PTSD Politics – Vets as Threats

When the War Comes Home: Chaos, Flashbacks & Dark Futures

What happens when stressed-out vets return from the war theatre and try to resume their lives with business-as-usual? Many, if not most, find that to be impossible, because they are not the same as they were prior to deployment. In fact, many contend with sleepless nights, inability to focus, depression and Post Traumatic Stress Syndrome.

SUICIDE EPIDEMIC: Studies show at least 35% of the Iraq War vets have PTSD, many to the point of being suicidal. Suicide is at a record high: 20.2 per 100,000 soldiers. As there is an average of 10 failed suicide attempts for each actual loss of life, the figures suggest that more than 1,600 serving army and marine personnel tried to kill themselves last year. An estimated 30 percent of soldiers who took their own lives in 2008 did so while on deployment. Another 35 percent committed suicide after returning from a tour of duty.

Two-thirds screened positive for PTSD are not receiving treatment. Those who do are often just medicated without talk therapy. Even so, many still experience attacks seemingly out of nowhere, mimicing their Iraq experiences. Twenty percent of female soldiers report “military sexual trauma.” The boundaries between friend and foe collapse.

When PTSD was first discovered in combat veterans in WWI, it was known as SHELLSHOCK, and studies of these vets by Britain’s Tavistock Institute led to new discoveries about the breaking points of personalities and how lives could be shattered by the faultlines of unseen wounds lacerating the soft connective tissues of the personality and self-image.

The big question is what happens when today’s vet becomes a danger to him or herself or others? How can we detect and avert potential tragedy in this growing population?

How can we best help our friends, families, and fellow citizens who now feel lost and alienated?

Veteran’s PTSD is a multidimensional issue involving disabilities, traumatic brain injury, psychophysical regulation, stress-management, depression, grief, dissociation, and perhaps ADHD, T-type behavior, chronic pain management, alcohol and drug use, and compulsive disorders. Soldiers in the 101st Airborne claim most use alchol and drugs in excess, including Valium and marijuana. That is the short list, as each unique individual will have particular adjustment issues depending on their life and combat histories. Some also have service-related chronic health issues from vaccines, Gulf War Syndrome, DU, etc.

Regardless of which war or conflict you look at, high rates of PTSD in veterans have been found. Throughout history, people have recognized that exposure to combat situations can negatively impact the mental health of those involved in these situations. In fact, the diagnosis of PTSD historically originates from observations of the effect of combat on soldiers. The grouping of symptoms that we now refer to as PTSD has been described in the past as “combat fatigue,” “shell shock,” or “war neurosis.”

It’s Not Your Fault

Traditionally, those in military and intelligence duty find it difficult to frame their difficulties as a mental health issue. There are associated taboos and shame surrounding perceived ‘weakness’ or inability to “be all you can be.” While PTSD distorts and unravels personality, it is not a character defect, nor the fault of anyone who finds themselves plagued with its symptoms and consequences.  In returning vets, as elsewhere, PTSD is a societal probelm, reflected in the sick society that creates a “dual reality” incongruent with our real needs.

Treatment for PTSD is varied but it usually consists of some form of talk therapy and group therapy plus medication, typically antidepressants or anti anxiety medications. The Army is experimenting with exposing veterans with PTSD to training video games in order to desensitize soldiers to their experiences. The Army also is funding research on Propranolol to treat PTSD. Propranolol is a blood pressure medication that may be useful in treating PTSD. It appears to reduce symptoms of emotional distress associated with traumatic memories. It doesn’t wipe out the memory, just limits the emotional response.

Treatment Options: To Medicate or Not to Medicate

The conventional view is that hyperarousal, sleep disturbances, and embeddedness of the trauma makes effective pharmacological treatment essential. However, innovative physicians, such as Marshall F. Gilula, M.D. strongly recommend consideration of complementary treatments such as Alpha Stim, brainwave resonance CDs,meditation and other means of self-care and self-regulation. Such alternatives can be used alone or in conjunction with medication, or weaning from medication.

 

Whether antidepressant, antianxiety, or sleeping medications are prescribed or not, dealing with traumatized people requires a staged process of treatment that is responsive to how much the victim can tolerate.  Here again, the specific nature of the therapeutic relationship is a critical variable in outcome.

PTSD plays a role in the dysregulation of neurohormones and their roles in the stress response.  Intense stress is accompanied by the release of endogenous, stress-responsive neurohormones, such as the catecholamines (including epinephrine and norepinephrine), serotonin, hormones of the hypothalamic-pituitary-adrenal (HPA) axis (including cortisol and other glucocorticoids, vasopressin, oxytocin), and endogenos opioids.  These stress hormones help us mobilize energy required to deal with emergency stress by increasing glucose release for quick energy and enhancing immune function.  Chronic stress inhibits their effectively and induces desensitization.

Drug therapy for PTSD is based on several biological models and has a few different purposes, (which also can be met with CRP’s intregrative approach).  (1).  Noradrenergic dysregulation is treated with MAO inhibitors, tricyclic antidepressants, beta-adrenergic blockers and benzodiazepines to calm the body’s alarm center.  (2).  Serotonergic dysfunction is treated with antidepressant SSRIs to regulate stress resilience, sleep, and for impulse control.  (3).  Anti-kindling drugs, such as carbamazepine, allegedly regulate an excitability threshold that has been lowered.  (4).  Anxiolytic drugs, such as clonazepam and buspirone are given in an attempt to reduce the startle response, which is one of the most persistent symptoms of PTSD.


Advertisements

~ by ionamiller on November 27, 2009.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

 
%d bloggers like this: