Published Thursday, 6th September 2018

Post-Traumatic Stress Disorder and the Therapeutic Benefits of the Mountains....

Just below the highest point in North America it’s -35 degrees Celsius and the weather is ferocious. The air is so thin that I gasp for each breath, the physical effort of climbing, of putting one foot in front of the other blocks out even the most persistent of my Post-Traumatic Stress Disorder symptoms. For that brief and hard-won moment, I forget the condition that has taken over and almost destroyed my life, and instead focus on each heavy footstep and the anticipation that I am about to summit Denali.

17 months ago my world was shattered when I was diagnosed with acute Complex Post Traumatic Stress Disorder (PTSD). In a moment, I went from being a highly functioning, very successful, and recently promoted Lieutenant Colonel in the Royal Marines, to a life in complete chaos. Suddenly, the most benign of experiences triggered flashbacks and unwanted memories; I startled aggressively and extremely easily; noise physically hurt and offended me; I was permanently on edge, searching for danger everywhere – even where none existed; I couldn’t relax, struggled to sleep, and woke with nightmares about my own death; I was exhausted, consumed with rage, and frequently overwhelmed; hyper-aggressive intrusive thoughts assaulted my mind, arriving with their own twisted logic that triggered a terrifying crisis of confidence and identity that all but destroyed me. My mind and body were trapped in a hideous amalgamation of the very worst moments of over a decade of trauma, and everywhere I now turned terror and tyranny lay waiting.

Although horrific, there is a very sound scientific explanation for all of these various complex changes. As chronic trauma of the kind that I had been exposed to causes actual, far reaching, and catastrophic neurological, biochemical, and physiological transformations throughout the body. Comparisons between the brain scans of those with and without PTSD show these changes extremely graphically – revealing spectacular damage across the brain that explains why the PTSD sufferer is unable to distinguish past from present, and instead exists in a state of perpetual physical and psychological crisis. Blood tests too expose a system in absolute turmoil; where the PTSD sufferers’ normally delicate biochemical balance is instead flooded with masses of adrenaline. This powerful stress hormone is normally used only rarely and sparingly by the body in moments of extreme danger or crisis; the impact of such a massive and persistent deluge of these chemicals, however, is obvious in the peculiar behaviours and extremely irrational responses of anyone suffering from chronic trauma. In short, and put very simply, PTSD is extremely real – it is not just in the sufferers head, it keeps past trauma persistent in the present, and places its many dysfunctional, dangerous, and extremely debilitating symptoms well beyond the control of the sufferer.

Of course, this reality didn’t just spontaneously arrive for me one morning in May 2017. It had, in fact, been developing for well over a decade. Very gradually the PTSD had ruthlessly colonised my mind, body, and soul, and then systematically attacked every aspect of my life. It did this very subtly, at least at first, such that any indication of a problem was easily explained away by other factors or challenges. As a consequence, as my PTSD progressed and became ever more aggressive I essentially continued to normalise and then dismiss my symptoms in a manner that rendered them all but invisible. So even as life descended into near complete chaos – I still couldn’t see the problem. Until, that is, someone with far more experience than I, with the patience, empathy, and interest to make a difference, had the reason and opportunity to shine a light into my increasingly dark world – then, without warning, it became agonisingly obvious.

This is how my battle with PTSD began, and for over a year I have desperately struggled with my symptoms, longing for the day I might feel a little better and dreaming of the moment I might get some respite from all the noise. But that day and those moments have remained excruciatingly elusive. For months I was unable to be in the same room as my family, often I couldn’t even be in the same building as anyone else, I couldn’t play with my children or walk them to school, I couldn’t do anything to support my wife, I couldn’t work, drive, socialise, or even take care of myself. The indignity and humiliation of it all cut right through me, tearing my soul, my confidence, my self-esteem and my pride to shreds. As the ground disappeared from beneath my feet all that I had taken for granted, in particular the certainty of who I was, where I had come from, and where I was going, collapsed in front of me. 

