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ADHD and PTSD: An Explosive Mix
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By Iban Goicoechea

 

My name is Iban Goicoechea (roughly pronounced: ee-bahn goy—ko-uh-chay-ah); my father is Basque—to answer the question about the origin of my name.  I am 25 years old with Attention Deficit Hyperactive Disorder (AD/HD also referred to as ADD).  I’m a United Sates Marine Corps infantry combat veteran, and a student at Columbia University.  

 

I’d like to help people understand the issues faced by men and women with AD/HD who serve(d) in the military who, like me, lived through potentially traumatizing events.  In this and future articles here in the eNews, I’ll share my perspective and opinions as well as my experiences as a combat veteran with AD/HD, and try to communicate the impact veterans’ issues have on our society.  

 

First, a little about myself; I’ve lived with ADD since early childhood, struggling to focus, pay attention and to prevent myself from "spacing out.”  My AD/HD remained undiagnosed until last year, and I realized living with AD/HD was exhausting and the coping mechanisms I’d found on my own were not always effective.

 

I enlisted in the United States Marine Corps infantry in 2006 and deployed to Iraq and Afghanistan in 2008 and 2009 respectively.  In Iraq I served as my squad’s patrol radio-operator, and in Afghanistan I led our Company Level Intelligence Cell and was a driver/turret gunner in our Company Commander’s Personal Security Detail.  My active duty contract ended in December 2010, and I decided to take a year to stabilize and work through issues I sensed were there, or developing.

 

That year made an inestimable difference.  My mentor helped me stop avoiding and directly confront the root of the problems I had been manifesting; I consider myself to be one of the lucky few to have someone who was able to provide me—not just help—but the help that I needed.  With the help of my mentor and VA resources, I was able to move on with life.   

 

In January 2012, I moved out of the homeless-veteran transitional-shelter where I was living and into a university housing apartment closer to the Columbia University campus.  Once at Columbia, I participated fully in student life; I was elected Legislative Assistant to the University Senator for our college (General Studies [GS]), became active in both the U.S. Military Veterans of Columbia University (MilVets) and the Student Council Policy Committee, and took advantage of miscellaneous other involvement opportunities that arose.  In April 2012, I was elected to be the 2012-2013 Student Body Alumni Affairs Representative for GS.

 

Because of my steady involvement in university life, one evening last semester the Dean of my College invited me to dinner at the Columbia Club in NYC.  The rest of the dinner party consisted of the Dean of enrollment, five other veterans who attend GS, and two White House staff members directly responsible for veterans’ affairs and programs.

 

I must interrupt my story for a second.  One of my goals here is to facilitate the honest dialogue that is needed to effectively approach veterans’ issues.  Unfortunately, many veteran experiences are hard to communicate.  Most civilians’ knowledge of veterans’ experiences is limited to what they learn from the media.   Few veterans can articulate their most personal experiences, leading to a lack of communication and understanding of the resulting issues.  That being the case, the media only provides civilians a false transparency in the civilian-veteran relationship.  In my articles, I will attempt to create a deeper understanding and true transparency in our relationship by sharing my own experiences (that haven’t been turned into a sound-bite) to give you the opportunity to form your own ideas and opinions.  And now, back to dinner…

 

Having been given an opportunity to dine with White House staff, I considered it a responsibility to address issues on behalf of the veteran community that is being marginalized, if mentioned, by the media.  I tabled three items with them.  We’ll be discussing all of them in future articles, but let’s start with the one pertinent to this month’s issue.

 

The rate of veteran suicides is alarming—on par with the Global War on Terror fatalities—and there is no research being done explicitly on AD/HD and PTSD as co-morbidities.

 

Following struggles in high school and doubts about future academic prospects, many young adults with diagnosed or undiagnosed ADD/ADHD join the military.  In an active military environment, the ability to shift focus rapidly is essential, and what with the excitement of constant danger and a variety of both physical and psychological challenges, the military gives attention-deficient adults many meaningful targets for their focus to land on.

 

However, and this is not only in the military, when we are unable to focus on a task that does not captivate our attention, our focus turns to something else.  When that happens, our attention often turns to issues—historic or current, pleasant or not—that our mind has magnified.  

