Props to Drew for talking about it. Validating the experience is a big step for him and his readers.
I feel like a lot of people in the outdoor world ignore or misunderstand the symptoms/effects of their head injuries, PTSD, and survivor guilt.
From my personal experience learning to live with it and talking with my peers (shoutout to Rob at Safety Third Blog)-
There's that inital cycle of manic-depressive substance abuse and super risky self destructive behavior. It's common to try to mask the issue like that, but all too often, it leads to tragedy.
Some time passes and you finally think you're over it and having the best day, when suddenly a random horrible thought hits ya and spirals you back into the cycle.
We might all think we're Mr. Toughnutz can just dissociate from our issues, but that is rarely, if ever, the case.
For me, hypnosis, EMDR, and support groups, have been helpful overall.
I'm coping day to day by using imaginal templates.
Like if I'm laying in bed and suddenly think, "I should have died that day, I should die today".
I'll take a breath and imagine the thought as some kind of object ranging from like a piece of paper to a big scary monster. Then I'll tell it, "You are just a random, passing PTSD delusion." And then crumple the paper or slay the monster, cast it into a black hole that looks like a 30 yard dumpster and then fly into a different room of my mind.
Kinda weird, but it keeps me from even weirder escapism.
Sometimes it doesn't work and traditional support group type therapy can get me the extra push.
Idk I'm rambling now... good thread @BigPurpleSkiSuit