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Chat Transcript with Dr. Cantrell, April 8, 2008
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Educational Purpose NOTE: The chat discussion is intended solely for educational and informational purposes and not intended as medical advice. Please consult a medical or mental health professional if you have questions about your health.

No patent liability is assumed with respect to the use of the information discussed. The speakers and/or assume no responsibility for errors or omissions. Neither is any liability assumed for damages resulting from the participation in the discussion or use of the information discussed.

The following is a transcript of the "Chat with Dr. Cantrell" from April 8, 2008. Links to additional resources and information from the chat transcript are included to the right.

linda038: Welcome back, its great to see you again

Dr. Cantrell: Yes, please just give me one question at a time, this way I can answer them

BJM_6378: Dr. Cantrell - have you had a son or daughter return from war?

Dr. Cantrell: No I do not have a child of that age.

BJM_6378: Dr. Cantrell....then homecomings and PTSD are disciplines you have studied?

Dr. Cantrell: Yes, absolutely. I have worked with veterans for over 18 years, and I did my dissetation research on PTSD in VN veterans, and I go all over the country doing my reintegration and PTSD workshops for all branches of service, their leaders and their familes. I just returned from working for four months in Hawaii with the 7100 troops who just returned from the Warzone.

katwig12: and thank you for that Dr Cantrell

Dr. Cantrell: I just wanted to let the parent know that this is my life, and I am immersed in the military culture and the current issues facing our men and women in uniform and their familes members

Dr. Cantrell: It is truly an honor and a privilege to be of service in this capacity.

Cuffnya: my son is in his first deploy in Afghan and I expect that he'll come back with some problems. We have a parent support group meeting the 24th with a PTSD clinician so we are trying to learn how to cope and talk with our marines and help

Dr. Cantrell: Yes, it can be very challenging. It is very important that you go with the flow, because your son has changed to a great degree and I have heard first hand from some of the Army troops I work with that their parents don't understand. The dynamics are different with the parents and it is very difficult assessing where you fit into their support system.

Dr. Cantrell: I hope you read Down Range to Iraq and Back and Once a Warrior Wired for Life, these will offer some insight into their lives and the issues they are facing. I think that one of the most difficult things is to decide when to intervene

Cuffnya: I just finished it

Dr. Cantrell: Did you read both of them?

Cuffnya: wired for life

Dr. Cantrell: Down Range is also very helpful and straight forward

Cuffnya: its on my list to do

linda038: Down range was very helpful

Dr. Cantrell: Thank you

PipersMom: My son still has a problem being in crowded areas, malls etc. will this get any better?

Dr. Cantrell: Working on my next one right now as well, should be out this summer

PipersMom: fantastic!

katwig12: Both books were excellent- I have shared them with everyone I meet that may be in need

Dr. Cantrell: Yes, being in crowded areas, with a lot of people is very anxiety arousing. They translate these types of situations to the warzone and it means that things are out of control and not contained. So it is good to know these things ahead of time so you can help your son temper these types of exposure and understand if he/she does not want to go to the mall etc.

PipersMom: We reseated him on his recent leave so his back was to the room at a restaurant and he seemed to calm down

Dr. Cantrell: Wonderful. I ask that you learn as much as you can, be a second set of eyes, anticipate situations and work with them to find a solution. We always want to normalize their experience and not shame them in any way.

PipersMom: I try to inform others also, new wife, family etc

katwig12: We have found that my son does best around his Marne buddies that are also out now

PipersMom: I haven't read the second book yet, will it be available at the conference?

PipersMom: I've noticed that too kat

Dr. Cantrell: Yes, they feel like they belong with their group, they have a very hard time relating to civilians and family members who do not have the same experience. and the bonds they form while serving in the military are unlike anything any of us will ever know. They often times feel like they no longer fit in, they have out grown their peer group and relate to those they vow to lay down their lives for.

Dr. Cantrell: My books are available at your bookstore and yes they will be available at the conference.

katwig12: also- his unit deployed again- brought up "stuff" for all of us

PipersMom: Yes, I have found that out, this last time he was home on pre-deployment leave he told me "most people stare at his tattoos and "don't understand him" he thinks they are judging him

BJM_6378: kat - is your Marine still active?

Dr. Cantrell: Yes, families get triggered or reminded of a previous deployment

katwig12: no- he is IRR

BJM_6378: what is IRR?

