Sunday, November 8, 2009

Secondary PTSD (Post Traumatic Stress Disorder)

When the S*** Rolls Down Hill...

Secondary PTSD is not a disorder which is recognized by the Diagnostic and Statistical Manual of Mental Disorders (as of the fourth edition). However, if you lived with someone who suffers from PTSD, you may notice yourself beginning to "mirror" some of their behaviors. This transformation is called Secondary Post Traumatic Stress Disorder.

You'll find often throughout this site that I reference a "wise Vietnam Veteran's wife" - that wonderful lady, who is the founder of the Vietnam Veteran Wives organization, was the first to tell me about secondary PTSD. Until that point, I really just thought I might be having a nervous breakdown.

The Many Faces of Secondary PTSD

The signs, symptoms, and effects of Secondary PTSD are just as varied as the ones exhibited by Veterans with "primary" PTSD. It really is hard to explain, unless you've lived it. However, I'm going to try!

Basically, when you're living with a veteran who has Post Traumatic Stress Disorder, you become his (or her) caretaker. You slip into a role, without even noticing it, that has you constantly watching for people or circumstances that might "set him off." You're trying to make sure everything stays in line - that nothing aggravates or upsets your vet - that everything is "perfect." Despite your best efforts, you're still getting screamed at and berated by the person you're trying to help on a much too frequent basis.

Your vet is not emotionally "there" for you. When you're upset or happy, angry or sad, you have to deal with your emotions on your own. You begin to feel ignored and unloved and start "protecting" yourself by treating others - especially your vet - the same way.

You're also probably handling all household chores, childcare, financial management, etc. You get no help (or very little) from your spouse. You're the cook, chauffeur, secretary, accountant, yard guy, child care provider, laundry service, etc., etc., etc. Everything in your family feels like it's up to you. It is a 24x7 job at which you constantly fail. It's not humanly possible to do everything - or to prevent PTSD from creeping in.

This cycle takes its toll on many spouses. You lose yourself. It's impossible to tiptoe around your vet, day in and day out, while taking care of all of life's other duties (duties normally shared between two people), without feeling the strain. And that strain soon transforms into... ta da... Secondary PTSD.

Secondary PTSD may make you feel overly angry, depressed, exhausted (but, alas, unable to sleep), overwhelmed, and just plain unhappy with the world around you. I can honestly say there have been times when I found the idea of folding a load of laundry absolutely impossible. I felt like I could not do anything right. I cried a lot and was really, REALLY pissed at the world.

What to do if you think you have Secondary PTSD...

Unfortunately, one of the reasons we started this website is there aren't a lot of resources available for family and friends of veterans who are suffering from PTSD. There are a number of counseling options available (for free) to veterans, but spouses and children are pretty much left out in the cold.

If you can afford to seek counseling on your own, it may be a good idea. However, you should look carefully for a counselor who has experience dealing with veterans and their family members. Normal, "civilian" counselors may try their best to understand, but it's like trying to explain the military way of life to someone who has never lived it... it's almost impossible.

If you can't afford private counseling or can't find someone with the right background, there are still several things you can do on your own. Try the following recommendations to see which work best for you...

Carve out time for yourself - I know from experience that this is easier said than done. But, simply giving yourself a few minutes a day to read, take a walk, enjoy a bubble bath, or do anything else that you enjoy, will make a difference.

Find someone to talk to - Ideally, you should talk to a fellow vet spouse. Again, it goes back to the difficulties involved in trying to explain what you're dealing with to anyone who hasn't "walked the walk." Most importantly, though, you should talk to a friend who is a good listener and isn't judgmental. You're going to need to be able to express how you're feeling without worrying about whether or not they're going to think you are a "bad" person. (Living with a spouse who has post traumatic stress disorder doesn't always bring out the "pretty" side of a person.)

There are several websites, etc., for vet spouses. My favorite is the Vietnam Veteran Wives (VVW) site and organization. I've joined the group and started working with them on their online forum. If you'd like to visit the VVW, CLICK HERE. It's a great way to find other spouses of veterans with PTSD.

Give yourself permission to be less than perfect for a while - A family who is adjusting to a post-combat, PTSD world, is experiencing a crisis. It's not pretty. It's not nice. And it may zap your physical and mental strength like nothing you've ever experienced. That may mean your house is messy, you're not great at returning calls, remembering birthdays, etc., etc., etc. I'm not saying you should turn into an inconsiderate slob forever. But, I am saying you've got to be willing to admit you may not be at "the top of your game" for a while. That's okay!

Get involved - Find something that lets you help other people. Sometimes the simple act of putting yourself and your own troubles aside to help someone else can help you shift your focus.

Learn to count to 10 (or 20... or 30) - Many spouses with secondary PTSD find themselves getting angry at small, insignificant things. You may find that you have little or no patience with your spouse or children. First, hopefully it will make you feel a little better to know that this is "normal." Second, learn how you "feel" when you begin to lose control (your ears may ring, you may begin to fidget, or tap your foot, etc.). Knowing these signs can let you catch your anger before it's out of control. As soon as you start to feel them, stop, take a few deep breaths, and count slowly to yourself until you start to settle down.

Counseling available at VA Vet Centers for spouses.

The Veterans Administration is currently operating 207 "Vet Centers" throughout the United States, Guam, Puerto Rico, and the Virgin Islands. These centers are designed to provide counseling and support for combat veterans. The description of the centers on the VA website, which says, "Services are also available for their family members for military related issues. Veterans have earned these benefits through their service and all are provided at no cost to the veteran or family," is a little misleading, though. Spouses are only eligible for family therapy AND only when the combat veteran is classified as a "clinical patient" with the Vet Center. The Vet Centers qualify someone as a clinical patient only when they are (1) enrolled in the center, (2) actively receiving counseling, and (3) have been to at least 3 appointments.

So, if you're interested in PTSD family therapy (marriage counseling), and you can get your hubby (or wife) to enroll for counseling, the centers are a great FREE resource. However, if you feel that you need individual counseling or your vet has refused to seek counseling, you're up a creek.

Don't get me wrong, the Vet Center that my husband is using is excellent, has a warm, friendly staff, and has been a great resource for him. I just REALLY disagree with the idea that family members cannot receive individual counseling and only qualify for services when a vet agrees to seek help. One of the hallmarks of vets with PTSD is they don't recognize they have a problem. This leaves the family out in the cold until the vet is ready to recognize his or her issues.

To view information about the Vet Centers, including locations, CLICK HERE to visit the VA's website.

To submit a message to the U.S. Senate Committee on Veteran Affairs to tell them you think family members of Veterans should have access to counseling, CLICK HERE.

Web Resources about Secondary PTSD

Walking on Egg Shells - A web article from VietNow

Dear Buttercup - A series of articles about primary & secondary PTSD from the Vietnam Veteran Wives organization. Written in a relaxed format that's a little funny & a little sarcastic, it's a nice way to read about something so serious.

Secondary PTSD Video on YouTube - 3 minutes 36 seconds - A good review of what Secondary PTSD is and how to avoid it.

Secondary PTSD Articles - A list of articles focused on Secondary PTSD available at

Key Elements in Couples Therapy for PTSD - This is a research article posted on the American Psychological Association website. It's very technical, but gives a wealth of information.

Article from Family of a Vet

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