When I left my last job, I was feeling that I was burned out. When I would walk from the car to the employee entrance, the closer I got to the door the lower my energy levels became and the less focused I was. I knew that if I kept up at this rate I would end up making a mistake that might harm a patient. So it was a great of regret that I tendered my resignation. When I started taking my first nursing class, I remember on my very first day what our instructor said. She made a few statements, all of which have stuck with me to this day; (1) do no harm, (2) above all else, be a patient advocate because in many instances they won’t be able to speak for themselves, (3) and finally, be flexible, nursing is an ever evolving discipline and that is what makes it an exciting field to work in. The exact wording may be off slightly but the message still remains clear. I tendered my resignation because I made a pledge to follow those unofficial tenets of nursing. Because I was concerned about doing no harm, I sacrificed a well paying job to do so. Not to mention I was also burned out. You might recall from my first book, one of the last things I wrote was a story about a police officer dying of COVID, well, that proved to be the final straw for me. I had just seen too many people die.

It wasn’t until a couple of weeks after I left my job and I was still having dreams about that police officer that I began to suspect that something was amiss. I had never done that before. Sure, on an occasion I would have a dream about work but never about a single patient. I also began having more and more dreams about taking care of patients and of death, in general.

I was just wrapping up my first book, so I thought that including a story about the police officer would in some way be cathartic. It helped somewhat to recount the story and to put it into writing. However, it did not take care of the problem because my dreams continued unabated. It was at this time that I began to think that I might be suffering from some form of PTSD. However, I did not give it a great deal of credence. The only reason I investigated it on the internet was to put those thoughts to rest and not to show that I was experiencing the actual symptoms.

Before I go any further with my narrative, let me first discuss the subject of PTSD a little, just in case the reader is unfamiliar with the subject. I never try to assume anything today. Everyone has different learning experiences, expertise and knowledge and no one except for God, can know everything.

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

PTSD: Top 5 signs of PTSD you need to know

• A life threatening event. This includes a perceived-to-be life threatening event. …
• Internal reminders of a traumatic event. These signs of trauma typically present as nightmares or flashbacks. …
• Avoidance of external reminders. …
• Altered anxiety state. …
• Changes in mood or thinking.

What are examples of PTSD?

It can have long-term effects, including flashbacks, difficulty sleeping, and anxiety. Examples of events that can trigger post-traumatic stress disorder (PTSD) include wars, crimes, fires, accidents, death of a loved one, or abuse of some form. Thoughts and memories recur even though the danger has passed.

What can trigger PTSD?

The most common events leading to the development of PTSD include:

• Combat exposure.
• Childhood physical abuse.
• Sexual violence.
• Physical assault.
• Being threatened with a weapon.
• An accident.

How long does PTSD last?

Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic. A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

Impact of PTSD on relationships and day-to-day life

PTSD can affect a person’s ability to work, perform day-to-day activities or relate to their family and friends. A person with PTSD can often seem uninterested or distant as they try not to think or feel in order to block out painful memories.

What does mild PTSD look like?

Symptoms of uncomplicated PTSD include: avoidance of trauma reminders, nightmares, flashbacks to the event, irritability, mood changes and changes in relationships. Uncomplicated PTSD can be treated through therapy, medication or a combination of both.

How do you calm down from PTSD?

Coping With Triggers

1. Deep breathing.
2. Expressive writing.
3. Grounding.
4. Mindfulness.
5. Relaxation.
6. Self-soothing.
7. Social support.

Can PTSD be cured without treatment?

As with most mental illnesses, no cure exists for PTSD, but the symptoms can be effectively managed to restore the affected individual to normal functioning. The best hope for treating PTSD is a combination of medication and therapy.

PTSD Test

1. Test
   Questions
2. Demographic
   Information
3. Your
   Results

• Sometimes things happen to people that are unusually or especially frightening, – horrible, or traumatic.
• For example:
• – a serious accident or fire
  – a physical or sexual assault or abuse
  – an earthquake or flood
  – a war
  – seeing someone be killed or seriously injured
  – having a loved one die through homicide or suicide.
• Have you ever experienced this kind of event?
• If YES – please answer the questions below.In the past month, have you….
• 1. had nightmares about the event(s) or thought about the event(s) when you did not want to?
  • NO
  • YES
• 2. tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)?
  • NO
  • YES
• 3. been constantly on guard, watchful, or easily startled?
  • NO
  • YES
• 4. felt numb or detached from people, activities, or your surroundings?
  • NO
  • YES
• 5. felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused?
  • NO
  • YES

After answering yes to all these questions, I still was not satisfied that I in fact had PTSD. So I continued to look for a more sophisticated tool.

