Combat-PTSD has been a part of my life for a long time, PTSD in general has been a huge talking point over the last couple of decades, since the beginning of the “Global War on Terror”.

Growing up in the ‘90s, watching 9/11 happen my freshman year of high school on live TV, like others, I became fascinated with the ideology of serving my country. Fixated on being a Marine, I felt it my Patriotic duty to fight for my Country. So I enlisted into the Marine Corps, in October of 2006 I signed my life away for 8 years, 4 years active and 4 years inactive. This was just a few years after President George W. Bush declared war on countries in the Middle East, hiding behind the ruse of this notion of “Global War on Terror,” the United States invaded places like Afghanistan, Iraq, Syria, Libya, 7 countries in total. I was lucky enough to go to Iraq, on our way there I was able to stop in Kuwait for a few weeks, that was 2008 and in 2010 I landed myself in Helmand Province Afghanistan, my battalion was to spear head the Battle for Marjah, pushing from the north, while 1/6 pushed from the south he were too clear the city of Marjah and liberate them from the persecution and control of the radical terrorist regime, formally known as, “The Taliban.”

Having been diagnosed with Combat-PTSD before I ever discharged out of the Marine Corps, I look to help identify why PTSD is viewed as a “disorder,” amongst society.

Looking specifically at Combat-PTSD as an example of how ignoring the symptoms and characteristics of PTSD can cause problems in your life; stress, anxiety, combining disorders, all compound the effects of PTSD. The biggest disorders, one can be seen happening within the workforce, as pointed out in one study; “Based on the results of this exploratory literature review, three solutions are proposed: (a) examine what is working at work for veterans with disabilities in an effort to change the research conversation from problems to solutions, (b) understand and begin to deconstruct the veteran–civilian career identity conflict, and (c) explore the lived experiences of veterans with service-connected disabilities and their employers.” (Stern, 2016) This shows the disorders that arise from ignoring the lingering effects of PTSD, this research also looks to show how often there is a misconception between the different forms of PTSD, which should be examined exclusively to show the differences between each form of PTSD, Combat and noncombat specific. Direct verse indirect, conventional verse gorilla. Street to street, verses mountain warfare, all forms have to be different. The stigma that PTSD is a disorder, is something that can be discussed in further papers, however, the stress that comes with PTSD; can create disorders when left unaddressed. It shows that PTSD, the trauma itself creates the disorders, when not addressed at the root cause. I often argue that it is not a disorder, having lived with it now for more than a decade, I can see the disorders for how they really are. This research will seek to explain my personal experience concerning other research that has been conducted on the subject matter. It will break down a few of the characteristics of other forms of PTSD and compare them specifically to Combat-PTSD. The goal of this paper is to create a clear understanding of what Combat-PTSD is and to separate the stigma from the stress of reality, that if left untreated and ignored, Combat-PTSD will create a ripple effect of disorders, that can be seen in your own life and amongst other members of society. It will make a comparison to “Cognitive Dissonance”, which is; “psychological conflict resulting from incongruous beliefs and attitudes held simultaneously.” (2003) This definition could indicate why this is a disorder, due to a common world-view most Americans hold, having religious ties as to why they shouldn’t do what is often necessary in war, to take life. They believe that they can overcome anything because of what they have done already, often failing to realize that because of what they have done their view of the world has changed completely. Most of the time in war you face scenarios that alter your views of reality, there is a looming feeling that you could die at any moment and you have to make decisions without hesitation, that if not activated upon could cost you the life of a fellow brother or sister, one fighting right alongside you.

The main theory in this paper, is to understand why Combat-PTSD is viewed as a disorder amongst society.

