intrusive symptoms include flashbacks, nightmares and intrusive memories or emotions.

Avoidant behaviors include efforts to avoid emotional involvement or relationships, avoiding taking responsibility for others, and avoiding any situation that may replicate the source experiences of the PTSD.

Hyperarousal behaviors include exaggerated startle reactions, explosive outbursts, panic attacks, and sleep disorders.

Dr. Eve Carlson and Dr. Joseph Ruzek of the National Center for PTSD wrote, “When people find themselves suddenly in danger, sometimes they are overcome with feelings of fear, helplessness, or horror. These events are called traumatic experiences. Some common traumatic experiences include being physically attacked, being in a serious accident, being in combat, being sexually assaulted, and being in a fire or a disaster like a hurricane or a tornado. After traumatic experiences, people may have problems that they didn't have before the event. If these problems are severe and the survivor does not get help for them, they can begin to cause problems in the survivor's family.”

Dr. Carlson and Dr. Ruzek encourage, in fact urge, sufferers and their families to seek help.
“Although individuals with PTSD may feel overwhelmed by their symptoms, it is important for them to remember that there are other, positive aspects of their lives,” Dr. Carlson and Dr. Ruzek say. “There are helpful mental-health and medical resources available, and survivors have their strengths, interests, commitments, relationships with others, past experiences that were not traumatic, desires, and hopes for the future.”

And the human brain is a lot more resilient and self healing than many people realize.

We wrote the follow essay a few years ago and it is still relevant to the discussion of PTSD.

The Doctor: A Civil War PTSD Casualty?

By John E. Carey
The Washington Times
July 31, 1999

During the Civil War the concept of “post traumatic stress disorder” did not exist. Physicians and family members close to disabled veterans certainly knew and understood the mental toll the carnage of battle inflicted on mind and body. Dr. William Chester Minor, himself a trained physician, suffered paranoia, uncontrolled fits of rage and severe headaches and nightmares after the Civil War. Ultimately his illness resulted in irrational behavior culminating in the murder of a complete stranger. Admitted to an asylum in 1872, he died in 1920 after making a major contribution to one of the most important books in the English language.

William Chester Minor, son of Eastman Strong Minor, had all the benefits of privilege. He enjoyed the advantages of a fine family name, wealth and education. His father, a true aristocrat, headed the seventh generation of Minors in the United States. Most of the Minors had established themselves as key members of the community dating back to Pilgrim times. Indeed, the property for Oakwood cemetery and an early Methodist Church expansion in Falls Church, Virginia, was donated to the church by a descendant of George Minor (T. Harrison) in 1818 (ironically, Union troops destroyed the church in 1861).

Eastman Minor closed his New England printing business, and with his wife Lucy, traveled to Ceylon (now Sri Lanka) in 1834 to spread the gospel of Christianity among the “brown peoples” from India through Singapore and up to Bangkok. William was born seven months after their arrival. Orphaned at the age of three, he saw his father re-married to another widowed missionary by the age of five.

William Minor’s father and other clergymen preached about the evils of sex and the damning temptations of the flesh. Yet young William witnessed first hand the local tropical girls bathing shamelessly naked (and apparently without fear of guilt or sin) in the surf – a vision and a dichotomy that would haunt him into adulthood.

A gentle soul, William took to water colors and other artistic pursuits. But his first love was a life-long admiration for great written works.

By the age of twelve, William Minor knew several languages and could ably navigate the back streets of Rangoon, Singapore, and Bangkok.

Sent back to the United States, William Minor completed a classical education and graduated from the difficult School of Medicine at Yale. He spent nine years in medical apprenticeship before he volunteered for service in the Union Army just four days before the Battle of Gettysburg.

After months of service far from the front, Dr. Minor was plunged into the horror of war. He was with the Army at the battle of the Wilderness, and heard wounded soldiers of both Armies crying out in pain as fire swept through the dry kindling of the battle ground. He amputated limbs and witnessed the terrible wounds inflicted by the large caliber lead rounds and cannon shot of the day. He saw gangrene, filth and infection frequently.

After the Wilderness, Dr. Minor was pressed into service by a court martial for a most unusual and difficult assignment. A Union Army deserter, an Irishman by birth, had been caught. This deserter was to face judgement in the field. Found guilty of a hanging offense by a hastily arranged court martial, the “merciful” court ordered the deserter branded on the face with a D, marking him forever after as an army deserter.

This fairly common punishment permanently marked former soldiers for shame. For an Irishman, this was a particularly heinous sentence, for it barred a man from returning to participate in the covert war against the English monarchy. The face scarred with the D alerted law officers who would watch or apprehend the wearer.

Dr. Minor was ordered to mete out the punishment of the court martial. Using a red-hot branding iron, the hesitant doctor carried out his assignment. But the sight and sound of searing flesh and the conflict with the physician’s Hippocratic oath haunted Minor for the rest of his life.

At war’s end, Dr. Minor was performing autopsies at the military hospital in Alexandria, Virginia. As he moved from posting to posting after the war, he began to exhibit unusual behavior. Irishmen, he believed, entered his quarters to molest him while he slept. He began to frequent the most unseemly establishments in the slums of New York. He complained of headaches.

Minor spent time in the government insane asylum that we now know as Saint Elizabeth’s in Washington, D. C. But doctors were unable to conclusively diagnose his illness. Then, at the urging of his family, Dr. Minor went to Europe, where, it was hoped, he could rid his mind of torment. Dr. Minor expected to read, read and paint.

But there was no escaping these post-war demons. Waking in the dark of night while living in London, Dr. Minor went into the street and shot to death a man on his way to work at the local brewery. Dr. Minor believed he had chased one of his Irish tormentors out of his apartment, but at his trial, the landlady proved that no one could have entered his locked chambers.

Convicted of murder and found to be insane, Dr. Minor was sent away to the Broadmoor insane asylum in England in 1872. While Grant became President of the United States and Chamberlain became Governor of Maine, William Chester Minor faced incarceration for the rest of his life.

But the story doesn’t end here. Dr. Minor, an educated man who became a physician because of his dogged determination and dedication to good study habits, used his Army pension to start his own library. He collected the best titles and authors of the English language. Ultimately he contributed twenty years of nearly continuous study effort to the editors of the Oxford English Dictionary.

William Chester Minor: student, physician, artist, Civil War veteran, murderer and lexicographer. Dr. Minor’s story has recently been illuminated by Simon Winchester in his book The Professor and the Madman, which sheds light upon the Civil War, the nature of man, and the roots of the English language.