PTSD: The War Within

by SSgt Travis N. Twiggs- originally published January 2008

All in all I made four trips over to the "sandbox." It was upon returning from my second trip that I began to notice "changes" in myself. By changes I mean I was more irritable, paranoid for no reason, unable to sleep, and had trouble focusing when around other people. At the time my wife and I agreed that I would not deploy again for a while. Well, after about 1 month at home, I began yearning to go back. The Marines and sailors in my charge were asking me daily to go back with them.

So late one night I approached my wife with my idea of returning to Iraq. She began to cry and said that I should go, bring the boys home safely, and get this out of my system. From that day forward, my symptoms went away. After all, I was going back to the fight, back to shared adversity, where the tempo is high and our adrenaline pulses through our veins like hot blood. It is in this place that there is no time for posttraumatic stress disorder (PTSD).

These Marines, assigned to Marine Forces Reserve, New Orleans, recently graduated from the MCMAP Instructor Course. The speaker at their graduation was Col Terry Ebbert, USMC(Ret) (center). Director, Homeland security, New Orleans. SSgt Twiggs (far right) and Sgt Kendall Mathurin (far left), the primary instructor, were the instructors for this course.

That third trip did not go as planned. I lost two Marines less than 2 months after arriving in theater. I cannot describe what a leader feels when he does not bring everyone home. To make matters even worse, I arrived at the welcome home site only to find that those two Marines' families were waiting to greet me as well. I remember thinking, "Why are they here?" From then on my life began to spiral downward. Not only did I have orders to transfer to Quantico and would have to deal with the stress of moving my family, but I was also experiencing the loss of the two Marines, having to communicate with their families, and saying goodbye to my platoon while dealing with my PTSD, which was back with a vengeance.

I checked into my new command about 1 ½ months later. My first day was painful. I couldn't seem to function around others. The sergeant major sent me home and told me to be standing outside his door at 0700 the following morning. The next morning arrived and the sergeant major told me to come into his office and take a seat. He asked me if I knew what PTSD was. He then told me that I had it bad and asked me if I knew how he knew this? I replied, "No, I don't," and he responded that it was because he had it too-that he could see himself in me.

That afternoon I checked myself into the medical clinic. While I was there I met a physician's assistant named Laurie Giertz. She had a list hanging on her wall of 10 symptoms Marines experience upon returning from combat. She asked me to read them and tell her if I had any of them. To this day I don't know why I answered her, but I told her that I had all of them. Before I left I was prescribed Zoloft for mood and Trazadone for sleep. The plan was to get me to calm down, have some good rest, and then begin therapy.

As the months progressed we altered the medications. At times the medications did not seem to do anything, or the side effects were intensifying. To be completely honest though, we may have had the right drug mixture, but she didn't know that I was mixing the medications with alcohol every night. I returned to Iraq for my fourth tour shortly afterward, and I was only at the clinic for a couple of weeks.

But those couple of weeks were the most peaceful I had experienced all year. All of my symptoms were gone, and I was sleeping well every night. Once again the common factors were shared adversity, with increased tempo, high adrenaline flow, and an environment in which any thoughts about PTSD would take my focus away from my mission.

When I arrived back in the States, it was as though I had never left. All of my symptoms were back, and now I was in the process of destroying my family. This was all taking place because I did not understand what was happening to me. My situation worsened, if you can believe that. I started neglecting my work, and my answer for everything was alcohol. All could see that I was in trouble, and everyone wanted to help.

They became increasingly concerned and had no choice in what they would do next. I backed them into a corner and they reacted. I was transported to Bethesda Naval Hospital for detoxification and to try to stabilize my vitals. I remained there for about 3 days and then lied my way out the front door. Needless to say, my command was furious!

For about 10 days I managed to convince them that I was better, at least I thought I had. Well, I ended up back in Bethesda, and this time I was in a locked ward where I would remain for 2 weeks. At Bethesda I was not exacdy a model patient. I was experiencing psychosis where I would fight my way through the hallways and clear rooms as if I were back in theater. The hospital police would have to be called in to secure me. This was not going over very well with my command members either.

