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I think people have the idea that every case of PTSD looks like this: An Iraq war vet is walking down the street when he hears a car backfire.  Suddenly, he thinks he is being fired at, imagines he’s back in Iraq, and goes home to get his gun.  And maybe it does look like that sometimes, but not always by any stretch.

There are certainly a lot of good clinical descriptions of the disorder out there, but somehow, when you’re going through it, they can feel inadequate. They are so objective; they never sound as crazy as PTSD actually feels, and so people suffering from it can end up feeling like it doesn’t quite describe them. They can feel like, “Those other people have PTSD. I’m just old-fashioned crazy.” It might be helpful to describe PTSD in layman’s terms, not as a clinician, but as one who has it. 
There are actual physical causes. It’s not all in our heads.  Let’s say you’re a primitive man, hunting on the plains of Africa with your best friend.  It’s a warm, sunny day.  The plain is dotted by antelope and zebras.  You smell dry grass and something musty.  You feel the tall grass tickling your bare legs.  You hear something snap, a low growl, the sound of something rushing through the grass, and the next thing you know, your best friend is being eaten by a lion.  Unable to stop it, you run, leaving your friend behind, screaming.  Your brain is not going to sort through all that sensory input and focus solely on the lion.  It’s going to take the input and build a neural pathway that says, “Sunshine, plains, antelope, zebras, feel and smell of grass, musty smell, snap, growl…mortal danger!”  These become triggers for the fight or flight instinct we all associate with PTSD.  This is a survival mechanism, ensuring that we will avoid future danger of a similar kind or run sooner if we encounter it again.

Not all of these triggers will cause a PTSD reaction.  It may be triggered by one; it may require several simultaneously.  It may not just be the most logical one, say the growl or snap.  It may be something unrelated to the mortal danger, say the sunshine and antelope or feel of grass on your legs—something you felt innocuously as you and your friend walked, then felt again in more intense circumstances as you ran, hearing your friend’s screams.  From that time on, walking through grass on a sunny day makes you feel nervous and anxious—maybe debilitatingly so for a while.

Fast-forward a few thousand years.  I went to work one day, and everything was exactly as it had always been. I went through the morning, taught war poetry to sophomores, had a planning period, and came back and taught ACE (a class for at-risk students). The kids had been working on a project in the tech lab, but some were finished and others weren’t, so my teammate took half the class to the tech lab, and I kept those who were finished in the room to work on other assignments. Since there were only a few kids there and they were all on-task, I ran to the bathroom. While I was there, the fire alarm went off, and I followed my students into the beautiful spring day. When kids ran by me screaming, “They’ve got guns!” I thought they were overreacting to something—a rumor of some kind. Kids did not bring guns to Columbine. When I heard gunfire, I thought there was a real fire after all and something was exploding. When administrators ran by and told us to get the kids over the chain-link fence and away from the building, I did what I was told, calmly certain that everything was going to be just fine.

I walked to the local library (not to be confused with the school library) in the warm sunshine with hundreds of kids, and the place was in chaos. I spent God knows how long getting kids to sign sheets of paper saying they were there, letting parents peruse the lists, and then trying to get the information faxed over to the elementary to panicked families there. There were people, mostly kids, packed tightly around me, bumping against me, pulling on my arms to try to get the sheets of paper closer so they could read or sign them. People kept shouting at me, “Have you seen so-and-so? Is such-and-such on any of those?” A tormented mother asked me whether I knew her son. I told her I didn’t, and she wailed, “No one knows him! My son goes to school here, and no one knows him!”

Later that day, I went to a local elementary school where the last of the kids were trickling in, and a number of families were beginning to realize that their children were never coming home. A member of the sheriff’s department walked up onto a stage and told those families they needed to obtain their children’s dental records. It was devastating. By the time the dust settled, 15 people were dead and 24 others had been shot. I had lost two members of the speech team I coached, a former ACE student, a senior girl I’d taught as a freshman, and a colleague.

For a couple of weeks we didn’t have school, but there were update meetings in local churches. I couldn’t sit still in them. I would stare out the window and think to myself over and over, “I want out. Out. Out. Out. Out.” My skin crawled, and I wanted to dig my nails in, strip it off, and run. People say you should talk about your feelings, but how do you tell anyone something like that?

The first real inkling of what I was up against happened when I was allowed back in the building in May, a few weeks before the rest of the teachers. Whereas most people’s personal effects were scattered throughout the buildings in places that were off-limits, my purse was in the ACE office, and that part of the building wasn’t a crime scene. It was, in fact, part of the FBI command center. I walked into the ACE room, and the strobe lights were still flashing from the fire alarm.

Investigators had turned off the sound, but the lights had been flashing ever since. Suddenly, I saw my face in the bathroom mirror as I was washing my hands, and I could hear the sound of the fire alarm and see myself in the bright strobe. It was a weird flashback. On April 20th, when I was in the bathroom and the alarm went off, I hadn’t known what was happening. I wasn’t afraid. Now, in the ACE room, again utterly safe, my heart started pounding, and I wanted to bolt. Remember, though, the primitive man walking through the African plains had taken in everything he’d been doing before the lion attack, stored it all up to warn of future danger. My brain had done the same thing with the fire alarm.

