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Grief Beyond Grief: Post-Traumatic Stress Disorder

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This recent, rabid gunman killed and injured too many. There will also be those families, friends, fellow students, and even many delicate young minds, who find that post-traumatic stress visits the grief that underlies grief. It does not need a war, even though we have one, to create the battle-scarred and shell-shocked. Virginia provided them, as did Columbine, the mass killings of women in Ciudad Juarez, the severed heads in Acapulco, the tsunami, and the legion of killers who sap the life out of America in the anonymity of endless highways and anomic sameness.

Lord Peter Whimsey suffered it from the trenches of Europe in that stiff-upper-lipped British society. He had Bunter the valet to care for him and sweet mysteries to saunter through. He could still say, “Toodle-pip” even if the bloody fields came to him in nightmares. The real stuff is the sad grit of life and death. It is the horror that undoes the human condition or is, perhaps, the base of the human condition.

It is insidious when it hides behind grief and mourning. It is the step beyond. The victims are those who cannot stop grieving.

I planned to write this week on a Steven King novel of little substance (but fun) or the E. Annie Proulix novel, The Shipping News , but I am still enjoying reading it. Then came the sadness and depression of a world that seems to be suffering collective post-traumatic stress disorder (PTSD). The Monster of Virginia changed my mind. Instead I thought that this is the important subject to keep in front of the public; in front of parents who may need to help children cope, to help young people weather their sadness and fear.

Even doubting the myths of heaven and hell, I believe fervently in the dichotomy of good and evil. Evil lurks and, if allowed, festers, boils, and strikes. The hurt hurts and subsides or, for some it dominates and disables. That is the nature of post-traumatic stress.

It is a kind of anxious reaction triggered “… by an extremely traumatic event.” It can happen when that event happens to you or to another or others. It does not have to be the blood bath in Virginia or the Muslim murders of innocents in Iraq or Israel. The disorder can be a result of sexual or physical assault, airplane crashes, cataclysmic natural events as well as the horrors of war, torture, or damage and death of one you love, your classmates, or pals.

It needn’t be totally direct. Rescue workers who work too long with gunshot victims and car smashes, those who attend mass tragedies suffer the “fear, helplessness or horror” that is this stress disorder. It is real. It can be serious or deadly. Telling someone who is being dominated by unending grief and horror to “snap out of it” doesn’t cut it.

Real disorders have real symptoms and it is important to watch for them in those who have suffered losses or trauma. Without treatment — self-administered or not — the symptoms may get worse. They can be disabling or terminal.

PTSD normally starts within three months of the horror. Sometimes symptoms wait years to appear. Since many are the normal reactions of grief and mourning, it is only the severity and lack of improvement that indicates a problem beyond what is the mind and body’s way of dealing with catastrophes.

Symptoms of stress disorder may include feeling emotionally numb, suffering unreasonable guilt, hopelessness, sleep and memory disturbances, losing interest in once enjoyable activities, hallucinatory thoughts, flashbacks, dreams and nightmares, anger and irritability, or self-destructive behaviors – among others.

In a first-person account by Dr. Edward Creagan at the Mayo Clinic, he recounts his feelings on the loss of his mother to bring us to a personal feeling in his narrative. Then he, doctor that he is, gives us his advice. He lists the ways in which to cope with grievous loss including allowing yourself to actively grieve and mourn. “Both grief and mourning are natural and necessary parts of the healing process,” he says, and warns that if you have not faced your feelings, the wounds may never disappear. Accept your need to grieve or it can return years later as “headaches, intestinal problems, psychiatric difficulties, eating disorders, or chemical dependency.”

He goes on to suggest the importance of sharing your feelings with others and to search (as the ‘Net shows our world needs in Web 2.0) for “community — connectedness – to heal.” He warns that decisions of importance — where you live, changing jobs, or taking new financial steps — should wait for four to six months or be over-seen by trusted others guiding.

Don’t let yourself go. When we grieve we use a lot of energy doing it. Stopping or losing interest in eating, bathing, sleeping or, especially losing the will to live can “… put you at higher risk of health problems, such as depression, insomnia and heart disease.” Time, he reminds us, heals all – sort of. It will help, “but your feelings of loss and emptiness may never completely go away.”

Dr. Edward Creagan, an oncologist who deals with the pain and death of cancer patients presents a descriptive look at a nebulous affliction, but a personal one and one that appears to be valid. The Mayo Clinic newsletter, MayoClinic HouseCall, suggests that it is not abnormal to suffer a number of similar symptoms after a traumatic event. Flashbacks, sadness, bouts of crying, and loss of appetite for the first month are normal and part of the process. However, if the symptoms are too severe and last more than a month or threaten to affect your life strongly, you need supportive help or, suggests the Mayo Clinic, “professional help.” They also discuss anti-depressive medications and even the use of beta-blockers to help control anxiety.

If you do not act to break the increasingly severe cycle of sadness, loneliness, and even self-destructive behavior (drinking, depression, suicidal thoughts, etc.) the results can “… disrupt your whole life, from your job to your relationships to your enjoyment of everyday activities.”

The National Institute of Mental Health (NIMH) offers an article on how to deal with and explain traumatic events to children and adolescents. This extensive part of the site includes a PDF download of their guide to working with children and adolescents. The Medicine Plus site has similar information in Spanish. Importantly, NIMH lists a number of things not to do for kids and adults after a tragedy. This includes not pushing for information or for their stories of the event, not saying stuff like “Everything will be okay” or that others suffered because of their actions or beliefs, nor should you make promises that you cannot reasonably expect to keep.

NIMH’s Medline Plus also notes that fully 30% of returning vets from the wars are coming home with PTSD. Vets and their families can turn to NIMH for advice. There is also a PTSD Alliance funded by Pfizer that offers an extensive website. The United Kingdom offers Mind.org, a part of The National Association for Mental Health.

The British make an insightful observation that “Man-made disasters, particularly those involving deliberate acts of violence or terrorism, seem to cause longer-lasting and more painful emotional consequences than natural disasters. The crucial factor may be that it destroys people’s trust in others, particularly when it involves someone they depended on.”

The tragic evil that overtook Virginia Tech is that sort of disaster and the effects will be longstanding in young people and perhaps in the psyche of our already damaged nation. They also note that those who feel themselves guilty or culpable in some way stand a much larger chance of developing PTSD. This is not surprising, but it needs to be addressed. Guilt is so easy in our society. Often there are those who would
“innocently” fan the flames of that guilt with thoughtless statements. Time may heal, but it may not heal everything. Those who care should be vigilant for the symptoms of PTSD and work to alleviate it or look for competent and caring professionals.

I mourn for those mowed down by this evil and for those left behind to face grief and the possibility that it will affect their lives substantially. I mourn, too, for those whose previous losses, sensitive natures, or childish innocence will be affected by the actions of a non-entity who became a devil.

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