Posts Tagged PTSD

[TED Talk] Understanding PTSD’s Effects on Brain, Body, and Emotions | Janet Seahorn | TEDxCSU – YouTube

PTSD disrupts the lives of average individuals as well as combat veterans who have served their country. The person experiencing the trauma often then impacts the lives of his/her family, friends, and workplaces. PTSD does not distinguish between race, age or gender and often goes undiagnosed. Even with proper diagnosis, many individuals do not know where to turn to get help. Society needs to understand the aftermath of trauma especially combat trauma and how to prepare for warriors when they return home. Janet Seahorn, Ph.D has been a teacher, administrator, and consultant for over thirty years. She currently teaches a variety of classes on neuroscience and literacy as an adjunct professor for Colorado State University in Fort Collins, CO. Jan has a Ph.D in Human Development and Organizational Systems. Her background includes an in-depth understanding of human development and neuroscience research as well as effective practices in organizational systems and change. She conducts workshops on the neuroscience of learning and memory, the effects of “at-risk” environments (i.e., poverty), brain development, and researched-based instructional practices. Jan has worked with many organizations in the business and educational communities in creating and sustaining healthy, dynamic environments. Dr. Seahorn has researched and studied the effects of trauma on the brain and how excessive or extreme trauma can impact changes in the brain’s neuro network and how that change impacts behaviors in s This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

via Understanding PTSD’s Effects on Brain, Body, and Emotions | Janet Seahorn | TEDxCSU – YouTube

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[ARTICLE] An acceptance and commitment therapy-based intervention for PTSD following traumatic brain injury: a case study

Introduction: A case study is presented to illustrate the management of Post-Traumatic Stress Disorder (PTSD) in the context of Traumatic Brain Injury (TBI), using an Acceptance and Commitment Therapy (ACT) based approach. A 48-year-old female presented to Neuropsychology with cognitive difficulties, significant distress and trauma symptoms following a car accident. ACT is a third wave cognitive-behavioral approach aimed at increasing psychological flexibility as a means of reducing distress: it is a trans-diagnostic model that may be suited to the complex and multi-factorial difficulties experienced by this client group.

Methods: A guided self-help approach based on ACT was implemented by the client working with a Clinical Psychologist within a Community Neuropsychology service, over 12 appointments.

Results: Outcome measures were administered pre and post-intervention as well as at three and then 12-month follow-ups. Improvements were seen across ACT outcome measures, psychological measures and quality of life ratings and were consistent with subjective reporting.

Discussion: Outcomes were positive in all domains post-intervention and at follow-up, indicating that this may be a feasible intervention for PTSD following TBI.

via An acceptance and commitment therapy-based intervention for PTSD following traumatic brain injury: a case study: Brain Injury: Vol 0, No 0

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[WEB SITE] TBI and PTSD: Navigating the Perfect Storm – BrainLine

Marilyn Lash, MSW, Brain Injury Journey magazine
TBI and PTSD: Navigating the Perfect Storm

So often people talk about the effects of traumatic brain injury or the consequences of post-traumatic stress disorder as separate conditions — which they are. But for the person who is living with the dual diagnosis of TBI and PTSD, it can be hard to separate them.

Just as meteorologists predict “the perfect storm” when unusual and unprecedented conditions move in to create catastrophic atmospheric events, so can the combination of PTSD and TBI be overpowering and destructive for all in its path. The person with TBI and PTSD is living in a state unlike anything previously experienced. For the family, home is no longer the safe haven but an unfamiliar front with unpredictable and sometimes frightening currents and events.

While awareness of PTSD has greatly increased with recently returning service members and veterans, it is not new and nor limited to combat. Anyone — children, adolescents, adults, elderly — who is exposed to a life-threatening trauma can develop PTSD. Car crashes, shootings, floods, fires, assaults, or kidnapping can happen to anyone anywhere. But the rate of PTSD after brain injury is much higher in veterans than civilians due to their multiple and prolonged exposure to combat. According to O’Connor and Drebing, it is estimated that up to 35% of returning veterans with mild brain injury also have PTSD.

What’s unique about PTSD?

Symptoms of PTSD include:

  • Unwanted and repeated memories of the life-threatening event
  • Flashbacks where the event is relived and person temporarily loses touch with reality
  • Avoidance of people, places, sights, or sounds that are reminders
  • Feelings of detachment from people, even family, and emotional numbness
  • Shame about what happened and was done
  • Survivor guilt with loss of friends or comrades
  • Hypervigilance or constant alertness for threats.

Individuals with PTSD are at increased risk for depression, physical injuries, substance abuse, and sleep problems, which in turn can affect thoughts and actions. These risk factors also occur with brain injury.

