Why can't soldiers take medication?

Living with the trauma : If the horror of Afghanistan doesn't want to end at home either

The flashbacks can come at any time. Once Alexander Sedlak was driving on the autobahn when he saw something in the bushes on the side of the road. Probably just a piece of foil, but suddenly in his head he was back in Afghanistan. Relived memories. What is a scrap of plastic here could be a booby trap there. “You can never lose sight of this detail. Is starting to sweat, ”he said during a conversation at the beginning of December in his barracks in Baden-Württemberg. "I felt really sick, I had to stop at the next parking lot, have a smoke first and come down."

A method from the war helps Alexander Sedlak at such moments. He takes a few deep breaths, just concentrating on that. As a sniper, he slowed his pulse so that he could fire a precise shot. Now he's using it to fight panic attacks.

Alexander Sedlak is a soldier in the German Armed Forces and suffers from post-traumatic stress disorder. The 30-year-old doesn't seem like someone who can be upset easily. Strong handshake, focused eye contact. A little stiff in posture. During the war he treated victims of booby traps as a first aid worker. He couldn't save all of them. Sedlak is someone who likes to have things under control, helplessness still hurts him.

According to the definition of the Working Group of the Scientific Medical Societies in Germany, PTSD is a “possible follow-up reaction to one or more traumatic events”, including “violent attacks on oneself”. Soldiers are particularly affected, but also police officers, firefighters and paramedics.

Some patients just need a few conversations to get the problem under control. Alexander Sedlak has been back from the war since 2012 and has been to hospitals seven times for treatment, the last time for six months. His longest inpatient visit. He's spent more time in clinics than in Afghanistan.

You can't cure PTSD, you can only control it

The Bundeswehr alone recorded 1875 cases in treatment in 2018. The number is rising steadily, an estimated 100 cases per year. Because the foreign deployments are becoming more numerous - currently twelve missions with a total of almost 4,000 soldiers - and because these are receiving treatment more often than in the past. There are probably many more, many patients do not want to admit that they need help. Especially in a group in which it is still sometimes frowned upon to show alleged weakness.

Sedlak therefore wants to bring the topic to the public. In 2017 he organized a charity run, talked a lot about his story, and raised almost 10,000 euros. A success for his cause, but his own struggle is not over yet. In the spring he will start walking again. For their comrades, for themselves. In a star march, five teams from all points of the compass should run to Mühlhausen in Thuringia in the middle of Germany. Again he wants to collect donations for the Association of German Veterans, which is committed to the care of soldiers after work.

That Sedlak wants to talk about the problem doesn't mean that it comes easy to him. The 30-year-old sits in a small office in the Robert Schuman barracks in Müllheim. Franco-German brigade, 30 minutes by car from his birthplace Freiburg. He speaks for more than three hours. A medical officer is in the room all the time, "because some questions could trigger the comrade".

PTSD is incurable, you can only learn to control it, explains the specialist. Alexander Sedlak says he's just fine. Except for the sleep disorders. He wakes up drenched in sweat. Sometimes in dreams he is on patrol in Afghanistan, suddenly his girlfriend is standing there on the side of the road.

Doors that fall shut, drawers that slam, scare him. He used to get angry. Today he can control himself better, he says. Not so easy, especially now, around New Year's Eve. Midnight itself is not so wild. The days before and after are bad when some of them suddenly boom.

He or I often means: die or kill

Sedlak wears a uniform, a blond beard and a short haircut. Dark rims surround his light blue eyes. The latest therapy has shaken a lot, he now has to learn to cope with it in everyday life. “In Koblenz we got down to business,” he says. Trauma therapy. Interjection from the medical officer: “First of all, soldiers need to stabilize them. You can compare that to a fire that needs to be contained. It will be deleted later. "

Step 1: Sedlak had to deal with the experiences that might have triggered his PTSD. Talk about it in groups, write it down. A total of three times, each time with more details, he should also note what he felt then and what he feels today.

Sedlak describes one of the situations as follows: He is securing the area, lying in hiding when a sniper targets him. The Freiburg resident heard the shot, the projectile hit the wall just below his chin, behind which he was in cover. He sees no muzzle flash. Don't know where the shooter is sitting. The second bullet hisses just past his ear. Again no muzzle flash. Sedlak knows from his own training: A sniper does not miss his target a third time. He withdraws.

Most of the time, snipers are used to observe, rarely to pull the trigger. But not always. “At that moment it's about: him or me. The other one will certainly not hesitate, ”says Sedlak. He or I often means: die or kill. That goes for every soldier. But unlike an ordinary infantryman, a sniper has the face of the other person clearly in view through the telescope. Yes, you are prepared for such things in class, made aware that it does something to you. That you don't shoot cardboard targets. With the images in their heads, however, the soldiers are later alone.

