The FReeper Foxhole Looks at PTSD (Post Traumatic Stress Disorder) - Jan. 25th, 2003

http://www.angelfire.com/va3/companyg/ptsd.html ^

[SAMWolf]

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What is PTSD?

The psychiatric definition of "trauma' is "an event outside normal human experience". Trauma leaves you feeling powerless, helpless, paralyzed. It tends to be sudden and overwhelming. It "owns" you. You can not think clearly during a severe trauma, yet you are forced to focus your consciousness in an attempt to deal. Trauma has been defined as "any sudden and potentially life-threatening event".

As the name implies, Post Traumatic Stress Disorder (PTSD) occurs after (post) an extremely stressful event (trauma). The more severe the trauma and the longer the person is exposed to it, the greater the likelihood is of developing PTSD.

The traumatic event is relived repeatedly. This can take the form of recurrent images, thoughts, dreams or "flashbacks" of the event. Even reminders of the event can cause extreme distress, so many people go out of their way to avoid places or events that bring to mind the traumatic event. Many experience increased anxiety, restlessness, sleeplessness, irritability, poor concentration, hypervigilence or an exaggerated startled response. Some are even plagued by feelings of "survivor's guilt" because they survived when others did not. The symptoms are obviously very disruptive and stressful to the victim, as well as their family and loved ones. It can even impair job performance and social functioning.

It has been called shell shock, battle fatigue, accident neurosis and post rape syndrome, and is too often misdiagnosed and misunderstood. PTSD is a diagnosis which was first made following the Viet Nam War. Veterans who saw combat in Viet Nam were found to have a number of symptoms not clearly documented in any other diagnostic category. These symptoms had been observed in combat veterans in many previous wars, so it seems that PTSD is constantly being rediscovered.

War has always taken a toll. Throughout history, accounts tell of nightmares and other emotional problems associated with the horrors of war. We repeatedly discover the effects of trauma on human beings every time we go to war. Terms like "combat fatigue" and "shell shock" were used in the past to describe the effects of combat. These terms were misleading because they imply that the effects of combat are short-term.



PTSD is not a mental sickness, but a "syndrome". In other words, a collection of symptoms. It describes the often chronic reaction experienced by people exposed to the particular kind of intense stress encountered in war zones and other catastrophic situations. This reaction is a normal human response to the impact of abnormal situations and events. The specific type of PTSD suffered by soldiers is known as Combat PTSD. There is no shame attached to it; it is often the most courageous man in a unit who gets hit by this syndrome.

A delayed stress reaction may surface after months or even years, including some or all of the symptoms below. Few suffer every symptom listed here; but if you recognize several of your own or some loved one's behavior, the chances are that person suffers more or less from severe post traumatic stress.

**"Intrusion" refers to the unwanted invasion of one's mind and body by memories of past traumatic events.

**"Constriction" refers to the strategies taken by the mind to stop this invasion.

**"Hyperarousal" refers to the state of constant alertness that is the legacy of having been involved in such events.

1. Nightmares, flashbacks, hallucinations and other forms of uncontrollable invasion of the present by memories of the past (intrusion).

2. Intense distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the event; certain smells can trigger waves of fear, as can loud noises and certain television shows (intrusion).

3. Difficulty in recalling events from the war years, especially those that were traumatic; unwillingness to remember the war; reluctance to meet people, read books, see films, etc. that remind one of the war (constriction).

4. Sleeplessness; difficulty concentrating (hyperarousal).

5. Hypervigilance; unmotivated, keyed-up alertness (hyperarousal).

6. Episodes of severe rage (hyperarousal).

7. Violent impulses towards what may be indiscriminate or innocent targets; unnecessarily violent reaction on being taken by surprise (hyperarousal).

8. Severe survival guilt; feelings of guilt at having survived the war while other (who the victim sees as more deserving) have died (constriction).

9. Psychic numbing; feeling that one has no feelings (constriction).

10. Alienation from one's own feelings; reacting with emotions that do not seem appropriate to the situation; periods of acute depression, interrupted by periods of sometimes manic behavior (constriction/hyperarousal).

11. Markedly diminished interest in significant activities; apathy (constriction).

12. Feelings of detachment or estrangement from others (constriction).

13. Sense of foreshortened future; feeling of being older than one's true age (constriction).

14. Doubt about whether one can ever love or trust someone else again; pessimism about the very nature of love and life itself (constriction).