PTSD is a mental disorder, but the associated stress can cause physical damage. TBI is a neurological disorder caused by trauma to the brain. It can cause a wide range of impairments and changes in physical abilities, thinking and learning, vision, hearing, smell, taste, social skills, behaviors, and communication. The brain is so complex, the possible effects of a traumatic injury are extensive and different for each person.

When PTSD and TBI coexist, it’s often difficult to sort out what’s going on. Changes in cognition such as memory and concentration, depression, anxiety, insomnia, and fatigue are common with both diagnoses. One basically feeds and reinforces the other, so it’s a complicated mix — it’s the perfect storm. It may help to consider and compare changes commonly seen with TBI and PTSD.

Memory

TBI: A period of amnesia for what went on just before (retrograde amnesia) or after (anterograde amnesia) the injury occurred is common. The length of time (minutes, hours, days, or weeks) of amnesia is an indicator of the severity of the brain injury. For example, the person may have no memory of what happened just before or after the car crash or IED explosion.

PTSD: In contrast, the person with PTSD is plagued and often haunted by unwanted and continuing intrusive thoughts and memories of what happened. The memories keep coming at any time of day or night in such excruciating detail that the person relives the trauma over and over again.

Sleep

TBI: Sleep disorders are very common after brain injury. Whether it is trouble falling asleep, staying asleep, or waking early, normal sleep patterns are disrupted, making it hard to get the restorative rest of sleep so badly needed.

PTSD: The mental state of hypervigilance interferes with slowing the body and mind down for sleep. Nightmares are so common with PTSD that many individuals dread going to bed and spend long nights watching TV or lying on the couch to avoid the night’s terrors. Waking up with night sweats so drenching that sheets and clothing are soaked. Flashbacks so powerful that bed partners have been struck or strangled while sleep battles waged.

Isolation

TBI: Many survivors of TBI recall the early support and visits of friends, relatives, and coworkers who gradually visited or called less often over time. Loss of friends and coworkers leads to social isolation, one of the most common long-term consequences of TBI.

PTSD: The isolation with PTSD is different as it is self-imposed. For many it is simply too hard to interact with people. The feeling of exposure outside the safe confines of the house is simply too great. The person may avoid leaving the house as a way of containing stimuli and limiting exposure to possible triggers of memories. As a result, the individual’s world becomes smaller and smaller.

Emotions

TBI: When the areas of the brain that control emotions are damaged, the survivor of a TBI may have what is called “emotional lability.” This means that emotions are unpredictable and swing from one extreme to the other. The person may unexpectedly burst into tears or laughter for no apparent reason. This can give the mistaken impression that the person is mentally ill or unstable.

PTSD: Emotional numbness and deadened feelings are a major symptom of PTSD. It’s hard for the person to feel emotions or to find any joy in life. This emotional shutdown creates distance and conflicts with spouses, partners and children. It is a major cause of loss of intimacy with spouses.

Fatigue

TBI: Cognitive fatigue is a hallmark of brain injury. Thinking and learning are simply harder. This cognitive fatigue feels “like hitting the wall,” and everything becomes more challenging. Building rest periods or naps into a daily routine helps prevent cognitive fatigue and restore alertness.

PTSD: The cascading effects of PTSD symptoms make it so difficult to get a decent night’s sleep that fatigue often becomes a constant companion spilling over into many areas. The fatigue is physical, cognitive, and emotional. Feeling wrung out, tempers shorten, frustration mounts, concentration lessens, and behaviors escalate.

Depression

TBI: Depression is the most common psychiatric diagnosis after brain injury; the rate is close to 50%. Depression can affect every aspect of life. While people with more severe brain injuries have higher rates of depression, those with mild brain injuries have higher rates of depression than persons without brain injuries.

PTSD: Depression is the second most common diagnosis after PTSD in OEF and OIF veterans. It is very treatable with mental health therapy and/or medication, but veterans in particular often avoid or delay treatment due to the stigma of mental health care.

Anxiety

TBI: Rather than appearing anxious, the person acts as if nothing matters. Passive behavior can look like laziness or “doing nothing all day,” but in fact it is an initiation problem, not an attitude. Brain injury can affect the ability to initiate or start an activity; the person needs cues, prompts, and structure to get started.

PTSD: Anxiety can rise to such levels that the person cannot contain it and becomes overwhelmed by feelings of panic and stress. It may be prompted by a specific event, such as being left alone, or it can occur for no apparent reason, but the enveloping wave of anxiety makes it difficult to think, reason or act clearly.

Talking about the Trauma

TBI: The person may retell an experience repetitively in excruciating detail to anyone who will listen. Such repetition may be symptomatic of a cognitive communication disorder, but it may also be due to a memory impairment. Events and stories are repeated endlessly to the frustration and exasperation of caregivers, friends, and families who have heard it all before.

PTSD: Avoidance and reluctance to talk about the trauma of what was seen and done is a classic symptom of PTSD, especially among combat veterans.

