PTSD

Menstuff® has compiled the following information on Post Tramatic Stress Disorder

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Trauma and Post-Traumatic Stress Disorder
PTSD affecting 'a quarter-million' Vietnam war veterans
Understanding a Veteran with PTSD
Newsbytes

Stressed Vets at Higher Risk for Autoimmune Diseases
NYC Kids Suffer From Stress Disorder

Other Veteran Issues

 

Trauma and Post-Traumatic Stress Disorder


Causes, Symptoms, and Treatment Options

Background Information

If you live through a terrifying event or experience, such as a horrific car crash, a killer tornado that cripples your hometown, or domestic violence, you are likely to feel shattered and experience difficulty coping and adjusting. However, as time goes on, and with good individual care, you are likely to get better and move on with your life. On the other hand, if you can’t stop reliving the experiences and it affects your everyday functioning, you might be suffering from post-traumatic stress disorder (PTSD). If you are suffering from this debilitating condition, you are not alone, but great treatment options are available.

One of the few mental illnesses triggered by an outside, traumatizing event, you can suffer from PTSD by experiencing or witnessing a terrifying event. What is considered traumatic? Certain traumatic events can be so severely frightening and overwhelming to individuals that they can cause temporary and sometimes permanent changes to how we physically and psychologically respond to stress in our lives. You may find yourself wondering what types of trauma can cause these changes to our physical and psychological responses. Any unexpected violation to our physical and mental well-being can be considered a trauma. Some of the most common traumatic events that may lead to post-traumatic stress disorder include:

  • Sudden death of a loved one
  • War
  • Rape
  • Kidnapping
  • Natural disasters (e.g., tornadoes, earthquakes, hurricanes)
  • Terrorist attacks
  • Car or plane crashes
  • Assault
  • Sexual or physical abuse
  • Childhood neglect

Not everyone who experiences a traumatic event will suffer from PTSD. As mentioned above, it’s normal to have nightmares, be fearful, and find difficulty “forgetting” what happened. When you get stuck in a state of fear and shock and your symptoms don’t improve or get worse, post-traumatic stress disorder is likely settling in because your body is having problems restoring itself to equilibrium.

PTSD is found to occur in approximately one in ten of individuals affected by a traumatic event. On average, 60% of men and 50% of women experience a traumatic event during their lifetimes. Of these, 8% of men are found to develop PTSD and 20% of women are found to develop PTSD. Individuals experiencing rape have a higher likelihood of developing post-traumatic stress disorder over any of traumatic event; therefore, as women are more likely to be raped than men (9% vs. 1% likelihood), this explains the imbalance in the statistics of post-traumatic stress disorder among genders. Additional research shows the majority of individuals affected by post-traumatic stress disorder also suffer from another psychological disorder (e.g., depression, anxiety). These individuals are also more prone to problems with substance abuse of drugs and/or alcohol.

What are the Symptoms?

There is no way of knowing who will develop post-traumatic stress disorder after a traumatizing event. As evidenced by past research, the majority of people who witness or live through a traumatic event will not suffer from PTSD. Most will likely have memories of the events, but their lives will not become negatively impacted by it in their daily interactions.

Symptoms of PTSD are often grouped into types. These types include: avoidance, intrusive memories, changes in emotional reactions, and negative changes in thinking and mood. The most common symptoms of post-traumatic stress disorder include flashbacks, jumpiness (literally “jumping out of one’s skin”), emotional detachment. These symptoms can come and go and vary in intensity. We outline the four types below:

Avoidance Symptoms

  • Avoiding talking about or thinking about the traumatic event
  • Avoiding places, activities, or people that remind you of the traumatic event

Intrusive Memories

  • Flashbacks – reliving the event as if it were happening all over again
  • Upsetting dreams/nightmares about the traumatic event
  • Recurrent memories of the traumatic event – even when you are trying not to think about them – as if they won’t “leave your mind”
  • Experiencing severe emotional distress or physical reactions to things that remind you of the traumatic event

Changes in Emotional Reactions

  • Overwhelming guilt or shame
  • Jumpiness – being easily startled or frightened – jumping out of your skin
  • Sleep disturbances
  • Difficulty concentrating
  • Always in “defense” mode – on guard for danger
  • Irritability
  • Angry outburst
  • Aggressive behavior
  • Self-destructive behavior (e.g., reckless driving, substance abuse)

