Combat Indicators
Signs that you or someone else are having a significant emotional event are going to differ from person to person, and can even be different indicators, at different times, for the same individual. The Military does a good job of teaching “Absence of the normal, presence of the abnormal” to troops, but this is also completely applicable to a civilian, so even if you’re unaware of poor mental health indicators, you will notice a change in the following.
General attitude – Not up to everyday tasks such as washing up, taking the dog for a walk and really any task that you, or someone else, would partake in without thinking on an average day in your life (average! Everybody is different. Don’t forget that).
Inability to vocalise internal struggles – Tripping over words, short temper, getting very frustrated at little things that are suddenly difficult to complete, poor attitude in general towards people that would normally be part of your social/work circle, and that you socialise with daily.
Energy – Feeling a lot more fatigued without just cause is a big one. When your mind starts going down the rabbit hole, just like a PC, it gets stuck in processes and doesn’t understand what’s going on, then tries to compensate by either stopping hormone/chemical production in some areas, or by dumping in excess amounts of others, such as adrenaline.
There are other significant indicators, however these are signs that you or someone else are more than likely to notice, but maybe don’t know what to do about.
Going Man Down
When this happens, it can be blindingly fast or it can take place over a varying timescale, where the sufferer is literally trying to hold on to their standard mindset and daily routines.
In my case, it built up over many years until some specific events, such as moving house for the tenth time and work treating me like a pariah every time I told them how badly I was doing, sent me over the precipice.
I was terrified of going to work, interacting with anyone, I couldn’t vocalise my thoughts or pain correctly, I already had bad headaches, but these increased in tempo and ferocity as all the internalised psychic pain spilled over.
I was also scared of telling a health professional just what was going on inside, as that would mean confronting it and having to do things that felt, at that time, just too mountainous to climb.
When I finally went off sick from depression, stress and anxiety, my wife basically became my carer, and I was in the extremely humiliating position of her doing everything from sorting out Universal Credit to ringing helplines for me.
I had extreme suicidal thoughts; had my rope and beam all lined up. When I sat outside having a smoke, I’d feel the appeal of that so much, I’d have to go back inside.
All of these issues and so many more, individual to you, are completely normal and no mental health professional or your GP is going to bat an eyelid if you put your hand up and tell them what you’re going through.
They want to help you, please let them.
Who Do I Speak To?
This is going to sound obvious, but anyone who will listen. Tell your partner, a friend, but prioritise making an appointment with your GP, OR speak to one of the many charities who are set up to deal with mental health in general and veterans in particular (or service-related orgs if you’re emergency services for example).
Friends and family – they want to help you, let them in if you’re able to.
GP – I know not all GPs are as up to date on all mental health conditions as I’ve experienced some of that myself, but there are systems in place to help and when these are shown to the surgery, they will act on it.
No, it shouldn’t be like that, but sometimes it is. Realise that there are still things you can do to help yourself and do those things.
For Veterans
As well as your GP, organisations such as NHS TILS (now Op Courage) should be a first port of call, as they can conduct a home assessment and then pass you on to the relevant clinical professionals. I’ve used the service twice; it works better now than it did then.
Medical Surgery – does your GP surgery know you’re a veteran? If they are not aware, they won’t have requested your military health records, which will be invaluable to your GP or the surgery’s Community Mental Health Nurse. Ask the receptionist to check the system as to whether your veteran status is on your record; if it’s missing, the surgery (or you, partner etc.) should look at the below for more details.
https://www.nhs.uk/nhs-services/armed-forces-and-veterans-healthcare/veterans-health-faqs
Walking with the Wounded – I’m not highlighting this charity for any reason other than they helped me, and I have personal experience of their care. They were brilliant in their dealings with me, have a website, phone numbers, text numbers, chat functions; all enabling yourself or a loved one to contact them and give them a sitrep, no matter the state you’re in. You can even contact them and have a chat via text if talking just isn’t an option right now.