Anger

TBI: Damage to the frontal lobes of the brain can cause more volatile behavior. The person may be more irritable and anger more easily, especially when overloaded or frustrated. Arguments can escalate quickly, and attempts to reason or calm the person are often not effective.

PTSD: Domestic violence is a pattern of controlling abusive behavior. PTSD does not cause domestic violence, but it can increase physical aggression against partners. Weapons or guns in the home increase the risks for family members. Any spouse or partner who feels fearful or threatened should have an emergency safety plan for protection.

Substance Abuse

TBI: The effects of alcohol are magnified after a brain injury. Drinking alcohol increases the risks of seizures, slows reactions, affects cognition, alters judgment, interacts with medications, and increases the risk for another brain injury. The only safe amount of alcohol after a brain injury is none.

PTSD: Using alcohol and drugs to self-medicate is dangerous. Military veterans drink more heavily and binge drink more often than civilian peers. Alcohol and drugs are being used often by veterans to cope with and dull symptoms of PTSD and depression, but in fact create further problems with memory, thinking, and behavior.

Suicide

TBI: Suicide is unusual in civilians with TBI.

PTSD: Rates of suicide have risen among veterans of OEF and OIF. Contributing factors include difficult and dangerous nature of operations; long deployments and multiple redeployments; combat exposure; and diagnoses of traumatic brain injury, chronic pain, post-traumatic stress disorder, and depression; poor continuity of mental health care; and strain on marital and family relationships. Veterans use guns to commit suicide more frequently than civilians.

Summary

There is no easy “either/or” when it comes to describing the impact of TBI and PTSD. While each diagnosis has distinguishing characteristics, there is an enormous overlap and interplay among the symptoms. Navigating this “perfect storm” is challenging for the survivors, the family, the caregivers, and the treatment team. By pursuing the quest for effective treatment by experienced clinicians, gathering accurate information, and enlisting the support of peers and family, it is possible to chart a course through the troubled waters to a safe haven.

References:

O’Connor, M. & Drebing, C. (2011). Veterans and Brain Injury. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Ehde, D. & Fann, J. (2011). Managing Depression, Anxiety, and Emotional Challenges. In Living Life Fully after Brain Injury: A workbook for survivors, families and caregivers, Eds. Fraser, Johnson & Bell. Youngsville, NC: Lash & Associates Publishing/Training, Inc.

Posted on BrainLine March 7, 2013. Reviewed July 26, 2018.

 

via TBI and PTSD: Navigating the Perfect Storm | BrainLine

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[WEB SITE] PTSD Anger, Irritability and Other Symptoms People Don’t Understand

13 ‘Impolite’ Things People With PTSD Do

 

Living with difficult PTSD symptoms day-in-and-day-out can sometimes make us act in ways others don’t understand. Unfortunately, some folks perceive behavior they don’t understand as being “impolite” — even when that couldn’t be further from the truth.

Maybe you struggle with physical contact in the wake of physical or sexual trauma — and your family members think you’re rude for refusing hugs. Maybe you struggle to make eye contact, and people think you aren’t interested in what they have to say. Or maybe you lash out in anger at loved ones when you’re feeling especially stressed.

If you struggle with an “impolite” manifestation of PTSD, we want you to know you’re not alone. The only way we can set the record straight about “impolite” things people do because of PTSD is to talk about it. To open up this discussion, we asked our Mighty community to share one “impolite” thing they do because of PTSD.

Here’s what our community had to say:

1. Not Responding in Conversations

“I’m accidentally anti-social. I dissociate in times of fear and stress. When I’m aware that I’m experiencing dissociation, I feel a warm fuzz come over my body. My surroundings don’t feel real. It’s harder to move and harder to speak. I’m not trying to be impolite… I’m just… stuck!” — Melissa T.

2. Leaving Events Early or Canceling Last-Minute

“I go home. I leave early, I leave big events, I leave when I want to stay — because I can only handle so much. I wish people knew I left because I felt like I needed to. I wanted to stay.” — Brittany P.

“Tell people yes to coming to events or friend outings and cancel last-second because I can’t pull myself together. I’m sure they assume I just don’t care, but it breaks my heart. It steals so many precious memories from me.” — Erin C.

3. ‘Ghosting’ Your Friends

I repetitively ghost my friends by not answering their messages and calls. I don’t want to rely on people too much or bond with them because my PTSD tells me intimacy is unsafe.” — Kareline E.

4. Lashing Out at Others

“Lashing out under immense stress.” — Harmony Y.

I’m not sure if it’s PTSD or anxiety — I get very short or sometimes aggressive with customer service people on the phone when I need to discuss a problem. Partly from the fear/stress of making a phone call and partly from a perceived injustice. This is (hopefully) different from simply being an aggressive, nasty person — I am usually very empathetic and considerate.” — John S.

