Posts Tagged PTSD

[BLOG POST] Sleep Disorders After Brain Injury, PTSD, TBI

Why Do So Many Survivors Have Sleep Disorders After Brain Injury?

January 2018,  Written by Bill Herrin

Click Here to sign up to receive a BULLETIN monthly!!!

January’s Brain Injury Journey Bulletin dives into the new year with a topic that often keeps people up at night…sleep disorders after TBI.

Sleep. It can be elusive, and one of the most frustrating things to accomplish after brain injury – especially on a consistent basis. Quite often, sleep disorders can take hold after brain injury – and cause everything from anxiousness to feeling depressed, tired, irritable, and more. In this issue of the Brain Injury Journey Bulletin, we’re going to take a look at all the things that sleep can affect, and some ways to conquer a sleep disorder after TBI.

Tossing and Turning

When your quality of life is being affected by lack of sleep, the desperation of wanting to rest can actually hinder you from getting the rest you need. Here are some changes in sleep patterns after TBI that are quite common:

  • difficulty falling asleep easily
  • trouble staying asleep throughout the night
  • waking up very early in the morning and not falling back to sleep
  • falling asleep and awakening far later than desired
  • purposely staying up late at night to get things done

Examples are:

  • You get into bed around 10 but it takes you several hours to fall asleep.
  • You wake up frequently during the night for no major reason.
  • You wake up at 4 in the morning and cannot fall back to sleep.
  • You’re up late every night working on the computer and your partner keeps asking
    you to come to bed.

Sleep Disorders and Other Factors

There are lots of different sleep disorders, and they can involve many different parts of the brain. Here are some of the more well-known sleep disorders that people encounter: Insomnia, extreme drowsiness, altered sleep patterns and Narcolepsy. Other disorders that can directly contribute to lack of sleep are Restless Leg Syndrome, teeth grinding or clenching, involuntary movements of your arms/legs during sleep, sleepwalking, sleep apnea, etc. Other factors that can deprive you from sleep are pain, alcohol, caffeine and nicotine, depression…and naps. A poorly timed nap (late in the day) obviously can end up backfiring on you later that night! It’s best to limit the length of naps so they help you get through the day, but don’t keep you up at night.

When PTSD is involved, especially in military veterans, sleep disorders can disturb sleep to the point of a person dreading bedtime, and efforts to quiet the symptoms with drugs or alcohol can make symptoms worse in the long run. Hyper-alertness, flashbacks, or nightmares can play a big part in keeping PTSD survivors up at night.

Research has found that sleep disorders are 3 times more common in persons with TBI than the general population, that about 60% of TBI survivors have ongoing problems with sleeping, that women are more affected than men…and that aging increases the likelihood of sleep problems.

This group has been researching how people sleep, and they have collected some great information about how drug addiction and recovery can affect a person’s ability to have healthy, restorative sleep….along with addressing other sleep disorders. You can read the full guide at this link.

Better sleep?

Sleep, when achieved regularly, brings a bevy of positive side-effects, and is an essential component of mental and physical well-being. It can affect healing of the brain and body, improve short-term memory and attention, improvement of your mood, and it can even reduce physical pain. The main thing that sleep obviously provides is that you feel rested and more alert!

How You Sleep Also Matters

Being uncomfortable can affect your sleep more than you realize, too. Here’s a link to an article on WebMD.com that covers different sleep positions, and how they can help (or hinder) sleep, or even cause pain in your back, neck, etc.  Here’s the link.

Talk It Over With Your Doctor

There are plenty of over-the-counter and off-the-shelf medications specifically made to help you “catch some ZZZZZ’s” – but it’s very important that persons with brain injury talk to their doctor about the side effects of sleep medications before using any of them.

Brain injury presents a variety of issues that can cause stress, and the stress can easily parlay itself into loss of sleep. If loss of sleep is wearing you down, or slowing your recovery after TBI, you should speak with a physician right away. Once you seek medical advice, the doctor can help you discover the causes and effects of your sleep issues, and discuss all possibilities of easing the loss of sleep. From sleep labs to prescription medications, to discussing techniques for easing your mind before bedtime, your doctor will hopefully help you resolve the sleep deprivation to some degree.

Suggested Reading

The person you are with little or no sleep, versus the one you are when well rested can be like the difference in…well, like night and day! Tips for managing your sleep schedule, and how to improve it, are available in this easy-to-read tip card – available on our website. It’s titled “Sleep after brain injury”, and if you go to this link, you can get a free tip card and catalog.  Here’s the link. for the catalog & tip card. Here’s more info on the SLEEP tip card.

New Year, New Sleep Habits?

With a new year started, you can reference any issues imaginable that relate to PTSD, TBI, ABI, brain injury, concussion, and more, on Lash & Associates’ blog page. Specifically relating to the new year, realistic resolutions after TBI, here is a blog article by Donna O’Donnell Figurski that talks all about it. Here’s the link.

