The Treatment of PTSD on Veterans

Post-traumatic stress disorder also known as PTSD is a physiological condition caused by exposure to traumatic events in a human's life experience. This condition is mostly diagnosed to those recognized as veterans. They have lived their life to serve but experience life's most traumatic events while doing their job. For example, have you ever had a bomb or many shots fired towards you while trying to save someone else's life, well they have, so any thing that triggers that can affect their whole life.

Post-traumatic stress disorder affects veterans in many ways and it leaves them scarred with flashbacks from the event or events that traumatized them. According to one of the veterans returning from war said the following, The first time I experienced what I now understand to be post-traumatic stress disorder, I was in a subway station in New York City, and I'd just come back from two months in Afghanistan I was on assignment to write a profile of Massoud, who fought a desperate resistance against the Taliban until they assassinated him two days before 9/11. At one point during my trip we were on a frontline position that his forces had just taken over from the Taliban, by the time I got home, though, I wasn't thinking about that or any of the other horrific things we'd seen; I mentally buried all of it until one day, a few months later, when I went into the subway. Suddenly I found myself backed up against a metal support column, absolutely convinced I was going to die.

There were too many people on the platform, the trains were coming into the station too fast, the lights were too bright, the world was too loud. I couldn't quite explain what was wrong, but I was far more scared than I'd ever been in Afghanistan. I stood there with my back to the column until I couldn't take it anymore, I had no idea that what I'd just experienced had anything to do with combat; I just thought I was going crazy. (Jonathan Franzen, pg 86) Post-traumatic stress disorder affects your behavior that is agitation where they are flooded with some sort of nervous excitement and anxiety, irritability, hostility, hypervigilance, self-destructive behavior, or social isolation. Then there is the Psychological side which includes flashback, fear, severe anxiety, or mistrust. It affects their Mood, loss of interest or pleasure in activities, guilt, or loneliness. And then is also often followed by insomnia or nightmares, emotional detachment or unwanted thoughts.

These are the most common effects that post-traumatic stress disorder has on veterans and it can come in a various amount of intensity and then that causes for different types of treatment. The effects of post-traumatic stress disorder include the re-experiencing of the traumatic event that the victim experienced, it varies from having mental flashbacks, intrusive memories or bad dreams and this has a detrimental effect on the mentality of the victim. The other form of re-experiencing is physical memories; at times the body remembers what the mind forgot or the mind may just have shut down due to the intensity of the traumatic experience. Post-traumatic stress disorder doesn't just affect veterans but it affects their families too. They experience withdrawals from their friends and families and their loved ones don't always understand why they do what they do.

Another post-traumatic stress disorder victim stated the following: I had classic short-term post-traumatic stress disorder. From an evolutionary perspective, it's exactly the response you want to have when your life is in danger: you want to be vigilant, you want to react to strange noises, you want to sleep lightly and wake easily, you want to have flashbacks that remind you of the danger, and you want to be, by turns, anxious and depressed. Anxiety keeps you ready to fight, and depression keeps you from being too active and putting yourself at greater risk. This is the universal human adaptation to danger that is common to other mammals as well. It may be unpleasant, but it's preferable to getting eaten. (Because post-traumatic stress disorder is so adaptive, many have begun leaving the word disorder out of the term to avoid stigmatizing a basically healthy reaction.) (Barbara Krasner, pg147) Post-traumatic stress disorder is a completely natural response to danger and it is unavoidable in the short term but it usually gets better in the long term.

Around twenty percent of people who are exposed to a traumatic event get chronic post-traumatic stress disorder which usually ends up affecting the victim long term. Rape is a very traumatic experience to the victim but studies show that forty-seven percent of rape survivors have been able to recover enough to continue living their lives normally. Although combat can be very traumatic it is generally less traumatic than rape. Combat is mixed with positive experiences that are attached to the negative experiences that caused the victim to suffer from post-traumatic stress disorder and it is hard to separate the positive experiences from the negative experiences which in turn makes it easier to recover from. There for the therapy for rape and combat victims are also different just because with rape victims they usually don't have a part from the experience that they would like to retain where for combat vitamins they would want to keep some of the memories that come with their experience.

According to David Marlowe that did a survey about the gulf war , combat veterans said that killing or even the witnessing of killing a enemy soldier was more traumatic that being self-wounded, but the most traumatic experience would be witnessing the killing of one of your friends in a war and they are usually harder to recover from and it triggers severe cases of post-traumatic stress disorder. Even though these experiences are traumatizing roughly eighty percent of victims recover from the events, although the victims recover from their traumatic experiences they never forget the memories of the experience. Treatment is very essential to all post-traumatic stress disorder victims but the treatment varies from all victims due to the different intensities of traumatic events. Traumatic event victims usually deal with a group of problems including, nightmares, intrusive memories, irritability, insomnia, hypervigilance, and emotional detachment. victims dealing with those Post Traumatic Stress Disorder symptoms show changes in their social, emotional, and physical well-being. They find it difficult to continue with their normal lives and they find it hard to interact with their family and friends who do not understand what they are going through.

Treatments have been making use and intergrading the use of high tech into the therapy sessions and the intergrading of virtual reality are becoming more common in these therapy's, The belief in the therapeutic power of confronting the source of one's anxieties and fears is as old as the practice of psychotherapy itself. New technology, however, has given this a decidedly modern twist. While it's easy to recreate the feared situation in therapy with a patient with a fear of heights or elevators, creating an opportunity for veterans to confront and gain mastery over their battlefield experiences has not been. Researchers at Emory University and the Georgia Institute of Technology were the first to create a Virtual Vietnam to treat veterans with PTSD. Over the years, they have developed this technology to create a 360-degree digital environment complete with the sights and sounds of a Middle East conflict zone, including gunfire noises, radio chatter, and aircraft flyovers. A vibrating chair can even mimic the feeling of distant explosions or Humvee driving, all within the safe confines of the therapy office.