There comes a point where my anger at having to go through all this crap and living with this constant tension reaches the limit, and I unload on the unfortunate soul who just put the last straw on my back. I don’t pity bullies, and when the latest one crosses me, it’s on. I don’t lose control of my anger, but I get on the mountaintop and throw out a big sermon.” — Amanda C.

5. Refusing Physical Affection

I hate hugs. Get off me! Respect the bubble. I do the one-armed pat on the back thing. Some people get offended by that and say something, some know it’s just how I roll.” — Megan G.

6. Seeming ’Unapproachable’

“I work nights at a hotel. I don’t smile a lot because I don’t want to seem too inviting.” — Emily S.

7. Running Away

“I can be difficult about certain things. Parking for instance. I also race across the parking lot in stores and stuff leaving people behind. They think I’m being rude. I have PTSD from being run over by a car.” — Liz T.

8. Being Uncooperative With Doctors

“I’m especially uncooperative with doctors. I need to know  I have control over my health care decisions and especially my body, so I tend to shut down and flat-out ignore them the second I feel threatened by their recommendations or approach. I make them work harder to come up with a solution by refusing to allow them to touch me at times. I just want them to listen first before assuming they have consent because I opted to be their patient. Fortunately, I now have a team that is open to working within my comfort level and continues to support me when I allow myself to be vulnerable with them, even when I respond negatively.” — Kristen P.

9. Avoiding Family Members

I avoid events with other family members that don’t try and understand after many times of explaining. I don’t like being put on the spot or even want to talk to anyone so ‘impolite’ is a nice way of saying rude. I’m just rude (in their eyes) because I don’t care anymore won’t go to Thanksgiving, social outings, etc. I don’t like to be around anyone at all. And I’m actually OK with that.” — Rebecca J.

10. Relying on a Friend or Partner to Speak for You

“I look at my phone to avoid contact of any kind. Or I hide behind my boyfriend so he can do the talking.” — Ember H.

“Ignore people and rely on my partner to ‘human’ for me. She’s a champion, at least with her I don’t have to say anything, she just understands and reads me at a glance to know when I’m not coping.” — David C.

11. Telling People to Stop Talking to You

“Telling people to please just shut up and do not touch me. To be honest, I do not think it is such an impolite thing to do, I find it more impolite by others to insist on touching and trying to rush me when I have flashbacks or a bad moment and am in pain and am just trying to get some space and air to breathe… but others, unfortunately, seem to perceive it as quite impolite.” — Leila B.

“Sometimes I go into sensory overload and can no longer process things — especially when people ask a ton of questions in a row! So I have to say I can’t handle any more questions at the moment.” — Briana W.

12. Not Making Eye Contact

“Making eye contact. I don’t like people grabbing my arms or touching me at all actually. So makes me seem pretty impersonal.” — Jolene F.

13. Oversharing

“I overshare. Every single person in my life knows my situation, from my boss to some kid I went to school with. They also know my every mood and difficulty. Secrecy led to 15 years of me being incestuously molested, so anything that feels like secrecy or me being told to be quiet or not speak triggers me and produces the opposite — I positively shout things out to everyone now. I know it’s not ‘polite’ to overshare, but being in a situation where I’d be used again terrifies me.” — Peta J.

Though some of these behaviors might seem “impolite” to people who don’t understand, we want to remind you it’s more than OK to set boundaries. If you don’t like to be touched, you’re not rude for requesting people not touch you. If you need to take a breather in social situations, take a breather! You deserve to make decisions about what’s best for you.

For support from a community that really understands, you can always post on The Mighty with the hashtag, #CheckInWithMe. PTSD can feel isolating, but you don’t have to go it alone. Join The Mighty community and find the support you need.

What “impolite” thing does your PTSD make you do?

 

via PTSD Anger, Irritability and Other Symptoms People Don’t Understand | The Mighty

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[Infographic] PTSD Facts

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[Infographic] What PTSD looks like

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[HelpGuide] Helping Someone with PTSD

Helping a Loved One While Taking Care of Yourself

Women embracingWhen someone you care about suffers from post-traumatic stress disorder (PTSD), it can leave you feeling overwhelmed. The changes in your loved one can worry or even frighten you. You may feel angry about what’s happening to your family and relationship, or hurt by your loved one’s distance and moodiness. But it’s important to know  that you’re not helpless. Your support can make all the difference for your partner, friend, or family member’s recovery. With your help, your loved one can overcome PTSD and move on with their life.

Living with someone who has PTSD

PTSD can take a heavy toll on relationships. It can be hard to understand your loved one’s behavior—why they are less affectionate and more volatile. You may feel like you’re walking on eggshells or living with a stranger. You may have to take on a bigger share of household tasks, deal with the frustration of a loved one who won’t open up, or even deal with anger or disturbing behavior. The symptoms of PTSD can also lead to job loss, substance abuse, and other problems that affect the whole family.