Knowing that stress and anxiety (after TBI) can take its toll, this blog post by Marilyn Lash and Taryn Stejskal, discusses managing stress, and the symptoms of stress that become evident when they’re taking their toll on your health and well-being. Here’s the link.

Blog Posts Galore On A Wide Range of TBI Issues

Feel free to keyword search our entire collection of blog posts, many written by well-known experts, clinicians in the field of brain injury, and also people who have survived brain injury, had family members that have a TBI, and much more. It’s a treasure trove of information that is available for FREE, 24/7/365. It’s all for you at this link!

Resolution of sleeping issues is a “2018 Resolution” for the new year that many have added to their lists to  achieve. We hope that you have a great new year, and that you rest assured…and sleep well!

 

 

 

 

via Sleep Disorders After Brain Injury, PTSD, TBI

Advertisements

, , ,

Leave a comment

[WEB SITE] ‘After, I feel ecstatic and emotional’: could virtual reality replace therapy? – The Guardian

If you’ve got acrophobia, paranoia, fear of flying, PTSD, even depression, software could soon be the solution

Virtual reality is the great hope for many mental health professionals.

 Illustration: Leonard Beard for the Guardian

Leslie Channell admits he’s not a typical case for treatment. Channell, known to everybody as Chann, is a registered pilot who served 24 years in the army working on Apache helicopters. Chann also happens to be scared of heights. He doesn’t mind flying planes or sitting on the side of the Apache with the door open; he’s just terrified of going up two or three floors of a building or driving over a bridge.

Chann is nervous; his speech is fast. He says he’s sweating. We meet at a trendy startup in Oxford, where he is about to undergo virtual-reality therapy for his phobia (although the term “virtual-reality” therapy is controversial: some say the VR is just a tool for the therapy; others argue that the virtual reality is the therapy itself). Psychologists are now trialling VR for all kinds of conditions, from phobias to pain management to post-traumatic stress disorder (PTSD).

There are two other people in the room. Cognitive-behavioural therapist Polly Haselton sits behind a curved computer screen watching Chann, occasionally asking questions. Daniel Freeman, professor of clinical psychology at the University of Oxford and one of the world’s pioneers in this field, watches Chann’s every movement. Freeman explains there are three common fears of heights: that you will fall; that what you are standing on will give way; or that you will jump, which is known as “the call of the void”. Chann’s fear is of falling.

A view of the virtual-reality therapy programme that guides patients through their fear of heights.

 The virtual reality therapy programme that guides patients through their fear of heights

A view of the virtual-reality therapy programme that guides patients through their fear of heights.

Photographs: Nowican/Oxford VR

He straps on his virtual-reality headset (also known as a head-mounted display, or HMD). Inside the headset, he will find himself fully immersed in a three-dimensional world. Today, he is going to level four of a 10-storey building in New York to rescue a kitten stranded on a branch of an indoor tree.

Chann has to use a lever to push himself on to a small platform towards the cat. He is a stocky, tough-looking man in his late 50s. But he’s not looking tough any more. His voice is rising, and he’s shaking. He edges forward along the virtual branch. In real life, his feet also move gingerly – then come to a sudden stop. His breathing becomes louder and more staccato.

“You’re doing really well,” Haselton says.

“You don’t know how difficult this is,” Chann pants. “Come here, cat.” Then he stops. “Nah, can’t get it. Aaaagh. No! Gotta come back.”

He starts again, cautiously edging forward. “Yes. Yes. Yes! No, stop Chann. Yes! Yes!” His yeses are urgent, desperate. He makes a grab for the kitten, and returns it to virtual safety.

Task complete. He takes his headset off, talking even faster. “My anxiety levels were way high. Super high.”

“We’re talking nine out of 10, 10 out of 10?” Freeman asks calmly.

“Yeah. I really didn’t want to be there. I had to think I was in a room in Oxford. ‘You’re not here, it’s all OK, do it.’”

Chann is one of a dozen people currently testing this software. (Next month, the trial is being extended to 100 people.) Already, he says, it has made a difference to his life. “Yesterday, I went on a rollercoaster with my daughter. I had never gone on one before. Not the big ones, the smaller ones, but still…” He’s spent only around 20 minutes in the virtual world today, but he is exhausted. “I was worried about coming here, and I’ve done it, and I’m buzzing. Elated.” He pauses, trying to catch his breath. “But I know in my heart of hearts, if there was a real cat on level four, I would not be going out and getting it. Polly asked me, what if it was a little baby? That would change the dynamics.”

Freeman has been working with VR for 16 years. What he loves about this therapy is its simplicity. “There are very few conditions VR can’t help,” he says, “because, in the end, every mental health problem is about dealing with a problem in the real world, and VR can produce that troubling situation for you. It gives you a chance to coach people in other ways of responding. The people I see are anxious or depressed, or worried about people attacking them, and what they’ve done in their life is retreat from the world. With VR, you can get people to try stuff they haven’t done for years – go in lifts, to shopping malls, then they realise they can do it out in the real world.”