PTSD is defined in the following way:

A. The person has been exposed to a traumatic event in which both of the following were present:

** The person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others;

** The person's response involved intense fear, hopelessness or horror.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

** Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions;

** Recurrent distressing dreams of the event;

** Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur on awakening or when intoxicated);

** Intense psychological distress or reactivity at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

** Efforts to avoid thoughts, feelings or conversations associated with the trauma;

** Efforts to avoid activities, places or people that arouse recollections of the trauma;

** Inability to recall an important aspect of the trauma;

** Markedly diminished interest or participation in significant activities;

** Feeling detachment or estrangement from others;

** Restricted range of effect (as in, unable to have loving feelings);

** Sense of a foreshortened future (does not expect to have a career, marriage, children or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

** Difficulty falling or staying asleep;

** Irritability or outbursts of anger;

** Difficulty concentrating;

** Hypervigilance;

** Exaggerated startled response.

E. Duration of the disturbance (symptoms in B, C and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

IMPORTANT NOTE:
When identifying trauma and its' symptoms, it is always best to ask "What HAPPENED to this person" rather than "What is WRONG with this person"!

I understand when someone says they have PTSD. It can be very debilitating, affecting one's ability to work, maintain relationships and to simply function in everyday living.

But there is a light in the darkness where PTSD resides -- it is a treatable disorder. With the help of medications, therapy and an adequate support system, there is hope for healing.

Please remember ..

YOU ARE NOT ALONE!

[SAMWolf]

PTSD AND THE FAMILY

When any family member experiences psychological trauma and suffers PTSD, the entire family is profoundly affected. Some traumas are directly experienced by only one family member, but other family members may experience shock, fear, anger and pain in their own unique ways simply because they care about and are connected to the survivor. Living with an individual who has PTSD does not automatically cause PTSD, but it can produce "secondary" traumatization. Whether family members live together or apart, are in contact often or rarely, and feel close or distant emotionally from one another, PTSD affects each member of the family in several ways.

* Family members may feel hurt, alienated, frustrated or discouraged if the survivor loses interest in family or intimate activities and is easily angered or emotionally isolated and detached. family members often end up feeling angry or distant towards the survivor, especially if he or she seems unable to relax and be companionable without being irritable, tense, anxious, worried, distractible or controlling, overprotective and demanding.

* Even if the trauma occurred decades ago, survivors may act (and family members may feel) as if the trauma never stops happening. They may feel as if they're living in a warzone if the survivor is excessively on-guard, tense or easily startled or enraged. Family members can find themselves avoiding activities or people and becoming isolated from each other and from friends outside the family. They may feel that they have no one to talk to, and that no one can understand.

* They may find it very difficult to have a cooperative discussion with the survivor about important plans and decisions for the future because they feel there is no future to look forward to, because they have difficulty listening and concentrating without becoming distracted, tense or anxious, or because they become angry and overly suspicious toward the family member or towards others (hypervigilant). They may find it difficult to discuss personal or family problems because the survivor becomes either controlling, demanding or overprotective, or anxious and fearful about problems becoming terrible catastrophes.

* Family members may become over involved with their children's lives due to feeling lonely and in need of some positive emotional feedback, or feeling that the partner can't be counted on as a reliable and responsible parent.

* They may find their sleep disrupted by the survivor's sleep problems (reluctance to sleep at night, restlessness while sleeping, severe nightmares or episodes of violent "sleepwalking". Family members also often find themselves having terrifying nightmares, afraid to go to sleep, or difficulty getting a full and restful night's sleep, as if they are reliving the survivor's trauma in their own feelings and sleep.

* Ordinary activities, such as going shopping or to a movie or taking a drive in the car, may feel like reliving of past trauma when the survivor experiences trauma memories or flashbacks. The survivor may go into "survival mode", suddenly and without explanation shutting down emotionally, becoming pressured and angry, or going away abruptly and leaving family members feeling stranded, helpless and worried.

* Trauma survivors with PTSD often struggle with intense anger or rage and can have difficulty coping with an impulse to lash out verbally or physically. Family members can feel frightened of and betrayed by the survivor, despite feeling love and concern.