Negative Changes in Thinking and Mood

  • Feeling negatively about yourself and others
  • Lack of interest in activities you once found enjoyment in
  • Difficulty maintaining relationships with others
  • Memory problems – not being able to remember parts of the traumatic event
  • Feelings of hopelessness for the future (e.g., marriage, career, living a normal life span)
  • Emotional numbness – feeling detached from others
  • Inability to experience positive emotions

Children and adolescents may exhibit slightly different symptoms of post-traumatic stress disorder than adults. These symptoms include:

  • Severe separation anxiety – fear of being separated from their parents
  • Somber play that showcases a revival of the traumatic events
  • Phobias unrelated to the traumatic event (e.g., fear of monsters)
  • Acting out the traumatic experience through drawings, social play, or stories
  • Loss of previously acquired skills (e.g., regression in toilet training)
  • Sleep problems and nightmares not related to the event
  • Irritability and aggression
  • Aches and pains that have no apparent cause

Causes, Risk Factors, and Diagnosis

You are more likely to suffer from post-traumatic stress disorder if the traumatic event you endure is life threatening or severely traumatic to your personal safety. Additionally, the more exposure to the event or prolonged exposure to a traumatic event is also more likely to increase your chances of developing PTSD. Other risk factors of post-traumatic stress disorder include:

  • Family history of PTSD and depression
  • History of physical or sexual abuse
  • High level of stress in your daily life
  • Lack of coping skills
  • Not getting help or support after the traumatic event
  • History of depression, anxiety, or other mental illness
  • History of substance abuse
  • Careers that exposure you to traumatic experiences (e.g., military, police, first responders)
  • Experiencing previous traumatic events, especially early in one’s life
  • Extent that the traumatic event was uncontrollable, inescapable, or unexpected
  • Type of traumatic event – intentional, human-afflicted harm (e.g., rape, sexual abuse) is more likely to result in PTSD than an act of God (e.g., hurricane, earthquake)

Suffering from post-traumatic stress disorder can increase your chances for other mental illnesses, such as depression and anxiety, suicide, eating disorders, and issues with drugs and alcohol. Therefore, it is especially important to seek treatment if you are suffering from PTSD for your own well-being. You should seek treatment for post-traumatic stress disorder if you are experiencing any of these symptoms and are not able to function or cannot function effectively in your day-to-day life.

Diagnosis of post-traumatic stress disorder is completed by medical professionals. Your diagnosis will be based on psychological evaluations of your signs and symptoms. To be diagnosed with post-traumatic stress disorder, you must meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychological Association. In addition to experiencing or witnessing a traumatic event, you must experience one or more of the following after exposure to the traumatic event:

  • Reliving the traumatic event
  • Upsetting dreams/nightmares about the traumatic event
  • Experience of flashbacks
  • Experience of emotional distress related to the traumatic event

In combination with these symptoms, you may also experience debilitating behaviors and emotions one month or more post-traumatic event to include things such as avoidance behaviors, memory loss, emotional numbness, self-destructive behavior, and difficulty sleeping.

Your doctor or mental health professional will then make a diagnosis of post-traumatic stress disorder and refer to you a number of treatment options.

Treatment Options for Sufferers of Post-Traumatic Stress Disorder

Several types of treatment options are available if you are suffering from post-traumatic stress disorder. The most often prescribed method of treatment is psychotherapy. Medications and other types of physical treatment options are also prescribed. Your doctor will formulate the best treatment course of action for you.

Psychotherapy, often referred to as “talk therapy” has been shown to elicit great responses from sufferers of post-traumatic stress disorder. Cognitive therapy is focused on recognizing patterns of thinking that get you “stuck” in your emotional state. For example, this type of therapy might help you in recognizing cognitive patterns associated with negative perceptions of normal situations. Exposure therapy is often coupled with cognitive therapy if you have been diagnosed with PTSD. Exposure therapy focuses on safe exposure to what is causing you intense fear. This exposure enables you to cope with the stimulus effectively and rationally. Eye movement desensitization and reprocessing (EMDR) is a form of therapy that combines exposure therapy with guided eye movements. These combination of events in EMDR help you in your cognitive processing of traumatic events and allow you to effectively change your reactions to these types of events.