Acrophobia, or the fear of heights, is just the start, Freeman says. He has already developed VR programs that treat people with paranoia – for example, placing them in virtual libraries, lifts or on tube trains with strangers eyeballing them. In a Medical Research Council-funded study, he used VR with 30 patients to help them re-learn that they are safe around other people.

“The results were remarkable. From just 30 minutes in VR, there were large reductions in paranoia. Immediately afterwards, more than half the patients no longer had severe paranoia. Importantly, the benefits transferred to the real world. It wasn’t a definitive study. It was small and short-term, but the results do show great potential.” The program will initially be used in NHS mental health services with a staff member present, but Freeman believes that, ultimately, it could be available commercially.

Nearly two million people sought advice for mental health issues in 2015, according to the Health and Social Care Information Centre – up from 1.2 million in 2010. Meanwhile, the number of mental health nurses fell by nearly 15% from 45,384 in 2010 to 38,774 in July 2016, according to a written parliamentary answer from Philip Dunne, the health minister. The British Medical Association recently revealed that in 2016-17, 5,876 adult patients with mental health conditions were referred to another health trust for treatment, with some patients being sent 600 miles away to Scotland. Against this backdrop, virtual reality is the great hope for many mental health professionals. Some psychologists believe they are on the brink of a VR revolution. Then again, they were saying the same thing a quarter of a century ago.

Barbara Rothbaum’s office in Atlanta, Georgia, is closed due to the impending arrival of Hurricane Irma. In between electricity cuts, I manage to speak to her at her home. Rothbaum is a professor in psychiatry, a clinical psychologist at Emory University, and the founding mother of exposure therapy using virtual reality. “We published the very first study using VR to treat a psychological and psychiatric disorder back in 1995,” she tells me. Again, it was to treat acrophobia, and the results amazed Rothbaum. “Seven out of 10 people who got the virtual reality reported putting themselves in real-life height situations afterwards.” That was when they thought they were on to something big. “We used to say: ‘We’re on the cutting edge of the lunatic fringe.’ That was our line at the time.” She laughs.

After acrophobia, Rothbaum developed a VR program for fear of flying. This was even more effective, because traditional exposure therapy (paying for yourself and a therapist to travel on a plane) is time-consuming and expensive. “I can do all that in my 45- to 50-minute therapy session, with ultimate control. So if I know they’re not ready for turbulence, I can guarantee there won’t be turbulence.”

Rothbaum then went on to do pioneering work with Iraq and Afghanistan war veterans suffering from PTSD. Before VR, veterans were confined to imaginal therapy – basically, shutting your eyes and thinking yourself back to the original situation. But now Rothbaum could recreate it for them in a controlled environment. “With PTSD, especially in military folk, they are very avoidant emotionally. With VR, it’s harder to avoid, because it is such a potent stimulus.”

Early on in her VR career, a public-private partnership between Emory University and the Georgia Institute of Technology insisted Rothbaum and her colleagues form a corporation and patent their software. The result was a company, Virtually Better, that designs environments for fellow clinicians to use. “That is my conflict of interest,” Rothbaum says. Whoever she speaks to, she instantly declares it. Does it worry her that she is responsible for the research showing how effective her own VR products are? “It has done, over the years,” she says. “One of the ways I manage it is, I disclose, disclose, disclose.”

Rothbaum is not alone. VR therapy is a small, niche world. Read the scientific papers, and the same names crop up again and again. And most of these academics are now also running commercial companies. As traditional funds dry up for universities, people such as Rothbaum are increasingly reliant on business – often their own business – for support in their research.

As it happens, Rothbaum says, she lacked the cut-throat instincts to be a good businesswoman. “A criticism of Virtually Better was that it was run more like an academic department than a business. We knew how to write grants so we’d write small business grants and enjoy collaborating rather than competing. I thought it was an interesting way to do exposure therapy and wasn’t very mercenary about it.”

Has she ever used VR to treat her own fears? “No. My fear early on was that somebody was going to make a lot of money, and it wasn’t going to be us. Actually, that is probably still going to come true. But I’ve adapted to that; it’s all right.” She’s still not rich? “Oh no, not by a long shot, no.”

Despite research showing its efficacy, the VR therapy revolution did not take off in the 1990s or the noughties. This time around, though, it looks as if it might. Mel Slater, a professor of virtual environments, shows me why. We meet in the London HQ of Digital Catapult, a government initiative to promote the digital economy. Slater hands me the headset used in the virtual psychotherapy sessions he is developing. “The VR world burst open in 2013 when this Oculus Rift was released for a few hundred dollars, compared with the next credible headset of $50,000, and now all the big companies have gone into it.”

Slater talks quietly and, facially, has a touch of Woody Allen about him. Although primarily a computer scientist, he is now largely based in the psychology faculty at the University of Barcelona. Slater is one of the most-in-demand academics in the virtual world, with an endless list of titles, including professor of virtual environments at University College London, co-founder of the company Virtual Bodyworks, and immersive fellow at Digital Catapult. He also works with Daniel Freeman on treatments for persecutory delusions and acrophobia.