Upon completion of my 2-week stay, I was asked if I would be interested in attending a PTSD program at the Department of Veterans Affairs (VA). I agreed to the move and off I went. Remember the two medicines I told you about? At one point while I was at the VA, I was up to 12 different medications a day. I saw several doctors throughout all of this, and it seemed that each one had a different medicine. I often wondered if they ever talked with each other.

During my stay at the VA, I managed to get into three automobile accidents, and I was experiencing visual and audible hallucinations that I firmly believe were a direct result of being overmedicated. On any given day I was sad, mad, or depressed. I often felt that I was weak and not worthy of calling myself a Marine anymore. I slept covered in sweat every night and constantly shook uncontrollably. I got to the point where I believed PTSD was nothing more than an acronym created for weak Marines.

The true horror of war is coming home without all of your Marines, because at some point you have to look at yourself in the mirror and wonder, "Did I give them my all?" "Did I train them to the best of my ability?" I could not answer yes to either question. I still can't and wonder if I ever will. About 1 ½ months into the program, somehow I went from 12 medications down to 4 overnight, and I don't believe anyone knew. I desperately wanted off all of them, though. Within a couple of days, everything started becoming clearer to me. I successfully completed the VA's 3-month PTSD program, and I stopped taking all medications with the exception of two.

When I returned to my command, I was offered an instructor's position at the Martial Arts Center of Excellence. Their reasoning for this offer was to give me time to heal mentally, physically, and spiritually. They also thought that getting me out of the office environment and putting me around Marines again would help as well. They were right. The shared adversity of the Marine Corps Martial Arts Program (MCMAP) has helped me get my life back on track.

Every day is a better day now. As my body and mind grow stronger through the synergies of MCMAP, so does my spirit. I see everything so much differendy now. Looking back, I don't believe anyone is to blame for my craziness, but I do think we can do better. We have got to make our Marines and sailors more aware of PTSD before they end up like me and others. The following is what I learned:

  • Medicine alone will not calm PTSD symptoms. Therapy is a must, and it has to be done with others who have experienced the same war or conflict. In other words, veterans of Operation IRAQI FREEDOM should not be undergoing therapy with Vietnam or Operation DESERT STORM veterans. The symptoms are the same, but the time periods are different.
  • Alcohol and pills don't mix. The Marine/sailor should never be told that moderate alcohol consumption is acceptable.
  • It is okay to mourn those you've lost, but remember, they don't want you to be sad. They want you to celebrate their lives.
  • PTSD is not a weakness. It is a normal reaction to a very violent situation.
  • I firmly believe that a lot of my problems were caused by overmedication. The medication affected my judgment and my ability to cope with the true issues that haunted me. I also have since suffered from a seizure, which is believed to have occurred from the same cause. So, ensure that the Marines/sailors know that it is okay to question the amount of medications they are taking and why.
  • Place more emphasis on the postdeployment health questionnaire all Marines/sailors have to fill out before leaving theater. I remember Marines being told that if they marked "yes" to anything, it would cause problems with their taking leave. They don't know that PTSD is not even noticeable until they come home. Marines/ sailors should fill out these questionnaires honesdy when they get back in garrison, and they need to know that it is okay if they are experiencing difficulties readjusting.
  • Leaders should sit down with their Marines/sailors prior to releasing them for leave and cite different examples of PTSD so that they know what to expect and how to recognize the symptoms. When they return from leave, leaders should get them enrolled in as many schools as they can. Regardless of whether they can get them into the schools or not, leaders should set up a well-planned schedule for them.

Every leader knows that the best way to begin the day is with physical training. It is a fact that physical fitness stimulates both the mind and the body. This statement doesn't mean you have to run 3 miles every day. Leaders should incorporate running the obstacle course with martial arts training or even just a simple drill that enhances combat conditioning. Whether this training is done for individual competition or as a team event, everyone will be able to achieve shared adversity.

One of our leadership principles is to know our Marines and look out for their welfare. They deserve this, and we owe it to them. With that being said, I leave you with this final thought from former Commandant, Gen James L. Jones:

Ensure that no Marine who honorably wore the Eagle, Globe, and Anchor is lost to the Marine Corps Family.

SSgt Travis N. Twiggs lost his battle with PTSD and died tragically on 15 May in Arizona. SSgt Twiggs had been undergoing treatment for PTSD at the Naval Hospital, Bethesda, MD. Our deepest condolences are extended to his family.