PTSD explained

The light went on in my head during a debate over PTSD nomenclature last year.imgres

Then-president of the American Psychiatric Association, John Oldham, was chairing a session entitled Combat-Related PTSD: Injury or Disorder? Today’s Time Magazine carries a no-nonsense article about what PTSD is, exactly.

“A stellar panel of trauma experts — retired generals, senior researchers and key framers of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — debated whether the term, post-traumatic stress disorder (PTSD) should be changed to post-traumatic stress injury (PTSI).

“Supporters of the change to “injury” argued that it might help overcome the stigma that many military members and veterans associate with seeking treatment for PTSD. Service members aren’t happy to report “a disorder” but might be willing to admit an injury. Those in opposition argued that “injury” is too imprecise a term for psychiatric diagnosis and treatment. As I sat through the heated session, it struck me that they were also implying that the term, disorder, is somehow “more scientific” and, therefore, “more psychiatric.” Continue reading “PTSD explained”

Deployment and suicide

The military suicide numbers, from the years 2008 to 2011, upend the popular belief that a large increase in suicides over the last decade stems from the psychological toll of combat and repeated deployments to war, reports today’s Los Angeles Times

“To researchers trying to unravel the causes of the rise, the statistics suggest that the mental health and life circumstances of new recruits are at least as important — and possibly more so — than the pressures of being in the military. It is clear that some enter with a predisposition to suicide and that stressors other than war are pushing them over the edge, experts said.imgres-1

“A lot of the risk for suicide in the military is the stuff they bring with them,” said Dr. Murray Stein, a psychiatrist at UC San Diego who is studying suicide in the Army. Among the unanswered questions: Did the type of people volunteering for service change after 9/11, when going to war — and dying — went from being an abstract possibility to a significant risk? One theory is that more recruits have backgrounds and psychological histories that make them prone to suicide. “Wartime is almost certainly going to be different than peacetime,” said Ronald Kessler, a Harvard sociologist and suicide authority.

“The Times interviewed relatives and friends of five service members who committed suicide without having gone to Afghanistan or Iraq. All were men who married young. In four cases, their relationships were over or crumbling. They struggled with the direction of their lives and joined the military in search of purpose or meaning, their relatives and friends said. And they concealed their psychological problems. Four of the men longed to go to war, and the disappointment of not being sent only heightened a sense of desperation.For Michael Griffin, enlisting in the Army at age 25 was a last-ditch effort to right his life. A former skinhead, he was struggling to find work, and he and his wife had separated. Active-duty military suicides reached a high in 2012, and a significant number of inactive reserve and National Guard troops also took their own lives. Continue reading “Deployment and suicide”

Veterans’ PTSD options are lacking

The Department of Veterans Affairs is being criticized for the shortfall in care for almost a million veterans who can’t get timely compensation and have been waiting hundreds of days for help, often to no avail, reports NPR today.images

“Frustration with the agency came to a head last Thursday when VA Secretary Eric Shinseki was called before a closed-door meeting of the House Appropriations Committee.”We are aggressively executing a plan that we have put together to fix this decades-old problem and eliminate the backlog, as we have indicated, in 2015,” Shinseki said after the meeting.“So this is a challenge [and] we’re making tough decisions that make it possible for more people to apply for and receive benefits.

“Glenn Smith, a 28-year-old Army veteran from St. Louis, joined the military in 2004.”I joined because I loved tanks, believe it or not,” Smith tells Jacki Lyden, host of weekends on All Things Considered.Smith was deployed to Iraq twice between 2006 and 2010; he spent most of four years in combat. He now has an irregular heartbeat, and attributes it to one of the many IED blasts he went through. The irregular heartbeat, discovered during a routine training exercise, led to him being discharged last spring.

“Smith described an anxiety attack in March in which “things just [closed] in” on him. It’s even happened while he was driving.”I didn’t feel like I had any release or way to break free of it,” he says. “I’ve had memories and nightmares of my experiences while I was in Iraq. Any all that just came rushing to the surface.”Smith also says he has a bad case of PTSD. His PTSD has been so debilitating, he needs help navigating the VA. He submitted his initial claim about a year ago, but still lacks regular treatment for the disorder. Continue reading “Veterans’ PTSD options are lacking”

Traumatic times

Each American generation has its characteristic psychiatric diagnosis, and, typically, a drug or medication that represents the times, states Salon.com

“When the world was on the verge of blowing up in the Dr. Strangelove 1960s, we lived in the Age of Anxiety. Valium, the drug that symbolized that period, was celebrated in books and movies like “Valley of the Dolls” and songs like the Rolling Stones’ “Mother’s Little Helper.” The 1970s was the Age of Malaise, and the drug that attempted to mediate that malaise was cocaine. Starting in the Prozac-fueled late 1980s and 1990s, the omnipresent diagnosis was depression. Later, the diagnosis was attention deficit disorder and the representative drug was Adderall.images

“If this is so, the appropriate diagnosis of the last decade — since Sept. 11, 2001, to be exact — may be PTSD: post-traumatic stress disorder. Of course legions of American soldiers have received the diagnosis, and enormous resources, appropriately, have gone into its treatment. The Department of Veterans Affairs estimates that nearly 30 percent of the more than 800,000 Iraq and Afghanistan War veterans treated in veterans’ hospitals and clinics are diagnosed with PTSD.

“But in the past 10 years, even non-veterans have been engaged in an ongoing narrative of American trauma. After 9/11 came Katrina, then the economic meltdown and the recession that never seems to end. This past year saw Sandy followed by Newtown. Along the way there’s been the mass killings at Virginia Tech, at Northern Illinois University, and in a Colorado movie theater. There also seems to be a deepening sense that one can never fully escape from potential catastrophe, not on a Boston street on a promising spring day or in a Connecticut elementary school a few weeks before Christmas.

“In the popular perception, the locus, both psychologically and geographically, of the tragedies has shifted. They’ve gone from being “out there” — in, say, the remote parts of the South or West, or the inner cities — to “right here,” in respectable, suburban America. The latest chapter is the bombing in Boston, with its indelible images — the 70-year-old runner laid out on the ground; the impossibly innocent smiling face of the 8-year-old boy who was killed. And it further cements post-traumatic stress in the popular psyche and lexicon in a similar way in which depression, bipolar disorder and ADD — and the drugs to treat them — were popularized in earlier eras. Continue reading “Traumatic times”

Veterens Day

On this Veterens Day we can say that if recent U.S. involvements have taught us anything, it is that the no one comes back from war unchanged. Gone are the Vietnam days of heckling returnees or earlier beliefs that combat is just another job. Regardless of one’s political beliefs, the undeniable truth is that military service is a serious and often dangerous business––one that frequently takes an unacknowledged toll on those who serve and their families.

FOCUS (Families OverComing Under Stress) is one of a number of notable efforts that have emerged from this new ethos. FOCUS provides resiliency training to military children and families. It teaches practical skills to meet the challenges of deployment and reintegration, to communicate and solve problems effectively, and to successfully set goals together and create a shared family story.

The science of forgetting

As the baby boom generation ages towards retirement, attention grows over how people can remain mentally sharp. Alzheimer’s and other forms of dementia make  boomers start to worry when they lose their car keys or stumble over a name. At the same time, Internet search engines
and home data storage have made the actual need to remember less important. Add to this the rapid pace of media and the public’s seemingly relentless focus on immediacy over history, and it seems like a wholesale assault on memory is sweeping the culture. So a story like “The Forgetting Pill Erases Painful Memories” recently appearing in Wired magazine would seem to support the current culture of amnesia. Continue reading “The science of forgetting”