“We no longer talk. Lately, every conversation has turned into a battlefield of angry, loud voices. Especially last night, I knew I shouldn’t have said it but I did; I told him I thought he had PTSD. He roared at me as if I had just told him he was no longer a man. He insisted that PTSD symptoms wouldn’t even come close to anything he’s dealing with, but I’ve Googled it and based on what I’ve read I know in some way it’s all interconnected. He doesn’t sleep; I feel the side of his bed shift throughout the night. Most nights I will fall asleep before him and then find that he’s still awake when I’ve lightly woken back up again. When he does sleep, it’s paired with intermittent babbling. He says something, but I don’t usually understand his words. Other times he will jerk his body as if to escape an unknown adversary. However, when I suggested his need for something to help him sleep he again found very little importance in my words.
I’m so frustrated, but I try and keep that at bay. I should have stopped last night after it was obvious our conversation wasn’t going well, but I didn’t. I posed the question I’ve been wondering for months. Was he even happy? He answered me so quick it hurt: no! My hurt brought on my anger and I accused him of wanting to be back playing GI Joe rather than being with his family. I didn’t expect him to agree.
“Yes,” he said, “A part of me does. Deployment was simple. I didn’t have all these daily stresses like I do here. All I worried about was the mission and the men. However, that doesn’t mean I’m not glad to be here with you."
Although his last sentence was said with all sincerity, I couldn’t stop my“ rage, storming off toward my room, feeling like a child. I feel the ever-present tears sting my eyes. I am lost as to how to deal with my husband. The man I thought I knew has become distant, hard, and angry. All possible signs of PTSD. But, I’m forbidden to say that word. What more can I do? I’m losing him even if he doesn’t know it and that scares me the most.
Are you this Veteran’s Wife? Is your husband that veteran? This is not a singular situation although it feels entirely isolated. However, there is an important lesson within this fictional dialogue. PTSD in its true form is not what I’ve defined as Military Separation Anxiety. MSA has more commonly been referred to as “Transition Issues.” Let’s explore the difference here more thoroughly.
Posttraumatic Stress Disorder (PTSD). Traumatic Brain Injury (TBI). Depression. Anger. Anxiety. Insomnia. Sleep Apnea. All these have one thing in common—a bad rap when paired with the words “military veteran.” Tell someone you have PTSD and they immediately take a step back and wonder if you’re about to explode. Tell someone you have trouble sleeping and they wonder if you’re having trouble dealing with the “sins of war.” Tell someone you have depression and they immediately recommend a prescription drug. All of these conditions have levels of severity, and like “with most things in life, should be taken case-by-case. Just because you have PTSD does not mean fireworks initiate a flashback. Just because you get mad easily does not mean you need to seek counsel. The stigma of PTSD has created a no-fly zone for our veterans to discuss their troubles and be open to accepting help from those who truly do care.
Military Separation Anxiety (MSA) is different than PTSD, but they may have some common symptoms / features. For the purposes of defining MSA more thoroughly for this book, here is the definition I’ve developed:
MILITARY SEPARATION ANXIETY
A condition in which a former member of the armed services experiences anxiety, worry or fear, grief or instability (uncertainty) regarding the separation from military service or to those former service members with whom they shared a strong emotional connection (brotherhood). In most cases, this is characterized as a loss of identity, and may include anger, lack of motivation or purpose, isolation, lack of focus, substance abuse, and/or depression.
Now, let me pause to say I am not a psychiatrist or a medical doctor; I have not studied the brain or relationships. The above is not a medical diagnosis or a clinical definition. This is simply my definition based on my observations and research. Do not take what follows as a diagnosis or treatment plan. Military Separation Anxiety is different than PTSD and in fact would most often not meet the criteria to be diagnosed as PTSD. The individual who experiences MSA does not necessarily have to have experienced the emotional or physical scarring of war and the details of such. MSA presents itself at different times, with different severities, and for varying durations, depending on the individual’s length of service, type of service, and other transitional factors. As Dr. Elk described in her foreword, MSA is often mislabeled as PTSD. “PTSD is defined as an anxiety laden disorder that CAN develop after one experiences a traumatic event that poses threat or serious injury too self or another. To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
•At least one re-experiencing symptom (this differs from MSA as a transitioning veteran most likely doesn’t have re-experiencing symptoms from the event of “getting out”).
•At least one avoidance symptom (a veteran with MSA may avoidpeers and unit as he tries to separate and form a new identity, social group, and role in relation to them however it is NOT due to traumatic avoidance from the event of “getting out”).
• At least two arousal and reactivity symptoms (again, different for a veteran with MSA as it is not usual to have these symptoms around the event of “getting out”).
• At least two cognition and mood symptoms (these PTSD symptoms ARE more common seen in MSA as Hillary describes in her book: from survivor guilt to irrational sense of responsibility and thoughts such as “Did I do enough in my service?” “I didn’t make it to Valhalla,” etc.).”
My personal belief is that many vets are dealing with what I’ve described as Military Separation Anxiety. In some cases, this may also be paired with stress from their wartime experiences, which may result in co-occurring MSA & PTSD. If you are concerned your spouse is indeed suffering from PTSD then I would refer you to the National Center for PTSD or the National Institute on Mental Health for a complete definition.