It’s hard not to take the symptoms of PTSD personally, but it’s important to remember that a person with PTSD may not always have control over their behavior. Your loved one’s nervous system is “stuck” in a state of constant alert, making them continually feel vulnerable and unsafe. This can lead to anger, irritability, depression, mistrust, and other PTSD symptoms that your loved one can’t simply choose to turn off. With the right support from friends and family, though, your loved one’s nervous system can become “unstuck” and they can finally move on from the traumatic event.

Helping someone with PTSD tip 1: Provide social support

It’s common for people with PTSD to withdraw from friends and family. While it’s important to respect your loved one’s boundaries, your comfort and support can help the person with PTSD overcome feelings of helplessness, grief, and despair. In fact, trauma experts believe that face-to-face support from others is the most important factor in PTSD recovery.

Knowing how to best demonstrate your love and support for someone with PTSD isn’t always easy. You can’t force your loved one to get better, but you can play a major role in the healing process by simply spending time together.

Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make them feel worse. Instead, let them know you’re willing to listen when they want to talk, or just hang out when they don’t. Comfort for someone with PTSD comes from feeling engaged and accepted by you, not necessarily from talking.

Do “normal” things with your loved one, things that have nothing to do with PTSD or the traumatic experience. Encourage your loved one to participate in rhythmic exercise, seek out friends, and pursue hobbies that bring pleasure. Take a fitness class together, go dancing, or set a regular lunch date with friends and family.

Let your loved one take the lead, rather than telling him or her what to do. Everyone with PTSD is different but most people instinctively know what makes them feel calm and safe. Take cues from your loved one as to how you can best provide support and companionship.

Manage your own stress. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one.

Be patient. Recovery is a process that takes time and often involves setbacks. The important thing is to stay positive and maintain support for your loved one.

Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you’ll be to help your loved one, understand what they are going through, and keep things in perspective.

Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.

Tip 2: Be a good listener

While you shouldn’t push a person with PTSD to talk, if they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. It’s the act of listening attentively that is helpful to your loved one, not what you say.

A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on.

Some of the things your loved one tells you might be very hard to listen to, but it’s important to respect their feelings and reactions. If you come across as disapproving or judgmental, they are unlikely to open up to you again.

Communication pitfalls to avoid

Don’t…

  • Give easy answers or blithely tell your loved one everything is going to be okay
  • Stop your loved one from talking about their feelings or fears
  • Offer unsolicited advice or tell your loved one what they “should” do
  • Blame all of your relationship or family problems on your loved one’s PTSD
  • Invalidate, minimize, or deny your loved one’s traumatic experience
  • Give ultimatums or make threats or demands
  • Make your loved one feel weak because they aren’t coping as well as others
  • Tell your loved one they were lucky it wasn’t worse
  • Take over with your own personal experiences or feelings

Tip 3: Rebuild trust and safety

Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves. If there’s any way you can rebuild your loved one’s sense of security, it will contribute to their recovery.

Express your commitment to the relationship. Let your loved one know that you’re here for the long haul so they feel loved and supported.

Create routines. Structure and predictable schedules can restore a sense of stability and security to people with PTSD, both adults and children. Creating routines could involve getting your loved one to help with groceries or housework, for example, maintaining regular times for meals, or simply “being there” for the person.

Minimize stress at home. Try to make sure your loved one has space and time for rest and relaxation.

Speak of the future and make plans. This can help counteract the common feeling among people with PTSD that their future is limited.

Keep your promises. Help rebuild trust by showing that you’re trustworthy. Be consistent and follow through on what you say you’re going to do.

Emphasize your loved one’s strengths. Tell your loved one you believe they’re capable of recovery and point out all of their positive qualities and successes.

Encourage your loved one to join a support group. Getting involved with others who have gone through similar traumatic experiences can help some people with PTSD feel less damaged and alone.

Tip 4: Anticipate and manage triggers

A trigger is anything—a person, place, thing, or situation—that reminds your loved one of the trauma and sets off a PTSD symptom, such as a flashback. Sometimes, triggers are obvious. For example, a military veteran might be triggered by seeing his combat buddies or by the loud noises that sound like gunfire. Others may take some time to identify and understand, such as hearing a song that was playing when the traumatic event happened, for example, so now that song or even others in the same musical genre are triggers. Similarly, triggers don’t have to be external. Internal feelings and sensations can also trigger PTSD symptoms.

