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Many Americans will celebrate this Memorial Day by taking weekend trips, holding picnics, barbecues, and parties, mostly because it unofficially kicks off the start of summer. All luxuries we enjoy from living in a fee society.

“May we never forget freedom isn’t free.”

                                                                                                  Unknown

For others, the day will be spent observing the holiday by visiting cemeteries and memorials, remembering the sacrificial acts of loved ones.

And then there are those… let’s call them the “walking wounded,” who valiantly served our country and returned home, where they are now expected to live “ordinary” lives. They seem typical, like you and me, but underneath this facade, they are attempting to forget the things that happened in battle. Some are very successful in moving on from the trauma they experienced, however, others are not so fortunate. For this group, their bodies and minds betray them on a regular basis. Daily sights, sounds, and smells can bring an avalanche of emotions and physical sensations they don’t understand. Sure we all get that the sounds from fireworks would make someone think of artillery, but standing in the middle of a grocery store feeling like you are going to have a panic attack? What sense does that make?   

Dr. Bessel van der Kolk, M.D., a leading scholar in the field of trauma, was curious about these individuals and how they processed their traumatic past events. His work lead to the significant discovery that the body and mind are deeply connected and communicate continuously. He also discovered that the brain does not collect these memories in neat linear formats, but rather in a chaotic, scattered way that contributes to the individual’s distress. What he identified is known today as PTSD.

Post-traumatic Stress Disorder (PTSD) is a disorder characterized by exposure to an actual or threatened traumatic event. This can be direct exposure by the individual to a traumatic event, witnessing another person experiencing a traumatic event, learning of an actual threat against a loved one, or experiencing repeated exposure or extreme exposure to the horrific details of a traumatic event. In addition, individuals may experience the following intrusive symptoms:

• Recurrent, involuntary, and intrusive distressing memories of the event.
• Recurrent, distressing dreams related to the traumatic event.
• Flashbacks, where the individual is reliving the event.
• Intense or prolonged psychological distress to internal or external cues resembling the traumatic event.
• Marked physiological reactions to internal or external cues that resemble the traumatic event.

Individuals may also seek to avoid stimuli associated with the traumatic event. This includes distressing memories, thoughts, feelings that can include people, places, and things that resemble the traumatic event.

Individuals may also have negative alterations in thoughts and moods associated with the traumatic event, including:

• Losing the ability to remember important aspects of the event.
• Persistent and exaggerated negative beliefs about oneself, others or the world.
• Distorted thoughts about the cause or consequences of the event.
• Have a persistent negative state, such as anger, guilt, shame, or fear.
• Diminished interest in activities they used to enjoy.
• Feelings of detachment from others.
• Inability to experience positive emotions, such as happiness, satisfaction or love.

Individuals may also notice significant changes in their arousal levels associated with the traumatic event, including:

• Irritable behavior.
• Angry outbursts.
• Increased verbal and physical aggression toward people and things.
• Reckless or self-destructive behaviors.
• Hypervigilance, especially related to the possibility of re-experiencing the traumatic event.
• Exaggerated startle response.
• Difficulty concentrating.
• Difficulty sleeping, including problems with falling asleep, staying asleep or overall restlessness.

Individuals will have experienced these symptoms for at least a month and will have noticed impairments in their ability to maintain healthy relationships, or obtain occupational success. And although many individuals experiencing posttraumatic stress may use substances like alcohol or medication to numb their thoughts and feelings, the effects of their substance use does not attribute to their condition.

If you or a loved one is struggling with post-traumatic stress disorder (PTSD), please seek out the help of a qualified professional. PTSD is very complex, yet treatable, with the right help. If you are a caregiver to someone who is struggling with PTSD, please take care of your own needs. Loving someone with PTSD can be very emotionally challenging, and you may not be aware of the impact on your own health.

This Memorial Day, as you celebrate, I would like to encourage you to reach out to those around you and offer your gratitude to the women and men of the armed forces, who not only risk their lives for our freedoms, but in other ways return suffering for their heroism. If you would like to do more, there are veterans associations that would love to receive your help, either financially or as a volunteer. Please reach out and connect. Enjoy your Memorial Day and never forget…freedom isn’t free.

Post-traumatic Stress Disorder diagnostic criteria taken from the DSM-5, American Psychiatric Association.