PipersMom: He is gone to Iraq again for third time, is there anything I need to do different this time while he is there

Dr. Cantrell: Yes, this is probably true, they don't understand him and they have no idea what the significance of those Tattoos mean.

katwig12: he served his 4 years active- now he is Ready Reserve

BJM_6378: thanks

elle105: i've heard the same about the tattoos

PipersMom: thanks for the help, he was seeing a counselor and I worry that he will miss that "unloading" while he is deployed this time. Thank so much for being here to help us mothers that feel caught in the middle

linda038: My son will not wear hsi OIF hat or tshirt, says too many people ask questions. He gets very upset with the things people ask him.

linda038: Some are very prying

katwig12: same here Linda

PipersMom: I've had that too Linda and the things that people will ask are unreal

Dr. Cantrell: They do not like to feel like they are being pointed out and many do not want to answer questions, they just want to disappear into the background.

BJM_6378: sorry but I don't know what OIF stands for?

linda038: Operation Iraqi Freedom

Dr. Cantrell: Operation Iraqi Freedom

BJM_6378: my big mistake - should of known that

linda038: will that ever go away Dr Cantrell

PipersMom: no problem

Dr. Cantrell: We all learn from each other

linda038: He isn't ashamed, just hates the questions

Dr. Cantrell: I am not saying they are ashamed at all, they don't want to be questioned, they do not want to get angry and they do their best just to be discrete

Dr. Cantrell: Linda will what ever go away?

katwig12: Dr. I took Nick to Charleston for a day/ night- and accidently booked a hotel right acrosss the street from the VA... and of course military were everywhere- I don't think he slept a wink that night- I said we could go somewhere else and he insisted it was ok- but it made him sad

linda038: the feeling that people are prying

Dr. Cantrell: I am sorry he is having such a difficult time (hold on Linda) and yes sometimes seeing others in uniform can also trigger them or going to the VA and seeing the veterans who are seeking care and are not well is very upsetting to many of them

Dr. Cantrell: Linda things settle down over time, and they will learn what works for them, but there may always be some things that they will not feel like addressing or discussing.

linda038: I try to tell him that its human nature to be curious, most aren't trying to pry. Itís very sad. He works at the local VA and he has run into many WWII vets

Dr. Cantrell: Yes, it very human, and sometimes many do not know how to approach our troops, they just don't know what to say sometimes

linda038: thats so true

Dr. Cantrell: Yes, seeing the WWII veterans who are dying in the hundreds is very sad for our new troops, who know that that old gentleman was once just as he is today: strong, capable, and fearless, and now the WWII vets are vulnerable, and many do not even recognize the incredible warrior they once were, so these are the things that makes one sad.

linda038: Does anyone have a question for Dr Cantrell? One at a time please.

Gunnerswife: Is it normal for my husband to be physical while he is sleeping and then not remember what happened when he wakes up

Dr. Cantrell: Yes, many have nightmares and act out in their sleep. Often times people will have nightmares, and not remember anything, but they just feel wasted the next morning or their loved one informs them of their combative sleep.

Dr. Cantrell: Please be careful when sleeping next to him. Sometimes it is preferable to sleep separately if your Marine is having a great deal of physical action during his/her sleep.

Gunnerswife: very combative sleep, this is our 11th deployment and 5th combat deployment

katwig12: wow

PipersMom: God Bless you and your husband gunners

Dr. Cantrell: This must be a very challenging time, and with each deployment it gets a bit more difficult to transition.

Melissa: whoa...I commend you gunners

Dr. Cantrell: It is very difficult on the wives when these deployments continue like this.

PipersMom: My son did that in his sleep after his first deployment and his first wife couldn't deal with it and left. Thank God he has a very understanding wife now.

katwig12: gunners- I'm surprised you guys aren't having a slug fest in both of your sleep

Gunnerswife: things are ok, he is deployed again, but things usally take a month or so to ease up

Melissa: dr. cantrell...that's where my question is headed

Dr. Cantrell: Sometimes in reailty it can be dangerous to the partner. I have had had wives held down, hit and kicked out of bed so it is very important that you assess the situation and Stay Safe

Gunnerswife: he would never hurt me intentionally, and feels really bad in the morning when I let him know what he has done, he does try to keep it in control but when he is asleep he doesn't know what he is doing, I do stay very aware of what goes on when he first gets home

Dr. Cantrell: Absolutley they do not intend to cause harm, but with the level of intensity they come home with, you must be smart. I have women who have been hurt by their husbands, and there is no history of domestic abuse, this is not what we are talking about. We are talking about the fact they are activated in their sleep, and they are hyper alert and sensitive to their surroundings. We don't want them to feel bad about their sleep issues. This is the primary problem is sleep and these types of issues.

Dr. Cantrell: This is one way of how transgenerational trauma issues come about. Lets say a loved one is falling asleep and one night their marine lets lose and hurts them unitentionally, and then the next night you lay there and have some anxiety as to whether or not they are going to come unglued again, and then the partner starts having hyper vigilence and sleep disruption. then we have to two people who are sleep deprived and more edgy and anger can come about. This is just an example of something that

Dr. Cantrell: Does this mean you did not get any of my answer?