During these treatment sessions, veterans are able to engage their senses in a more modulated, controlled, and secure way while gaining insights and new perspectives through talking about their experiences. This work has demonstrated some early and promising results from simple phobias to PTSD, including in some who had failed to respond to other treatments based on imaginal exposure. Virtual reality programs have been adapted for use with survivors of the World Trade Center or other terrorist attacks and even for motor vehicle accidents. Tetris: Forget Angry Birds, Tetris was the original addictive digital time-suck. Oxford University researchers claim that the colorful puzzle block game can serve as a "cognitive vaccine" against intrusive traumatic memories. In a series of experiments, researchers exposed non-clinical volunteers to graphic and traumatic film scenes. After the film, volunteers were assigned to either play Tetris, complete a Pub Quiz video game, or do nothing and asked to record any intrusive memories of the film images occurring to them throughout the week.

Participants who played Tetris had significantly fewer intrusive memories than those who did not. The researchers propose that the visuospatial task of fitting Tetris blocks into incessantly growing piles uses up the brain's visual resources and interferes with its ability to encode visual trauma memories that are the building blocks of symptomatic re-experiencing and flashbacks. Before you dust off that old Nintendo Game Boy, note that the findings are preliminary, without independent replication yet, and based on healthy undergrad volunteers exposed to video clips instead of actual trauma survivors. Still, this innovative and intriguing line of research points to the possibility of simple and proactive approaches to preventing or reducing PTSD development. Currently, there are only two FDA-approved medications for the treatment of PTSD [sertraline (Zoloft) and paroxetine (Paxil)]. The evidence on the effectiveness of these anti-depressant medications and other medications used "off-label" for PTSD-related symptoms is limited and the medications often come with problematic side effects that many users find disagreeable.

Instead, researchers are rounding up some unusual suspects and looking at new uses for some already well-known drugs. D-cycloserine (DCS): DCS is a broad-spectrum antibiotic which has been used in clinical trials to improve learning in rats and humans. DCS helps activate NMDA receptors in the brain which are associated with learning and memory formation. DCS-treated rats are able to learn fear extinction more quickly, taking far fewer trials to stop being afraid of a non-harmful stimulus (e.g. a flashing light) that they had once been taught to fear (by pairing the light with a loud noise, for example). While stress responses in traumatic situations such as combat are appropriate and even adaptive, the problem with PTSD is that extremely heightened fear responses continue to occur in non-life threatening situations (such as in a noisy restaurant or when a loud truck drives by).

Exposure to non-threatening but anxiety-provoking situations offers a chance to regulate these fear responses, and DCS may accelerate this process. When used with therapeutic exposure sessions or virtual reality exposure, DCS seems to enhance treatment effectiveness for phobias and panic disorder and may do the same for PTSD (though very preliminary results are uncertain). MDMA: On the streets it's known as Ecstasy, but in the research lab it's known as 3,4-Methylenedioxymethamphetamine, or MDMA. This illegal recreational psychedelic party drug associated with raves and mind-numbing trance music is believed by some to have potential therapeutic benefits. After years of campaigning, researchers from the Medical University of South Carolina and the Multidisciplinary Association for Psychedelic Studies in California got the FDA and DEA to approve a small pilot clinical trial of MDMA administration for treatment resistant PTSD sufferers. Under close clinical monitoring and in conjunction with intensive psychotherapeutic engagement, 20 participants were randomized to two administrations of either MDMA or placebo.

While the trial was extremely small and the results anything but conclusive, 83% of the MDMA group exhibited substantial treatment response compared to 25% in the placebo group. Distress tolerance therapies: One major aspect that differentiates PTSD from other normative reactions to traumatic experiences is the presence of emotional detachment/numbing/dissociation. The body's emotional system seems to log off or anesthetize in an effort to cope with the overwhelming stress of traumatic events. Unfortunately, this shutting down can cause drastic consequences for everyday functioning. Therapies like Dialectical Behavior Therapy, Acceptance and Commitment Therapy, or Mindfulness approaches focus on reducing emotional avoidance, tolerating distressing affects, and engaging in life with full, focused and controlled attention and acceptance. Interpersonal and family therapies: While a number of standard PTSD psychotherapies prioritize exposure methods, some individuals are reluctant to undergo re-experiencing approaches or are turned off by such treatments. Not all psychotherapy for PTSD needs to be trauma-focused, however.

Like most problems, PTSD occurs in a social context and comes with unique interpersonal costs and challenges. PTSD symptoms are related to intimate relationship troubles, relational detachment, and even interpersonal aggression. Social support is a strong buffer against the development of PTSD symptoms following a trauma, and couples and family-oriented interventions help individuals engage and enlist their families and social supports in recovery.

These treatments can help rewrite dysfunctional family scripts and engender trust, agency, and security. Present-centered approaches focus on current adaptations to symptomatic problems while interpersonal therapy works on adapting to problematic role transitions following traumatic events or interpersonal role disputes with significant others at work or at home. The effectiveness of these approaches illustrates that problematic trauma reactions can be managed with less of a focus on the traumatic past and more of an eye toward interpersonal adaptation and post-traumatic growth.

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