Screening for Posttraumatic Stress Disorder (PTSD)

If you suspect that you might suffer from PTSD, answer the questions below, print out the results and share them with your health care professional. You can also download this form here.

To locate a specialist who treats PTSD, visit the ADAA Find a Therapist.

Are you troubled by the following?

Yes  No

You have experienced or witnessed a life-threatening event that caused intense fear, helplessness, or horror.

Do you have intrusions about the event in at least one of the following ways?

Yes  No	Repeated, distressing memories, or dreams
Yes  No	Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)
Yes  No	Intense physical and/or emotional distress when you are exposed to things that remind you of the event

Do you avoid things that remind you of the event in at least one of the following ways?

Yes    No	Avoiding thoughts, feelings, or conversations about it
Yes    No	Avoiding activities and places or people who remind you of it

Since the event, do you have negative thoughts and mood associated with the event in at least 2 of the following ways?

Yes    No	Blanking on important parts of it
Yes    No	Negative beliefs about oneself, others and the world and about the cause or consequences of the event
Yes    No	Feeling detached from other people
Yes    No	Inability to feel positive emotions
Yes    No	Persistent negative emotional state

Are you troubled by at least two of the following?

Yes    No	Problems sleeping
Yes    No	Irritability or outbursts of anger
Yes    No	Reckless or self-destructive behavior
Yes    No	Problems concentrating
Yes    No	Feeling “on guard”
Yes    No	An exaggerated startle response

When I took this test I had answered YES to 12 of the 18 questions. Well, that was good enough for me and I had tested positive on two respected questionnaires for PTSD. So, now what does this mean for me? First off, I am not a military vet. There are few resources out there for veterans let alone for other high risk careers. I called a few legal teams that handle PTSD cases. All of them that I called on handle cases for veterans, none of them had the vaguest idea how to pursue a PTSD case for a civilian. I finally found one legal group that handled civilian cases of PTSD and as luck would have it, they were not licensed to handle cases in Nevada. So, that basically left me up a creek without a paddle. I was at the time both unemployed and uninsured. No way could I afford any type of counselling. The only treatment for me was to stay away from hospitals as long as possible, get some sleep, spend time outdoors with nature, and work on a second book. I felt that the more I dealt with the subject and the more I kept my mind occupied the better off I would be.

While I still can’t sleep, I am a little less jumpy and I startle less easily. Concentrating on my book, blog and podcast is giving me a sense of purpose. I have found a less stressful job to work at. So that took care of the income-related stress issues. Over the last few years, I have been gradually gaining weight, so now I have self-image problems as well. I have decided to be proactive and attack that problem head-on by having a gastric sleeve procedure done in June. They say that there is no cure for PTSD, so all I can do is to continue on doing the best I can. I am fortunate that I have a roof over my head and love and support of a loving and caring wife. I know that I am more fortunate than a lot of other sufferers of PTSD, so, of that I am grateful. Only time will tell how successful the actions I have been taking are. I am, however, ever hopeful that my life will eventually return to some state of normalcy.

Note that the material that I referenced for PTSD was found by doing a simple Google search and is in the public domain.

At this time I have decided to write a third book, this one devoted strictly to my medical career. To make it more enticing to perspective readers, I decided to cover not only my experiences with nursing but to discuss the medical field in general, and to include a history of the medical field and the problems our society is having with it. I am also discussing other aspects as well. I know it is a daunting project but all I have is time on my hands right now as I prepare for my surgery. I have covered areas of my nursing career in my first two books, so there is some overlap in this book. Readers of my first two books will find that I have copied portions of the previous two books for this one, but you can rest assured that there is plenty of new material to justify not only my writing this book, but your buying and reading this one as well. As I write each chapter, I am doing additional research on these subjects and I am updating these chapters where appropriate. Likewise, I am also checking the net out for any new material on PTSD. As luck would have it, I came across a new site devoted to the subject: helpguide.org.

I have covered a lot of the material in this chapter already, however, there is a lot of new and pertinent information. So I will cherry pick the new information I found and will include it in the following section.

PTSD vs. a normal response to traumatic events

Following a traumatic event such as a natural disaster, traffic accident, terrorist attack, or assault, almost everyone experiences at least some of the symptoms of PTSD. When your sense of safety and trust are shattered, it’s normal to feel unbalanced, disconnected, or numb. It’s very common to have bad dreams, feel fearful, and find it difficult to stop thinking about what happened. These are normal reactions to abnormal events.

