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    20080505
    PEOPLE News.
  • MENTAL HEALTH News. PSYCHIATRIC News.MentalHEALTH News. MEDICAL News.HealthPTSD News: Post-Traumatic Stress Disorder News.PTSDSCIENCE News.ScienceMARYLAND NewsMarylandUS AMERICAN News.USIRAQ News.IraqAFGHANISTAN News.AfghanistanMILITARY News.VeteransGOVERNMENT News.GovernmentFINANCIAL News.FinancialPOLITICS News.Politics - "Post-War Suicides May Exceed Combat Deaths, U.S. Says (Update1)." ... "The number of suicides among veterans of wars in Iraq and Afghanistan may exceed the combat death toll because of inadequate mental health care, the U.S. [United States] government's top psychiatric researcher said." ... "Community mental health centers, hobbled by financial limits, haven't provided enough scientifically sound care, especially in rural areas, said Thomas Insel, director of the National Institute of Mental Health in Bethesda, Maryland. He briefed reporters today at the American Psychiatric Association's annual meeting in Washington." ... "Insel echoed a Rand Corporation study published last month that found about 20 percent of returning U.S. soldiers have post-traumatic stress disorder or depression, and only half of them receive treatment. About 1.6 million U.S. troops have fought in the two wars since October 2001, the report said. About 4,560 soldiers had died in the conflicts as of today, the Defense Department reported on its Web site." ... "Based on those figures and established suicide rates for similar patients who commonly develop substance abuse and other complications of post-traumatic stress disorder, ``it's quite possible that the suicides and psychiatric mortality of this war could trump the combat deaths,'' Insel said. " -By Avram Goldstein -Bloomberg 
  • 20080417
    PEOPLE News.
  • MENTAL HEALTH News. PSYCHIATRIC News.MentalHEALTH News. MEDICAL News.HealthPTSD News: Post-Traumatic Stress Disorder News.PTSDUS AMERICAN News.USIRAQ News.IraqAFGHANISTAN News.AfghanistanMILITARY News.Military - "Nearly 1 In 5 Vets Reports Mental Problems: Study: 300,000 U.S. Troops Suffering From Depression, PTSD; 320,000 Have Brain Injuries." ... "The Department of Veterans Affairs said this month that its records show about 120,000 who served in the two wars [Iraq and Afghanistan] and are no longer in the military have been diagnosed with mental health problems. Of those, approximately 60,000 are suffering from PTSD, the VA said." ... "In December, CBS News correspondent Kimberly Dozier reported that veterans' advocates say symptoms of PTSD - from substance-abuse to rage to suicidal depression - are misdiagnosed or blamed on the troops themselves." ... "Veterans Affairs is responsible for care of service members after they have left the service, while the Defense Department covers active duty and reservist needs." -AP via -CBSNews 
    PEOPLE News.
  • BRAIN News. PSYCHOLOGICAL News.BrainHEALTH News. MEDICAL News.HealthPTSD News: Post-Traumatic Stress Disorder News.PTSDSCIENCE News.ScienceMONEY News.MoneyOPINION News.OpinionUS AMERICAN News.USIRAQ News.IraqAFGHANISTAN News.AfghanistanMILITARY News.Military - "One In Five Iraq and Afghanistan Veterans Suffer from PTSD or Major Depression." ... "Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — report symptoms of post traumatic stress disorder or major depression, yet only slightly more than half have sought treatment, according to a new RAND Corporation study." ... "In addition, researchers found about 19 percent of returning service members report that they experienced a possible traumatic brain injury while deployed, with 7 percent reporting both a probable brain injury and current PTSD or major depression." ... "Many service members said they do not seek treatment for psychological illnesses because they fear it will harm their careers. But even among those who do seek help for PTSD or major depression, only about half receive treatment that researchers consider "minimally adequate" for their illnesses." ... "In the first analysis of its kind, researchers estimate that PTSD and depression among returning service members will cost the nation as much as $6.2 billion in the two years following deployment — an amount that includes both direct medical care and costs for lost productivity and suicide. Investing in more high-quality treatment could save close to $2 billion within two years by substantially reducing those indirect costs, the 500-page study concludes." ... ""There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan," said Terri Tanielian, the project's co-leader and a researcher at RAND, a nonprofit research organization. "Unless they receive appropriate and effective care for these mental health conditions, there will be long-term consequences for them and for the nation. Unfortunately, we found there are many barriers preventing them from getting the high-quality treatment they need."" ... "The findings are from the first large-scale, nongovernmental assessment of the psychological and cognitive needs of military service members who have served in Iraq and Afghanistan over the past six years. The RAND study is the first to comprehensively assess the current needs of returned service members from all branches of the military." ... "Researchers concluded that a major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans. The effort must include the military, veteran and