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About PTSD Information

Introduction:

ILLUSTRATION BY ANANDA SPADT-THE WORLD-HERALDThis information about PTSD has been collected by CareForTheTroops. This page focuses on a treatment approach named EMDR that has been approved by the VA for the treatment of PTSD. Additionally, we have included information about Marriage and Family Therapy and other professions which may be helpful in treatments of mental health issues and symptons that are also experienced by returning veterans and their extended family members. We have developed a relationship, within the States CFTT operates, with Certified EMDR and MFT Therapists and they can be found by searching our Therapist Database on this website. There are much more detailed websites about PTSD than what CFTT could create on its own, so be sure to look for the collection of websites provided for your reference and research further down on this page.

Military PTSD Requirements Relaxed - Announced the Week of November 03, 2008

http://www.military.com/military-report/military-ptsd-requirements-relaxed

The Department of Veterans Affairs (VA) is amending its adjudication regulations regarding service connection for post-traumatic stress disorder (PTSD). The amendment will eliminate the requirement of evidence that corroborates the occurrence of in-service stressor in which PTSD is diagnosed in the service. This is necessary to facilitate the proof of service connection in such claims. By this amendment, the VA intends to reduce claim-processing time for such claims. This interim final rule is effective Oct. 29, 2008. Going forward -- in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service -- the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. The VA believes that this change will contribute to faster processing of PTSD claims by eliminating the need for VA to develop evidence of occurrence of the in-service stressor in claims in which the veteran's PTSD was diagnosed during service.


The following information and much more can be found on HelpGuide.org. The site covers a wealth of information on PTSD, EMDR, and other good information.

Symptoms of post-traumatic stress disorder (PTSD)

Soldier alone in IraqFollowing a traumatic event, almost everyone experiences at least some of the symptoms of PTSD. It’s very common to have bad dreams, feel fearful or numb, and find it difficult to stop thinking about what happened. But for most people, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift.

If you have post-traumatic stress disorder (PTSD), however, the symptoms don’t decrease. You don’t feel a little better each day. In fact, you may start to feel worse. But PTSD doesn’t always develop in the hours or days following a traumatic event, although this is most common. For some people, the symptoms of PTSD take weeks, months, or even years to develop.

The symptoms of post-traumatic stress disorder (PTSD) can arise suddenly, gradually, or come and go over time. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell. While everyone experiences PTSD differently, there are three main types of symptoms, as listed below.

What are some of the warning signs, "triggers" and coping strategies for war veterans and their family members to look for?

Triggers indicate when someone you know may need some extra assistance with issues affecting them from the conflicts in Iraq or Afghanistan?

Adapted From Pre-Publication Excerpts: Scurfield, Raymond, DSW, LCSW; From the Vietnam and Gulf Wars to 9/11 and Iraq: Veterans, Families, Post-Traumatic Stress and Healing (in press) (raymond.scurfield@
usm.edu) Kathy Platoni, Psy.D. Clinical Psychologist, COL/MS/USAR

Want to know more? -- click here...

Re-experiencing the traumatic event

PTSD symptoms of avoidance and emotional numbing

PTSD symptoms of increased arousal

Other common symptoms of post-traumatic stress disorder


Chart from the VA and DOD clinical guidelines showing the approved PTSD Psychotherapy InterventionsWhat do the VA and DOD recommend?

The VA and DoD have established clinical practice guideline for the management of post-traumatic stress. The latest version of the policy is as of January, 2004. The complete document is available by clicking here in PDF format.

Here are two updated documents, as of 2010, that explain the recommdations of the VA and DOD for the treatment of PTSD.

Document 1 - Overview of Psychotherapy for PTSD
Document 2 - 2010 VA-DoD CLINICAL PRACTICE GUIDELINE FOR MANAGEMENT OF POST-TRAUMATIC STRESS

A summary chart of the approved treatments for PTSD is shown below. EMDR is one of those treatments that have been approved. You can find a list of therapists on this web site who are trained in EMDR and who have undertaken some level of training about working with military families and/or have experience with the military service in their background.

As time permits, CareForTheTroops will provide background information about the other treatment forms approved by the VA and DOD. We will also try to keep up to date with information on the latest guidelines published by the VA and DOD..


Types of treatments for post-traumatic stress disorder (PTSD)


Treatment of PTSD from the Department of Veterans Affairs

This information was extracted from the Department of Veterans Affairs National Center for PTSD Fact Sheet on PTSD in 2010. The link to the fact sheet is no longer available, but the content below is still valuable. Please refer to the VA PTSD website that discusses Military Trauma.

Today, there are good treatments available for PTSD. When you have PTSD dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But talking with a therapist can help you get better.

Cognitive-behavioral therapy (CBT) is one type of counseling. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. There is also a similar kind of therapy called eye movement desensitization and reprocessing (EMDR) that is used for PTSD. Medications have also been shown to be effective. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.

Cognitive Behavioral Therapy Types:

What is EMDR?

Eye movement desensitization and reprocessing (EMDR) is a fairly new therapy for PTSD. Like other kinds of counseling, it can help change how you react to memories of your trauma.

While talking about your memories, you'll focus on distractions like eye movements, hand taps, and sounds. For example, your therapist will move his or her hand near your face, and you'll follow this movement with your eyes.

Experts are still learning how EMDR works. Studies have shown that it may help you have fewer PTSD symptoms. But research also suggests that the eye movements are not a necessary part of the treatment.

What is cognitive therapy?