* In addition it exposes family members to emotional, financial and domestic problems. Survivors experiencing PTSD may seek relief and escape with alcohol or other drugs, and through addictive behaviors such as gambling, workaholism, overeating or refusing to eat (bulimia and anorexia). Addictions offer false hope to the survivor by seeming to help for a short time but then making PTSD's symptoms of fear, anxiety, tension, anger and emotional numbness far worse. Addictions may be very obvious, such as when binge drinking or daily use of drugs occurs. However, they may involve lighter or less frequent episodes of "using" that are a problem because the survivor is dependent ("hooked" on the habit and can't cope without it.

* When suicide is a danger, family members face these unavoidable strains: worry, guilt, grief and anger.

What can families of trauma survivors with PTSD do to care for themselves and the survivor?

* Continue to learn more about PTSD by attending classes.

* Continue to learn more about PTSD by viewing films or reading books on the subject.

* Encourage, but don't pressure, the survivor to seek counseling from a PTSD specialist.

* Seek personal, child, couples or family counseling if troubled by "secondary" trauma reactions such as anxiety, fears, anger, addiction or problems in school, work or intimacy.

* Children often have low self-esteem and blame themselves for their father's unhappiness. There is a good chance that the child will feel unwanted, unloved and inadequate.

* Anyone can have sexual problems, but there is a greater likelihood that they will occur in couples where one partner has PTSD. For some veterans, it just doesn't mean anything anymore. The wife will feel rejected. The feeling of being unloved will diminish her self-esteem and she will feel that the veteran is not meeting her needs.

* Like other working women, spouses of veterans with PTSD play many roles. But a veteran's spouse also needs to worry about her husband's psychological condition while continuing to function at work. For financial reasons, she can not afford to lose her job. Often she has to play the role of both mother and father. Eventually, she realizes that she doesn't have time to take care of herself, and blames herself for all shortcomings.

Secondary PTSD in Wives

MEMORIES:

Preoccupation with the veteran. Constant tension and anxiety because she "never knows what he'll do next". Critical or self-righteous martyr attitude because of "what he puts me through". Continual manipulation of veteran and/or circumstances in order to be in control in a situation that is out of control.

ISOLATION:

May have a few friends or be unable to relate to friends as she would like because the Vet has alienated them with his attitude and actions in the past. The Vet has isolated the family and/or is jealous of them. She has alienated friends because of her constant family hassles. The friends and family she does have tell her to "get rid of him".

EMOTIONAL NUMBING:

Sexual problems. She feels that she cannot be truly intimate with her Veteran husband. Distrust of God ("How could He let this happen?"). Low self-esteem. Escapes into a fantasy world, television, thoughts of affairs, compulsive buying, etc. May lean on children, friends or her mother too heavily for emotional support.

DEPRESSION:

Sense of helplessness and hopelessness. "Tired of trying". Low self-esteem, evidenced by poor appearance, dirty home, etc.

ANGER and OTHER RELATED EMOTIONS:

Resentment and bitterness developed over the years not only toward the Vet, but others. Withdrawal from Vet and family emotionally. Constant fear and anxiety. May provoke or instigate fights or arguments with Vet or take it out on the kids.

OVER-RESPONSIBILITY (the "Enabler"):

In an attempt to keep the family stable, may take over the financial and other responsibilities as well as the "wife" and "mother" roles leading to such traits as: feeling responsibility for others, perfectionism, nagging or silence, peace at any price, does things out of a sense of duty, feelings of anxiety, pity, guilt, need to "help" husband, pressure, constant time pressure, blames the husband for the situation the family is in, feelings of anger, victimization, lack of appreciation and being used.

GUILT:

Guilt for having married a Vet, as well as guilt for thoughts of leaving him. Sorry for putting the children through such a life. Constant financial stress, never knowing how they will be able to pay mounting bills, how long he will work, "if I were a better wife, he would be different". Feels guilty about spending money no themselves or having a hard time just having fun. Feels guilt about just about everything. Fears rejection. Feels that if "one more thing happens, I'll lose my mind". Over-commitment leading to constant pressure.

EMOTIONAL EXPLOSIONS OR PROJECTION:

Takes out frustrations on the children. Children may become severely withdrawn or demanding, hyperactive and agitated. Children may have less friends because of a negative home environment leading to their own loss of self-esteem. They may try to find fulfillment in other worthy causes, including getting overly involved in the church, children's activities and other "worthy" organizations or projects.