One common denominator I have seen from Combat-PTSD, is the anti-malaria drug known as Mefloquine and its potential for toxic side effects that mimic PTSD within the human mind. “Using data from the National Health Study for a New Generation of U.S. Veterans, a population-based study of U.S. veterans who served between 2001 and 2008, we investigated associations between self-reported use of antimalarial medications and overall physical and mental health (MH) using the twelve-item short form, and with other MH outcomes using the post-traumatic stress disorder Checklist-17 and the Patient Health Questionnaire (anxiety, major depression, and self-harm).” (Schneiderman et. al, 2018) Shows a comparison to mefloquine and the disorders created by Combat-PTSD. In 2009 a warning was issued on mefloquine regarding its toxic side effects, if taken while experiencing trauma; “[US Boxed Warning]: Do not prescribe for prophylaxis in patients with major psychiatric disorders including patients with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia; use is contraindicated in these patients. Use with caution in patients with a previous history of depression.” (2020) Shows that this medication issued during war, which is stressful and during a time of hyper paranoia because people are trying to kill you, could be related. But, this does not negate from the fact that trauma is stressful. War is traumatic in itself, the rigors of war last forever and can be felt by everyone around you. That is the true nature of a disorder, it is not so much you that is affected but the people who are around you, that do not understand how to cope with the side effects you are suffering from. Depression and anxiety usually go hand in hand, you think of the past and get depressed and that makes you anxious for the future. Because you are so stuck in the past you become hyper-focused on changing your future, which takes you out of the present moment. According to Leon Festinger cognitive dissonance; is “the distressing mental state that people feel when they “find themselves doing things that don’t fit with what they know, or having opinions that do not fit with other opinions they hold.”(Ch. 16) “A social psychologist wishing to engage in a “consideration of affair” confronts provocative questions: How does a soldier justify his taking of life in the face of the powerful sanctions against this act that likely informed his upbringing.” Does his subsequent struggle with guilt, grief, and cognitive dissonance suggest a moral indictment of war?” (Kelly, Howe-Barksdale, & Gitelson, 2011) The book later states; “the groundbreaking work of “Leon Festinger(1957), who introduced cognitive dissonance as a key to self concept and adaptive ego defenses. Defined as the discomfort one feels when simultaneously holding two psychologically incompatible beliefs, cognitive dissonance characteristically involves a pre-existing view of one’s self and a subsequent behavior or belief that challenges that view.” (Kelly, Howe-Barksdale, & Gitelson, 2011)

This paper and the definitions of the term “cognitive dissonance,” shows that Combat-PTSD in itself could be a constant state of dissonance, one that distorts the Military member’s previous world-view and conflates it with their world-view of experiences in war.

This constant state of inner dialogue, challenges one to think about their experiences and what they thought they knew the world to be before they happened, before the Combat experience. It changes you and distorts your moral beliefs that the world is all good. It forces you to make ethical choices without hesitation and contorts the inner belief system. What is ethical in war? Usually people have an inner moral compass that guides them to ethical choices, good versus evil, right versus wrong choices. In Combat this line is blurred beyond recognition, learning in basic training on how to kill your fellow human, this could be what creates the stress that you feel later, those lingering “disorders.”

Most times, people have a “world-view,” of not killing other humans and that goes out the window when you are in a Combat situation.

Chaos usually ensues when you are at war, you are trained to follow orders and if you hesitate it could cost the life of innocent people people on both sides. So you learn in basic training how to do the things necessary to protect those who fight alongside you and cause the least amount of injury to anyone else, or those who are just innocent bystanders. This is a constant state of cognitive dissonance, and one that anyone who has experienced Combat soon realizes and eventually comes to terms with, or doesn’t. War being necessary at times to preserve the life of the innocent, by destroying those who prey on the innocent. The inner innocence before war, is instantly lost when faced with choices made in Combat. One study done shows a connection to Combat experiences and cognitive dissonance and disorders are always created when you add alcohol into the mix. “Results support the notion that Veterans with PTSD symptoms may drink to cope and that perceived stigma surrounding help seeking may further contribute to alcohol related problems.” (Miller, Pedersen, & Marshall, 2016) This comparison shows that there is not only a comparison to Combat and a disposition to drinking, but a unique one to as why Combat-PTSD can result in society viewing it as a disorder. The cognitive dissonance that comes from the psychological effects of war are described in many books written about war from the perspective of those who have experienced war. Different therapies can help you cope with these effects of war, but they take a certain level of discipline to get through.