Yet I struggled on, every day struggling, fighting to find the courage to face a world that had been viciously transformed into a dark succession of frightening and impossible ordeals. I gradually assembled and surrounded myself with a fantastic team of specialists, who patiently helped me to really understand what had happened to me, and together we began processing many of the more toxic and traumatic of my memories. As well, I recognised that PTSD is a very serious life changing injury, and that persisting with life as if nothing had happened was to guarantee further misery – so I changed my life. I began listening very carefully to my PTSD to learn what made my symptoms worse, what made them easier, and so, subsequently, I was able to gently adjust, adapt, and – ultimately – change my life. In combination, these endeavours laid an essential foundation and framework for my recovery; but broader progress to tackle my symptoms remained exasperatingly slow and unspectacular – until, that is, I went to Denali.

The positive effects of outdoor sports on mental health, including PTSD, have been well documented. The opportunity to connect with nature and the great outdoors, to participate in an activity and achieve a goal, however small, can have a significant effect on those battling with their own minds. For my part, I have always loved the outdoors, and since my diagnosis I have been desperate to escape to the mountains for some peace, some solitude, and to nourish my battered and exhausted soul. Yet I have had neither the confidence nor the opportunity to do this safely and constructively – the obvious risk being, quite simply, that I might easily never return. So it was, in every respect, a dream come true when I was introduced to the charity 65 Degrees North, who invited me to join a small team to climb Denali – the highest, coldest, and most remote mountain in North America, and the most challenging of the revered Seven Summits (the tallest mountains across seven continents).

The timing of this introduction was impeccable – any earlier and I wouldn’t have been ready, and any later and I would have missed the opportunity altogether. As well, although the invitation allowed me to meet the team and do some training in the Alps beforehand, it didn’t allow any time to overthink or get nervous about the journey. In fact, because I was so consumed with just getting through each day I barely had the capacity to think about the journey at all. This, without doubt, helped enormously, as the most difficult part of the whole journey would be the first part – getting to and through London’s Heathrow airport – which is an absolute nightmare for someone with symptoms such as mine. Yet because of the timing of the invitation before I knew it I was boarding a tiny eight seater ski-plane in the rustic Alaskan frontier town of Talkeetna with over 80 kilograms of high altitude mountaineering equipment and food for a month. From here we flew north for an hour over the stunning Denali National Park, slowly watching the foothills and rivers grow into the most spectacular mountains and glaciers. Landing at Base Camp we were catapulted from the relatively benign and temperate climate in Talkeetna, to a volatile glacier over 7000 feet high and where the temperature was racing towards -10 degrees Celsius. And as we left the relative comfort of the aircraft and entered Denali’s giant frozen kingdom – like the rush of a nearby avalanche – everything began to change for me.

Although I had hoped my journey to Denali might have a moderately positive effect on my PTSD, I hadn’t for a moment anticipated just how immediate and profound the impact of the climb would actually be. For the first time in well over a year my body started to relax. I started to relax. I felt at ease, comfortable in my surroundings, and safe – which was, at first, such unfamiliar experience it was disconcerting. Simultaneously, it was as if previously dark areas of my brain were suddenly illuminated, my mind was able to start thinking again, imagining and dreaming again, and I was able to begin making sense of where I was, where I had come from over the previous year, and where I was going. Although these changes felt almost impossible, there are a number of explanations that – I think – have helped allow me to make sense of my experience on Denali.