Like Rothbaum, Slater is one of the early 1990s pioneers. “Nobody told me virtual reality died, so I stayed with it.” He smiles.

And had it died? “No, but for a long time people said, ‘It’s not going anywhere because it’s too expensive.’ The equipment we used at UCL cost £1m. The equipment I have in Barcelona, when I set up there 10 years ago, was £100,000. Now I can do the same thing with £3,000.”

Slater says the human reaction still surprises him. “There is some level of the brain that doesn’t distinguish between reality and virtual reality. A typical example is, you see a precipice and you jump back and your heart starts racing. You react very fast because it’s the safe thing for the brain to do. All your autonomic system starts functioning, you get a very strong level of arousal, then you go, ‘I know it’s not real’. But it doesn’t matter, because you still can’t step forward near that precipice.”

Virtual reality therapy session

Simon Hattenstone explains his problems to Sigmund Freud…

 
Virtual reality therapy session

 …then analyses himself as Freud. Photographs: Event Lab, University of Barcelona, Spain

In some ways, he says, virtual reality beats reality because it enables you to experiment in ways you can’t, physically, in real life (for example, putting people in different bodies to experience what it is like to be a different gender or ethnicity) or in situations you would avoid.

“I was in one session where the guy had such a fear of public speaking that he told us about speaking at his daughter’s wedding, and we said, ‘How old is your daughter?’ and he said, ‘Three!’ So he spoke to a virtual audience. He said: ‘I can’t do this, I’m turning bright red, my voice is an octave higher.’ The psychologist later played it back to him and said: ‘Is your face red? No. Are you speaking an octave higher than normal? No.’ The psychologist did in one afternoon what would normally take 12 weeks.”

I have seen headlines suggesting that VR can cure depression. Surely that is an exaggeration? “Cure, I don’t know,” Slater says. “But we published a study last year where we reduced the level of depression among a cohort of people through a VR intervention not that dissimilar from what I’m going to show you today. Part of having depression is that you are overly self-critical and cannot give compassionate thoughts to yourself. So in the VR, you see a crying child. Beforehand, the therapist has given you a structure of things you should say to other people in order to give them compassion. So you say these things to the child who starts looking at you and stops crying. Then, in the next phase, you are that child, so you then see and hear your previous self giving you the compassionate speech. When we gave this to a group of moderately depressed people three times, the level of depression decreased.”

I put on my headset and sit in front of a screen. The program I’m trying, called VReflect-Me, is still being developed for people with anxiety issues and depression. It is based on the notion that, when advising friends, we are often kinder and more objective than when analysing ourselves.

First of all, an avatar is created of me. Then I embody that avatar. I am in a therapy session with a psychiatrist (in this case, Sigmund Freud) and I tell him my problems. In the next stage, I embody Freud. When my head moves, Freud’s head moves; when my hands move, his move; and when I’m ready, I advise myself in the form of Freud. (Slater says that Freud is a useful avatar, because you tend to adopt characteristics of your avatar; so, if he is wise, you become more wise.)

I tell Freud I have paranoid tendencies; generally, I think I’m incredibly boring with nothing to say and hate formal social situations (not the pub), because I fear my stupidity will be exposed. More specifically, I tell Freud, I have just read comments on social media about an interview I just wrote saying that I gave my subject an easy ride. I am full of self-loathing, and feel useless at my job.

Now I switch roles, and am Freud advising me. The first time I do it, I’m too self-conscious. Slater gently suggests that I was not fully immersed. I ask if I can do it again. This time, I go for it. It might not be the way Freud would have responded, but I listen to my problems and then tear into myself – rightly or wrongly, I make a good case for not being boring, stupid and a rubbish journalist. I verbalise everything and dismiss it as solipsistic nonsense. I then return to my own avatar. “Good points. Well made,” I say to Freud. And I mean it.

When I take off my headset and leave the virtual world, my breathing is fast and shallow – not unlike Chann’s after he’d been to the heights. I feel both ecstatic and emotional. Tearful, almost. Even if it doesn’t last, it’s been a useful exercise. I might say this kind of stuff to myself in my head, but it feels different when you say it out loud.

Slater is pleased with me. “Wow! You did amazing. You said, ‘You, you, you!’ which is great.” What he means is, I successfully got out of my head and into Freud’s. It strikes me as a powerful tool for therapists. There is no way I would have said what I said, as Freud, if I was simply talking to a real person.

But I can’t help thinking I’m a relatively safe case. What if I were more vulnerable? What, for example, if I suffered from the acrophobic’s call of the void, did the VR program, convinced myself I’d overcome my phobia, went to the nearest high-rise and jumped?

Dr Kate Anthony, an expert on the use of technology in therapy and a fellow of the British Association for Counselling & Psychotherapy, stresses that technology is there to be used alongside therapy, rather than instead of. “VR is a good opportunity for helping psychotherapists,” she says, “but we’re not at a stage yet where virtual reality is going to be able to replicate a human therapist.”