Common external PTSD triggers

  • Sights, sounds, or smells associated with the trauma
  • People, locations, or things that recall the trauma
  • Significant dates or times, such as anniversaries or a specific time of day
  • Nature (certain types of weather, seasons, etc.)
  • Conversations or media coverage about trauma or negative news events
  • Situations that feel confining (stuck in traffic, at the doctor’s office, in a crowd)
  • Relationship, family, school, work, or money pressures or arguments
  • Funerals, hospitals, or medical treatment

Common internal PTSD triggers

  • Physical discomfort, such as hunger, thirst, fatigue, sickness, and sexual frustration
  • Any bodily sensation that recalls the trauma, including pain, old wounds and scars, or a similar injury
  • Strong emotions, especially feeling helpless, out of control, or trapped
  • Feelings toward family members, including mixed feelings of love, vulnerability, and resentment

Talking to your loved one about PTSD triggers

Ask your loved one about how they may have coped with triggers in the past in response to an action that seemed to help (as well as those that didn’t). Then you can come up with a joint game plan for how you will respond in future.

Decide with your loved one how you should respond when they have a nightmare, flashback, or panic attack. Having a plan in place will make the situation less scary for both of you. You’ll also be in a much better position to help your loved one calm down.

How to help someone having a flashback or panic attack

During a flashback, people often feel a sense of disassociation, as if they’re detached from their own body. Anything you can do to “ground” them will help.

  • Tell your loved one they’re having a flashback and that even though it feels real, the event is not actually happening again
  • Help remind them of their surroundings (for example, ask them to look around the room and describe out loud what they see)
  • Encourage them to take deep, slow breaths (hyperventilating will increase feelings of panic)
  • Avoid sudden movements or anything that might startle them
  • Ask before you touch them. Touching or putting your arms around the person might make them feel trapped, which can lead to greater agitation and even violence

Tip 5: Deal with volatility and anger

PTSD can lead to difficulties managing emotions and impulses. In your loved one, this may manifest as extreme irritability, moodiness, or explosions of rage.

People suffering from PTSD live in a constant state of physical and emotional stress. Since they usually have trouble sleeping, it means they’re constantly exhausted, on edge, and physically strung out—increasing the likelihood that they’ll overreact to day-to-day stressors. For many people with PTSD, anger can also be a cover for other feelings such as grief, helplessness, or guilt. Anger makes them feel powerful, instead of weak and vulnerable. Others try to suppress their anger until it erupts when you least expect it.

Watch for signs that your loved one is angry, such as clenching jaw or fists, talking louder, or getting agitated. Take steps to defuse the situation as soon as you see the initial warning signs.

Try to remain calm. During an emotional outburst, try your best to stay calm. This will communicate to your loved one that you are “safe,” and prevent the situation from escalating.

Give the person space. Avoid crowding or grabbing the person. This can make a traumatized person feel threatened.

Ask how you can help. For example: “What can I do to help you right now?” You can also suggest a time out or change of scenery.

Put safety first. If the person gets more upset despite your attempts to calm him or her down, leave the house or lock yourself in a room. Call 911 if you fear that your loved one may hurt himself or others.

Help your loved one manage their anger. Anger is a normal, healthy emotion, but when chronic, explosive anger spirals out of control, it can have serious consequences on a person’s relationships, health, and state of mind. Your loved one can get anger under control by exploring the root issues and learning healthier ways to express their feelings.

Tip 6: Take care of yourself

Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout and may even lead to secondary traumatization. You can develop your own trauma symptoms from listening to trauma stories or being exposed to disturbing symptoms like flashbacks. The more depleted and overwhelmed you feel, the greater the risk is that you’ll become traumatized.

In order to have the strength to be there for your loved one over the long haul and lower your risk for secondary traumatization, you have to nurture and care for yourself.

Take care of your physical needs: get enough sleep, exercise regularly, eat properly, and look after any medical issues.

Cultivate your own support system. Lean on other family members, trusted friends, your own therapist or support group, or your faith community. Talking about your feelings and what you’re going through can be very cathartic.

Make time for your own life. Don’t give up friends, hobbies, or activities that make you happy. It’s important to have things in your life that you look forward to.

Spread the responsibility. Ask other family members and friends for assistance so you can take a break. You may also want to seek out respite services in your community.

Set boundaries. Be realistic about what you’re capable of giving. Know your limits, communicate them to your family member and others involved, and stick to them.

Support for people taking care of veterans

If the person you’re caring for is a military veteran, financial and caregiving support may be available. In the U.S., visit VA Caregiver Support to explore your options, or call Coaching into Care at (888) 823-7458. For families of military veterans in other countries, see the section below for online resources.

Authors: Melinda Smith, M.A., and Lawrence Robinson. Last updated: June 2019.

via Helping Someone with PTSD – HelpGuide.org

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[WEB SITE] Virtual Reality + Psychiatry: VR Storytelling Could Transform Mental Health

Virtual Psychiatry

By Jeffrey Rindskopf  August 21, 2019

In the early ‘90s, psychologist Albert “Skip” Rizzo was trying to rehabilitate cognitive function in brain injury patients with workbooks and pen-and-paper exercises – tools one might expect more from a special education class than a psychiatric treatment center. Then one patient, a frontal lobe-impaired 22-year-old, came in with a Game Boy, playing “Tetris.”

