The scars you don't see: what it's like to live with PTSD

I didn’t break down instantly. It was at least a month before I had the first dream where I woke up, safe in my bed, but sheeted in sweat, scared to go back to sleep.

I was standing about 40 ft away from the man when the mortar bomb hit him.

They don’t travel that fast, and I’d swear to this day I could see it coming, a little dart zipping down, hitting right at his feet. At least, that’s what happens in the dreams. The bomb was small – probably a 60mm round with no more than 2lbs of explosive in it.

I know that because I’m not dead. 

That small bomb was still enough to make that man just instantaneously cease to exist as anything recognisably human. The effect was not unlike a jar of strawberry jam being struck with a sledgehammer.

I was knocked to the ground. I scrambled into the slit trench nearby and hid, terrified. As the shelling died down, I felt I had something sticky on my face. I reached up and slowly peeled a rasher of bloody human skin off my cheek. This is hard to write. I’m shaking and breathing quickly from the memory. Thinking about it is like picking at a scab.

I didn’t break down instantly. It was at least a month before I had the first dream where I woke up, safe in my bed, but sheeted in sweat, scared to go back to sleep. After a few months, I was a mess. I was incredibly irritable, and would fly off the handle at the slightest thing. I stopped enjoying reading or watching films, spent whole days doing nothing. Just eating and sleeping. Staying alive.

I loved the oblivion of sleep when I didn’t dream. I didn’t want to talk about it. I knew something was very wrong, but I kept putting off doing something about it. I didn’t want to admit to myself I’d gone mad. I was incredibly embarrassed about the fact I’d often wake up my housemates, screaming. I’m pretty loud.

It was the embarrassment that made me realise I’d become very strange. I reluctantly went to the doctor, and started getting treated. It’s a long process, and I’m much better now, but I’m basically never going to be cured, never going to get a piece of paper saying “Congratulations, you are sane again”. You learn to live with it.

I can’t bear to be touched unexpectedly. This goes from being mildly unpleasant when it’s a pat on the back through clothes, all the way to chills, sweats and burning tension if someone with wet hands touches my bare skin. It makes nightclubs an all but no-go area. Wherever I work, there’s always one touchy-feely person. It’s telly, there’s always a woman who likes to hug you if you don’t get a commission or a man who likes jolly backslaps when things go well. Fairly swiftly I have to have the conversation where I say “Please don’t touch me, I have PTSD.” Cue the odd looks from then on.

When I sleep with someone for the first time, I have to have the conversation where I warn them that if I go to sleep, I might start screaming – literally screaming - about mortars, stumbling out of bed and taking cover behind something in the room. I used to wait until I knew someone quite well before I’d lay that on them, but I had one experience where I didn’t tell the girl, I had one of those dreams, and she was absolutely terrified of me.

The noise of diesel engines turning over upsets me immensely - I took cover from rockets under a tank once. The DUNK-DUNK-DUNK of a diesel just brings bad things back. Buses are a no-go. Oh, and fireworks. I hate fireworks now. If I can see them, it’s OK, but it’s unexpected bangs that really upset me. The week of bonfire night and the week around to New Year I usually spend indoors, with good headphones in.

Those are my most common triggers, but almost anything can set you off. Indeed, after reading this brilliant article about PTSD, I was an emotional mess, and had to take a day off work. Which is pretty ironic as it’s an article that says trigger warnings are bullshit. You live in a world where suddenly you can be pushed into re-experiencing something awful at a moment’s notice.

When I have flashbacks, it’s never a Hollywood hallucination of the sounds of the day, or the sights. I relive what happened emotionally and physically, in moments. The terror, the horror, the emptiness, the dry throat, the tense muscles, all dumped on you in five seconds. A day ruined because some goon lets off a firework.

That said, it’s the dreams that are the most pervasive legacy. A doctor told me to think of them as dreams, not nightmares. I can avoid and mitigate triggers; not the same with dreams. I now probably have them about once every couple of months, but it always ruins the following day. I thrash around in my sleep, live out those moments, over and over. I’ve hurt myself; clawed a couple of nails off on my wall thinking I was buried once.

Of course, I’m much better now than I was. I go to support groups, and often I’m the one leading the discussion. People like that I make jokes in the awkward moments where we break and have tea and biscuits, in between sharing horrors. 

PTSD is much more common than you think – the incident I experienced happened when I was on a journalistic assignment, covering a war. And although veterans - represented by brilliant charities like Combat Stress and Help for Heroes - are the most visible face of it, they represent a small minority of sufferers. There's no shortage of medical care, but support groups are few and far between.

The mix of people in support groups is odd. I’m not sure my experience is representative, but as I say, mine have been split largely between male combat veterans and female rape survivors. While only around 3% of the population are thought to have PTSD, as many as 50% of rape survivors develop it. Rape is by far and away the most common reason for a woman to be there. Everyone bonds over tea; we all share experiences of how we’ve learned to cope, and stories of times when we didn’t.

So that's what it's like. Personally, I always come back to a bitter, sarcastic part of a Sassoon poem, called “Does it matter”, which sums up in 30 words what I've done in a thousand.

Do they matter? — those dreams from the pit?

You can drink and forget and be glad,

And people won't say that you're mad;

And no one will worry a bit.

 

[This piece is part of the New Statesman's Mental Health Week - find more articles on this subject here.]

A soldier on patrol in 2010. Photo: Getty

Willard Foxton is a card-carrying Tory, and in his spare time a freelance television producer, who makes current affairs films for the BBC and Channel 4. Find him on Twitter as @WillardFoxton.

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An unmatched font of knowledge

Edinburgh’s global reputation as a knowledge economy is rooted in the performance and international outlook of its four universities.

