Post traumatic stress can be hard to understand — for those going through it and those trying to treat them

Afghanistan, early spring 2003. At a Special Forces camp near the Pakistan border.

Ron Capps served in five combat zones in 10 years. He was sent to Kosovo, Central Africa, Afghanistan, Iraq and Darfur.

He started showing signs of post-traumatic stress while stationed in Rwanda, but it was during his tour of duty in Afghanistan that he knew he needed help.  

"Not long after I got there I was having a lot of intrusive thoughts, both day and night, real trouble sleeping and once I realized what was going on I had a kind of decision to make about whether I would get treatment,” Capps said.

Capps recounts his struggle getting that help in a memoir of his service "Seriously Not All Right," which comes out next month.

“I really believed that two things would happen if I did ask for help. I thought I would be mocked and ridiculed as being weak and broken,” said Capps. “But I also feared that I would lose my security clearance and I wouldn’t be able to work, because you can’t be an intelligence officer without a security clearance.

Capps did get help while he was in Afghanistan. He ended up speaking with a psychiatrist who told him to keep track of how he felt over the following weeks until they met again.

“But he didn’t give me any guidance, so I had to come up with some sort of continuum,” Capps said.

So he developed a rubric of his own to rate his state of mind from ‘I Feel All Right’ to ‘I Feel Vaguely All Right’ to ‘I Feel Seriously Not All Right.’

“There were a lot of days [in Afghanistan] where I felt seriously not all right,” he added.

So he started writing. He poured all of his feelings, thoughts, memories, all the stuff of "seriously not all right" onto pages upon pages of text.

“Going back through that writing, going back through those moments was how I got control of it,” Capps said, “because once it’s written down it’s no longer sort of just stuck in the back of your head spinning wildly though your mind. You can physically print it out and hold it.”

Today, Capps runs the Veterans Writing Project, where he helps other veterans and their families write out their stories. But former military psychiatrist Dr. Ron Koshes says there are many veterans who, rather than something like writing, try to use substances to try to help self-medicate away some of the symptoms.

“Most of us, as human beings, try to master the stress that we are under and may not immediately seek help,” he said.

And that can mean it takes longer to get a dianosis. According to Koshes, when it comes to PTSD, a lot of the mental health professionals are “learning on the job.”

One reason for that, he added, is that the military has changed dramatically.

“We have a very different military than we had 20 years ago. There are many more females in it, and there’s cultural diversity,” he said.

Koshes has some concerns as the US troops head back home. One, for example, is that the soldiers come back to an environment that might not have a lot of knowledge about what it’s like to fight in a war.

But as information and awareness increases, he is hopeful that veterans with PTSD find it easier to seek help and adjust to life when they return to the US.

Ron Capps served in five combat zones in 10 years. He was sent to Kosovo, Central Africa, Afghanistan, Iraq and Darfur.

He started showing signs of post-traumatic stress while stationed in Rwanda, but it was during his tour of duty in Afghanistan that he knew he needed help.  

"Not long after I got there I was having a lot of intrusive thoughts, both day and night, real trouble sleeping and once I realized what was going on I had a kind of decision to make about whether I would get treatment,” Capps said.

Capps recounts his struggle getting that help in a memoir of his service "Seriously Not All Right," which comes out next month.

“I really believed that two things would happen if I did ask for help. I thought I would be mocked and ridiculed as being weak and broken,” said Capps. “But I also feared that I would lose my security clearance and I wouldn’t be able to work, because you can’t be an intelligence officer without a security clearance.

Capps did get help while he was in Afghanistan. He ended up speaking with a psychiatrist who told him to keep track of how he felt over the following weeks until they met again.

“But he didn’t give me any guidance, so I had to come up with some sort of continuum,” Capps said.

So he developed a rubric of his own to rate his state of mind from ‘I Feel All Right’ to ‘I Feel Vaguely All Right’ to ‘I Feel Seriously Not All Right.’

“There were a lot of days [in Afghanistan] where I felt seriously not all right,” he added.

So he started writing. He poured all of his feelings, thoughts, memories, all the stuff of "seriously not all right" onto pages upon pages of text.

“Going back through that writing, going back through those moments was how I got control of it,” Capps said, “because once it’s written down it’s no longer sort of just stuck in the back of your head spinning wildly though your mind. You can physically print it out and hold it.”

Today, Capps runs the Veterans Writing Project, where he helps other veterans and their families write out their stories. But former military psychiatrist Dr. Ron Koshes says there are many veterans who, rather than something like writing, try to use substances to try to help self-medicate away some of the symptoms.

“Most of us, as human beings, try to master the stress that we are under and may not immediately seek help,” he said.

And that can mean it takes longer to get a dianosis. According to Koshes, when it comes to PTSD, a lot of the mental health professionals are “learning on the job.”

One reason for that, he added, is that the military has changed dramatically.

“We have a very different military than we had 20 years ago. There are many more females in it, and there’s cultural diversity,” he said.

Koshes has some concerns as the US troops head back home. One, for example, is that the soldiers come back to an environment that might not have a lot of knowledge about what it’s like to fight in a war.

But as information and awareness increases, he is hopeful that veterans with PTSD find it easier to seek help and adjust to life when they return to the US.

Do you support journalism that strengthens our democracy?

At The World, we believe strongly that human-centered journalism is at the heart of an informed public and a strong democracy. We see democracy and journalism as two sides of the same coin. If you care about one, it is imperative to care about the other.

Every day, our nonprofit newsroom seeks to inform and empower listeners and hold the powerful accountable. Neither would be possible without the support of listeners like you. If you believe in our work, will you give today? We need your help now more than ever!