Dear Mr. Trump,

            Upon reflection of your recent statement regarding returning soldiers who suffer from the signs and symptoms of Post Traumatic Stress Disorder (PTSD), I felt compelled to reach out to you in hopes to clarify the common misunderstandings and misinterpretations that your choice of words appear to reflect. While the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does categorize PTDS as a mental illness, it is imperative to understand PTDS is a physiological phenomenon that alters the way the neurological system functions. This disruption causes debilitating signs and symptoms that can lead to suicidal ideation and subsequent fatalities. Just as a diabetic cannot think their way out of a diabetic crisis, sufferers cannot “think” their way out of PTSD. How do I know so much about PTSD? I am one of the seven million Americans who have PTSD.

            I am not a soldier in the conventional sense, Mr. Trump, but I have been to war. My son was diagnosed with lead poisoning as a baby and the effects have been catastrophic. When my son turned four years old, he slowly began to show signs of improvement. His lead levels were finally normal and some of the symptoms began to subside. That same summer, I was diagnosed with Paget’s disease, a rare form of nipple cancer. The underlying cancer within my left breast was HER, PR, and ER negative. I was in the fight for my life. A bilateral mastectomy and a prophylactic unilateral oophorectomy were performed.

           Cancer is horrific but having a sick child was and is the worst thing that has every happened to me. When I reflect on that time, I realize that I was suffering from PTSD and needed help. But like many parents with a chronically ill child, my focus was on my son. A study at Stanford University found that over 40% of parents with a baby in the NICU have PTSD. Parents of chronically and terminally ill children are highly susceptible to this disorder but it often goes underdisgnosed and undertreated. The statistics are similar for cancer survivors and those who have lived with chronic or terminal conditions. My hope, as a nurse, is to advocate for screening and treatment of PTSD in these vulnerable populations. Health care professionals have worked tirelessly to debunk the negative stigma that surrounds mental health issues and Mr. Trump, your choice of words will make it harder for my patients to accept help.

            Within two years after my diagnosis, my mental health crumbled but I refused to get help because I was “strong”. Mr. Trump, that was the word I used and still use to describe myself. I had survived caring for a chronically ill child and battling cancer and I didn’t want to sit in a therapist’s office talking about all the terrible things that had happened to me. I wanted to spend that money on guitar lessons and shoes. If I was going to die, I was going to go down singing Joni Mitchell in a killer pair of pumps.

            The word “strong” has conflicting connotations for cancer survivors and, I imagine, for soldiers as well. Being a survivor of a battle, be it gunfire or proliferating abnormal cells, is weighted with copious amounts of self-inflicted guilt. The survivor questions the survival and wonders why their neighbor, friend, buddy, fellow platoon mate, brother died. Why did I survive? Why am I here and not them? That question is what makes getting help for PTSD so difficult. For me, getting help was an admission that I was ungrateful for surviving. I was weak and unappreciative of the second chance I was given. This prevented me from getting help for almost three years.

The spring my son had his ulcer, the DOE tried to shut my kids’ grammar school down. My children’s school represented a community that had held me up when I was sick and cared for my child’s needs and that safety net, that family, was going to be ripped from me. And on top of that, I had another health scare and another procedure to rule out cancer. Knock out! I went down for the count right on my bathroom floor, the cool tile pressed against my face keeping me from sinking though an eternal black hole. I fell down and I couldn’t get up for about an hour. I broke, Mr. Trump, under the weight of cancer, childhood trauma, and a sick child. My nervous system collapsed which frightened my husband but I finally conceded to get help.

            Within the first fifteen minutes of my first counseling session, my therapist diagnosed me with PTSD. The past five years suddenly all made sense: the insomnia, the flashbacks, the rage, the panic attacks, and the extreme avoidance. Of course I would get a shooting pain in my chest every time I was startled because the neurotransmitters responsible for my startle reflex had been pushed into hyper drive! I had this PTSD. And what was even more amazing is: I didn’t have to suffer anymore.