Melissa: oh yeah i do!

Gunnerswife: I got all of your answer

Dr. Cantrell: great.

Melissa: I was just wondering if you knew anything about PTSD in the spouses of deployed marines...

HapE2BaMom: can i ask what is PTSD

Melissa: if that was even possible

PipersMom: Post Traumatic Stress Disorder

linda038: post traumatic stress disorder

HapE2BaMom: oh, ok thanks

PipersMom: you're welcome

Dr. Cantrell: Yes, I do know about PTSD in spouses, what would you like to know.

Melissa: i dunno...maybe how to deal with it

PipersMom: Do you have a question for Dr. Cantrell?

Melissa: I just wasn't sure if it was possible...I've acquired anxiety that i've never had before

Dr. Cantrell: The example I gave with the sleep issues is an example of how wives begin to walk on egg shells. Family members develop similar symptoms based on living with someone who is having severe PTSD symptoms.

PipersMom: I think I walk on eggshells sometimes when my son is home, I find myself "running interference" for him

Dr. Cantrell: Yes, I have seen this. Are you walking on egg shells to forge off others from saying things that might set your son off?

cjv: I do that too,. isnt that just trying to protect them from anything more than they have been through?

Melissa: well what about having a form of ptsd just from experiencing deployment...prior to your marine coming home?

PipersMom: yes I think so and I have the extreme anxiety that I didn't have years ago that melissa mentioned

Melissa: unless ive totally got the definition wrong

Dr. Cantrell: You can have a stress reaction, and there is a great deal of anxiety about the homecoming process

Melissa: yes and the readjustment process too

Melissa: which is probably the same thing

Dr. Cantrell: PTSD has several components, and you must also have experienced or witness something horrific

katwig12: I think that part is harder for wives

Dr. Cantrell: Yes, some of my wives say that even hearing the doorbell ring or the phone ring the adrendaline surges in their bodies

Dr. Cantrell: anticipating bad news, so it is a very difficult time and anxiety certainly plays a huge role in this process.

elle105: I have a question. I' m no longer with my marine, he ended our relationship when he got back in november due to many issues, he was really unhappy with himself and things he had experienced and wanted to be alone. I learned he was drinking A LOT when he came back. It seems like this is normalized in his circle but I was and still am concerned about it. What can loved ones do about the excessive alcohol use? i mean, i felt so useless and helpless..he knew he prob shouldnt b drinking so much but

cjv: I felt that way during my son's 1st depolyment

elle105: my message was too long. did u get it or should i retype?

Dr. Cantrell: Yes, many are chosing to leave their relationships because they feel they donít have the capacity to deal with their loved ones and themselves. Alcohol unfortunately is part of the military culture, and it is a problem. Most of the MP calls deal with Alcohol, anger (domestic abuse) and speed (motorcycles accidents). They choose Alcohol over psychiatric drugs as a means of self medication to sleep, forget and to avoid dealing with some of their issues.

elle105: yeah he does have sleeping problems so i guess it is a way to self medicate

PipersMom: My son will not take so much as an aspirin but will drink to excess, I just don't get it

Melissa: i see that with a lot of my marine's friends and sometimes him...he became a "rebel" for a few was so hard

elle105: said he was going to seek counseling but for some reason he was hesitant to go through the military. was going to try to go to a private one but i doubt he followed through

Dr. Cantrell: If you feel he is in danger the best thing is to call one of his buddies and let them deal with it, especially if you are no longer with him. If you feel he is of danger to himself you should report this to his command.

elle105: we don' t have much contact anymore so i can' t even asess it anymore =(

Dr. Cantrell: They are so afraid of the stigmas of taking and anti Anxiety, anti depressant or sleep pill because they fear they will lose their secret clearance and their career will be in jeopardy. I run into this all the time when I talk to all the troops I do.

PipersMom: Well, that does make sense, thank you.

Dr. Cantrell: We still want to encourage them to get help if you see that they are having some hard times. Help comes in all forms too: Older veterans, their buddies, church, family, chaplains, therapists

floridapmm: my son is on his first deployment now, he told me that many guys who have been deployed don"t sleep well, don't stop at red lights when they come home, don't like crowds.

Melissa: im going to check out the wives room...thanks dr. cantrell!!! :)

Dr. Cantrell: Yes, this is all very typical. If we take all of these behaviors and link them back to the warzone, it will explain these issues. They are on all the time, they do not sleep well, they must get up at a moments notice, and things happen at night, Stopping at lights could mean the difference between life and death in the war zone, they want to keep moving at fast steady pace, crowds mean that things could be out of control and too much stimulation.

floridapmm: thankyou for your explanation

cjv: I noticed the crowd thing with my son when he got back

Dr. Cantrell: Yes, this is very common.