Medications that have been found useful in the treatment of post-traumatic stress disorder include antidepressants and anti-anxiety medications. Selective serotonin reuptake inhibitors (SSRIs), including Zoloft and Praxil, have been approved by the Food and Drug Administration as antidepressant treatments for PTSD.

Anti-anxiety medications are typically prescribed short-term to relieve severe anxiety problems associated with PTSD. They are usually only prescribed temporarily because of the ease of addiction to this type of medication. Nightmare suppressant drugs (e.g., Prazosin) may also be prescribed if you are suffering from post-traumatic stress disorder to help you sleep more easily and with fewer disruptions.

Final Thoughts

If you have experienced a terrifying traumatic event and now suffer from post-traumatic stress disorder as a result, treatment does exist and following it can lead you to a life of well-being. To get the most of your treatment plans, follow these pieces of advice:

  • Learn all you can about your disorder and what effects it has on your body – this allows you to recognize signs and symptoms and coping strategies
  • Follow the treatment plans prescribed to you by your doctors and mental health providers – even if you are feeling “fine”
  • Don’t turn to drugs and alcohol to “numb” your feelings
  • Stay healthy – eat well-balanced meals and exercise on a regular basis
  • Find support groups that can help you through difficult times – and to have a support base that you can talk to about anything
    Source: www.psycom.net/iwar.1.html

PTSD affecting 'a quarter-million' Vietnam war veterans


Even 40 years after the end of the war in Vietnam, former US soldiers are presently suffering post-traumatic stress disorder (PTSD) or other mental ill health, finds a study published in JAMA Psychiatry.

The study has implications for the future care of veterans of the Iraq and Afghanistan wars.

The study by Dr. Charles Marmar, of the New York University Langone Medical Center, and colleagues estimates that around 15-17% of war veterans have had post-traumatic stress disorder (PTSD) at some point in their lifetime.

The authors conclude there is an estimated 271,000 Vietnam veterans presently living with full PTSD, a third of whom have current major depressive disorder.

The authors' National Vietnam Veterans Longitudinal Study builds on the National Vietnam Veterans Readjustment Study (NVVRS), which ran from 1984 through 1988.

Of the 1,839 veterans from the original study, 1,450 (78.8%) participated in at least one phase of the new study, which ran from July 2012 to May 2013.

The prevalence among male war-zone veterans for a current PTSD diagnosis varied by definition:

4.5% for a current PTSD diagnosis, based on the clinician-administered PTSD scale for the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders" ("DSM-5")

10.8% against that assessment plus subthreshold PTSD (meeting some diagnostic criteria).

11.2% based on the PTSD checklist for "DSM-5" items for current war-zone PTSD.

Among female veterans, these estimates were, respectively: 6.1%, 8.7% and 6.6%.

Of the veterans with current war-zone PTSD, some 36.7 also had major depression.

Other estimates were that about 16% of war-zone Vietnam veterans reported a rise of more than 20 points on a PTSD symptom scale; 7.6% reported a fall of the same size on the scale.

 Of this latter finding, the study authors say:

"An important minority of Vietnam veterans are symptomatic after 4 decades, with more than twice as many deteriorating as improving."

'High-quality findings'

In an editorial article published in the same issue of the journal, Dr. Charles Hoge, of the Walter Reed Army Institute of Research in Silver Spring, MD, writes:

"This methodologically superb follow-up of the original NVVRS cohort offers a unique window into the psychiatric health of these veterans 40 years after the war's end.

No other study has achieved this quality of longitudinal information, and the sobering findings tell us as much about the Vietnam generation as about the lifelong impact of combat service in general, relevant to all generations."

"The study is of vital importance to subsequent generations of war veterans and underscores medical service needs for PTSD and related comorbidities extending decades after service," the editorial concludes.
Source: www.medicalnewstoday.com/articles/297149.php

Understanding a Veteran with PTSD


Servicemen and women oftentimes face unique challenges when leaving active duty and readjusting to civilian life.

