Post-Traumatic Stress Disorder, Coronavirus, and You – A Framework to Navigate the COVID-19 Crisis

Dr. David R. Andrews

For those living with post-traumatic stress disorder (PTSD), the self-quarantine and social
distancing of the Novel Coronavirus (COVID-19) might seem like a welcome
reprieve from having to interact with society. A hallmark side-effect of PTSD is
wanting to isolate from others and embracing avoidance: avoiding people, news,
and triggers that serve to remind us of our trauma. It’s comfort food for the
psyche. Unfortunately, it’s also a trap that prolongs our recovery and management
of life with PTSD. So while we must be smart and follow the self-quarantine and
social distancing protocols to help mitigate the spread and disastrous
consequences of COVID-19, there’s an intelligent way to do it so that we don’t
backslide in our healing from PTSD. Using the 5C Framework I developed, which
outlines the five elements – community, connection, commitment, culture, and
courage – needed for building resilience, here are some ways you can still move
forward in your healing during the COVID-19 crisis.

Community: Just as the COVID-19 response is a community challenge,
our recovery from PTSD and the suicide crisis impacting our nation is a
community challenge. And just as we fought two wars in Iraq and Afghanistan
simultaneously, we must fight the new COVID-19 challenge head-on while still
maintaining the battle against PTSD and suicide. That means if you are coping
with PTSD, you need to balance your COVID-19 self-quarantine and social
distancing with the need to remain engaged with society. It’s critical that you
don’t lose the ground you’ve fought so hard for in the PTSD and suicide fight,
and the good news is that you don’t have to lose that ground. Marine Corps
General O.P. Smith famously said during the Korean War, when 270,000 Chinese
soldiers surrounded the 1st Marine Division at the Chosin Reservoir:
“Retreat, Hell! We’re not retreating, we’re just advancing in a different
direction.” Now is an opportunity to advance in a different direction by
embracing the positive elements of the community fight against COVID-19,
including finding ways to applaud and appreciate those on the front lines: first
responders, healthcare professionals, community planners, spiritual leaders,
grocery workers, postal workers, garbage workers, restaurant workers, and
everyone else you can think of who is neck-deep in the fight to hold our
community together during this crisis. Showing appreciation for their service
to the community is a great way to continue engaging society in a positive,
meaningful way. Think back on how military service members were treated upon
returning home from the Vietnam War, and how we as a society today have changed
that abhorrent mistreatment of our nation’s heroes to now welcome home service
members – including those who served in Vietnam so long ago – from war and to
thank them for their service. It is no different for those risking their
wellbeing and lives in the fight against COVID-19. Find a way to encourage and
appreciate them in meaningful ways: create a ‘thank you’ sign you can put on
your front lawn; post notes of encouragement and gratitude online; ask first
responders (police, fire, medical) how you can support them. Maybe even build
care packages and find ways to deliver them safely (i.e., drop off at the front
door) to those in the thick of the fight. The point is to engage and develop
positive ways of maintaining our sense of community right now.

Connection: Oh, the warm false embrace of isolation. For those of
us with PTSD, it’s all too easy to disconnect from others, including family and
friends, especially after we are triggered. Admittedly, I struggle when it
comes to connection, and I use a ton of excuses to find reasons to unplug my
connection to the outside world. If you’re like me, or you know someone like me
who has PTSD and struggles deeply with staying connected to others, now is the time
to tap into the reservoir of resilience and grit. For those of us who’ve been
down the dark road of PTSD and stared into the abyss of suicide, let’s be
crystal clear: isolation and avoidance are paths to depression and suicide. One
of my fellow Purple Heart recipients (Vietnam War and Gulf War veteran), who is
a cherished friend and mentor who struggles with PTSD over 50 years after he was
wounded-in-action, noted just how easy it is for those with PTSD to backslide in
their healing, even decades after the trauma occurred. If you’re struggling
with it now or in the past, you know exactly what I’m talking about. The way to
fight against the backsliding is to stay engaged with others. Use your phone,
use your texts, use your email. Hell, wave to your neighbor across the hallway
or across the street (remember that social distancing recommendations are to
stay six feet away from others). Have you seen the news videos of neighborhoods
singing Neil Diamond songs together? That’s connection. Have you received texts
and calls from friends who ask how you’re doing and if you need anything?
That’s connection. I’m very blessed with friends who know how bad I struggle
with PTSD and connection, and they care enough to reach out and help me break
away from the succubus of isolation. You can be that friend for someone with
PTSD, and if you’re struggling with PTSD, you need to reach out and stay
connected with your support system during the self-quarantine and social
distancing period. You’ll be glad you did.