They are also warned that they should always expect to be attacked themselves. “To hear that is one thing. It's a different experience to experience that, ”says the medical officer. Sedlak looks relieved to have him in the room. As professional evidence of his own stories. He didn't count the number of times his unit came under fire. “At some point you just shrug your shoulders when the vehicle jingled again.” That's what he calls it when shots are fired. He stirs milk into his coffee. Smoking break. Sedlak lights two in a row.

Sedlak said he was interested in the military as a child. “For me, soldiers have always been people of great respect.” He is doing his student internship with the German Armed Forces. In 2008 he volunteered for military service. After the basic training, he is trained step by step more precisely, from the simple infantryman to the first aider, on the Milan anti-tank missile and finally to the sniper.

He knew what he was getting into in Afghanistan. His service time was almost over. He wanted to go out again and do what he was trained to do. It was not his first assignment abroad, he was in Kosovo in 2009. It was quiet there. Not this time.

The fighting in Afghanistan had lasted nine years before the then Defense Minister Karl-Theodor zu Guttenberg managed to speak of "war". Three German soldiers had just fallen. That was 2010. In that year, says Sedlak, he raised his hand when the Bundeswehr was looking for volunteers for the ISAF mission. It started a few months later.

He never questioned that. He is athletically built, sturdy posture, clear statements. He needs all of this when in doubt he lies motionless for hours in a hiding place. He answers precisely and succinctly, only starts talking when it comes to military matters. About the rifles he had stowed under his cot. The DMR for the medium range, the armor-piercing G82, which is not likely to be used against people. The G22 with an almost guaranteed accuracy of 900 to 1100 meters.

When he talks about it, Sedlak looks like it is on autopilot. He calls up what is needed without questioning or hesitation. It works. Just as the Bundeswehr asked him to do. Sedlak rarely says "I", mostly "one". A grammatical shield.

The Bundeswehr calls this "military service damage"

His regular service ends four months after his return. Sedlak starts with a private security company and works during the day. But because he can't sleep anyway, at some point even at night. The tiredness only makes him more nervous, every noise can make him lose his composure. He isolates himself in his apartment. In the first few months after the mission, this is completely normal, say doctors, the body is under constant stress in such an operation. But then it should get better. It wasn't.

Once, at a gas station, a friend tapped him from behind on the shoulder. Sedlak turns around and almost hits the friend in the face with his fist. At a height of 1.84 meters, he still weighs 66 kilograms. Sedlak knows he has to do something. You can do a self-test on the Internet to see whether you have PTSD. Again and again he fills it out. The result is always clear. He ignores it every time. Until his girlfriend at the time gives him an ultimatum. Either he gets help or she goes. That's 2015, three years after his return.

So he reports to the social services of the Bundeswehr. Soldiers, including former soldiers, who have been damaged while on duty, are entitled to assistance. The Bundeswehr calls this “military service damage”. It also means: Sedlak will be returned to service as a soldier. Sits at a desk today, continues to receive his wages and has social and health insurance through the army.

It takes almost a year for Sedlak to open up to therapists. His girlfriend has since left him. He meets a new woman, they meet in a motorcycle shop. He gets a Rottweiler. Forcing him to go outside. During the donation march two years ago, he accompanied him across Germany. In the meantime he has given the animal back. “He reminded me of a dark phase in my life, so I couldn't give him the attention he needed. And I didn't want the dog to get depressed. "

In the clinic, he practices reducing fears. This is the second phase of therapy. He drives into town on the bus with other patients and goes out to eat ice cream. Sedlak actually avoids crowds. He can't help but constantly assess his surroundings. The more stimuli, the greater the stress. “When I sit on my balcony, I know exactly which car was parked there the day before, which window is currently open and where the light is still on.” Old reflections.

He hates not being able to control things himself. For example, many PTSD patients cannot tolerate the subway. “I have to trust the driver, I can't just get out. New people all the time, the situation is constantly changing. Maybe I can't find a place from which I can see everything, ”says Sedlak.

Some soldiers take medication. Sedlak tried a few himself, but later discontinued them. He has a sedative in case of emergency. “So I don't break anything.” Otherwise, he'll want to do it on his own.

His commitment to the topic is a good support. He is currently busy planning the star march. Then more teams should start running from all directions so that even more people can see and listen to them. He hopes to make many people aware of the problem - and to show his comrades: It's okay to talk about it. He has a clear mission to carry out. That's how he learned it in the Bundeswehr. Only this time he gave it to himself.

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