 

As explained by U.S. Veterans Magazine, these challenges include

  • discovering ways to re-establish their roles within the family,
  • having to find and obtain a civilian job (sometimes for the first time ever, such as when enlisting after graduating from high school),
  • and adjusting to a life that involves making their own choices versus being told what to do, how to do it, and when.

However, sometimes soldiers also return home with challenges related to their mental wellbeing as a result of what they’ve witnessed while on active duty. And one of the most common mental challenges is post-traumatic stress disorder (commonly known as PTSD).

PTSD and the Military

The National Institute of Mental Health (NIMH) explains that PTSD is “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.” In the case of military personnel specifically, these types of events typically occur during times of war when soldiers find themselves face-to-face with not only their own mortality, but that of their fellow comrades as well.

In fact, PTSD is more common for military personnel than for the general population. According to the U.S. Department of Veterans Affairs, approximately 7 to 8 percent of the population will experience PTSD at some time in their lives. Yet, this rate is much higher for military veterans, and the exact amount depends largely on which conflict they endured.

For instance, those serving in operations Iraqi Freedom and Enduring Freedom have somewhere between an 11 and 20 percent of developing PTSD. However, it is estimated that approximately 30 percent of Vietnam War veterans developed or will develop this particular mental health condition. So, what is it like for veterans who are living with PTSD?

Living with PTSD

The NIMH says that individuals suffering from PTSD often have flashbacks of the traumatic event, bad dreams, and other frightening thoughts. They may also develop avoidance symptoms whereby they purposely stay away from anything that reminds them of the experience. This can mean avoiding certain places and objects that serve as a reminder of what they’ve experienced.

With PTSD also often comes what the NIMH refers to as arousal and reactivity symptoms. These include being easily startled, feeling on edge, and displaying angry outbursts. Trouble sleeping is also common with PTSD. According to the National Sleep Foundation, this is generally due to the individual feeling like they need to be alert, which is a result of the anxiety that sometimes comes with the nighttime and subsequent darkness, or the nightmares the person seeks to avoid.

Veterans with PTSD may notice cognitive and mood changes as well. For instance, they may find it difficult to remember the entire traumatic event or feel guilt associated with their part in it. Sometimes, they have negative feelings toward themselves or the world at large, or they lose interest in activities they used to enjoy.

These are all trademarks of PTSD and all of these types of responses must be present on some level for a professional to render a diagnosis. But why do some military personnel develop PTSD where others don’t, even if they’ve witnessed the exact same event?

PTSD Risk Factors

Many studies have been conducted on this very topic. One meta-analysis published in PLOS One reports that after reviewing 32 different pieces of research (21 retrospective studies, 4 prospectively studies, and 7 cross-sectional studies), there are many factors that stand out as strong predictors of whether or not combat-involved military personnel will develop PTSD.

They include:

  • Previous exposure to adverse life events: Being exposed to troubling life experiences (such as sexual abuse or assault) prior to joining the military can increase the risk of PTSD, partially because the event’s negative impact creates other psychological issues.
  • Witnessing injury or death: If a servicemember witnesses an injury or death, or discharged his or her weapon during active duty, there is a higher risk of developing PTSD than a servicemember who has not experienced these circumstances.
  • Various military characteristics: Military rank and occupation, branch of service, length and number of deployments have all been found to contribute to PTSD risk, because each factor determines how likely it is the soldier will be part of active combat.
  • Deployment stressors: Being exposed to excessive temperatures, a lack of privacy in the unit, and worrying about family can all increase a vet’s risk of PTSD.
  • Gender: Female veterans develop PTSD more often than their male counterparts, possibly due to reasons associated with being more susceptible to depression, experiencing less cohesion in the military unit, and being more sensitive to threats.
  • Race: Minorities have been found to be more susceptible to PTSD than non-minority military personnel. However, it’s unclear if this is because this demographic tends to have more of the other risk factors, or if they are assigned to military roles that see combat more often.
  • Level of education: The lower a serviceman or woman’s educational level, the higher the risk of PTSD, potentially due to not having learned effective coping skills or limited access to helpful resources.

PTSD and Post-Deployment Risks

PLOS One’s research also found that PTSD risk can rise after returning home and is often based on various post-deployment factors.