It’s all very well, she adds, having software to encourage you to talk and tackle your fears, but that will take you only so far. “The VR therapist can’t respond in any meaningful way, and without that meaningful response, I don’t think the client is going to progress.”

Once VR treatments have been proven to be effective, she says, she would like to see them available on prescription. What about making them commercially available? No, she says, it’s too risky. “If we’re talking about paranoia, for example, any of these situations can trigger the client. The trouble with something like that is it could bring up all sorts of issues. I would want to see it closely managed.”

Dr Michael Madary, a philosopher and technology ethicist, and his colleague Thomas Metzinger, have drawn up a code of conduct for the use of VR, some of which addresses its use in therapy. He thinks VR can have a positive impact, but that therapists must not blind themselves to the dangers. One particularly sensitive issue, Madary says, is data. Participants in studies know their data is confidential, but that could be very different if commercial companies invest in VR therapy purely for profit. “With motion tracking, particularly facial tracking, users are going to reveal a lot about themselves – about their mental state, about how they react to various stimuli – and that data can be collected and then used as a powerful bargaining tool.”

He envisages a scenario where there is an advertisement flashed, or product placed, in the virtual world and the content creators collect the response of users to that ad based on the faces they make. “You can imagine seeing your avatar in a new jacket, for example. There will be a lot of powerful techniques that emerge in marketing, with widespread use of motion capture.”

Mel Slater accepts that virtual reality can be abused. But anything can, he says. “You can use a bread knife to cut bread or to stab someone, so any tool can be misused deliberately. This is why I think the applications in clinical psychology have to be led by people such as Daniel, who know the risks.”

Back in Oxford, Daniel Freeman is not so sure the programs need his presence to be effective. He is talking about his company Nowican, and anticipating the launch of its first product – Nowican Do Heights, the acrophobia program being trialled by Chann.

He hopes that the NHS and individual psychologists will invest in it, but believes its prime use will be for individuals seeking help. “We’re putting a virtual coach in there so you don’t need a therapist, and we’re also looking at better techniques than simple exposure.”

Is he in danger of doing himself out of a job? “No. We’re not saying it has to replace the therapist. Some people will want to talk to a therapist, and sometimes the complexity means you need a therapist. But the issue is, there aren’t enough therapists.” Freeman is hoping that, before long, we will be able to download this as an app on our smartphones.

In a world of diminishing NHS resources, Freeman regards it as a no-brainer: “I see people who have been waiting 20 years and not had a chance of seeing a therapist. The idea that we can give so many people the chance to access what the best therapists should be doing – that is really exciting.”

  • Watch the Guardian’s latest VR experience The Party, filmed from the perspective of a 16-year-old girl with autism, on our new Guardian VR app. You can download it from the Apple App Store and the Google Play Store, or watch it as a 360 video, along with other Guardian VR experiences, at theguardian.com/vr

via ‘After, I feel ecstatic and emotional’: could virtual reality replace therapy? | Technology | The Guardian

, , , , , ,

Leave a comment

[WEB SITE] Beyond VR Games – VR Techs Applied to Medical Treatment such Psychotherapy, Mock Surgery

The field to which VR is most actively applied is posttraumatic stress disorder (PTSD).

The field to which VR is most actively applied is posttraumatic stress disorder (PTSD).

Seoul, Korea – 22 November 2017 – 9:45am –Choi Mun-hee

Virtual reality (VR) is used in various areas in hospitals such as medical treatment, the education of medical staffs and the enhancement of the convenience and safety of those who visit hospitals.

According to the medical world on November 21, VR is touching various medical fields such as medical education through virtual surgery, virtual rehabilitation treatment and the like. Especially, the field of mental health medicine is garnering much attention and an exposure treatment method which treats various phobias and addictions by using VR is already in a clinical utilization stage.

An exposure therapy is a behavioral therapy that develops emotional tolerance in a deliberate and painful situation for patients suffering from psychological distress that occurs in certain situations. VR is receiving much attention from medical staffs in that it allows precise control over a situation that doctors want to expose patients to. The field to which VR is most actively applied is posttraumatic stress disorder (PTSD). VR is actively used to treat patients suffering from the avoidance and re-experiencing of traumatic situations such as war or traffic accidents and anxiety about such situations.

Gil Hospital of Gachon University will establish the ‘Virtual Reality Therapy Center’ in January of next year and treat PTSD and panic disorder patients in earnest. In the future, the hospital is planning to expand VR treatment areas to mild cognitive impairment or attention deficit hyperactivity disorder (ADHD). “In order to treat PTSD and panic disorder, patients and therapists must go to sites which trigger PTSD and panic disorder or be exposed to stimuli that spark off stress but it is practically or physically impossible,” said professor Cho Seong-jin, a professor of mental health medicine in Gil Hospital. “VR can enable patients to reach a treatment stage by repeatedly giving stimuli in accordance with patients’ conditions.”