“This is a guy I couldn’t motivate for more than five minutes to stay focused, but there he was lasered in on this Game Boy,” Rizzo recalls. “That was the first lightbulb that we could start using digital technology to motivate and engage people.”

He became one of many medical professionals at the time to recognize the early potential of virtual reality (VR) to help diagnose and treat a wide range of mental health issues. In 1995, Rizzo accepted a research director position at USC’s Institute for Creative Technologies to launch a new kind of cognitive rehab, supplementing the old analog and talk therapy tools with VR simulations.

“Now the technology has caught up with the vision,” he says.

So, what is the vision? Given that most health concerns are inseparable from one’s environment, Rizzo calls VR “the ultimate Skinner box,” meaning it can create safe yet emotionally evocative experiences to serve virtually any assessment or treatment approach imaginable. These therapeutic programs could be uniquely reliable for evaluating patients in the subjective world of mental health, wherein up to 85 percent of conditions can go undetected, according to the World Health Organization.

VR could bridge this gap in awareness and improve diagnoses by letting providers monitor patients’ physiological reactions to virtual scenarios, resulting in better treatment outcomes down the line. At Exeter University, a “mirror game” requiring subjects to duplicate the movements and expressions of a virtual avatar aided early detection of schizophrenia. In a similar vein, University of Oxford researchers are developing a VR-based test that gauges subjects’ reactions to neutral social situations for instances of paranoid thinking. Another study from Cambridge University diagnosed early Alzheimer’s-related spatial impairments more accurately than the current gold standard method, just by having participants don an HTC Vive and retrace their steps along an unmarked L-shaped path.

Another area where VR offers proven advantages is “extinction learning,” a method for overcoming fear and emotional trauma by gradually desensitizing one to the source of their anxiety. Though patients know these experiences aren’t real, that doesn’t change the preconscious response and fear activation of their limbic systems, manifesting in increased heart rate and production of the stress hormone cortisol. Our emotional command centers naturally suspend disbelief even when our logical minds know better, putting VR on par with real-life exposure therapy in clinical effectiveness, but with none of the travel costs or physical danger.

While early programs were calibrated to extinguish common phobias like fear of heights (balancing on a plank between skyscrapers), flying (sitting on the runway in a commercial aircraft) and spiders (progressing through increasingly realistic arachnid encounters), advancements in tech have allowed researchers to tailor more complex experiences, like crowded streets to stimulate social anxiety or traumatic memories for PTSD.

Starting in 2003, Rizzo modified a VR shooter game into an exposure tool called “BRAVEMIND” for veterans to reprocess their traumatic experiences, whether relating to IED blasts or sexual assault, with a therapist virtually recreating the memory as described.

“Most treatments out there for PTSD don’t have a lot of empirical evidence,” explains Rizzo. “The ones that do so far are ones that help a person focus on addressing the trauma, not avoiding it.”

The same principle seems to apply for another trial use of VR to treat schizophrenia. Traditionally, therapists advise patients to ignore auditory hallucinations, but a University of Montreal research team instead helped them create and interact with virtual avatars for the voices in their heads. While four of 19 subjects quit after the first session, the remaining 15 rated each interaction less frightening than the last, and their hallucination-related distress dropped an average of 5 points on a scale of 20 by the study’s end.

More recently, Rizzo and others have taken VR a step further, exploring something increasingly unheard of in American healthcare – prevention.

“BRAVEMIND” was retooled into the award-winning training simulation “STRIVE,” or Stress Resilience In Virtual Environments, preparing military members for the trials and traumas of combat before they’re deployed. Standing atop a vibrating platform in an immersive headset, recruits experience 15-minutes episodes at the midpoint of which an “emotionally challenging” event occurs based on real combat situations, such as the death of a civilian child or beating of a woman for infidelity. The scenario pauses, and a virtual “mentor” pulls players aside to help them process the event and teach physiological coping strategies, like deep breathing with a pair of onscreen lungs.

“We’re trying to engage people in stuff they normally get by way of death by PowerPoint,” says Rizzo. “We know experiential learning with a story sticks in the brain way more than somebody telling you in a lecture.”

Other psychological applications where VR has shown promise include weakening cravings that drive addiction and relapse, reducing body size overestimation in anorexia patients, imparting job interview skills to the autistic or formerly incarcerated, distracting from acutely discomforting procedures like chemotherapy and teaching mindfulness in ways that can engage and offer relief for even chronic pain sufferers. Some VR treatments are already rolling out to clinicians’ offices and consumers – “BRAVEMIND” and “STRIVE” are being donated by the charity SoldierStrong to VA offices across America, while the company Limbix offers $200 monthly subscriptions for a headset with their range of medical-grade VR apps.

