Monday, July 28, 2008

PTSD...I Have It.'s the story why: Story.

So I had my first counseling session regarding the incident above. Which also directly related to the story I related Here.

Why did it take me 6 months to seek help? Typical bull-headed, male-ego reasons. Thought it was something I could just tough out. You know, "this kind of stuff happens in this industry" etc. Turns out, screwed my up more than I than I was willing to admit. Once I did, my wife told me I needed to seek help. I found the DSM on-line and looked up PTSD.

DSM-IV-TR criteria for PTSD

In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The diagnostic criteria (Criterion A-F) are specified below.
Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor
The person has been exposed to a traumatic event in which both of the following have been present:
1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2. The person's response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection

The traumatic event is persistently re-experienced in at least one of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content
3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.
4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (e.g., unable to have loving feelings)
7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response

Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than three months
Chronic: if duration of symptoms is three months or more

Specify if:
With or Without delay onset: Onset of symptoms at least six months after the stressor

(All that's marked in red is what led me to seek counseling.)

Soooo...I have PTSD. Wonderful. Now I have to deal with it. My counselor, who said he'd wished I'd contacted him sooner and, looking back, so do I, said I have to re-tell the tale over and over again. Talk about it with others. Go back and fly planes on nice, smooth days. Realize that I'm alive, no one died, I had the shit scared out of me, no one died, what I went through was most likely a one-time experience, I'm a good pilot, I didn't do this on purpose, I will survive.

So I'm talking about it here. I will talk about it with my wife tonight when she gets home. I'll try to talk about it amongst my aviation peers.

It's amazing sometimes what can shake us to the core. What can rattle us to our foundation. Most of us see it on TV or read about in the paper or hear about it from others and silently, almost reactively, thank God it wasn't them. "There, but for the Grace of God, go I" is the phrase that I used to say. Now it is I who has gone there and, but for the Grace of God and a mighty updraft, I'm still here. We never see it coming. Or if we do, we can dupe ourselves in a matter of seconds that it won't happen to me even as the we see the word "GREYHOUND" two feet away. I used to think I could handle anything. That death didn't scare me. I knew I was going to die and yet I didn't want to. I fought it. I had two lives that were my responsibility on that plane. Yet, in the back of my mind, I knew that if I died it would be okay I just didn't want them to feel any pain. I didn't want to feel any pain. But I didn't die. I'm alive. And shook up. But there is hope, always hope.

"Cast your burden on the Lord and he will sustain you; He will never permit the righteous to be moved." - Psalms 55:22

I have that on a sticky note beside my computer. I pray it every day.


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