Sejong Hospital recently launched a VR application to let patients take a tour of examination rooms, wards, the checkup center and surgery center before visiting the hospital in person. ‘Cancer Hospital VR’ App was released by Samsung Seoul Hospital. The application guides patients about the hospital’s major facilities. VR can help patients reduce their anxiety and stress by taking a look at places where they will be treated and their medical procedures. Bundang Hospital of Seoul National University came up with the results of the application of a VR video for child patients. That is to say, the hospital developed a VR video that allows children close to undergoing surgery to experience surgical procedures with “Pororo” Character popular among kids in a VR world. So the hospital could reduce children’s anxiety before anesthesia 40% in actual surgery.

Gangnam Severance Hospital which has operated a virtual reality clinic since 2005 is developing technology to manage mental health via VR in cooperation with Samsung Electronics. The hospital and the IT giant will jointly develop diagnostic kits and chairs to analyze psychological states with VR devices, a VR mental health program including psychological evaluation, education and training processes, and an artificial intelligence diagnosis system among others with the goal of commercializing them next year.

 

via Beyond VR Games: VR Techs Applied to Medical Treatment such Psychotherapy, Mock Surgery | BusinessKorea

, , , , , , ,

Leave a comment

[BLOG POST] Recognizing the Signs of PTSD After Stroke

Post-Traumatic Stress Disorder (PTSD) is a condition that runs its victims down emotionally and physically. Though most frequently linked to combat veterans and sexual-assault survivors, PTSD can present itself following any traumatic experience, and that includes medical emergencies. Following a stroke and its resulting medical treatment, it is common for patients to feel overwhelmed.

 

According to a study published in the journal PLoS ONE in June of 2013, almost one quarter of patients who survive a stroke will suffer from PTSD. Unfortunately, it is common for the symptoms of PTSD following a stroke to go unnoticed; due to the intense nature of physical recovery, the psychological hardship associated with it can lead to increased risk for heart disease or another stroke.

 

What is PTSD?

After experiencing or witnessing a traumatic event, such as a medical emergency, natural disaster, or an assault, it is difficult to adjust to everyday life again. Some people may struggle with relaxing or sleeping, have flashbacks or unsettling memories, or feel constant anxiety.

This psychological reaction is common and very frustrating. The good news is that it typically diminishes, and life returns to normal over the course of weeks or months, depending on the severity of the event. If a patient is experiencing these mental health symptoms for longer than a few weeks or months, whether constant or in waves, it is possible that they may have PTSD.

 

Symptoms of PTSD After Stroke

It is important to know the signs and symptoms of PTSD so that you can recognize them in a patient or loved one you are caring for after a stroke. Common symptoms of PTSD include experiencing a traumatic event over and over again, having nightmares, or being unable to stop thinking about it. To add to these extremely uncomfortable experiences, victims can also feel  general, unyielding anxiety and try to avoid reminders of the event that started their suffering. They can also be tortured with feelings of self-doubt or misplaced guilt after a stroke or other traumatic event, a state of hyperarousal, or feeling overly alert.

If you are worried that a patient or family member is suffering from PTSD, ask them questions such as:

  • Are you having nightmares?
  • How are you coping?
  • How does this make you feel?

These questions can help the patient discuss their symptoms and improve the likelihood of psychological recovery.

 

TIA and PTSD

Transient Ischemic Attack (TIA), also known as a mini stroke, can increase the likelihood of developing PTSD because the fear of having a stroke may become overwhelming. According to a study published in the American Heart Association journal Stroke, about one third of TIA patients develop signs of PTSD. Approximately 14 percent of TIA patients also experience a drop in physical quality of life, with 6.5 percent of patients experiencing a drop in mental quality of life.

 

Treating PTSD

There are ways to relieve the strain of PTSD. Treatment for PTSD may include medication, psychotherapy, or both. Patients experiencing signs of PTSD should see a trained and qualified mental health professional as treatments may vary from patient to patient.

Medications

A mental health provider or psychiatrist may prescribe antidepressants to patients struggling with PTSD. Antidepressants have been shown to relieve the symptoms of anger, sadness, and overwhelming worry better than other available medications.

Psychotherapy

Sometimes referred to as “talk therapy,” psychotherapy can take place in a one-on-one capacity or in a group setting. Talk therapy is the process of speaking with a mental health professional and can encompass the discussion of PTSD symptoms alone or the effect such symptoms may be having on a patient’s life.

PTSD can sometimes wreak havoc on a person’s social, family, or professional life. To help heal the damage, a mental health professional may combine multiple forms of psychotherapy to address any and all issues a patient may be having with the aftermath of a stroke or TIA. Most often, psychotherapy lasts six to twelve weeks, but it is not unusual for it to take longer to address each patient’s symptoms and struggles. Patients are encouraged to involve family and friends in their recovery because having the extra support can improve the speed and efficiency of mental recovery from a stroke.