civilian health care systems, and should focus on training more providers to use high-quality, evidence-based treatment methods and encouraging service members and veterans to seek needed care." ... "Rates of PTSD and major depression were highest among Army soldiers and Marines, and among service members who were no longer on active duty (people in the reserves and those who had been discharged or retired from the military). Women, Hispanics and enlisted personnel all were more likely to report symptoms of PTSD and major depressions, but the single best predictor of PTSD and depression was exposure to combat trauma while deployed." ... "Researchers found many treatment gaps exist for those with PTSD and depression. Just 53 percent of service members with PTSD or depression sought help from a provider over the past year, and of those who sought care, roughly half got minimally adequate treatment." ... ""If PTSD and depression go untreated or are under treated, there is a cascading set of consequences," Jaycox said. "Drug use, suicide, marital problems and unemployment are some of the consequences. There will be a bigger societal impact if these service members go untreated. The consequences are not good for the individuals or society in general."" ... "Service members report many reasons for not seeking treatment. Many are worried about the side effects of medication or believe that family and friends can provide more help than a mental health professional. Even more reported that they worried seeking care might damage their career or cause their peers to lose confidence in their abilities." ... "The RAND report recommends the military create a system that would allow service members to receive mental health services confidentially in order to ease concerns about negative career repercussions." ... ""We need to remove the institutional cultural barriers that discourage soldiers from seeking care," Tanielian said. "Just because someone is getting mental health care does not mean that they are not able to do their job. Seeking mental health treatment should be seen as a sign of strength and interest in getting better, not a weakness. People need to get help as early as possible, not only once their symptoms become severe and disabling."" ... "Researchers also found an urgent need to train more mental health providers throughout the U.S. health care system on delivering evidence-based treatments to service members and veterans. While many opportunities for treatment exist for active-duty personnel, there is no system in place to monitor the quality of those services to ensure they are getting the latest science-based forms of treatment." -Rand.org 
    PEOPLE News.
  • PSYCHOLOGICAL News. BRAIN News. COGNITIVE News.PsychologicalHEALTH News. MEDICAL News.HealthPost-Traumatic Stress Disorder News.Post-Traumatic Stress DisorderSCIENCE News. TECHNOLOGY News.ScienceMONOGRAPH News. BOOK News.MonographUS AMERICAN News.USIRAQ News.IraqAFGHANISTAN News.AfghanistanMILITARY News.Military - "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery." ... " Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments — many involving prolonged exposure to combat-related stress over multiple rotations — may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise." ... " The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it." ... [full 499 page monograph available at Rand] "Not only is a higher proportion of the armed forces being deployed,but deployments have been longer,redeployment to combat has been common,and breaks between deployments have been infrequent (Hosek,Kavanagh,and Miller,2006). At the same time,episodes of intense combat notwithstanding,these operations have employed smaller forces and have produced casualty rates of killed or wounded that are historically lower than in earlier prolonged wars,such as Vietnam and Korea.Advances in both medical technology and body armor mean that more servicemembers are surviving experiences that would have led to death in prior wars (Regan,2004;Warden,2006). However,casualties of a different kind are beginning to emerge —invisible wounds,such as mental health conditions and cognitive impairments resulting from deployment experiences.These deployment experiences may include multiple deployments per individual service member and exposure to di ?cult threats,such as improvised explosive devices (IEDs)." ... "As with safeguarding physical health,safeguarding mental health is an integral component of the United States ’ national responsibilities to recruit,,prepare,and sustain a military force and to address Service-connected injuries and disabilities.But safeguarding mental health is also critical for compensating and honoring those who have served our nation." -Edited by Terri Tanielian and Lisa H. Jaycox -Rand.org 
  • References
           Hosek,J.,J.Kavanagh,and L.Miller.How Deployments Affect Service Members .Santa Monica, Calif.:RAND Corporation,MG-432-RC,2006.As of March 13,2008: http://www.rand.org/pubs/monographs/MG432/
           Regan,T.Report:High survival rate for US troops wounded in Iraq.Christian Science Monitor, November 29,2004.
           Warden,D.Military TBI during the Iraq and Afghanistan wars.Journal of Head Trauma Rehabilitation ,Vol.21,No.5,2006,pp.398 –402.
PTSD Websites
Post-Traumatic Stress Disorder PTSD Defined
GOVERNMENT News. Government.GOV News.
NIMH.NIH.Gov/health/topics