In cognitive therapy, your therapist helps you understand and change how you think about your trauma and its aftermath. Your goal is to understand how certain thoughts about your trauma cause you stress and make your symptoms worse.

You will learn to identify thoughts about the world and yourself that are making you feel afraid or upset. With the help of your therapist, you will learn to replace these thoughts with more accurate and less distressing thoughts. You also learn ways to cope with feelings such as anger, guilt, and fear.

After a traumatic event, you might blame yourself for things you couldn't have changed. For example, a soldier may feel guilty about decisions he or she had to make during war. Cognitive therapy, a type of CBT, helps you understand that the traumatic event you lived through was not your fault. What is exposure therapy?

In exposure therapy your goal is to have less fear about your memories. It is based on the idea that people learn to fear thoughts, feelings, and situations that remind them of a past traumatic event.

By talking about your trauma repeatedly with a therapist, you'll learn to get control of your thoughts and feelings about the trauma. You'll learn that you do not have to be afraid of your memories. This may be hard at first. It might seem strange to think about stressful things on purpose. But you'll feel less overwhelmed over time.

With the help of your therapist, you can change how you react to the stressful memories. Talking in a place where you feel secure makes this easier.

You may focus on memories that are less upsetting before talking about worse ones. This is called "desensitization," and it allows you to deal with bad memories a little bit at a time. Your therapist also may ask you to remember a lot of bad memories at once. This is called "flooding," and it helps you learn not to feel overwhelmed.

You also may practice different ways to relax when you're having a stressful memory. Breathing exercises are sometimes used for this.

Medication

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective. SSRIs include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Chemicals in your brain affect the way you feel. When you have or depression you may not have enough of a chemical called serotonin. SSRIs raise the level of serotonin in your brain.

There are other medications that have been used with some success. Talk to your doctor about which medications are right for you.

Other types of treatment

In addition to CBT and SSRIs, some other kinds of counseling may be helpful in your recovery from PTSD. Group therapy

Many people want to talk about their trauma with others who have had similar experiences.

In group therapy, you talk with a group of people who also have been through a trauma and who have PTSD. Sharing your story with others may help you feel more comfortable talking about your trauma. This can help you cope with your symptoms, memories, and other parts of your life.

Group therapy helps you build relationships with others who understand what you've been through. You learn to deal with emotions such as shame, guilt, anger, rage, and fear. Sharing with the group also can help you build self-confidence and trust. You'll learn to focus on your present life, rather than feeling overwhelmed by the past.

Brief psychodynamic psychotherapy

In this type of therapy, you learn ways of dealing with emotional conflicts caused by your trauma. This therapy helps you understand how your past affects the way you feel now.

Your therapist can help you:

•  Identify what triggers your stressful memories and other symptoms.
•  Find ways to cope with intense feelings about the past.
•  Become more aware of your thoughts and feelings, so you can change your reactions to them.
•  Raise your self-esteem.

Family therapy

PTSD can impact your whole family. Your kids or your partner may not understand why you get angry sometimes, or why you're under so much stress. They may feel scared, guilty, or even angry about your condition.

Family therapy is a type of counseling that involves your whole family. A therapist helps you and your family communicate, maintain good relationships, and cope with tough emotions. Your family can learn more about PTSD and how it is treated.

In family therapy, each person can express his or her fears and concerns. It's important to be honest about your feelings and to listen to others. You can talk about your PTSD symptoms and what triggers them. You also can discuss the important parts of your treatment and recovery. By doing this, your family will be better prepared to help you.

You may consider having individual therapy for your PTSD symptoms and family therapy to help you with your relationships.

How long does treatment last?

For some people, treatment for PTSD can last 3 to 6 months. If you have other mental health problems as well as PTSD, treatment for PTSD may last for 1 to 2 years or longer.

What if someone has PTSD and another disorder? Is the treatment different?

It is very common to have PTSD at that same time as another mental health problem. Depression, alcohol or substance abuse problems, panic disorder, and other anxiety disorders often occur along with PTSD. In many cases, the PTSD treatments described above will also help with the other disorders. The best treatment results occur when both PTSD and the other problems are treated together rather than one after the other.

What will we work on in therapy?

When you begin therapy, you and your therapist should decide together what goals you hope to reach in therapy. Not every person with PTSD will have the same treatment goals. For instance, not all people with PTSD are focused on reducing their symptoms.

Some people want to learn the best way to live with their symptoms and how to cope with other problems associated with PTSD. Perhaps you want to feel less guilt and sadness? Perhaps you would like to work on improving your relationships at work, or communication issues with your friends and family.

Your therapist should help you decide which of these goals seems most important to you, and he or she should discuss with you which goals might take a long time to achieve.

What can I expect from my therapist?

Your therapist should give you a good explanation for the therapy. You should understand why your therapist is choosing a specific treatment for you, how long they expect the therapy to last, and how they see if it is working.

The two of you should agree at the beginning that this plan makes sense for you and what you will do if it does not seem to be working. If you have any questions about the treatment your therapist should be able to answer them.

You should feel comfortable with your therapist and feel you are working as a team to tackle your problems. It can be difficult to talk about painful situations in your life, or about traumatic experiences that you have had. Feelings that emerge during therapy can be scary and challenging. Talking with your therapist about the process of therapy, and about your hopes and fears in regards to therapy, will help make therapy successful.

If you do not like your therapist or feel that the therapist is not helping you, it might be helpful to talk with another professional. In most cases, you should tell your therapist that you are seeking a second opinion.