 

Finding Relief

PTSD can plague individuals who experience or witness a traumatic event. Medical emergencies are often traumatic, so it is common for survivors of stroke to suffer from PTSD; survivors of TIA can develop PTSD because they may be scared of suffering another mini stroke or of having a full-fledged stroke.

Symptoms can be very taxing on survivors and heartbreaking for their families to see. Fortunately, there are effective treatments for PTSD, including antidepressants and talk therapy with a mental health professional. If you are experiencing PTSD, it is important that you communicate how you feel with your doctor, family, and friends, as a strong support system can help you find the relief from psychological pain that you deserve.

Source: Recognizing the Signs of PTSD After Stroke | Saebo

, , , ,

2 Comments

[WEB PAGE] What Is PTSD? – PTSD: National Center for PTSD

What Is PTSD?

PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault.

It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.

If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time.

What factors affect who develops PTSD?

PTSD can happen to anyone. It is not a sign of weakness. A number of factors can increase the chance that someone will have PTSD, many of which are not under that person’s control. For example, having a very intense or long-lasting traumatic event or getting injured during the event can make it more likely that a person will develop PTSD. PTSD is also more common after certain types of trauma, like combat and sexual assault.

Personal factors, like previous traumatic exposure, age, and gender, can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.

What are the symptoms of PTSD?

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

There are four types of symptoms of PTSD (en Español), but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

  1. Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
  2. 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.
  3. Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.
  4. Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.

Can children have PTSD?

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

  • Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
  • Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
  • Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.

What other problems do people with PTSD experience?

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

  • Feelings of hopelessness, shame, or despair
  • Depression or anxiety
  • Drinking or drug problems
  • Physical symptoms or chronic pain
  • Employment problems
  • Relationship problems, including divorce

In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.

Will people with PTSD get better?

“Getting better” means different things for different people. There are many different treatment options for PTSD. For many people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense. Your symptoms don’t have to interfere with your everyday activities, work, and relationships.

What treatments are available?

There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.

Psychotherapy for PTSD

Psychotherapy, or counseling, involves meeting with a therapist. There are different types of psychotherapy:

  • Cognitive behavioral therapy (CBT) is the most effective treatment for PTSD. There are different types of CBT, such as cognitive therapy and exposure therapy.
    • One type is Cognitive Processing Therapy (CPT) where you learn skills to understand how trauma changed your thoughts and feelings. Changing how you think about the trauma can change how you feel.
    • Another type is Prolonged Exposure (PE) where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
  • A similar kind of therapy is called Eye Movement Desensitization and Reprocessing (EMDR), which involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.

Medications for PTSD

Medications can be effective too. SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are also used for depression, are effective for PTSD. Another medication called Prazosin has been found to be helpful in decreasing nightmares related to the trauma.

IMPORTANT: Benzodiazepines and atypical antipsychotics should generally be avoided for PTSD treatment because they do not treat the core PTSD symptoms and can be addictive.

Visit Site —> What Is PTSD? – PTSD: National Center for PTSD

, , , , , , , , , ,

Leave a comment

[WEB SITE] Can caregiving lead to PTSD? – The Caregiver Space

Most people associate PTSD with veterans of war, but you don’t have to be a soldier to experience this condition.

The NIMH defines PTSD as ‘a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.’ When people experience a traumatic event, it’s common to be impacted by it with a range of emotions. People with PTSD don’t recover from this initial trauma. It doesn’t have to be triggered by a ‘dangerous’ event; many people experience PTSD after the death of a loved one or another emotionally challenging experience.

Risk factors for PTSD will sound familiar to family caregivers. They include:

  • Living through dangerous events and traumas
  • Seeing another person hurt, or seeing a dead body
  • Feeling horror, helplessness, or extreme fear
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home

You can learn about the symptoms and diagnosis of PTSD on the NIMH website.

If you think you may have PTSD, talk to your family doctor. If you aren’t comfortable seeking treatment, there are still some first steps you can take. Reducing stress through exercise and seeking out comforting situations can help you feel more secure. Get support from your friends and family, especially by letting them know what situations trigger your symptoms. Try to be realistic about what you can do each day, break up projects into small tasks, and accept that you can’t do everything. PTSD doesn’t go away overnight, but it can get better.

Here’s what some of our veteran caregivers have to say about PTSD:

After caring for my husband, for 20 years, I am afraid to answer my phone, open mail, or attend doctor appointments, fearing more bad news. I just want to hide. – Lynn R.

If you sleep with one ear open, you startle easily. Loss of sleep triggered by this startle reflex, will lead to ptsd. People who fail to understand my situation don’t believe me, but thankfully medical professionals do. – Angela M.

After 27 years caring for my very vulnerable son, I can tell you that it is indeed PTSD. For a mother, the fear of something happening to your child is much worse than anything that could happen to yourself. I have an anxiety disorder and have suffered from depression. You live in terror every time you hire a new respite worker, and only trust yourself as a caregiver. Your decisions carry so much weight that some days you feel they will crush you. – Dawn D.

