PTSD, TBI & MST

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In the Spotlight

PTSD Treatment Options Can Work with Help from My HealtheVet

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June is PTSD Awareness Month, a good time to stop and consider what type of help Veterans may need. PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

If you have PTSD, you might also have other health problems, such as depression or traumatic brain injury (TBI), problems with abusing drugs, or other physical health issues.

Whether you are getting treatment for PTSD or PTSD and one of these conditions, you need a way to keep track of appointments, medications, and sometimes vital signs. You will also need to have regular communication with your health care team.

My HealtheVet helps Veterans with PTSD manage their health care, access their records, and talk to their providers by logging in with a Premium account.

Army Veteran Jerry Tyler has been using My HealtheVet for several years, and even more since he started therapy for PTSD. “I use Secure Messaging to ask about medication refills, and even to ask about appointments,” Tyler said. “Mostly I would rather send a secure message than talk on the phone.”

Veterans receiving treatment for PTSD often find using Secure Messaging to be a safe and secure way to communicate with therapists, doctors, and other members of the health care team. When you have questions about medications or treatment, you can more easily follow up with your doctor. You won’t have to worry about getting bounced around on the phone.

Air Force Veteran Kenyon Campbell started using Secure Messaging after he took the PTSD screen. “I had TBI after a tour in Iraq, and I wasn’t sure if I had PTSD, but I had symptoms that were upsetting me,” Campbell said. “I signed up for My HealtheVet awhile back and saw an article in the health library about PTSD and thought I would check it out. Shortly after answering the questions I sent a Secure Message to my provider to ask for a mental health referral.” Campbell said. “My advice to anyone is to sign up for Secure Messaging. It’s so much easier than calling.”

There are many resources available for Veterans with PTSD. One of the newest online tools from the National Center for PTSD is the PTSD Treatment Decision Aid.

The Decision Aid helps Veterans and family members learn about effective PTSD treatment options, compare different PTSD treatments, and read or watch videos about treatments and how they work. Veterans can build a chart to compare treatments they like most, and at the end print out a personalized summary they can share with their health care providers.

Read More

PTSD screening tool (My HealtheVet)

Mobile Apps for PTSD (VA)

PTSD Treatment Decision Aid (VA)

National Center for PTSD


FACT SHEET ON MILITARY SEXUAL ASSAULT/MILITARY SEXUAL TRAUMA

How often does military sexual assault occur?  “The annual incidence of experiencing sexual assault is 3% among active duty women and 1% among active duty men. Sexual coercion (e.g., quid pro quo promises of job benefits or threats of job loss) and unwanted sexual attention (e.g., touching, fondling, or threatening attempts to initiate a sexual relationship)occur at an annual rate of 8% and 27%, respectively, among women and 1% and 5% among men. Research on deployment stress finds that such experiences constitute important duty-related hazards.”

Source: American Journal of Public Health|December 2007, Vol 97, No. 12 “The Veterans Health Administration and Military Sexual Trauma,”  by Rachel Kimerling, PhD, Kristian Gima, BA, Mark W. Smith, PhD, Amy Street, PhD, and Susan Frayne, MD, MPH

What is the impact of military sexual assault on health?  A system-wide study of VA patients concluded that sexual assault was positively correlated to all categories of mental health co-morbidities, including posttraumatic stress disorder for both men and women at a 99% confidence interval. Associations with other medical comorbidities (e.g., chronic pulmonarydisease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged.

Source: American Journal of Public Health|December 2007, Vol 97, No. 12 “The Veterans Health Administration and Military Sexual Trauma,”  by Rachel Kimerling, PhD, Kristian Gima, BA, Mark W. Smith, PhD, Amy Street, PhD, and Susan Frayne, MD, MPH

Healing PTSD: Any Way We Can

Although many soldiers returning home from tours of duty reintegrate into civilian society relatively well, other veterans may encounter significant obstacles to leading a normal civilian life. The challenges are myriad. For instance, “the younger, post-9/11 veteran unemployment rate [in October 2013] was 10 percent, and this is not a one-time spike,” reports Forbes, noting that veteran unemployment has been consistently higher than civilian unemployment for the last four years, due to factors including youth and lack of experience, employers who insist on duplicating training already completed in the military (such as IT training), and social stigma.

