Asked by (Name Withheld), Alabama
I deployed to Iraq for 15 months (in 2007-08). Upon my redeployment, I was reassigned; not only was I separated from my 2-year-old twins, but now I had to sell a home and relocate us. I have been back for a year. My husband says I have PTSD. I say it is just stress. I did not see any "hard" combat but worked 18-plus hours a day for 15 months. I have been tense; I don't sleep or dream; I am constantly exhausted. I can't lose weight (despite exercising daily); I have no patience and find myself biting my tongue instead of saying something I will regret later. Additionally, I have no interest in sex or other hobbies that I used to enjoy. Should I seek help? If published, please do not use my name.
Mental Health Expert
Dr. Charles Raison
Emory University Medical School
The quick answer to your question is, yes, you most definitely should seek help. You have done an amazing job at describing an episode of major depression, which is an eminently treatable disorder but one with really bad long-term consequences if left to grow, fester and spread over time.
Let's start at the top and work our way through your question. Your husband is right that your symptoms very likely arose from your stressful experiences in Iraq. But post-traumatic stress disorder doesn't quite capture what you are describing.
PTSD really is a word we use for people who have experienced a life-threatening type event that they just can't shake. It bothers them so badly that they go out of their way to avoid any reminders of it, but despite this, they dream about it, have flashbacks about it, etc. And this puts their nerves on edge so badly that they are ready to jump out of their skins at all times. That's the essence of PTSD.
Although not life-threatening, the barrage of stressors you describe is truly terrible. There is a whole literature showing that separating a mother from her babies is a great way to make her depressed, even without the danger, the heat and the 18-hour workdays. Then there is the business about having to move; that in itself is a pretty potent stressor. So in a way, you are right, it is "stress."
The problem is that now, the stress has gotten inside you and taken on a life of its own. That is what your symptoms are telling you. They are a sure sign that your brain and body have gone into a state of stress hyperdrive. It is that hyperdrive state that is most likely causing the depression. In a very real sense, when people get depressed, it's as if they have swallowed all the stressors of the outside world and now it's all inside of them, tearing them up.
One way that this internalized state of stress manifests is through depressive and anxiety symptoms. But humans can't feel anxious or depressed for very long without the body getting into the act, and so depression is almost always accompanied by changes in sleep and appetite, and usually by exhaustion and often by physical aches and pains. It's also not unusual for people to feel overwhelmed, lousy about themselves and irritable.
These symptoms are bad in themselves because they badly disrupt people's lives. Of course, they also make people miserable, which I don't have to tell you. But the symptoms are also bad because they are markers that your brain and body have moved into a state that is bad for your long-term mental and physical health.
I don't have space hear to really explain this properly, but just briefly I'll tell you this: The longer a person is depressed, the more likely he or she is to have brains shrinkage and to develop diabetes, heart disease, cancer and dementia. The effect on heart disease is about equal to smoking a couple of packs a day, so it's not trivial. And unfortunately, when a mom is depressed, it greatly increases the risk that her children will also develop depression and other behavioral problems.
So please see a doctor or other mental health clinician right away.
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