"What is Post-Traumatic Stress Disorder?
     Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. More about PTSD »

Signs & Symptoms

People with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. They may experience sleep problems, feel detached or numb, or be easily startled.

Treatment

Effective treatments for post-traumatic stress disorder are available, and research is yielding new, improved therapies that can help most people with PTSD and other anxiety disorders lead productive, fulfilling lives. More about Treatment »

Getting Help: Locate Services

Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and listings of professionals and organizations. More about Locating Services »

Related Information

    * Information on Coping with Traumatic Events
    * Helping Children and Adolescents Cope with Violence and Disasters: What Parents Can Do
    * Helping Children and Adolescents Cope with Violence and Disasters: What Community Members Can Do
    * Helping Children and Adolescents Cope with Violence and Disasters: What Rescue Workers Can Do
    * Children and Violence
    * Information about medications
    * Post-Traumatic Stress Disorder Information and Organizations from NLM's MedlinePlus (en Español)
    * Some mental illnesses also carry an increased risk for suicide. 


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    via: http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_faqs_on_ptsd.html
    [Posttraumatic Stress Disorder FAQ] Frequently Asked Questions

    What is PTSD?

    Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

    Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

        * Combat or military exposure
        * Child sexual or physical abuse
        * Terrorist attacks
        * Sexual or physical assault
        * Serious accidents, such as a car wreck.
        * Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.

    After the event, you may feel scared, confused, and angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

    For a more information, please see our fact sheet What Is Post-Traumatic Stress Disorder.

    What treatments are available for PTSD?

    There are many types of treatment for PTSD. You and your doctor will discuss the best treatment for you. You may have to try a number of treatments before you find one that works for you.

    A type of counseling called cognitive-behavioral therapy and medicines known as SSRIs appear to be the most effective treatments for PTSD. Treatment can help you feel more in control of your emotions and result in fewer symptoms, but you may still have some bad memories.

    For more information, please see our fact sheet on Treatment for PTSD

    How do I locate specialists or support groups for PTSD?

    If you are in an immediate crisis, please go to your nearest Emergency Room or call 911.

    Although the Center does not provide any direct clinical care, we provide links and information to help you locate mental health services in your area. See our fact sheets on:

        * Finding a Therapist

    I am an American Veteran. Who do I contact for help with PTSD?

    You can contact your local VA Hospital or Veterans Center located in your telephone book, or call the VA Health Benefits Service Center toll free at 1-877-222-VETS. In addition to its medical centers, VA also has many CBOCs (Community Based Outpatient Clinics) around each state so you can look for one in your community. You can also use any of the information on treatment for the general public.

    For online help, the VA also offers the MyHealtheVet and Seamless Transition websites. Please also see Specialized PTSD Treatment Programs in the U.S. Department of Veterans Affairs.

    As an American Veteran, how do I file a claim for disability due to PTSD?

    A formal request ("claim") must be filed by the veteran using forms provided by the VA's Veterans Benefits Administration. After the forms are completely submitted, the veteran must complete interviews concerning her or his "social history" (a review of family, work, and educational experiences before, during, and after military service) and "psychiatric status" (a review of past and current psychological symptoms, and of traumatic experiences during military service). The forms and information about the application process can be obtained from Benefits Officers at any VA Medical Center, Outpatient Clinic, or Regional Office.

    The process of applying for a VA disability for PTSD can take several months, and can be both complicated and quite stressful. The Veteran's Service Organizations (VSOs) provide "Service Officers" at no cost to help veterans and family members pursue VA disability claims. Service Officers are familiar with every step in the application and interview process, and can provide both technical guidance and moral support. In addition, some Service Officers particularly specialize in assisting veterans with PTSD disability claims.

    Even if a veteran has not been a member of a specific Veterans Service Organization, the veteran still can request the assistance of a Service Officer working for that organization. In order to get representation by a qualified and helpful Service Officer, you can directly contact the local office of any Veterans Service Organization -- or ask for recommendations from other veterans who have applied for VA disability, or from a PTSD specialist at a VA PTSD clinic or a Vet Center.
    ...

    Does the National Center for PTSD publish any journals? How do I subscribe?

    Yes, the National Center publishes some regular publications, and our staff regularly publishes in major journals. All are available to download from our website. Use our advanced search to locate articles and chapters written by staff at the National Center for PTSD.

    The PTSD Research Quarterly contains review articles on specific topics related to PTSD, written by guest experts. Each article contains a selective bibliography with abstracts and a supplementary list of annotated citations.

