It goes without saying that PTSD, much like any medical condition, can be managed. Diabetics have to manage their diet, and even the more severe cases of type I have insulin pumps to help cope. Post Traumatic Stress is really no different. There are things I have trouble doing, not because I'll "freak out" but because the memories associated with it are truly painful. Does the average person wish to rip out their stitches if they have a gash their arm? Why would they assume that I somehow enjoy reliving my memories of young men dying in truly horrible ways. I have learned that the trick to ensuring that your life isn't like walking through a minefield, is to plan ahead your day, to make sure that you don't run afoul of the things that will "trigger" an event.
It was almost a year after I had been CASEVAC'd out of Baghdad that I learned, much to my dismay, that a song that I loved could trigger an event. You tend not to realize how sad Sweet Home Alabama is until it is played at a friend's funeral. At first it would cause full on flashbacks, forcing me to relive his death, now however, after hearing it a few times on the radio, being caught unaware, I realized that I couldn't simply avoid it forever. So I played this song on low levels, while trying to remember the good times I had with PFC Harrelson. The laughter he and I shared, the time we were on guard together, and got into a deep debate about which was better 'Bama (which he planned on going to) or USC (which I planned on going to). I still get a kick out of intentionally inflating the USC stats just to get him red faced. Now the song merely makes me uncomfortable rather than having me huddled in a corner crying.
There are things that make me angry. Stolen Valor. People talking about Call of Duty as if they had somehow actually been to a war. People telling me that Iraq was an "illegal war", or somehow suggesting that I had a great old time raping and pillaging everything in sight. Yes these things can make me angry. Very angry. Do I contemplate violence against such people? Well, if you were in my shoes wouldn't you? I've learned that working out, often strenuously, can help cope with this anger. Draining away the things that got on your nerves and leaving you in a semi-blissful state. I have also learned that walking away is one of the better things I can do. If I stay and engage, I will no doubt get worked up, and want very much to put their face into the concrete. This would be a less than optimal response.
The problem is that some things will strike like a raw exposed nerve. Some civilians don't understand why I can go from lukewarm to boiling in no time flat. Even more, if they did know, wouldn't understand the titanic struggle it is to keep calm. I know if I ever were to get into a fight with certain people I can cause serious harm, so its absolutely vital I maintain my cool. Sometimes I have to detach my mind and think about something else entirely, sometimes I just have to shut my eyes and breathe deeply. The hardest times is when its a boss, and you can not show disrespect. In those times I have leaned that the best solution is to pull out a notepad and pretend to make note, but really make a list of things that calm me down. I've also learned that if you are able, you just have to do a few pushups. Its far better that than slam them against the wall to explain just why they're pissing me off (as much as that seems like a good idea at the time).
I have also learned, the hard way that the very direct method of talking used in the military is off putting. People don't like it when you explain to them the numerous ways they screwed up little things, and the suggestion that they fix themselves, is just as often not well received. I have learned that being quiet, except when trying to give needed information is better than speaking my mind. I have tried hard to curb my swearing, often practicing speaking to a voice memo, with sample conversations, playing it back to myself to make sure that I wasn't swearing. Unfortunately much like the physical aspect the mental aspect of dealing with the uninformed or the intentionally ignorant is taxing. Thus I have turned to blogging, and writing in general, where I am free to let it out. Much like a pressure cooker, if you do not let off steam it will not end well.
The hardest thing to cope with is the things that you don't expect. The smells of burning diesel, or cooking pig, the sound of distant gunfire, or pops that sound like them. These things can pop up at random. Even movies that you once enjoyed may remind you a little too strongly of events that happened. I used to love the film "Midway", unfortunately there is a scene where Charlton Heston's son (in the movie) gets hit, and his plane catches on fire. I can tell you those screams are a little too real for me to deal with. Getting pulled over by police is also a hazard. I have learned that the flashing lights do not bode well for me. I usually cover my eyes as much as possible, but if I've had a few, and the Designated Driver (DD) gets pulled over, the effect is crippling, and I feel the urge to run. This has happened to me twice. Both times did not end well. I understand why they have the flashing lights, but there is just something about them at night that really disturbs me.
If you are a Combat Veteran with post traumatic stress, I would tell you figure out what your triggers are. What makes the experiences come back, and find some coping strategies that work for you. Keep a journal, and track your progress. You would be amazed how far you come in just a few short months. Remember life will not be the same as it was before the war. You need to deal with that. You're not crippled, or infirmed, you're just going to have to deal with this. Life is worth fighting for. Don't give up because the days seem hard, and the nights endless. You are not alone, and you can get through this.