Q. Since my husband returned from his last tour of duty, he has been drinking more, constantly irritable, and verbally abusive. I am afraid that he is going to harm me, but he refuses to get help because he doesn’t think anything is wrong with him. What should I do?
A. Some sources estimate that 1 out of every 3 soldiers who return from combat in Iraq and Afghanistan has Post-traumatic Stress Disorder (PTSD). Yet 60 percent of them will not seek help. The symptoms that you are describing are those reported by many spouses and family members. The Department of Veterans Affairs has established several worthwhile programs for individuals to receive the assistance they need in returning to civilian life; however, your problem is getting him there.
If you have not already done so, try calmly talking to your husband about your fears. Let him know that you are his partner in dealing with the trauma. Offer to go with him to meet with a mental health professional at the Veteran’s Affairs Hospital. Most centers have individual counseling, support groups for veterans, and groups for partners or spouses. Reassure him that there is nothing unmanly about having PTSD or in seeking help. It does not mean that he is “crazy” or that he cannot manage his life, but that he has been exposed to trauma that few of us can imagine.
If a calm discussion does not help, you can try an intervention. Involve his parents, friends, or anyone close to him. Let him know that all of you love him and are concerned that his behavior is damaging his relationships and his future. A trusted male friend may convince him to seek help when you cannot.
If he still denies he has a problem, you must take care of yourself. You need to find a place away from him so that you feel safe should his behavior escalate. Any time you feel that you are in danger, you must leave at once and seek assistance.
Q. My wife was in a serious car accident last year. She’s afraid to drive, and gets anxious when she’s in a car with anyone. In the last few months, she doesn’t want to leave home. Can the accident really have had a long-lasting impact?
A. Although many people think Post-traumatic Stress Disorder (PTSD) is only caused by combat fatigue, we now know that survivors of accidents, serious illnesses, domestic violence, and other types of trauma are also at risk. From your description, it sounds as if PTSD could be your wife’s problem. Research indicates that any extremely stressful event can cause structural and functional brain changes which bring about PTSD symptoms.
The emotional and behavioral symptoms of trauma vary according to the incident and the individual’s coping mechanisms. Your wife may also have difficulty concentrating, an exaggerated startle response, excessive irritability, and nightmares. Additionally, she may experience symptoms such as agitation, faintness, a rapid heartbeat, and a feeling of impending doom. This heightens her fear of leaving home. One of my patients, whose office was close to the World Trade Center, could not use public transportation or go to work for several months after 9-11. Another patient, who had breast cancer, became fearful of leaving home because she was experiencing constant panic attacks.
Your first step should be for your wife to meet with her primary care physician. You need to rule out any physical disorder that can resemble PTSD. If there is no underlying physical problem, then your physician will most likely prescribe medication and refer her to a mental health professional.
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Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to email@example.com. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.