    The Clinician's Trauma Update (CTU-Online) provides summaries of clinically relevant publications. Links to the full article (PDF) or to the abstract are available.

    The NCPTSD Clinical Quarterly archives are available (1990-2003). The CQ was published by our Education Division and addressed the needs of practicing PTSD clinicians and program administrators.

    To subscribe to these publications see Subscribe to NCPTSD Publications.

    How do I locate books on PTSD?

    You can contact your local library for books or articles on trauma, PTSD, and related subjects. The National Center for PTSD's PILOTS database is another way to locate information. It is an electronic index to the worldwide literature on traumatic stress. You can search for citation information and electronic links to full text articles. The National Center for PTSD's Resource Center houses this information at our Executive Division in VT. Also see our recommended reading lists.

    I am a professional who would like to know what training is available from the National Center for PTSD.

    The National Center for PTSD now offers PTSD 101, an online web-based training course on traumatic stress. Many other training videos and materials are also available on our site. Our Education Division offers an on-site clinical training program in the treatment of PTSD. The training program is 35 hours long, and is approved for category 1 continuing medical education credit. We also provide Postdoctoral Fellowship Programs and Internships.

    For more information, see Training Opportunities at NCPTSD.

    As a professional, I need to locate a specific assessment instrument for PTSD. How do I do that?

    Assessment instruments created by National Center for PTSD staff, such as: the CAPS, CAPS-CA, and TESI-C, can be requested online through the National Center for PTSD website. For more information on these and other measures, see our Assessment section.


    News Reference Facts Information Sources Intelligence Haven Works !-) HavenWorks.com/acronyms/a-z/p/ptsd/#what+is+PTSD
    #Weblog - #Veterans - #FAQ - #What+is+PTSD - #Common Reactions After Trauma - #Treatment of PTSD - #History - #"Soldier's Heart"
    via: http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_what_is_ptsd.html
    What is Posttraumatic Stress Disorder (PTSD)?

    Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

    Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

        * Combat or military exposure
        * Child sexual or physical abuse
        * Terrorist attacks
        * Sexual or physical assault
        * Serious accidents, such as a car wreck.
        * Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.

    After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

    How does PTSD develop?

    All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

    Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:

        * How intense the trauma was or how long it lasted
        * If you lost someone you were close to or were hurt
        * How close you were to the event
        * How strong your reaction was
        * How much you felt in control of events
        * How much help and support you got after the event

    Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.

    What are the symptoms of PTSD?

    Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

    PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

    There are four types of symptoms: reliving the event, avoidance, numbing, and feeling keyed up.

    Reliving the event (also called re-experiencing symptoms):

    Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:

        * Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
        * Seeing a car accident, which can remind a crash survivor of his or her own accident
        * Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped

    Avoiding situations that remind you of the event:

    You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.

        * A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
        * A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
        * Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

    Feeling numb:

    You may find it hard to express your feelings. This is another way to avoid memories.

        * You may not have positive or loving feelings toward other people and may stay away from relationships
        * You may not be interested in activities you used to enjoy
        * You may forget about parts of the traumatic event or not be able to talk about them.

    Feeling keyed up (also called hyperarousal):

    You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:

        * Suddenly become angry or irritable
        * Have a hard time sleeping
        * Have trouble concentrating
        * Fear for your safety and always feel on guard
        * Be very startled when someone surprises you

    What are other common problems?

    People with PTSD may also have other problems. These include:

        * Drinking or drug problems
        * Feelings of hopelessness, shame, or despair
        * Employment problems
        * Relationships problems including divorce and violence
        * Physical symptoms

    Can children have PTSD?

    Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older their symptoms are more like those of adults.

        * Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom
        * Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.

    What treatments are available?

    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 treatment can help you get better.

    There are good treatments available for PTSD. Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.


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    via: http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_commonreactions.html
    Common Reactions After Trauma

    Following a traumatic event, people typically describe feeling things like relief to be alive, followed by stress, fear, and anger. They also often find they are unable to stop thinking about what happened. Having stress reactions is what happens to most people and has nothing to do with personal weakness. Many will also exhibit high levels of arousal. For most, if the following symptoms occur, they will slowly decrease over time.