DENIAL:

Denies that she or the children have problems. Denial that husband has problems or totally blames him for ALL the problems. Denial that the Lord or others can help her husband or her family.

[SAMWolf]

Here are some very common signs and signals of a stress reaction:

PHYSICAL SIGNS:

*Fatigue
*Muscle remorse
*Chest Pain
*Difficulty Breathing
*Elevated Blood Pressure
*Rapid Heart Rate
*Thirst
*Visual Difficulties
*Weakness
*Dizziness
*Profuse Sweating
*Chills
*Shock Symptoms
*Fainting
*Trouble Sleeping

COGNITIVE SIGNS:

*Blaming Someone
*Confusion, Disorientation
*Poor Attention
*Poor Decisions
*Heightened or Lowered Alertness
*Hyper-Vigilance
*Poor Concentration
*Memory Problems
*Poor Problem Solving
*Difficulty Identifying Familiar Objects or People
*Loss of Time, Place or Person Orientation
*Disturbed Thinking
*Nightmares or Unwanted Thoughts
*Intrusive Images

EMOTIONAL SIGNS:

*Anxiety
*Insecurity
*Guilt
*Grief
*Denial
*Uncertainty
*Severe Panic
*Shock, Numbed Emotions
*Crying
*Inflexibility
*Fear
*Agitation
*Depression
*Disassociation, Feelings of Unreality
*Apprehension
*Irritability
*Inappropriate Emotional Response
*Intense Anger
*Feeling Overwhelmed
*Loss of Emotional Control

BEHAVIORAL SIGNS:

*Change in Activities
*Chance in Speech Patterns
*Emotional Outbursts
*Suspiciousness
*Withdrawal
*Inability to Rest
*Erratic Movements
*Change in Sexual Functioning
*Change in Usual Communications
*Hyper-alert to Environment
*Loss or Increase in Appetite
*Alcohol Consumption
*Antisocial Acts
*Non-specific Bodily Complaints
*Startle Reflex Intensified
*Pacing

Trauma survivors spent a lot of time thinking about what they could have done differently. The truth is, they couldn't have done it differently -- the body takes over. And the important thing is not what you did -- it's that you survived.

During a traumatic experience, you adapt and choose new approaches that are survival-oriented for the situation you're in. The problem comes after the trauma, when those approaches and responses are no longer functional. Recovery involves recognizing what responses are and aren't functional, and getting rid of the ones that hurt you. In effect, trauma reprograms your reactions very quickly; recover is a kind of process of "deprogramming".

Some practitioners believe that trauma causes changes in brain chemistry, changes that are helpful in the short term by reducing the level of emotion to something bearable, but that are harmful in the long term because they reinforce the PTSD symptoms.

Crucial to helping someone survive trauma is realizing that you, too, are affected by the trauma, that deciding to help is a big commitment, and that you need helpers, too.

One of the best ways to help a traumatized person is simply to listen compassionately and actively, and make the person aware that you are willing to listen. Reassure the person that there are realistic ways to make it okay, they can survive, that you are willing to help.

DO NOT criticize the person's reaction, minimize the trauma, suggest it was fate or "God's doing", minimize the person's feelings, or say you know exactly how they feel. Do not interfere with actions the person has chosen to take unless they are endangering themselves or others. If you think an action is too extreme, encourage the person to slow down and talk it through.

Healing begins when the survivor realizes that the trauma was real and had real effects on their life, not all of which are adaptive in terms of "ordinary living".

Trauma creates overwhelming fear and leaves behind a feeling that the world is not a safe place. Many practitioners believe recover begins with establishing a safe place, a situation within which the survivor can feel some sense of safety and predictability. This usually involves developing an honesty about and awareness of the fear. As the fear subsides, the survivor is able to focus on other feelings and symptoms, to recognize them, sear for meaning and decide whether or not to act on them.

In summary, here are ten ways to recognize PTSD. Recognizing these symptoms is the first step toward recovery and finding treatment.

1) Re-experiencing the event through vivid memories or flashbacks.

2) Feeling "emotionally numb".

3) Feeling overwhelmed by what would normally be considered everyday situations, and diminished interest in performing normal tasks or pursuing usual interests.

4) Crying uncontrollably.

5) Isolating oneself from family and friends, and avoiding social situations.

6) Relying increasingly on alcohol or drugs to get through the day.

7) Feeling extremely moody, irritable, angry, suspicious or frightened.

