Senate The scourge of PTSD

PTSD or post tramatic stress disorder has always been a factor of war. Unfortunately that same PTSD can can cause issues in the civilian world as well. Vets have been known to cause lots of criminal actions including murder, assaults, drunk driving and many other offences. Around bases, sheriffs are forced to deal with those soldiers coming back from wars and causing trouble. Where as when the vets retire from the military their communities and them face an uncertain future. Employers are scared to hire vets because they might have PTSD. Vets complain about it but it won't do any good. Seeing action is no longer a badge of honor but a mark of disgrace in society. Even though society supports all of its vets they do so with trepidation because no one knows when the next Vet will snap. This past week we lost a good soldier in texas when he was shot at a gun range by a fellow vet. They were there as therapy for the guy since he had PTSD. Although now it seems gun ranges may no longer welcome vets because of the possibility of PTSD. Although honestly, being an exsoldier to a gun range who suffers from PTSD may not have been the smartest move on their part. Maybe a paintball range would have been safer. So what can be done?

 

PTSD isn't exclusively related to war and veterans.

 

That's what I was going to say (and did say HERE).


But it is definitely a huge problem among soldiers. 2012 was another year when more soldiers died from suicide than from combat and combat-related injuries.

http://www.cnn.com/2013/02/02/us/army-suicides/

What more can we do for them?

 

No, but a PTSD diagnosis is still percieved with negative connantations among the military and military health care providers.

As to what can we do about PTSD, I think this kind of goes to the point that I've made a few times in the gun control thread that we need to completely reform our mental health system. The military even more so.

 

Posts that do not contribute to the discussion under way are considered spam - SuperWatto

 

What do you mean when you say this? Reform it, how?

 

reagan style: kick everyone out

 

First and formost, the federal and state govts. need to put more money into mental health services instead of those being one of the first things cut out of budgets when the economy goes south. Lack of resources available to deal with mental health issues or leaving people with mental issues with no where to go because of budget cuts, or options that are so expensive they might as well be considered only a luxuary for the rich only makes things worse in the long run. I know a few psychiactric facilities here in Virginia have long waiting lists of people wanting beds in those facilities that maybe if funding were available for more beds and outpatient resources, more people might be able to get help.

Also, people need to be made to feel as though it's okay to seek out help for mental issues. Mental issues are so stigmitized in this country (especially when mass shootings come up and people go "oh so and so had this type of mental illness" or the donkey's butt on CNN a few months ago that said an airline was right to throw a boy and his family off a plane because "He might become violent because of his Down's Syndrome), that even if all they need is counseling with no medication some people are afraid of getting help from mental health professionals for fear of being labled. Perhaps if society as a whole got the fact that, no most people with mental illnesses, if they are able to get properly treated, are not dangerous or a threat, then again, more might be willing to seek out professional help.

There's more, but I need to sit down with myself and actually think about how I want to articulate those things.

 

Posts that do not contribute to the discussion under way are considered spam - Lowbacca_1977

 

How about we separate vets who have PTSD and design and develop a center that allows them to recover and repair themselves. It might sound like a prison but a prison where soldiers get the help they need and still does stuff that helps them get the answers they seek and skills they need to prepare. Kinda like a group home or a halfway house for ex cons.

 

Yes, let's treat the mentally ill like criminals.

 

Yeah, we called those psychiatric hospitals. The big problem in this country is that we gave up on institutions to house people that are mentally ill in favor of smaller places where they can live within society. I'm not saying lock them up permanently, but I think larger, more advanced facilities are needed. As it is whenever there's places in budgets to be cut it's always lower income services dealing with what the state will cover and education.

I'm also of the opinion that we're overloading our culture with medical information and negativity and it's creating some disorders as a result (germaphobia, hypochondria, depression). Specifically with regards to depression. I feel we place too much emphasis on what other people have to the point where if you're not molded in a particular way that you've failed as a person. That can create an atmosphere where depression seeps in and takes hold.

 

I think the infrastructure just needs to expand. I mean, you all know about my experience last year, I'm sure. I mean, four days I was inpatient and it just caused a totally dramatic turnaround. And my depression wasn't playing with me; it was serious.

Now, something like PSTD, that's a whole other level of illness. My depression was really hard, but I can't imagine what it must be like for some people with some of these other disorders. In no way do I want to say that my depression is on the level of some of these other horrible disorders like PTSD (to say nothing of things like schizophrenia and such as that). But I do feel very strongly that being in a well-run, positive facility can be a tremendous help. I've always been skeptical of those kinds of situations and facilities prior to actually being in on. I'm a huge booster for them now. Now, obviously there are other treatments that need to be explored. You can't just put a bunch of people with PTSD in a house together and expect that to turn out well. But I definitely believe that we need to start with two things: creating more inpatient facilities & improving the level of care at the ones we already have.