    Remember that most trauma survivors (including veterans, children, disaster rescue or relief workers) experience common stress reactions. Understanding what is happening when you or someone you know reacts to a traumatic event will help you be less fearful and better able to handle things. These reactions may last for several days or even a few weeks and may include:

        * Feeling hopeless about the future & detached or unconcerned about others
        * Having trouble concentrating, indecisiveness
        * Jumpy & startle easily at sudden noise
        * On guard and constantly alert
        * Having disturbing dreams/memories or flashbacks
        * Work or school problems

    You may also experience more physical reactions such as:

        * Stomach upset, trouble eating
        * Trouble sleeping & exhaustion
        * Pounding heart, rapid breathing, edginess
        * Severe headache if thinking of the event, sweating
        * Failure to engage in exercise, diet, safe sex, regular health care
        * Excess smoking, alcohol, drugs, food
        * Worsening of chronic medical problems

    Or have more emotional troubles such as:

        * Feeling nervous, helpless, fearful, sad
        * Feeling shock, numb, unable to experience love or joy
        * Avoiding people, places, and things related to the event
        * Being irritable or outbursts of anger
        * Becoming easily upset or agitated
        * Self-blame or negative views of oneself or the world
        * Distrust of others, conflict, being over controlling
        * Withdrawal, feeling rejected or abandoned
        * Loss of intimacy or feeling detached

    Use your personal support systems, family and friends, when you are ready to talk. Recovery is an ongoing gradual process. It doesn't happen through suddenly being "cured" and it doesn't mean that you will forget what happened. For most, fear, anxiety, remembering, efforts to avoid reminders, and arousal symptoms, if present, will gradually decrease over time. Most people will recover from trauma naturally. If your emotional reactions are getting in the way of your relationships, work, or other important activities you may want to talk to a counselor or your doctor.  Good treatments are available.

    Common problems that can occur

    Posttraumatic Stress Disorder (PTSD): PTSD is a condition that can develop after someone has experienced a life-threatening situation.  People with PTSD often can't stop thinking about what happened to them.  They may try to avoid people and places that remind them of the trauma and may work hard to push thoughts of the event out of their head.  Feeling numb is another common reaction.  Finally, people find that they have trouble relaxing.  They startle easily and are often on guard.

    Depression:  Depression involves feeling down or sad more days than not, and losing interest in activities that used to be enjoyable or fun. You may feel low in energy and be overly tired.  People may feel hopelessness or despair, or feeling that things will never get better. Depression may be especially likely when a person experiences losses such as the death of close friends. This sometimes leads a depressed person to think about hurting or killing him or herself. Because of this, it is important to get help.

    Self-blame, guilt and shame: Sometimes in trying to make sense of a traumatic event, people take too much responsibility for bad things that happened, for what they did or did not do, or for surviving when others didn't.  Remember, we all tend to be our own worst critics and that guilt, shame and self-blame are usually unjustified.

    Suicidal thoughts:  Trauma and personal loss, can lead a depressed person to think about hurting or killing themselves. If you think someone you know may be feeling suicidal, you should directly ask them. You will NOT put the idea in their head.  If they have a plan to hurt themselves and the means to do it, and cannot make a contract with you to stay safe, try to get them to a counselor or call 911 immediately. National Suicide Prevention Lifeline http://www.suicidepreventionlifeline.org/ 1-800-273-TALK (8255)

    Anger or aggressive behavior:  Trauma can be connected with anger in many ways.  After a trauma people often feel that the situation was unfair or unjust.  They can't comprehend why the event has happened and why it has happened to them.  These thoughts can result in intense anger.  Although anger is a natural and healthy emotion, intense feelings of anger and aggressive behavior can cause relationship and job problems, and loss of friendships.  If people become violent when angry, this can just make the situation worse as people can become injured and there may be legal consequences.

    Alcohol/Drug abuse:  Drinking or "self-medicating" with drugs is a common way many cope with upsetting events to numb themselves and to try to deal with the difficult thoughts, feelings, and memories related to the trauma.  While this may offer a quick solution, it can actually lead to more problems. If someone close begins to lose control of drinking or drug use, it is important to assist them in getting appropriate care.

    Recovery

    Immediately following a trauma, almost everyone will find themselves unable to stop thinking about what happened.  Many will also exhibit high levels of arousal.  For most, fear, anxiety, remembering, efforts to avoid reminders, and arousal symptoms, if present, will gradually decrease over time. Use your personal support systems, family and friends, when you are ready to talk. Recovery is an ongoing gradual process. It doesn't happen through suddenly being "cured" and it doesn't mean that you will forget what happened.  But, most people will recover from trauma naturally over time.  If your emotional reactions are getting in the way of your relationships, work, or other important activities you may want to talk to a counselor or your doctor.  Good treatments are available.


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    Treatment of PTSD

    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. It appears to be the most effective type of counseling for PTSD. 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

    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.

    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.

    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...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.


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