The combination of lack of employment opportunities, weakened family and social ties, and the risk of mental illness and concomitant problems such as substance abuse lead to both a horrifically high suicide rate of “22 deaths per day,” according to the New York Daily News, and a record high in 2013 of nearly 50,000 veterans of Iraq or Afghanistan who were “either homeless or in a federal program aimed at keeping them off the streets,” reports USA Today. Clearly, we are failing as a society to welcome our veterans back with open arms.

Military service has been shown to result in “increased risk of posttraumatic stress disorder (PTSD), major depression, substance abuse, [and] functional impairment in social and employment settings,” reports a study conducted on the mental healthcare usage of returning veterans. While modern veterans are probably more likely to seek mental healthcare than veterans in previous generations, there is also an indication that veterans of Operation Iraqi Freedom are particularly affected, even more so than veterans of Operation Enduring Freedom in Afghanistan, with 17% of soldiers returning from Iraq screening positive for PTSD, generalized anxiety, or depression. While male veterans are more likely to suffer from PTSD, female veteranshave a higher prevalence of depression and military sexual trauma (MST), the latter arising from the extremely high rates of sexual assault and harassment in the military. For women, experience of sexual assault or harassment is thought to have a “larger impact on PTSD symptomatology than combat exposure”, according to a study conducted at the Boston Veteran Affairs Medical Center. PTSD may result in flashbacks, nightmares, and “exaggerated physical and emotional reactions to triggers that remind them of the event,” explains PsychGuides.com, as well as related symptoms such as panic attacks, difficulty concentrating, difficulty sleeping, and exaggerated startle responses. PTSD is commonly associated with depression, suicidal thoughts, and substance abuse.

– Jenni Fitton

Treating PTSD

There are two main options for treating PTSD: medication and therapy. Medications used to treat PTSD include anti-anxiety, anti-depressant, and mood stabilizing drugs, which may be used for a period of between three months and a year, and again if the patient continues to need them or suffers a relapse. Therapy options include techniques to manage anxiety, such as relaxation and deep breathing techniques, as well as cognitive therapy and exposure therapy that help the patient learn to cope with triggers and change their thinking patterns.

Along with the main therapeutic options, there are various complementary therapies that can be used in combination with medication and/or therapy. While mainstream therapy should not be overlooked in favor of complementary treatments, there is growing evidence that therapies such as animal contact and yoga can have a positive effect on recovery. A study conducted with survivors of the 2004 Asian tsunami compared usage of a yoga breathing treatment, yoga breathing treatment in conjunction with exposure therapy, and a control group on a waiting list for treatment, finding that the group using yoga alone improved significantly more than the group with no treatment, although not as much as the group using exposure therapy as well. The study concludes that “yoga breath-based interventions may help relieve psychological distress following mass disasters.” A review study in the journal The Primary Care Companion to CNS Disorderssimilarly found that yoga may be an effective treatment for mental illness. For veterans who do not have access to yoga classes, the deep breathing techniques of yoga, which can be easily practiced at home, may also result in improvement, and online yoga schools – often free of charge – are now widely available. Pet therapy has also been suggested as an effective complementary treatment, as has time spent outdoors, such as gardening or hiking. Seeking therapy dog organizations or other therapy animals can therefore be helpful for veterans suffering from PTSD.

The Veterans’ National Recovery Center for the Homeless and PTSD Distressed is committing to helping veterans pursue any and all treatment options for PTSD, MST, depression, anxiety, substance abuse, and all other mental disorders.

– Jenni Fitton

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