As sociologist-turned US Senator Daniel Patrick Moynihan recognised when asked how to create a world-class city, a strong academic offering is pivotal to any forward-looking, ambitious city. “Build a university,” he said, “and wait 200 years.” He recognised the long-term return such an investment can deliver; how a renowned academic institution can help attract the world. However, in today’s increasingly globalised higher education sector, world-class universities no longer rely on the world coming to come to them – their outlook is increasingly international.

Boasting four world-class universities, Edinburgh not only attracts and retains students from around the world, but also increasingly exports its own distinctively Scottish brand of academic excellence. In fact, 53.9% of the city’s working age population is educated to degree level.

In the most recent QS World University Rankings, the University of Edinburgh was named as the 21st best university in the world, reflecting its reputation for research and teaching. It’s a fact reflected in the latest UK Research Exercise Framework (REF), conducted in 2014, which judged 96% of its academic departments to be producing world-leading research.

Innovation engine

Measured across the UK, annual Gross Value Added (GVA) by University of Edinburgh start-ups contributes more than £164m to the UK economy. In fact, of 262 companies to emerge from the university since the 1960s, 81% remain active today, employing more than 2,700 staff globally. That performance places the University of Edinburgh ahead of institutions such as MIT in terms of the number of start-ups it generates; an innovation hothouse that underlines why one in four graduates remain in Edinburgh and why blue chip brands such as Amazon, IBM and Microsoft all have R&D facilities in the city.

One such spin out making its mark is PureLiFi, founded by Professor Harald Haas to commercialise his groundbreaking research on data transmission using the visible light spectrum. With data transfer speeds 10,000 times faster than radio waves, LiFi not only enables bandwidths of 1 Gigabit/sec but is also far more secure.

Edinburgh’s universities play a pivotal role in the local economy. Through its core operations, knowledge transfer activities and world-class research the University generated £4.9bn in GVA and 44,500 jobs globally, when accounting for international alumni.

With £1.4bn earmarked for estate development over the next 10 years, the University of Edinburgh remains the city’s largest property developer. Its extensive programme of investment includes the soon-to-open Higgs Centre for Innovation. A partnership with the UK Astronomy Technology Centre, the new centre will open next year and will supply business incubation support for potential big data and space technology applications, enabling start-ups to realise the commercial potential of applied research in subjects such as particle physics.

It’s a story of innovation that is mirrored across Edinburgh’s academic landscape. Each university has carved its own areas of academic excellence and research expertise, such as the University of Edinburgh’s renowned School of Informatics, ranked among the world’s elite institutions for Computer Science. 

The future of energy

Research conducted into the economic impact of Heriot-Watt University demonstrated that it generates £278m in annual GVA for the Scottish economy and directly supports more than 6,000 jobs.

Set in 380-acres of picturesque parkland, Heriot-Watt University incorporates the Edinburgh Research Park, the first science park of its kind in the UK and now home to more than 40 companies.

Consistently ranked in the top 25% of UK universities, Heriot-Watt University enjoys an increasingly international reputation underpinned by a strong track record in research. 82% of the institution’s research is considered world-class (REF) – a fact reflected in a record breaking year for the university, attracting £40.6m in research funding in 2015. With an expanding campus in Dubai and last year’s opening of a £35m campus in Malaysia, Heriot-Watt is now among the UK’s top five universities in terms of international presence and numbers of international students.

"In 2015, Heriot-Watt University was ranked 34th overall in the QS ‘Top 50 under 50’ world rankings." 

Its established strengths in industry-related research will be further boosted with the imminent opening of the £20m Lyell Centre. It will become the Scottish headquarters of the British Geological Survey, and research will focus on global issues such as energy supply, environmental impact and climate change. As well as providing laboratory facilities, the new centre will feature a 50,000 litre climate change research aquarium, the UK Natural Environment Research Council Centre for Doctoral Training (CDT) in Oil and Gas, and the Shell Centre for Exploration Geoscience.

International appeal

An increasingly global outlook, supported by a bold international strategy, is helping to drive Edinburgh Napier University’s growth. The university now has more than 4,500 students studying its overseas programmes, through partnerships with institutions in Hong Kong, Singapore, China, Sri Lanka and India.

Edinburgh Napier has been present in Hong Kong for more than 20 years and its impact grows year-on-year. Already the UK’s largest higher education provider in the territory, more than 1,500 students graduated in 2015 alone.

In terms of world-leading research, Edinburgh Napier continues to make its mark, with the REF judging 54% of its research to be either world-class or internationally excellent in 2014. The assessment singled out particular strengths in Earth Systems and Environmental Sciences, where it was rated the top UK modern university for research impact. Taking into account research, knowledge exchange, as well as student and staff spending, Edinburgh Napier University generates in excess of £201.9m GVA and supports 2,897 jobs in the city economy.

On the south-east side of Edinburgh, Queen Margaret University is Scotland’s first university to have an on-campus Business Gateway, highlighting the emphasis placed on business creation and innovation.

QMU moved up 49 places overall in the 2014 REF, taking it to 80th place in The Times’ rankings for research excellence in the UK. The Framework scored 58% of Queen Margaret’s research as either world-leading or internationally excellent, especially in relation to Speech and Language Sciences, where the University is ranked 2nd in the UK.

In terms of its international appeal, one in five of Queen Margaret’s students now comes from outside the EU, and it is also expanding its overseas programme offer, which already sees courses delivered in Greece, India, Nepal, Saudi Arabia and Singapore.

With 820 years of collective academic excellence to export to the world, Edinburgh enjoys a truly privileged position in the evolving story of academic globalisation and the commercialisation of world-class research and innovation. If he were still around today, Senator Moynihan would no doubt agree – a world-class city indeed.

For further information www.investinedinburgh.com