One factor is social support, and their study found that “a positive recovery environment after trauma exposure may serve as a protective factor” for PTSD. In other words, the more the servicemember’s family and friends are there to offer support after duty is complete, the less likely it is that PTSD will develop. That’s because this level of support gives the servicemember the self-reliance and self-security needed to fend off this condition.

Work status after employment is a potential risk factor as well. Specifically, if the veteran comes back and is unemployed, and therefore unable to provide financially for the family unit, this may instigate PTSD.

These types of situations can occur long after the combat ends, but they can still affect the soldier psychologically, making PTSD a threat even after returning home. Knowing all of this, how can you best help a veteran with PTSD?

Helping Veterans with PTSD

The first step involves educating yourself about how someone with PTSD typically reacts. According to the National Center for PTSD, a person with this mental health condition may appear angry, tense, or worried. They may also come across as numb, distant, or detached.

Veterans with PTSD may also be easily irritated, jumpy, or nervous, while being more demanding or protective at the same time. Intimacy issues are not uncommon with PTSD either.

All of these responses can affect family and friends, who may feel hurt, dejected, angry, or sad, especially if they don’t recognize these patterns as being normal reactions to PTSD. So, creating a positive response first requires that you understand these responses enough to know they are a normal way of dealing with this condition.

The second step is to get the veteran the outside help he or she needs. This may involve counseling-type therapy sessions (either one-on-one, group, or both), or even family therapy so the everyone involved can work through the PTSD together. In this case, it helps to find a professional who specializes in the disorder.

If possible, ask local military veterans for their recommendations. Alternatively, you can do an internet search. For instance, Psychology Today offers the ability to do a quick search based on your geographic location. Just enter your city or zip code and all local therapists with this specialty are provided. This site even provides other necessary information to help make a more informed decision as to whether to hire them, such as:

  • a brief bio, along with qualifications and credentials
  • specialties, issues covered, and treatment approaches
  • cost per session and insurance plans accepted
  • contact information for setting up an introductory meeting

VA Specific Services

The National Center for PTSD also offers The Guide to VA Mental Health Services for Veterans and Families, which shares the types of treatments that are available through Department of Veterans Affairs (VA) and what happens when you request help.

For instance, for PTSD specifically, there are various medications that can sometimes help when treating depression, anxiety, mood disorders, and sleep disorders related to PTSD. There are also various talk therapies and residential care if long-term, intensive treatment is needed.

Eligibility for these types of services is based on a number of factors, but it generally involves completing active military service in one of the U.S. branches of military, being honorably discharged, or being a National Guard member or Reservist who served in a combat zone. If they determine that you qualify, you will likely be referred to a local VA facility for treatment to begin.

There are nearly 2,000 facilities, and you can use the online locator if you want to find the closest ones to you. Simply enter your location (either your full address or zip code), what type of facility you’re searching for, and how close the facility is (you can search based on a certain mile radius or request the 5, 10, or 25 closest centers to you). The results give you the facility name, its address and phone number, and how many miles it is from your home.

The Vet Center Program is one of the options available to any active or veteran military member who has served in a combat zone or area of hostility, has experienced military sexual trauma, or has provided emergent medical care or mortuary services. Services offered at these facilities include counseling, outreach and education, substance abuse assessment and referral, employment assessment and referral, explanation of VBA benefits, and screening and referral for other issues, such as traumatic brain injury (TBI) and depression.

The more you know about and understand PTSD, the easier it is to see the impact this condition can have on the military veteran individually and the family unit as a whole. Educating yourself about treatment options helps as well, and provides you with the tools you need to help yourself or a loved one overcome this sometimes debilitating condition.
Source: online.maryville.edu/online-bachelors-degrees/psychology/understanding-a-veteran-with-ptsd/

Newsbytes


Stressed Vets at Higher Risk for Autoimmune Diseases


Link found with post-traumatic stress disorder
Source: www.healthcentral.com/news/NewsFullText.cfm?id=512136

NYC Kids Suffer From Stress Disorder


Nine out of 10 New York City schoolchildren suffered at least one symptom of post-traumatic stress six months after Sept. 11, and almost 10 percent likely had the disorder, according to a study released Wednesday.
Source: www.intelihealth.com/IH/ihtIH/WSIHW000/333/8014/349610.html

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