Yet this ability to literally shape and heal human minds has mainly been overshadowed by commercial excitement for VR video games, not that Rizzo minds. Gaming industry investment has driven the technology to new heights in sensory immersion and new lows in cost – from $15k for a full setup in the ‘90s to $200 for a standalone headset today – giving it a clinical edge over pricier techniques like neuroimaging.

Now, however, Rizzo considers the incubation period for VR over and stresses the need to distinguish between entertainment versus health-related applications, lest business motives get in the way of credible science and set back public acceptance of the technology. There are many ethical considerations still to be sorted out as well, like ensuring providers have adequate training on the tech as well as patients’ needs and establishing safeguards for self-administered VR treatments.

“We’re not building games here,” Rizzo emphasizes, “we’re building experiences.”

But at the same time, that gaming element may be the key to VR’s revolutionary potential for healthcare. Effective treatment means nothing if people don’t use it, and the allure of VR, demonstrated time and time again in preliminary studies, could actually drive engagement and education in mental health as a whole. Just as the introduction of flight training simulators in the ‘30s led to a precipitous drop in aircraft accidents, this could be another immersive practice tool to minimize real-world distress, but with a universal scope and appeal well beyond that of any Game Boy.

via Virtual Reality + Psychiatry: VR Storytelling Could Transform Mental Health

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[NEWS] ‘Mind-blowing’: Virtual reality PTSD treatment central to launch of consortium

Col. Rakesh Jetly, chief pyschiatrist, Canadian Armed Forces, demonstrates the 3MDR system with Capt. Anna Harpe at the Glenrose Rehabilitation Hospital in Edmonton on Wednesday, Feb. 13, 2019. HiMARC’s Motion-Assisted Multi-Modal Memory Desensitization and Reconsolidation (3MDR) uses virtual reality to treat post traumatic stress syndrome. LARRY WONG / POSTMEDIA

Virtual reality to help more military and other public safety workers cope with PTSD is central to the work of a new group launched in Edmonton.

Heroes in Mind, Advocacy & Research Consortium (HiMARC) is made up of those who want “to serve the men and women in uniform who have served us and continue to serve us daily,” Bob Haennel, dean of the University of Alberta’s Faculty of Rehabilitation Medicine, said in a Wednesday news release.

HiMARC’s Motion-Assisted, Multi-Modal Memory Desensitization and Reconsolidation (3MDR) research study — the largest of its kind in Canada with 40 Armed Forces participants — allows PTSD patients to use the Computer-Assisted Rehabilitation Environment (CAREN) system at the Glenrose Rehabilitation Hospital.

“It was incredible. I don’t know how else to describe it. My senses were heightened. I was even sensitive to the clanging sound of the carabiner on my harness,” said Capt. Anna Harpe, a social worker at CFB Edmonton, after experiencing the 3MDR system.

Patients who step into the CAREN unit walk on a treadmill toward a stimulus, sounds and images that may remind them of events that trigger traumatic memories. A therapist is with them through the process, guiding the patient confronting the memories.

While Harpe does not have PTSD, she said testing the 3MDR brought back vivid recollections of a mission in Afghanistan when she was in the infantry.

“I have worked with some clients who have been diagnosed with PTSD, and I have to say, the 3MDR is mind-blowing. My whole body was activated. You just cannot get the same thing through talk therapy in an office,” she said.

Study participants are receiving the therapy once a week for six weeks.

“By walking towards the fear, there is a shift in the brain,” said Suzette Brémault-Phillips, director of HiMARC in the Faculty of Rehabilitation Medicine and co-principal investigator for the study in Canada.

The 3MDR system — developed by Col. Eric Vermetten, head of research at the Military Mental Health unit of the Dutch ministry of defence in the Netherlands — has been effective in the Netherlands where it’s been used to treat the rise in PTSD cases there after its mission to Afghanistan.

Vermetten traveled to Edmonton to train Brémault-Phillips and her team to use the system.

HiMARC’s founding members also include the Royal Canadian Legion Alberta-NWT Command, NAIT, the Department of National Defence, Veteran Affairs Canada and Covenant Health.

“HiMARC is creating hope and I am so grateful for this group. I really believe this is just the beginning,” added Harpe.

Source:
https://edmontonjournal.com/news/local-news/mind-blowing-virtual-reality-ptsd-treatment-central-to-launch-of-consortium

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[TED Talk] Rebecca Brachman: A new class of drug that could prevent depression and PTSD – TED Talk

Current treatments for depression and PTSD only suppress symptoms, if they work at all. What if we could prevent these diseases from developing altogether? Neuroscientist and TED Fellow Rebecca Brachman shares the story of her team’s accidental discovery of a new class of drug that, for the first time ever, could prevent the negative effects of stress — and boost a person’s ability to recover and grow. Learn how these resilience-enhancing drugs could change the way we treat mental illness.

This talk was presented at an official TED conference, and was featured by our editors on the home page.

via Rebecca Brachman: A new class of drug that could prevent depression and PTSD | TED Talk

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