PipersMom: Are there any long term effects that show up later in PTSD patients

Dr. Cantrell: PTSD is something that one has in their lives, it is a matter of learning the triggers and adapting to them over time. Some do well, some not so well. and everyone is different.

elle105: can they do this without treatment?

PipersMom: I understand thanks

cjv: he has said that he is dreaming a lot since he came home. He does not say about what but just that he is. is this common?

Dr. Cantrell: Treatment has shown to reduce the symptom duration in half, so it is important that one gets help if they need it.

floridapmm: my friends son who came home from a deployment went out to dinner with the family, it was a noisy resturaunt, he finished his meal and jumped up from his seat and went outside to wait for the family

Dr. Cantrell: Dreams are very common, this is when we do a lot of work. Our defense mechanism are not in place as they are when we are awake and issues come up. If he is having nightmares this can certainly be disturbing.

cjv: I donít think they are nightmares but more replaying things he has been through and trying to put them into a place he can deal with it.

Dr. Cantrell: This young man was taking care of himself, I must commend him for doing what he needed to do and he knew his level of tolerance, so please let the parents know that their son was be proactive and it is not easy for them to go to places such as this. GOOD for HIM!

floridapmm: thankyou

Dr. Cantrell: Yes, our sleep allows us to revisit things, and this is helpful in many aspects.

PipersMom: My son was better after his second deployment than his first, I am hoping this third one will not make things worse.

Dr. Cantrell: The deployments are all different and they have different issues. So there is no way of predicting how he will do.

PipersMom: I agree, but the more prepared families are the better and your books are an excellent read and source of information

Dr. Cantrell: Yes this is so true, the better prepared the better it is for your marines, as they know you have taken the time to learn and do you best to understand them and their behaviors.

cjv: is there one that you recommend for siblings?

floridapmm: What is the name of your book?

Dr. Cantrell: You can go to my website and download Hearts on the Homefront and there are a lot of things for kids and the affects these deployments have on them. Our books are:

Dr. Cantrell: Down Range to Iraq and Back, and our new one is Once a Warrior Wired for Life.

Fryone55: terrysmom, do you have any questions for Dr. Cantrell?

terrysmom: I don't think so, I am hoping with this current deployment we won't have these issues. He is depressed at times but i believe will be fine when he gets back home

Dr. Cantrell: Why do you think this deployment will be different?

terrysmom: he is on a MEU, so he hasn't been in action so to speak

floridapmm: my son is deployed and is going to be right in the thick of it

Dr. Cantrell: One does not have to go into action to be affected. I have Marines who are MEU and they see some things too.

cjv: cant just seperation be tough on them?

Dr. Cantrell: SO many of the soldiers tell me "I was on the FOB", but the fact of the matter you do not have to go out in ground units to have issues.

terrysmom: Oh, he has HAD MANY ISSUES that we have discussed

Dr. Cantrell: This is great that you are communicating. It is said that with the multiple deployments that our troops and 50% more likelihood of acute stress symptoms, which means sleep, anger, hypervigilence, etc. So we must always be open to see the nuances of their behaviors and get help if necessary

cjv: I am heading out. Thanks Dr. Cantrell

Dr. Cantrell: You are welcome

floridapmm: Thankyou for taking the time to answer our questions

Dr. Cantrell: You are most welcome

Fryone55: elle, do you have any more questions for Dr. Cantrell

elle105: not any right now

PipersMom: Dr. do you think that most PTSD patients will seek treatment after they are out of the Marines? My son will get out in October and I'm afraid he will just push all this aside.

Dr. Cantrell: It is hard to say, the stats show that only 40% of those needing help or seeking it. I do my best to dispell stigmas which get in the way of getting help, and a lot depends on the command and how supportive they are.

elle105: i' m going to head out. Thank you doctor. I will definitely read the books, I hope to catch you at your next chat. Good night everyone!

Dr. Cantrell: If your son pushed things aside, this can also be a coping mechanism, which works for a while for some, but you can always call an older veteran and ask them to take him to coffee or call one of his buddies and let them know your concerns.

Fryone55: take care elle

PipersMom: thanks, he was dealing with it until he was recently deployed again and I want to make sure he continues treatment when his EAS date rolls around but of course, you can't make them.

Dr. Cantrell: No we can't make them and this is what is painful. The great part is that you are communicating and you sound like you are very aware of his issues.

terrysmom: Thank you Dr. Cantrell, good night everyone

Dr. Cantrell: You are so welcome.

Fryone55: thank you again Dr.


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