Plenty of people have serious enough problems that they aren't going to see any kind of change in just four days; I was lucky in that regard. But I honestly believe that you can see definite turn around due to inpatient care for mental and emotional issues. There's a fear that you essentially get locked up and lose your freedom. Yeah, that fear is not entirely unfounded; you do have to be ready and willing to give up some of your freedom in order to get better. But going inpatient doesn't mean that you'll be locked up for years or even months. I think it's very possible to have people suffering from PTSD go inpatient for intensive treatments and have them come out greatly improved in a moderately short period of time. No, not four days, but not four years either.

The stigma is a problem that hampers this kind of solution. I know I fought going inpatient for a lot longer than I should have because it felt shameful to me for God knows what reason. If it feels shameful to me to admit that I need help with my emotional problem, I can't imagine how hard it must be for people like soldiers, who take pride in their ability to survive and in their strength and toughness and skills. That's a huge problem that I think keeps people from seeking treatment. It needs to be reframed for people somehow, so that they can understand that the true strength is in seeking help, not in fighting on your own. It takes real courage and real strength to admit that you need help, much more than it does to keep trying to fix the problem yourself; that's what we need to help people understand.

I dunno, those are two areas that feel pretty strongly about. More & better inpatient facilities; less stigma and better understanding among those suffering. Now the problem is how do we get anywhere on either of those? That . . . well, that I don't know.

 

Is there a stigma, though? I'd argue there's not much of one against depression and PTSD (I hate that term, btw) these days. Now if you say you're depressed people actually try to comfort you a little. Same with PTSD. The only ones that I see a general 'stigma' (see: cringing) about are things like schizophrenia or hoarding (or really any disorder related to anxiety. But the big two that are widely accepted are depression and PTSD. So I don't believe any so-called stigma is attached to it--or at least not much of one.

The only stigma that I see people with are the ones suffering with the disorders because they're...weird. Being depressed and having anxiety and panic attacks, I can safely say that does give you weird thoughts. Mostly along the lines of people not understanding.

 

how did people cope with this many years ago. before there was extensive studies done on this..

Like WW2 veterans. howd they deal with this.

 

Honestly, I'd say the stigma still is absolutely there. Well, stigma and misunderstanding as well. It's certainly improving, but i don't think it's at all gone.

 

I do agree that more attention needs to be given to actual treatment of ptsd. Often, especially in publicly funded settings, the go-to treatment method is medicating, which is okay, but there should also be counseling going on in tandem. Medicating people only treats half the problem... it makes the person calmer, yes, but it doesn't really do much in the way of moving past the traumatic memories. It's more of a band-aid than a treatment.

 

most medications only cover the problem up not solve the problem...

and how did people handle this years ago. What did people do in the 50's...

 

Keep it to discussing the topic, not discussing other posters - Lowbacca_1977

 

Repressed the hell out of everything, and drank.

But arguing that back then there "wasn't a problem" is knowingly false and not dissimilar to advocating leeches as a panacea for most ailments.

beezel I think your opening post tries too hard to link PTSD to combat veterans and doesn't really look too deeply into the issue. A person quite close to me has PTSD and it has nothing to do with war. I would also suggest you read up on the concept of resilience as it might give some insight into why it affects some people, and not others.

 

PTSD wasn't added to the DSM until 1980.

A brief history...

It appears Swiss military physicians in 1678 were among the first to identify and name that constellation of behaviors that make up acute combat reaction or PTSD. “Nostalgia” was the term they used to define a condition characterized by melancholy, incessant thinking of home, disturbed sleep or insomnia, weakness, loss of appetite, anxiety, cardiac palpitations, stupor, and fever.

German doctors diagnosed the problem among their troops at about the same time as the Swiss. They referred to the condition as heimweh (homesickness). Obviously, it was strongly believed the symptoms came about from the soldiers longing to return home.

In time, French doctors termed the same symptoms maladie du pays, and the Spanish, confronted with the same reactions among their soldiers, called it estar roto (literally, “to be broken”).

The French surgeon Larrey described the disorder—what we now call PTSD—as having three dif ferent stages. The first is heightened excitement and imagination; the second is a period of fever and prominent gastrointestinal symptoms; the final stage is one of frustration and depression.

