I’ve talked before about genre writers who have been very open about personal trials, particularly the kind of depression/anxiety conditions that I feel are a natural part of the uneven terrain all authors have to walk. I’ve always appreciated their willingness to go public with these issues, as the first (and false) thing that most people suffering from these sorts of things think is a.) that they’re alone and b.) the problem is unique to them. When your literary heroes step into the spotlight and say, “hey, this is more normal than you think and you can figure out how to live with it,” well, let’s just say I wouldn’t be surprised if there are more than a few folks still pushing air past their teeth because of a blog post they read.

The thought of talking about what goes on in my head in anything but the most general terms in the public square takes me way out of my comfort zone. But I reread the first paragraph of this post, especially that last line. Sometimes, you need to go outside your comfort zone, talk about a thing not because you need to get it off your chest, but because it might help others to hear it.

I was diagnosed with PTSD in August of ’09, just after my third tour in Iraq. Of course my first concern (like everyone in my line of work) was losing my security clearance, and that kept me from going for help for a long time. But DoD did right by me, and I kept working for another 2 years before the book deal got me out of the business.

I had a hard time admitting it to myself. There was a culture in my line of work, that PTSD was the province of the hard operators, the doorkickers who got into 2-3 firefights every single day. Like most cultures, you bought into it silently, it was simply a thing that was, not worth questioning any more than the law of gravity.

I mean, sure I’d supported certain specialized units, sure I’d been to some funerals, sure there’d been some danger close indirect rounds. Sure I’d had some misgivings about what I was fighting for, what my actions were contributing to. But, I’d seen the ads on AFN, showing young men with gunpowder still on their hands, often fresh off the battlefield, having trembling flashbacks of a firefight where their best friend went down right next to them. THAT was PTSD.

Except, it wasn’t.

I kept seeing nonprofit TV spots, charity pieces and solemn psychoanalytical essays. They all described a PTSD that I’d never seen in myself, and more importantly, in anyone else I knew who suffered from it. I’ll never forget this one spot on AFN, where a soldier washes his hands, only to find blood pouring out of the faucet Stephen King’s Shining style. He hears gunfire, looks into the mirror, the background is a desert battlefield strewn with corpses, glowing red.

I picked that apart with some friends for an hour. I’m not saying that there aren’t people out there for whom PTSD is like that, but it sure as hell wasn’t like that for any of us. As I thought about that spot, as I considered the mounting reports of suicides, homeless vets, collapsing families, I began to get the uneasy feeling that PTSD is a lot like autism: A thing identified, but poorly understood. I read about the supposed symptoms, the heightened alertness, the re-experiencing of specific trauma, the going numb. It was all true. Up to a point.

When James Lowder invited me to write an essay for BEYOND THE WALL, we started brainstorming what it would be about. After a few rounds of back and forth, I realized that I wanted to write about PTSD, and how I saw it manifesting in fantasy characters. I used the Cooper Color System, talked about how living in the perpetual state of readiness known as “Condition Yellow,” both enfranchised and hurt people. Constant vigilance has its uses, but it is exhausting and, over time, transforming.

After the book was published I realized that I hadn’t gotten close enough to the issue. Arya Stark and Theon Greyjoy aren’t real people, and so addressing their PTSD was tackling the issue at a safe remove. It was a toe in the water. It wasn’t good enough.

Because the truth is, I’ve never heard anyone, medical professional, spiritual leader or otherwise describe the PTSD I know. What I see are people embracing a definition that explains PTSD using the vocabulary of classical pathology. It implies that, like a disease, you can prescribe a course of treatment and fix it.

But, in my experience, PTSD doesn’t get fixed. That’s because it was never about getting shot at, or seeing people die. It was never the snap trauma, the quick moment of action that breaks a person. PTSD is the wages of a life spent in crisis, the slow, thematic build that gradually changes the way the sufferer sees the world. You get boiled by heating the water one degree each hour. By the time you finally succumb, you realize you had no idea it was getting hotter.

Because you kept adjusting.

Because PTSD isn’t a disease, it’s a world view.