Firstly, since my diagnosis I have been so consumed by my symptoms and the challenge of getting through each day that I haven’t had the capacity to take a step back and pull myself, my mind, and my thoughts together – to start making sense of my diagnosis, my recovery, and my new reality. Yet, uniquely, this is exactly what I was able to do on Denali – in an environment that I loved, surrounded by people I trusted, and temporarily freed from the clutter of normal life. It was precisely here that the almost incomparable contrast with normal life struck me – for in the mountains I felt metaphorically and intellectually liberated, and able to connect with my imagination and powers of analysis in a way that is largely still denied to me in normal life. Thus, with this new found freedom I enthusiastically and relentlessly deliberated my predicament. This was an unanticipated and intense experience that allowed me to establish, for the first time, a broad and thorough perspective on my life, my recovery, and my future. All of a sudden, as if waking up for the first time, I realised how tremendously lucky I have been, and how much I have to be grateful for and positive about. This has helped to radically change my outlook on life for the better, and has particularly improved my attitude towards my PTSD and my recovery. Although life remains terrifying, I am no longer quite so terrified, and at times I am even excited.

Secondly, as alluded to, the PTSD shattered everything about who and what I thought I was. I might have travelled the world, had a successful career, been to war, commanded over a hundred Royal Marines, and achieved masters degrees and academic fellowships – but the PTSD callously stole all of it. In a moment, I could no longer work, look after my children, support my wife, or even take care of myself and live an independent life; the world became so difficult and overwhelming that I struggled to get out of bed and could rarely leave the house or even speak to anyone. This completely destroyed my sense of identity; and in so doing it left me a ghostly shadow of my former self, which very nearly killed me. Essentially I no longer existed, and because the PTSD had so thoroughly eliminated me, I found it impossible to find any self-confidence, respect, esteem, or worth. This was a truly awful place to be in. Yet Denali, for the first time since my diagnosis, gave me an opportunity to do something remarkable, to achieve something amazing, and, in the process, to rediscover who I am. For in stark contrast to normal life, in the mountains I am still very comfortable, I can thrive, I can trust my instincts, and I can perform really well. Prevailing over temperatures as low as -35 degrees Celsius, vicious storms that prevented any movement for over a week, crevasses a hundred feet deep, avalanches that engulfed the slopes around me, loads well in excess of my own body weight, and the effects of extreme altitude, to get to the summit of Denali gave me something extraordinary to be proud of, immediately and spectacularly reawakening my sense of self-confidence and self-worth. On Denali I began to feel alive again, and although I still have very debilitating and life limiting symptoms, life doesn’t feel quite so desperate or disturbing anymore.

Thirdly, this journey didn’t just occur in my head – I was in-fact part of a very special team of five Royal Marines, all of whom had been variously impacted by the recent wars. Yet, curiously, it was not our physical and mental injuries that distinguished us from the other teams on the mountain. Instead, what made us different was that we kept going up against all the odds even as team after team – often with far more mountaineering experience than us – simply gave up and turned around. Of course, our Royal Marines training helped, instilling in all of us an attention to detail, a sense of urgency, and a self-discipline that undoubtedly made us individually far more effective in the extreme conditions encountered on Denali. But more important than any of our individual training was our basic identity as Royal Marines, and the accompanying certainty that we would unhesitatingly go to the ends of the world for each other if or when required. To find such an absolute confidence in the person next to you is really exceptional, but this is also precisely what it means to me to be a Royal Marines Commando. To undertake an endeavour as dangerous as Denali in the company of such people, with such confidence and certainty in ones’ own team, is amongst the greatest privileges of my life. As team mates we inspired, motivated, and encouraged each other, we helped each other laugh when there was nothing to laugh about, we lifted each other up whenever we were down, and together we got to the top of the tallest mountain in North America in the most difficult of circumstances. There was nowhere and no-one else I would have rather been with on Denali – I have returned home with four of the best friends anyone could wish for, and this makes me feel both immensely happy and proud. 