In the military, there is an unspoken rule that you should not ask for help, but there are things in the Marine Corps called “battle buddies,” it is where there is never a Marine working alone and you have someone to always help. You have a buddy watching your 6 always, making sure nothing is going to sneak up behind you. Combat-PTSD will sneak up behind you and get you when you least expect it, if you are not consciously aware of the different views you now have on the world around you. Because you see things completely different now, you now view the world through a different lens. One that changes your psychological mindset of morality and your views on reality. If you do not understand this, then you will be caught off guard and it can cause lasting disorders in your day-to-day life. These disorders carry from work to family life, to all social interactions if you let it. That is why I have always had a battle buddy since I got out of the Marine Corps, it was a guy I served with. For us, we keep ourselves on track to not slip up, even though we have. We are starting to learn new tools to help us get through the disorders and start viewing them from a perspective of understanding. You have to keep checks and balances and someone to keep you accountable to your actions. If you do not do these things you will create post war disorders daily.

RQ 1: “Why is Combat-PTSD viewed as a disorder amongst society.”

In this study, I will use Veterans who have Combat-PTSD from similar experiences, one who was blown up in war during an Improvised Explosive Device(I.E.D.) attack, where he broke his back and neck. I will follow this Veteran for 10 plus years documenting his experiences concerning the view society has on him. I will log his interactions and his responses to such interactions, I will document different factors in life in comparison to his worldview; i.e; did he drink? If so, how much? Were there things that acted differently in comparison to others? How is his personal life? I.e; relationships with significant others, kids, friends, and family? Are there certain things that make his Combat-PTSD heightened? What are those things, what was the response to the stimuli?

The other Veteran I will follow is myself, documenting the same interactions but from a slightly different perspective.

What are my triggers? What are the signs of my triggers? What was my experience in comparison to his? These are important factors to a better understanding of the misconception within society about Combat-PTSD. To have a better understanding of the different side effects of PTSD, concerning war and the lasting disorders that can have a ripple effect throughout the Veteran’s life. In this research which has already been conducted after my decade-long study of using my friend and myself, I hope to write a path to help Veterans find recovery. We had one of our good friends kill himself in Iraq and through this study, the hope is to help Veterans find a path to recovery and learn to heal their beliefs about themselves to overcome the suffering Combat-PTSD brings.

Stern, L. (2016). Post 9/11 veterans with service-connected disabilities and their transition to the civilian workforce. Advances in Developing Human Resources, 19(1), 66-77. doi:10.1177/1523422316682928

Merriam-Webster’s collegiate Dictionary. (2003). In Merriam-Webster’s Collegiate Dictionary: Cognitive Dissonance (p. 240). Merriam-Webster Incorporated.

Schneiderman, A. I., Cypel, Y. S., Dursa, E. K., & Bossarte, R. M. (2018). Associations between Use of Antimalarial Medications and Health among U.S. Veterans of the Wars in Iraq and Afghanistan. The American journal of tropical medicine and hygiene, 99(3), 638–648. https://doi.org/10.4269/ajtmh.18-0107

Mac. (2020, November 16). What is MEFLOQUINE and ITS TOXICITY? – PTSDiscussion™. Retrieved April 29, 2021, from https://ptsdiscussion.com/mefloquine-toxicity

Kelly, D. C., Howe-Barksdale, S., & Gitelson, D. (2011). Treating young veterans: Promoting resilience through practice and advocacy. New York, NY: Springer Pub.

Miller, S., Pedersen, E., & Marshall, G. (2016, November 15). Combat experience and problem drinking in veterans: Exploring the roles of ptsd, coping motives, and perceived stigma. Retrieved April 29, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0306460316303914?casa_token=0qnIFgK-gZEAAAAA%3AOgL-9mWqKGZduR7ed3aBkZLC7BHLotGfhc6tybmStadqQWPgnnY0xNUYJYCnpz8JTqdL4JexpXE