They were able to organise 12 free therapy sessions that I could take up in person or via video call. I had an ex QUARANC WO who had been on Telic at the same time, so I had an instant veteran connection with him, who took me through Cognitive Behavioural Therapy.
https://walkingwiththewounded.org.uk/Home/Programmes
For everyone
Local Authority Mental Health Service – I’ve ended up having the best care so far with my local Personality Disorder Service, who in conjunction with the charity Mind, run very good DBT courses. More about this below, but if you are diagnosed with a personality disorder (all 400+ of them) then being in the correct system will ensure you get the best care.
Treatment/Therapy
You’ve flagged up that there’s an issue that needs to be looked at and you’re in the system. You’ve received a diagnosis of (insert diagnosis here) and now you know what’s broadly wrong, you’re ready to begin treatment or therapy. This can be a quick process or can sometimes take months/years so be aware (this is an extreme example, but I have had services that took that long to access, and I had others that took a week).
This is an NHS page that gives a broad range of mental health information and signposting of mental health treatments/therapies.
https://www.nhs.uk/mental-health
There are a lot of different treatments ranging from prescribed medications to talking therapies. I’ve tried to take the recommended medicines and found them to be counterproductive for me, that doesn’t mean that they won’t work for you, and in fact I know other sufferers who are on a variety of meds, and it works really well for them.
Dialectical Behaviour Therapy coupled with Mindfulness – This is what I have found to work for me, for Borderline Personality Disorder, also known as Emotionally Unstable Personality Disorder. This is through a collaboration between my local mental health authority and the charity Mind.
20 sessions of DBT, with 5 of those sessions being 1-1 and the rest in a group setting (group video call) with around 10 people, 3 of those being facilitators.
All the people, whether staff or service users that I’ve met so far, also have some sort of mental health condition. They know what it’s like and can teach, talk through, and generally guide your learning process.
DBT aims to give you the tools to manage your own life, with support from the service a text or email away. I’m not going to go into detail about this as it would be too long winded; but check out the link and that will explain it further.
Military/Emergency Services Training – The training that everyone goes through, in my experience, sets you up perfectly to understand DBT or CBT or any therapy that involves you talking to a professional, and getting to the root of the psychic trauma.
Through the Explain, Demonstrate, Imitate, Practice formula, the DBT counsellors/facilitators teach you all about why and how your brain and body are working against you, and just as importantly, what you can do about it.
Anyone who has the most basic knowledge of Battle Drills, or Immediate Action Drills, will recognise the way of learning the basics in small chunks, and then getting good with those before starting to string all those small skills together to form a coherent battle plan.
Open Minds – Lots of the therapies, especially the talking therapies can feel bloody strange if you’re used to bottling and compartmentalising. I know it’s difficult, take it slow, don’t judge and see where it goes.
You’ve got nothing to lose if you’re at this stage.
Post Traumatic Growth
This is something that I personally think gets overlooked as the priority is about treating the trauma. That makes complete sense. However, there’s little point having treatment if there isn’t a plan to follow afterwards, Again, in my experience and listening to others, being able to take the chaotic darkness that you found within your mind, and having the ability to literally reach in, turn it 180 degrees and project it outwards has been massively beneficial for myself and for my family.
I found that all my deepest, darkest fears, rationales, neuroses etc. were all based on how others viewed and interacted with me. Once I fully realised this, I was able to turn it around and project outwards by writing all of this down in the form of my page Renaissanceislandjud, on social media platforms.
Coupled with the DBT, it’s allowed me to learn to effectively communicate again, not just with my family and friends, but with anyone I want to, and have real conversations about whatever I want too again.
Part of this growth process has been the discovery of new friends, old comrades I thought had forgotten me, and some truly exciting opportunities for the future.
I have Borderline Personality Disorder, quite possibly Autism or Asperger’s (yet to be diagnosed), but as I locate my “flaws” and turn them around, they can become my greatest tools to project me into a life I’d given up on.
Try different hobbies, read authors you’ve never heard of, do anything to generate interest in your poor, fatigued mind, and gradually build up a plan for a new mission, which will give your life meaning again.
It’s not easy but stick with it and I’ll see you on the Re-Org.
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