For most people, however, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift. But if you have post-traumatic stress disorder, the symptoms don’t decrease and you don’t feel a little better each day. In fact, you may start to feel worse.

PTSD symptoms in children

In children – especially very young children – the symptoms of PTSD can differ from those of adults and may include:

• Fear of being separated from their parent.
• Losing previously-acquired skills (such as toilet training).
• Sleep problems and nightmares.
• Somber, compulsive play in which themes or aspects of the trauma are repeated.
• New phobias and anxieties that seem unrelated to the trauma (such as fear of monsters).
• Acting out the trauma through play, stories, or drawings.
• Aches and pains with no apparent cause.
• Irritability and aggression.

PTSD risk factors

While it’s impossible to predict who will develop PTSD in response to trauma, there are certain risk factors that increase your vulnerability. Many risk factors revolve around the nature of the traumatic event itself. Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God,” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Other risk factors for PTSD include:

• Previous traumatic experiences, especially in early life.
• Family history of PTSD or depression.
• History of physical or sexual abuse.
• History of substance abuse.
• History of depression, anxiety, or another mental illness.

Types of PTSD and trauma

Trauma or PTSD symptoms can result from many different types of distressing experiences, including military combat, childhood neglect or abuse, racism, an accident, natural disaster, personal tragedy, or violence. 

PTSD in military veterans

For all too many veterans, returning from military service means coping with symptoms of PTSD. You may have a hard time readjusting to life out of the military. Or you may constantly feel on edge, emotionally numb and disconnected, or close to panicking or exploding. But it’s important to know that you’re not alone and there are plenty of ways you can deal with nightmares and flashbacks, cope with feelings of depression, anxiety or guilt, and regain your sense of control.

Emotional and psychological trauma

If you’ve experienced an extremely stressful event—or series of events—that’s left you feeling helpless and emotionally out of control, you may have been traumatized. Psychological trauma often has its roots in childhood, but any event that shatters your sense of safety can leave you feeling traumatized, whether it’s an accident, injury, the sudden death of a loved one, bullying, domestic abuse, or a deeply humiliating experience. Whether the trauma happened years ago or yesterday, you can get over the pain, feel safe again, and move on with your life.

Rape or sexual trauma

The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone, or plagued by nightmares, flashbacks, and other unpleasant memories. But no matter how bad you feel right now, it’s important to remember that you weren’t to blame for what happened, and you can regain your sense of safety, trust, and self-worth.

Racial trauma

Race-based traumatic stress stems from exposure to racist abuse, discrimination, or injustice. It can erode your sense of self-worth and lead to anxiety, depression, chronic stress, high blood pressure, disordered eating, substance abuse, and even symptoms of PTSD such as hypervigilance, negative thoughts, and mood changes. But there are ways to strengthen your resilience and protect your mental health.

Whatever your personal experiences or symptoms, the following tips can offer effective ways to help you heal and move on:

PTSD self-help tip 1: Challenge your sense of helplessness

Recovery from PTSD is a gradual, ongoing process. Healing doesn’t happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many steps you can take to cope with the residual symptoms and reduce your anxiety and fear.

Overcoming your sense of helplessness is key to overcoming PTSD. Trauma leaves you feeling powerless and vulnerable. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.

One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity. Taking positive action directly challenges the sense of helplessness that is a common symptom of PTSD.

Positive ways of coping with PTSD:

• Learn about trauma and PTSD.
• Join a PTSD support group.
• Practice relaxation techniques.
• Pursue outdoor activities.
• Confide in a person you trust.
• Spend time with positive people.
• Avoid alcohol and drugs.
• Enjoy the peace of nature.

Tip 2: Get moving

When you’re suffering from PTSD, exercise can do more than release endorphins and improve your mood and outlook. By really focusing on your body and how it feels as you move, exercise can actually help your nervous system become “unstuck” and begin to move out of the immobilization stress response. Try:

Rhythmic exercise that engages both your arms and legs, such as walking, running, swimming, or dancing. Instead of focusing on your thoughts, focus on how your body feels. Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin.

Rock climbing, boxing, weight training, or martial arts. These activities can make it easier to focus on your body movements—after all, if you don’t, you could get hurt.

Spending time in nature. Pursuing outdoor activities like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing helps veterans cope with PTSD symptoms and transition back into civilian life. Anyone with PTSD can benefit from the relaxation, seclusion, and peace that come with being out in nature. Seek out local organizations that offer outdoor recreation or team-building opportunities.