During the American Civil War, military physicians diagnosed many cases of functional disability as the result of fear of battle and the stresses of military life. This included a wide range of illnesses now known to be caused by emotional turbulence, including paralysis, tremors, self-inflicted wounds, nostalgia, and severe palpitations—also called “soldier’s heart” and “exhausted heart.” It was reportedly surprising to some Civil War physicians that soldiers on normal leave often collapsed with emotional illness at home, even when they had shown no symptoms of mental debilitation before they had left the fighting.

... research tells us that in 1863 the number of insane soldiers simply wandering around was so great, there was a public outcry. Because of this, and at the urging of surgeons, the first military hospital for the insane was established in 1863. The most common diagnosis was nostalgia. The government made no effort to deal with the psychiatrically wounded after the war and the hospital was closed. There was, however, a system of soldiers’ homes set up around the country. Togus, Maine, was designated as the eastern branch of this system, and in 1875, its director noted that, strangely enough, the need for the hospital’s services seemed to increase rather than decrease.

... discounting of effects of the trauma by charging the victim with having ulterior motives was also common in the military. “It is by lack of discipline, confidence, and respect that many a young soldier has become discouraged and made to feel the bitter pangs of homesickness, which is usually the precursor of more serious ailments,” commented the assistant surgeon general in 1864, reflecting the sentiment that most who suffered signs and symptoms of war trauma were, in fact, malingering.

The brutalities of WWI produced large numbers of the psychologically wounded. Unfortunately, what little had been learned up to then was forgotten. The only American experience with psychiatric casualties that anyone remembered was when American soldiers under the command of Gen. John J. Pershing in Mexico exhibited an abnormally high rate of mental illness. Consequently, the medical establishment set out once again to recreate the wheel. This time, they began by attributing the high psychiatric casualties to the new weapons of war; specifically, the large-caliber artillery. It was believed the impact of the shells produced a concussion that disrupted the physiology of the brain; thus the term “shell shock” came into fashion.

Although WWI generated stress theories based on models of the mind, such as Freud’s “war neurosis,” these theories never gained wide acceptance. Quite simply, Freud postulated “war neurosis” was brought about by the inner conflict between a soldier’s “war ego” and his “peace ego.”

In Vietnam, 2.8 million served. Given the nature of guerrilla warfare, it is hard to estimate the number exposed to hostile fire. However, the Research Triangle Institute’s Vietnam readjustment study concludes 480,000 have full-blown PTSD and another 350,000 have partial PTSD.

In 1980, the American Psychiatric Association added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme. Although controversial when first introduced, the PTSD diagnosis has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual (i.e., a traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the conceptof"trauma."

http://www.vva.org/archive/TheVeteran/2005_03/feature_HistoryPTSD.htm http://www.ptsd.va.gov/professional/pages/ptsd-overview.asp

 

Oh, there's still a stigma. You might not hear it as much if you tend to avoid the kind of people that continue to perpetuate it, but it's definitely still there. I find it usually goes hand-in-hand with a somewhat black-and-white view of the world, in which everything that happens to an individual is of their own doing. Still quite prevalent in many areas.

 

I can tell you that within the Christian community there is still a stigma. It's seen as somehow being different than other illnesses. It's just an issue of not having enough faith or have lost the "joy of the Lord" or whatever to some people.

Also, I can tell you that medication is a huge part of making people better. In many illnesses it comes down to the fact that the brain is, because of stress or trauma, not producing enough of certain chemicals. Medicine can help with that and lead to a person feeling much better. It can't be medication alone; a lot of depression is definitely situational and some of that won't change until you work on changing the situation. But often to get people to the point where they believe they can change their situation or learn to live with it, it requires medication.

 

PTSD symptoms among vets are much higher then the general population. PTSD is more of a problem with Vets then the general population. For the general population we just medicate and give them pyschological treatment. For Vets its different, the normal ways are not working. More has to be done. That is why it is a scourge, a scourge on the military.

 

Just using some Wikipedia numbers, though, does seem to show that while it may be higher among veterans than those that aren't veterans, it's still appearing in a significant portion of the population, such that the majority of sufferers are not veterans. As such, I'm not sure I see the point in narrowing it down to a smaller subset, rather than addressing the topic broadly as a health issue that we're handling insufficiently, veteran or not. A better handling of PTSD across the board would be beneficial to not just veterans with PTSD, but any of the many others dealing with it, as the apparent rate of PTSD in the nation is something like 1 out of 12 people.

It also seems like, at least as far as the mental health of soldiers are concerned, no one has brought up the suicide rates in the military, which I had though was noticeably higher than the general population.