From Shell Shock to PTSD: What Real Help Looks Like for Ohio Patients

The man we keep thinking about spent the first four minutes of his appointment talking about his truck. Transmission. He had been quoted eighteen hundred and was trying to decide whether to fix it or let it go.

He got to the actual thing eventually. He had not slept more than three hours at a stretch since 2014.

His wife had moved into the guest room, not over anything he had done, just because he was up at two every morning and the getting-up woke her.

We say this often and we mean it: two in the morning is not a life sentence.

Almost everyone who reaches us has been told, by somebody, that this is simply how things are now. Usually they were told it kindly. It was still wrong.

A hundred years ago a British Army physician named Charles Myers put a name to what he saw in men coming back from the front. Shell shock. He thought the artillery had done something physical to the nerves, which was a reasonable guess at the time and turned out to be mostly incorrect.

It took until 1980 for the condition to become PTSD, and longer still for medicine to accept a person could develop it without going near a war. Myers did not live to see the name change.

Roughly 6% of American adults will meet criteria at some point. Combat, sure. Also the car wreck, the assault, the childhood nobody discusses, the ICU stay, being the one who found somebody.

We certified a man last year whose PTSD traced back to a house fire he was not even in.

Nobody has the same version of this

Something goes missing when PTSD gets discussed as one condition. It spans four symptom clusters, intrusion and avoidance and changes in mood and changes in arousal, and which one is running the show differs in nearly every patient who sits down across from us.

One man is nightmare-dominant and otherwise entirely functional. You would not pick him out of a room.

A woman we have followed for three years sleeps adequately and has, over roughly a decade, stopped driving highways, stopped going to the store on Saturdays, and narrowed her life down to about four rooms without ever once using the word afraid to describe any of it.

A third came in because his wife made the appointment. He was not anxious. He was not much of anything. Flat, was how she put it, and she was right.

Three charts, same diagnostic code.

There is no protocol. There is your version of this, and a plan built for it.

Nobody gets there on one thing

The patients who do well are rarely the ones who found the one thing. They ended up with four or five that each helped a little and added up.

Therapy carrying most of the weight. Sleep handled deliberately rather than hoped for.

Whatever the psychiatrist has them on, genuinely managed. Exercise, where the PTSD data is better than most people expect and worse than we would like. Peer groups, which do something for veterans we cannot, largely because veterans tell each other things they will not tell a physician.

And cannabis, if it earns a place by doing something the patient can point to. We have written separately about what the research actually shows there, which is less than most people assume and more than nothing.

Most people are already running some version of this by the time they reach us. They are just running it at two in the morning with whatever is in the house, and nobody has looked at the whole list in one sitting.

What the visit is like

We want to know what you have tried and what it cost you, and we mean cost broadly: money, side effects, hours, the thing you stopped doing.

Which version of this you have matters enormously, because the plan for a man who cannot sleep is a different document than the plan for a woman who cannot feel anything. If you are not in therapy, that is usually the conversation before the cannabis conversation.

We will also want a target that can be checked at three months, since neither of us can verify “better” but both of us can verify “I slept Tuesday, Wednesday, and Thursday.”

That check is also where we watch for the thing worth watching. Cannabis use disorder turns up more often in people with PTSD than in the general population and the sequence is predictable: it helps, so the dose creeps, then tolerance, then stopping feels like the symptoms coming back. We bring it up at the first visit so it is not a surprise at the fourth.

PTSD is one of 26 qualifying conditions in Ohio, listed by name rather than tucked under something broader, and the registry fee dropped. Your real cost is the evaluation.

The truck, for whatever it is worth, he fixed. He mentioned it at the next visit before he mentioned the sleep, which had gotten better, though not on account of any single thing we did.

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Schedule your evaluation, in person or virtually, here. We work with every patient individually to determine whether medical cannabis belongs in your plan, what it should look like if it does, and what belongs around it. This is how We Do Cannabis Differently.

Many of our certification patients also use non-THC products for daily wellness support, available at Green Harvest Health Medicinals, the #1 Doctor-Recommended CBD Brand.

If you are in crisis or having thoughts of harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, available 24/7. Veterans can press 1.