June is Posttraumatic Stress Disorder Awareness Month

By: Michael Ruiz

The U. S. Military equips their soldiers with field and survival gear. We are learning that our service personnel also need to be equipped with survival skills related to the stress they encounter in combat. To support the efforts of the National Center for Posttraumatic Stress Disorder, part of the United States Department of Veterans Affairs, it seems appropriate this month to discuss some of the history and the current research on this crisis. The National Center began seeking ways to serve personnel returning from the war in Iraq and the war in Afghanistan following the start of the war in Iraq in 2003. To reach more individuals, including those in remote locations, they placed information, like the Iraq War Clinician Guide on their website. In 2006 they invested $95,668,340 in research funding to better understand the causes, effects, and to identify potential interventions. (Source: NCPTSD Annual Report 2006) There are four types of PTSD symptoms (for more in-depth description of these symptoms, please visit http://www.ptsd.va.gov/public/pages/symptoms_of_ptsd.asp: 1. Reliving the event (re-experiencing symptoms): this may include having nightmares; you may see, hear, or smell something that causes you to relive the event. 2. Avoiding situations that remind you of the event: you may avoid crowds, or you may avoid seeking help to avoid having to think or talk about the event. 3. Feeling emotionally numb: you may not have positive or loving feelings toward other people or avoid relationships or activities you used to enjoy. 4. Feeling keyed up, or experiencing hyper arousal: you may have a hard time sleeping or concentrating. U. S. Military service members have admitted that they thought being treated would be seen as a sign of weakness to their family or fellow service members. Others distrust the medications often used. Many do not seek treatment for these reasons. Of those that do, only half receive treatment considered

minimally adequate by researchers (Nauert, R. (2008). Veterans Fail to Seek Care for PTSD.). The Journal of Traumatic Stress reports that those who do seek treatment are often not completing the full course of necessary treatment. The reasons for seeking help are clear. Early treatment is better. Untreated, symptoms of PTSD may get worse. PTSD symptoms do not only affect the suffering service member this condition can impact the entire family. Getting along with people may become difficult, and it is not uncommon to experience moments of confusion or to become unexpectedly angry or violent. Also, in treating PTSD, other related health problems may be found and treated concurrently. For example, studies have shown a relationship between PTSD and heart trouble. (Source: National Center for PTSD). The very first thing to do is talk with your family doctor. There are many good treatments currently available for PTSD beyond cognitive behavioral therapy, exposure therapy, group therapy and drugs. Equine therapy has been very successful. The American Physical Therapy Association and the American Occupational Therapy Association both recognize the benefit of establishing and nurturing a relationship with a horse. Horses are said to be good animals to work with because they mirror the emotions of the people around them. Additionally, the nurturing skills learned when caring for a horse can easily be applied to personal relationships. The use service dogs have also shown tremendous success in the treatment of PTSD. These dogs are trained to wake the soldiers when they are having nightmares and remind them to take their medication. In the cases of wounded veterans, services dogs are trained to assist in everyday tasks like picking up wallets, turning on lights, and pushing automatic door buttons. For more traditional treatments utilizing current technology, Teleheath delivers health services via telephone, videoconferencing, and internet-based programs. These therapies have shown promise in substituting for in-person sessions. The U. S. Military is implementing a program called Comprehensive Soldier Fitness. This program utilizes resilience experts to provide coping skills to soldiers and their family members. CSF is still new, however, it is thought that the training provided could be used to limit the negative impact of stress and trauma that might otherwise lead to PTSD (Comprehensive Soldier Fitness). The following is from the Master Resilience Trainer (MRT) Unit Implementation Guide: Also beginning at accession, CSF provides instruction on specific mental and physical skills that Soldiers can use to enhance their performance when facing challenges, regardless of whether those challenges are in their personal or professional lives, in garrison or in combat. First line leaders will be taught how to instill these qualities in their subordinates as part of their leadership training. There will be continuous, progressive and sequential sustainment training of both Soldiers and Leaders. Additionally, CSF will train subject matter experts - the MRTs - in both the operating and generating forces to oversee resilience programs within their units.

Based on the relative psychological strengths identified on the assessment, CSF will offer a menu of appropriate self-development opportunities to Soldiers, Family members and DA Civilians. Each Soldier will be afforded the opportunity to improve in each of the dimensions. Panels of military and civilian experts serve to identify and refine the training content for each dimension, and only training proven to be effective will be offered. Training at each level can be accessed either virtually, or local courses or programs will be made available. One of the critical benefits of this prevention focused program is the elimination of our soldiers suffering from this treatable condition. They will be armed with the necessary coping skills before entering combat. Considering the average age of a person entering any of the military branches is under 21, these are skills not likely to have been learned. Hopefully, this will also eliminate the stigma associated with mental/emotional trauma and sufferers will more readily seek help when they need it.