This is why, if you’ve never had PTSD, you can’t make assumptions about what will trigger a reaction in someone based upon your rational thoughts of what you think you might react to.  I am far less likely to react to sounds like fireworks or cars backfiring than I am to strobe lights, and yet, you would think I’d be more afraid of possible gunfire than a harmless light. If you’re not in my head and don’t understand my experience, that probably doesn’t make much sense, but I was never in gunfire. The first sign of danger—one I didn’t even register consciously at the time—was the fire alarm with strobe lights.

My family went to Disney World for a vacation that June, where I discovered the worst of my triggers: tightly packed crowds. The feel of being jostled, the sounds of voices calling out names—I was right back in the crowd of people begging to know whether I’d seen this friend, that sibling, this son or daughter. The mother looking for her son haunted my nightmares at night, accusing me of not caring about her child. (I never did find out who she was or whether her child had been lost.) At Disney World, it seemed she might come out of that crowd at any moment. I had to fight the urge to claw at my skin as I felt flesh tighten, and that now-familiar crawling sensation took over.

At first, there were a lot of symptoms. I struggled in the grocery store. Lights, colors, noise, people—it was overwhelming, and with all those tall shelves, it felt unsafe. Long before the Aurora shootings, I had begun making movie theater escape plans in my head in case someone stood up in the dark and started shooting. I did the same thing in restaurants and malls, always figuring out what instructions to give my own children if they were with me.

It didn’t last forever. It can’t. You can’t operate at that level of anxiety 24/7, year after year. It felt like it would never stop, but eventually, I had to use that same bathroom at school again, so I breathed and watched the fire alarm strobe the whole time I was in there. The strobe was dark. I was fine. It wasn’t April 20th. We had practice fire drills, and I breathed, and we all got out, and no one was dead. Then we all went back inside and went back to work; it wasn’t April 20th. The more times we did this, the more comfortable I became.

My husband was extremely patient through this process, and I know it wasn’t easy. He married a confident, optimistic woman, and stuck by me, even though, for the first three years or so after the shootings, it looked like that woman was gone forever. She seemed buried in depression and anger and inexplicable anxiety attacks that could happen while Christmas shopping or attending Harry Potter movie premieres (crowds of kids—my number one trigger). Around everyone else, I did my best to hide it, feeling depressed and ashamed. I didn’t understand why I couldn’t just get over it. Because I was so good at hiding it, people just assumed I was my usual, competent self, and they asked me to serve on church committees or do this thing or that thing, never knowing how the stress of additional responsibilities was crushing me. I found myself on the brink of suicide more than once, the devastation I knew it would cause my family holding me back.

Finally, three years after the shootings, I took time off from work. I wrote romance novels with guaranteed happy endings where I was in total control of every outcome. I focused on rebuilding connections with my family that depression and shame had eroded. I gave myself permission to say no to requests from church and other places. I didn’t withdraw from everything. I just took inventory, figured out exactly what I needed to give myself to, and gave myself only to that. I learned that it’s OK to give yourself space in which to heal. By the time I went back to school, I was on much more solid ground. Since I had stabilized my home life and had that bedrock, work was much easier, even in a building where there were so many triggers.

Warm days in April can still make me sad, but anymore, they are just likely to feel good. I take the good days as they come and let the bad ones slide behind me. Fire drills are generally OK now, but I still don’t do well in tightly packed crowds, and if there are enough triggers all put together, I can still head into a tail spin. We had a bomb threat in 2007. The entire school evacuated to the predesignated spot—that nearby elementary school where I had ended the day on April 20th, 1999. The process was much more organized than things had been eight years earlier, but I was back in a crowd of kids and anxious parents. By the end of the day, I was back in the same gymnasium where a man had once told mothers and fathers to get their children’s dental records.

I hadn’t really, fully understood the physical aspects of PTSD until that day. I fell to pieces, wept and shook uncontrollably, and nothing—nothing—could move me to get myself together. The next day, during the follow-up faculty meeting at Columbine, it started again. No matter what I did, I couldn’t get a grip: skin crawling, hands shaking, tears pouring nonstop. That’s when I got a prescription for Lorazepam. I take it when I feel an anxiety attack hitting, and within minutes, I am completely myself. I’m not high or drowsy or any of the things I once assumed an anti-anxiety med would make me. I’m just me, and since my brain and body are no longer pumped full of adrenalin, I can get the perspective I need and resume the rest of my day. I don’t need or use it often, but when I do, it makes a world of difference.

I’m just not a one-size-fits-all person.  Some people need meds, some don’t; some recognize their PTSD early and find effective ways to deal with it, some take a while to realize they have it and/or struggle to find solutions that work.  A person with PTSD needs space in which to figure this out. It’s not a fast process. It’s not curable with a pill or a couple of sessions of therapy. Getting through it takes patience on the part of those who have it and on the part of those who care about them. It’s not about being strong or weak, sane or crazy. It’s an injury, and it can leave scars, but remember, scars don’t only mark where we have been hurt; they mark where we have healed.

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