Tip 3: Reach out to others for support

PTSD can make you feel disconnected from others. You may be tempted to withdraw from social activities and your loved ones. But it’s important to stay connected to life and the people who care about you. You don’t have to talk about the trauma if you don’t want to, but the caring support and companionship of others is vital to your recovery. Reach out to someone you can connect with for an uninterrupted period of time, someone who will listen when you want to talk without judging, criticizing, or continually getting distracted. That person may be your significant other, a family member, a friend, or a professional therapist. Or you could try:

Volunteering your time or reaching out to a friend in need. This is not only a great way to connect to others, but can also help you reclaim your sense of control.

Joining a PTSD support group. This can help you feel less isolated and alone and also provide invaluable information on how to cope with symptoms and work towards recovery.

Tip 4: Support PTSD treatment with a healthy lifestyle

The symptoms of PTSD can be hard on your body so it’s important to take care of yourself and develop some healthy lifestyle habits.

Take time to relax. Relaxation techniques such as meditation, deep breathing, massage, or yoga can activate the body’s relaxation response and ease symptoms of PTSD.

Avoid alcohol and drugs. When you’re struggling with difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But substance use worsens many symptoms of PTSD, interferes with treatment, and can add to problems in your relationships.

Eat a healthy diet. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed food, fried food, refined starches, and sugars, which can exacerbate mood swings and cause fluctuations in your energy.

Get enough sleep. Sleep deprivation can trigger anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as quiet, dark, and soothing as possible.

Getting professional help for PTSD

If you suspect that you or a loved one has post-traumatic stress disorder, it’s important to seek help right away. The sooner PTSD is treated, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.

It’s only natural to want to avoid painful memories and feelings. But if you try to numb yourself and push your memories away, PTSD will only get worse. You can’t escape your emotions completely—they emerge under stress or whenever you let down your guard—and trying to do so is exhausting. The avoidance will ultimately harm your relationships, your ability to function, and the quality of your life.

Why you should seek help for PTSD

Early treatment is better. Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.

PTSD symptoms can change family life. PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.

PTSD can be related to other health problems. PTSD symptoms can make physical health problems worse. For example, studies have shown a relationship between PTSD and heart trouble. Getting help for your PTSD could also improve your physical health.

PTSD treatment and therapy

Treatment for PTSD can relieve symptoms by helping you deal with the trauma you’ve experienced. A doctor or therapist will encourage you to recall and process the emotions you felt during the original event in order to reduce the powerful hold the memory has on your life.

During treatment, you’ll also explore your thoughts and feelings about the trauma, work through feelings of guilt and mistrust, learn how to cope with intrusive memories, and address the problems PTSD has caused in your life and relationships.

The types of treatment available for PTSD include:

Trauma-focused cognitive-behavioral therapy involves gradually “exposing” yourself to feelings and situations that remind you of the trauma, and replacing distorted and irrational thoughts about the experience with a more balanced picture.

Family therapy can help your loved ones understand what you’re going through and help you work through relationship problems together as a family.

Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety, although they do not treat the causes of PTSD.

EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. EMDR therapy techniques work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

Finding a therapist for PTSD

When looking for a therapist, seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can ask your doctor or other trauma survivors for a referral, call a local mental health clinic, psychiatric hospital, or counseling center.

Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel comfortable and understood.

Authors: Melinda Smith, M.A., Lawrence Robinson, Robert Segal, M.A., and Jeanne Segal, Ph.D.

Helplines and support

Find treatment and support for PTSD

In the U.S.: Call the NAMI helpline at 1-800-950-NAMI to find a support group near you or search for Trauma Treatment Programs (PDF).

UK: PTSD UK offers treatment and support options.

Australia: Phoenix Australia offers PTSD helplines and resources.

Canada: Find Your Local CMHA division for support and treatment options.

If you’re a veteran with PTSD:

In the U.S.: Call the Veterans Crisis Line at 1-800-273-8255 (Press 1); call the Veteran Center Call Center hotline to talk with another combat veteran at 1-877-927-8387; or use the PTSD Program Locator to find specialized VA PTSD treatment.

UK: Visit Combat Stress or call the 24-hour helpline 0800 138 1619.

Canada: Visit Operational Stress Injury Social Support (OSISS)  for a local number to talk to a peer who has been through similar experiences.

Australia: Visit Veterans and Veterans Families Counselling Service (VVCS) or call 1800 011 046.

I don’t know about you, but I found this site to be incredibly insightful but helpful as well. I don’t think they will mind me including some of there information in this chapter. The material in this chapter was and is meant to help those afflicted with this disorder. I want to wish all you who have been cursed with PTSD not to lose hope. There are a lot of good people working on the problem. This new website is certainly evidence of efforts being made to help those suffering from it.