 

For combat veterans, once the battles have ended and our shiftless focus finds nothing as interesting as imminent threat and responsibility to others to settle on, the "magnified issue” our focus turns to can easily be very dark.  Talking about those issues with civilians or non-combat-veterans, at the random times our attention drifts to them, can be unnatural or discomforting for both parties.  Even talking about them to another combat veteran can feel unnatural, and worse, the conversation may do more than just graze a sensitive emotional "trigger” for either of you.

 

When emotionally unstable survivors of traumatic events decide to not discuss their issues, and remain trapped alone with these distractions, it is common to ruminate and further magnify the issues.  Throw untreated ADD into this situation of emotional instability and reality can quickly become an isolated trip through a nightmare.  Imagine an episode of distraction driven by the force of hyper-focus on the most life threatening or devastating thing you’ve ever experienced, and not having the emotional tools with which to handle those memories; that is a common daily reality for many returning combat veterans with untreated ADD.

 

Simultaneously, that same combat veteran may be struggling to fit back in at work or in school, and even with their own family or their childhood friends.  Compound that with the stigma of a PTSD diagnosis, veterans’ disdain of psychiatric help and undiagnosed ADD (the VA does not test for ADHD) and we have a recipe for disaster.

 

More than one Marine I fought side-by-side with has ended their battle against these invasive memories with suicide.  And while we hear of the struggles with PTSD most often regarding veterans, this reality exists for anyone with ADD and PTSD.

 

Personally, I object to the classification of "Post Traumatic Stress” as a "Disorder.”  After a traumatic experience, you are living "post-trauma.”  If that event sensitized you to certain stimuli, the resulting stress is post-traumatic.  If that stress inhibits you from performing certain activities, it’s called a disorder, but a Medal of Honor recipient reframed PTSD for me, saying, "I lived on after a traumatic experience, and sometimes I feel stressed out.  I don’t consider it a disorder…”

 

From my own experience, I agree.  I believe, though, that PTSD is a dynamic between the memory of an event, and preexisting cognitive patterns; not its own disorder.  Personally, I felt like I was a passenger, the traumatic event was the scenery I was seeing through the windows of a vehicle, and something beyond my control was the vehicle that propelled me through reality and defined the scenery.  Unless I could stop the vehicle, I couldn’t do anything to change the scenery.  Once I could stop it, I was able to leave the vehicle behind and reevaluate the scenery, finally choosing to create new scenes in my life.

 

I was able to sort out my PTS, but only after confronting and addressing the residual effects of what I’ll gloss over as a "rough childhood” was I able to re-evaluate how and why I assigned the significance I did to the subsequent traumatic events.  With that, the memories no longer caused external or internal stress even though my mind still drifted to, and hyperfocused on, those memories.

 

On the other hand, my ADHD is more of a challenge.  My attention eludes me before I begin treating it each morning, and drifts after the medication wears off.  I try to focus, think about focusing, then think about my inability to focus, and the consequences if I don’t immediately redirect my focus and before I know it I’ve fallen into the same devious trap.

 

In my empirical-yet-admittedly-unqualified opinion, treating the ADHD-PTS dynamic is a promising approach to stemming PTSD related suicides, and would lay the groundwork for researching other PTS related dynamics affecting individuals and families far beyond the veteran community.  It may prove more promising to deduce the appropriate treatment from the nuances in manifestation of PTSD-related symptoms, rather than the broad commonalities of the cause.

 

In my next article, I’ll share more about the issues discussed at my dinner with the White House staffers, and my own personal experiences.  If you have questions or comments, opinions, or similar experiences, I’d love to hear from you.

 

 

Iban Goicoechea is the ADDA eNews "Vetran’s Affairs” Editor.  Many military veterans with ADHD are facing life, not only with ADHD and PTSD, but with other comorbid cognitive disorders as well.  ADDA’s eNews is giving a voice to the veterans through Iban’s articles.  If you wish to add your voice to the discussion, you may contact Iban directly at ADD.Iban@gmail.com.

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