War, disaster response, police work, these things force a person to live in the spaces where trauma happens, to spend most of their time there, until that world becomes yours, seeps through your skin and runs in your blood. Most of us in industrialized western societies live with feeling that we are safe, that our lives are singular, meaningful, that we are loved, that we matter. We know intellectually that this may not be the case, but we don’t feel it.

PTSD is what happens when all that is stripped away. It is the curtain pulled back, the deep and thematic realization that life is fungible, that death is capricious and sudden. That anyone’s life can be snuffed out or worse, ruined, in the space of a few seconds. It is the shaking realization that love cannot protect you, and even worse, that you cannot protect those you love. It is the final surrendering of the myth that, if you are decent enough, ethical enough, skilled enough, you’ll be spared. The warriors that the media ascribes so much power are the first to truly know powerlessness, as death becomes commoditized, statistics that you use to make an argument for promotion, or funding, or to score political points.

Warrior cults (and, heck, most religions) were invented to give death meaning. Even if you look past the promise of immortality, they offer a tremor in the world, a ripple of significance in your passing. You do the right thing knowing that, somewhere down the line, you have a meaningful death. PTSD is what happens when you realize that you won’t, that your survival will be determined by something as random as the moment you bent over to tie your shoelace.

Diseases are discrete things. But how do you treat a change in perspective? Joe Abercrombie captured it best in his description of Ferro Maljinn’s final revelation of the world of demons just alongside our own. Once seen, the creatures cannot be unseen. When you’re quiet enough, you can hear them breathing.

Nobody talks about this. Nobody talks about the boredom, the impossibility of finding meaning in 8 hours work in an air-conditioned office after you just spent months working 18 hours a day on a battlefield where your touch altered history. Nobody talks about the surreal experience of trying to remember how you got excited about a book, or clothing, or even a car or house. On the battlefield, in the burning building, the ground trembled, we felt our impact in everything we did, until the world seemed to ripple at our touch. Back home, or off shift, we are suddenly the subject of sympathetic glances, of silly, repetitive questions. The anonymity of the uniform is nothing compared the anonymity of comfort. We drown in it, cut off from what makes it worthwhile for others, unable to carve out a piece of it for ourselves.

Time helps you to shift back, but you never shift back all the way. You develop the dreaded “cop’s eyes,” where you see the potential threat around every corner, where you ask the waiter for the chair with its back to the wall. Where the trust essential to build relationships is compromised, because in the world you live in, everybody is trying to harm someone.

And this is why so many of us, even post diagnosis, go back to work in the fields that exposed us to the trauma in the first place. Because the fear is bone deep, and the only thing that puts it to sleep is the thought that you can maybe patch a few of the holes in the swiss cheese net under the high wire. Because we are frightened from the moment we wake until the moment we sleep, and if we can stave that off for someone else, well, then maybe that’s something to live for.

And that’s for those of us who get off easy. In the worst cases, people aren’t able to find meaning in a regular job, or in wealth-building, or relationships, or any of the things that modern societies tell us charts the course of a life. These are the people that PTSD takes, as they flail their way into suicide, or crime, or insanity, desperately trying to carve meaning out of a world where all the goal posts have suddenly moved, where the giant question that no one can answer is, “why bother?”

The root of the treatment has to come from meeting those who suffer where they are. It isn’t just hard operators. It’s clerks and phlebotomists and chemical engineers. It’s people who thought they were fine, only to wake up one morning and realize that the last few years have changed them in ways they don’t quite understand. It isn’t just soldiers and cops and ER nurses. Life in poverty can bring on PTSD. An abusive parent can have the same effect.

We need to treat the fear, address the world view, acknowledging that these aren’t things you cure, maybe aren’t even things you change. We need to tip our hat to the trauma, and look instead at what the life after it looks like. We have to find a way to construct significance, to help a changed person forge a path in a world that hasn’t changed along with them.

And if you’re a vet, or an EMT, or a cop, or firefighter and you’re reading this, I want you to know that you can’t put the curtain back, but it’s possible to build ways to move forward, to find alternatives to the rush of crisis. There are ways you can matter. There is a way to rejoin the dust of the world, to find your own space on the dance floor.

I know this.

Because I did it, am still doing it, every day.

Don’t give up.