Commitment: Commitment boils down to a simple question to ask
yourself, “how important is this to me (or our organization)?”
Because if it’s not all that important, please stop reading here and move on to
what is important to you. However, if this topic is important to you – whether
you have lived experience with it or not – then you need to follow-up with some
commitment to someone in need. I tell executives and large audiences that I
share the 5C Framework with to write down five random dates over the next year where
they will commit to talking about PTSD and suicide prevention. For the COVID-19 pandemic,
since we’re in the midst of the crisis, my recommendation is to pick five
random days over the next month to reach out to someone with PTSD or a person or
organization on the frontlines of the COVID-19 response. Call, text, or email
them and ask them what you can do to help. Please note that I say ask them
“what you can do” instead of “how are you doing.” There is
a significant difference, especially in our society where independence and
façade are common facets of life. For instance, if you ask me how I’m doing,
the military veteran and leader in me tends to give the automatic response of
“I’m okay” regardless of how I’m actually doing. It’s much more
effective to ask “what” you can do to help because the underlying
premise is that I know you need assistance and I want to help. If you ask me
what you can do to help, that allows me the opportunity to decide what (not if)
I need help at that moment. I promise that if I open up to you, it will be a
genuine request for help. As a dear friend and fellow Purple Heart recipient (Vietnam
Veteran) sagely noted, “What would work for me much better is, “How about
having lunch and we can talk.” This relieves me of the burden of admitting
something is wrong but still opens the door for help from a concerned friend.”  If I don’t need help at that moment, perhaps
we can come up with ideas to help make a positive difference for someone else
in need. The important thing is making the commitment to help and support those
in need, and to make it a long-term tangible commitment. By reaching out to
others, by showing a commitment to caring, you are building bridges of healing
and goodwill.

Culture: You may have seen the news reports saying that life as
we know it has changed with the COVID-19 pandemic. Schools are closed for
in-person classes. Restaurants are closed for eating in (delivery or takeout
only). Gathering places – theaters, gyms, clubs – are closed. Conferences and
concerts are canceled. Grocery store shelves are empty of many essential
supplies as people hunker down in their homes. Businesses are forced to use alternate
work options like telework or are having to lay off employees. It’s a new way
of life for society, and it’s a profound culture shock, particularly for open
societies like ours. Here’s the thing about culture: everyone owns it.
Everyone, from the President to the grocer to the schoolteacher to the homeless
person. Everyone. With ownership comes responsibility, and therefore all of us
have a responsibility to shape our culture to what is right, just, and
benevolent. So as our culture shifts in an effort to mitigate the effects of
the COVID-19 crisis, we must leverage the opportunity to influence what our
culture looks like moving forward. The September 11, 2001, terrorist attacks forever
altered how we travel. Likewise, the COVID-19 crisis has the potential to permanently
alter how society gathers and interacts. Social distancing must never mean
social isolation. Just as our nation’s military cultural norm is that no one
ever gets left behind on the battlefield, we as a society have the opportunity
to create a cultural attitude that no one gets left behind in the COVID-19
crisis. We do it through small groups – work, veterans groups, church – and
those small groups, in turn, contribute to changing society as a whole.

Courage: Courage often comes to the forefront during a crisis. For those of us with PTSD, it means an opportunity to take a leadership role as trauma survivors, regardless of the type of trauma. Use your voice or your keyboard to be a beacon of hope and purpose during this crisis and in the aftermath when society is reflecting on what went right, what went wrong, and what to do the next time. Courage means speaking up when you see something that needs to be addressed, as well as meaningful action when you see others need help. Courage means asking for help when you need it. If you have PTSD and you’re reading this, it means that you’re a survivor; you are strong, you have endured, and you can help others find hope and healing. If you’re reading this as a family member or friend of someone with PTSD, it means that you have likely seen firsthand the ups and downs that come with PTSD, and you too are a survivor. As my family knows all too well, PTSD affects the whole family, not just the trauma survivor. And it takes a lot of courage – as well as patience and grace – to live with someone struggling with PTSD. Collectively, we know what it is like to endure and emerge from a crisis. Let’s share that information. Put it to paper, post it online, and let the authenticity of your voice serve as a beacon for others. Having presented this 5C Framework to audiences across the US, I will tell you that it takes a lot of courage to open yourself up and talk about PTS and suicide and life with the permanent scars of war. What I have found is that people with the right heart and compassion will gravitate toward you and share their profound gratitude for your courage to share. More importantly is having people in the thick of their fight with PTSD and suicide come up to you, sobbing from emotion and pain, and telling you how much comfort they take from your words and that they want to get help. Make no mistake, folks: some of the people on the front lines of this fight with COVID-19 are going to have PTSD, and they’re going to need those of us who are successfully managing PTSD to become their mentors and beacons of hope. Like us, they’re going through a life-changing experience, and like us, they will need a lot of courage and help in the coming months, years, and decades. Let’s be there for them and each other.

Putting all five of those elements – community, connection, commitment, culture, and courage – to work during the COVID-19 crisis is an effective way to help those struggling with PTSD navigate the challenges that come with social distancing and self-quarantining. Passing on a bit of wisdom shared with me by combat wounded veterans of WWII, the Korean War, and the Vietnam War: you don’t cure PTSD, you learn how to manage it. The 5C Framework is a tool that you can use in helping those with PTSD weather the COVID-19 crisis. Please put it to work.