8) Having difficulty falling or staying asleep, sleeping too much or experiencing nightmares.

9) Feeling guilty about surviving.

10) Feeling fears and a sense of doom about the future.

THE DO'S AND DON'TS OF PTSD

It can help the healing process occur faster if you remember:

DO learn about the disorder

DO talk to others about the problems you're having

DO expose yourself to situations that remind you of the trauma

DO take medication if prescribed, in the recommended dosage

DO give your medication time to work

DO join a support group

------------------------

DON'T ignore what you're experiencing and reexperiencing

DON'T avoid situations that remind you of the trauma

DON'T keep the traumatic experience to yourself

DON'T drink alcohol or use other drugs to numb your pain

DON'T give up hope (!!!)

DON'T forget ... you are not alone and you are not to blame!

[SAMWolf]

'PTSD is the enemy within ... in the mind, slowly exploding before our very eyes, but unidentified, and therefore invisible, even to those who suffer directly from its effects'

-- Peter Tucker

[SAMWolf]

Thanks, Doughty!

[SAMWolf]

[SAMWolf]

Current Military News
Bagram Bazaar

Local Afghan merchants gather just outside of Bagram Air Base, Afghanistan, to sell everything from clothes to trinkets to guns to the large multinational military population stationed at Bagram. The bazaar, which brings a touch of Afghanistan culture to the military members, also brings a significant amount of money to the local economy. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby


U.S. and coalition forces shop at a bazaar set up just outside of Bagram Air Base, Afghanistan. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby


Local Afghan merchants gather just outside of Bagram Air Base, Afghanistan, to sell everything from clothes to trinkets to guns to the large multinational military population stationed at Bagram. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby


Local Afghan merchants watch as U.S. and coalition forces look over their wares at a bazaar just outside of Bagram Air Base, Afghanistan. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby


Two service members spread out an Afghan rug at a bazaar just outside of Bagram Air Base, Afghanistan. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby


Afghan children try to sell merchandise through concertina wire to U.S. Air Force Staff Sgt. Cherie Thurlby, 1st Combat Camera Squadron, Charleston Air Force Base, S.C., who is on her way to the weekly bazaar at Bagram Air Base, Afghanistan. Local Afghan merchants gather just outside the base to sell everything from clothes to trinkets to guns to the large multinational military population stationed there. The bazaar, which brings a touch of Afghan culture to the military members, also brings a significant amount of money to the local economy. U.S. Air Force photo by Staff Sgt. Cherie A. Thurlby

[Jen]

PING to the FReeper Foxhole. Bring your shovel and dive on in to today's thread in the VetsCoR Forum!

To be removed from this list, Click this link and send a BLANK FReepmail to AntiJen.

If you have comments for me to read, use this link. Thanks!

[backhoe]

Here's what I have:

Gulf War Syndrome- Where there's smoke, *is* there fire?

[Jen]

	Citizens	Business
	Government	Employees

[Mudboy Slim]

Good Mornin', AJ...gonna be a seriously-fun coupla weeks, IMHO...MUD

[Jen]

Thanks for your exhaustive research! I bookmarked your thread so I can explore the many links.

[E.G.C.]

Howdy AntiJen, Freepers. It's been a busy week for this freeper. Been involved a number of threads this week. Trying to keep one bumped right now to save conservative talkradio so we can continue to live in freedom. Hope everyone here is doing well.
BTTT!!!!!

[Jen]

Good morning! What on earth am I doing up at this early hour???

Anybody need coffee besides me?

[Mudboy Slim]

I'm UP 'cuz I'm RARIN' TA GO!!

Coffee would be great, thanks...MUD

[Jen]

Jen's Genuine GI coffee is ready! I also scrounged up some bagels. Well.... I think they're bagels, but they may be some petrified donuts...

Hurry back Fiddlstix!

[Jen]

Oh my heavens! You're not one of those 'morning' people are you? I'm definitely an owl, not a lark If you start chirping, I may have to hurt you. ;-)

[backhoe]

Thanks for looking- that post is old, but there is still a lot to look at. The only conclusion I ever reached on that issue was "we haven't been told the full story."

[Mudboy Slim]

I be a nightowl and a mornin' person...sleep SUCKS...MUD

[Pippin]

GOOD MORNING EVERYBODY!

[Pippin]

GOOD MORNING MUDDY!