Fourthly, despite all our heroics high on the mountain – for me, the real heroes of this story were many miles away, back at home in the UK. For all the hardship and the challenges we faced on the mountain pale into utter insignificance when compared to the enormity and ferocity of the challenges I faced, and continue to face, every day at home. And although this reality has been horrific for me, it’s been awful in the extreme for my wife Amy and our three beautiful children. Yet despite this, and all the torture and horror my diagnosis has reigned on their very innocent lives, their love and affection towards me has been absolutely relentless. Right from the moment that I got diagnosed with PTSD Amy and the children have been so incredibly patient and supportive, comforting and encouraging me even when I have been at my most dysfunctional or aggressive. Amy in particular has been unbelievably courageous, identifying the problem not as me per se but as the PTSD’s total and deeply malign influence. In doing so, Amy has refused to let the PTSD devastate our family in the way it has for so many others, and in turn – she has given me the best reason in the world to keep going, to keep battling this hideous disorder, and to never give in. Whenever I have felt lonely, scared, exhausted or hopeless – at home and on the mountain, all I have had to do is think of them, of their love, of their courage, and of their determination, and they have never failed to help pick me up and put me back on the right track. That I am here at all is as amazing as it is entirely attributable to Amy and our children, and all their hard work and persistence with me – they have been absolutely amazing. Together my family give me so much hope and faith, in myself and in the future, and if it wasn’t for them I simply wouldn’t have got through the last year let alone anywhere near Denali.

Finally, I don’t think for a moment that the mountain alone was sufficient to bring about the changes that I experienced during my journey on Denali; no, these changes were a consequence of many disparate factors. Amongst these, was the foundation for my recovery – painstakingly laid by many specialists over many months, the impeccable timing of the expedition, the team’s distinctive dynamic, the calm of the mountain, and – most important – the involvement of Amy and our children in the whole journey, from diagnosis to the summit of Denali and back again. Delicately wrapping all of this together was the extraordinary charity with whom I travelled to Denali, 65 Degrees North. Led by Rich Morgan MBE, a former Royal Marine himself, 65 Degrees North was born in 2014 when Rich bought together a team to help one seriously injured veteran become the first amputee to cross the Greenland ice cap, unsupported, travelling along the northern 65th parallel. Since then, 65 Degrees North has taken other teams of wounded, injured, or sick military veterans to successfully summit Mount Kilimanjaro – the highest mountain in Africa, Mount Vinson – the highest mountain in Antarctica, Aconcagua – the highest mountain in South America, and now Denali – the highest mountain in North America. Other teams have cycled coast-to-coast across the Pyrenees, and sailed a Brixham trawler along the south coast of the UK. Yet in reality, 65 Degrees North is so much more than the sum of its various expeditions. For what Rich has created and patiently nurtured is, in every sense, a family – where the imprint of everyone who has been involved can be seen in its short but incredible history. But 65 Degrees North isn’t dwelling on its past achievements – as exceptional as they are, because they are on a remarkable journey to help as many veterans as they can ‘rehabilitate through adventure’. And as my own family’s journey has merged with the 65 Degrees North journey, we no longer feel quite so lonely or afraid of the future, because together we have discovered a new optimism, a new focus, and a new energy for life.

To finish, climbing Denali has not cured my PTSD – I continue to struggle with my symptoms every day; but in many ways the journey has done something even better – it’s given me a glimpse of a much happier, brighter, and less chaotic future, a future in which I am a better husband, father, and friend, and a future where I am, at last, at peace with myself and the world around me. So, incredibly, my journey to Denali has been about far more than just getting to the top of the highest mountain in North America – as if this wasn’t enough, as it has helped bring about a profound re-awakening of my soul, afforded me a whole new perspective on life and my recovery, and re-energised me for the many significant challenges that I know still lie ahead. The journey also helped me find these words that, I hope, give the unfamiliar an insight into the full horror of PTSD, and fellow sufferers the inspiration to find their own words and the reassurance that the struggle is worth it – they too can have a Denali moment.

My final comment is this, please – if you ever meet anyone with PTSD don’t try to give them any wisdom or advice as you can’t possibly understand what it’s like; the single most important thing you can do is to listen, really listen to them and don’t ever give up, and you might just save their life.

Joe Winch

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