            Now, I love to research, Mr. Trump, and I have my degree in nursing so I’d like to share some information on PTSD with you so you understand the facts on the disorder. The nervous system, Mr. Trump, is actually made up of two neurological systems called the sympathetic and the parasympathic nervous system. The parasympathetic is commonly known as “the rest and digest” system; this system slows the heart rate, constricts the pupils, and promotes digestion. Remember when your mother told you to not to jump in the pool right after lunch? Well, she was talking about giving the parasympathetic nervous system the opportunity to direct blood and vital resources to alimentary system. The sympathetic nervous system is commonly known as the “flight or fight mode”; the heart rate increases, the pupil dilates, and the sensory awareness increases.

The evolution of species often contributes or enhances characteristics (if you are not a believer in evolution, I’ll address that in another letter!). The nervous systems of homosapians developed in such a way that when faced with imminent danger (e.g. being eaten by a lion) the sympathetic nervous system causes our body to jump into action: increasing our heart rate to rush blood to the brain, muscles, and other vital organs; dilating pupils to allow more light in to increase our visual acuity; and arousing our senses to help us figure out how to escape the beast that is now licking its chops and coming straight for us!

PTSD is a disorder that happens when someone has faced a traumatic event. This event flips on the sympathetic nervous system switch but with PTSD the problem is: the body gets stuck in that “fight or flight” mode and can’t get out of it. Arousal and reactivity, avoidance, and re-experiencing symptoms can occur involuntarily making the suffer feel out of control. This often leads to depression and suicidal ideation can occur. Sleep deprivation due to insomnia can compound the effect of PTSD creating a vicious cycle that traps the sufferer in an endless state of alertness.

         Mr. Trump, please ponder this hypothesis for a moment: PTSD is not an example of human weakness but exemplifies the genius in the evolution of our survival as a species. If you take a closer look at the various signs and symptoms, you will realize that each sign and symptom of PTSD aided in the survival of our species. Re-experiencing symptoms (e.g. flashbacks, bad dreams, frightening thoughts) teaches us to have constant vigilance of the danger. Avoidance symptoms (i.e. staying away from elements of the traumatic experience) utilize our instincts to avoid death. And the arousal and reactivity symptoms (e.g. being easily startled, tense feelings, insomnia) would all be beneficial if we were living in the woods under constant threat of being some creature’s lunch.

         As Charles Darwin meticulously examined, species usually evolve in ways that enhances their survival rate. Fantastic! Right? Not in every case. Sometimes in the process of evolution, we are left with useless body parts, vestiges (the appendix, wisdom teeth, and leg hair). But sometimes, in its quest to improve the survival of the species, evolution can actually alter the body in a way that is detrimental to positive health and well being of that species (e.g. sickle cell anemia evolved in humans in Africa as a way for the body to resist malaria, however, sickle shaped blood cells occlude blood vessels causing pain and necrotic tissue). Specifically, while signs and symptoms of PTSD evolved to keep us out of danger, PTSD prevents the sufferer from functioning when normalcy is now a series of non-life threatening events.

         Now, I’m not implying that those who don’t developed PTSD are less evolved than those who do, I just think we need to readjust our perception of this disorder so that people can seek help without fear of judgment. PTSD is NOT a sign of weakness. PTSD is NOT a personality flaw. And PTSD did not happen because the suffer couldn’t handle it. PTSD is an evolutionary byproduct of the survival of our species that affects the neurological system. AND the best new is: PTSD is treatable.

      As a nurse, a mother, and a PTSD sufferer, I implore you, Mr. Trump, to make a personal statement about your remarks on PTSD. I’ve even written them for you because I know you’re a very busy man.

 

So people, I’m gonna do something I’ve never done before because it’s the right thing to do. I gonna say I was wrong. Wrong. Wrong. Wrong. I was wrong for saying that people with PSTDBS, I mean PBDST, I mean, what, okay people with P…T…S…D….are not un-strong for not being not being able to “handle” seeing terrible things while fighting for our country. In fact, I’m gonna just say here, now, that people who get help for P…T…S…D…have tremendous balls. I’m just saying. Huge. They have huge balls for asking for help. Like huge. Like as balls as big as China. These people who ask for help are the bravest, most courageous, biggest ball carrying people I’ve every met. Please, if you think you or someone you love might be suffering from PTSD please call (802) 296-6300 or email ncptsd@va.gov. That’s all I’m gonna say.

 

Thank you for your time, Mr. Trump, and I look forward to the release of your statement!

Sincerely,

Shannon Burkett R.N.