Being part of caring for my MIL definitely has caused PTSD. Its a complete nightmare, and now I am scared of her! She talks about cutting people and watching them bleed! I know its the dementia, but she scares the hell out of me! I have nightmares about all of it! – Vickie B.

Anecdotally, caregivers who take care of a family member who is or has been abusive are more likely to talk about suffering from caregiver PTSD.

I’m the only child in my 50’s. My parents are near 90, refuse all outside care, cashed in their life insurance policy with not enough for burial. Now there is over 12k in medical bills and they won’t call a lawyer or approve forms for Medicaid. They say no one is putting them in a home. Mom has fallen numerous times and in nursing care and Dad signs her out. To stay out of care she shifts blame onto anyone including, and most of all, me. Agencies won’t help. Doctors quit the case. AOA said it’s one of the most difficult cases they have encountered. – Jacqueline A.

I wish my mom would understand that no one wants to help her because she is a mean old spiteful monster who has alienated EVERY one in the family to the point that they don’t even want to call to talk to her anymore. But she blames me for it! – David R.

I used to think that I would ignore my stepfather who abused me, but when it came down to it…I had to treat him better than me. – Jennifer K.

I can relate to caregiver PTSD from taking care of my mother that never took care of me & Granny that raised me! – Chrissy G.

What should you do if you feel you have caregiver PTSD?

The reason you have PTSD is because you love and you care. The key to reducing anxiety is to get out of your own head. Watch your self talk. Be kind to your mind, it does not know the difference between perceived danger and real danger….live in the moment! – Dawn D.

If you are feeling overwhelmed, you may, very well, benefit from talking with a therapist or counselor. I have learned to take time, for myself, once in a while, to spend a few hours, with friends, or even just go for a ride. I feel guilty, for even smiling, sometimes, but we have to take care of ourselves, and find ways to keep our spirits uplifted, while we care for others. For what it’s worth, I would advise you to, whenever you can, do something special, for yourself, even if it is a meal out, a movie, or just something you like. Try to interact, in a positive way, with others, and rejoin the human race. You are entitled to happiness, and, your [loved one] may even want that for you, as well. – Lynn R.

Source: Can caregiving lead to PTSD? | The Caregiver Space

,

Leave a comment

[Abstract] Systematic review: Predicting adverse psychological outcomes after hand trauma

Abstract

Study Design

Systematic review.

Introduction and Purpose of the Study

After traumatic hand injury, extensive physical and psychological adaptation is required following surgical reconstruction. Recovery from injury can understandably be emotionally challenging, which may result in impaired quality of life and delayed physical recovery. However, the evidence base for identifying high-risk patients is limited.

Methods

A PROSPERO-registered literature search of MEDLINE (1946-present), EMBASE (1980-present), PsychInfo, and CINAHL electronic databases identified 5156 results for studies reporting psychological outcomes after acute hand trauma. Subsequent review and selection by 2 independent reviewers identified 19 studies for inclusion. These were poor quality level 2 prognostic studies, cross sectional or cohort in design, and varied widely in methodology, sample sizes, diagnostic methods, and cutoff values used to identify psychological symptoms. Data regarding symptoms, predisposing factors, and questionnaires used to identify them were extracted and analyzed.

Results

Patients with amputations or a tendency to catastrophize suffered highest pain ratings. Persisting symptom presence at 3 months was the best predictor of chronicity. Many different questionnaires were used for symptom detection, but none had been specifically validated in a hand trauma population of patients. Few studies assessed the ability of selection tools to predict patients at high risk of developing adverse psychological outcomes.

Discussion and Conclusion

Despite a limited evidence base, screening at 3 months may detect post-traumatic stress disorder, anxiety, depression, and chronic pain, potentially allowing for early intervention and improved treatment outcomes.

Source: Systematic review: Predicting adverse psychological outcomes after hand trauma – Journal of Hand Therapy

 

, , , , , ,

Leave a comment

[ARTICLE] A Virtual Reality Exposure Therapy Application for Iraq War Military Personnel with Post Traumatic Stress Disorder: From Training to Toy to Treatment – Full Text PDF

Abstract

Post Traumatic Stress Disorder is reported to be caused by traumatic events that are outside the range of usual human experiences including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) exposure treatment has been used in previous treatments of PTSD patients with reports of positive outcomes. The aim of the current paper is to specify the rationale, design and development of a Virtual Iraq PTSD VR application that has been created from the virtual assets that were initially developed for a combat tactical training simulation, which then served as the inspiration for the X-Box game entitled Full Spectrum Warrior.

Introduction

In 1997, researchers at Georgia Tech released the first version of the Virtual Vietnam VR scenario for use as a graduated exposure therapy treatment for Post Traumatic Stress Disorder (PTSD) with Vietnam veterans. This occurred over 20 years following the end of the Vietnam War. During that interval, in spite of valiant efforts to develop and apply traditional psychotherapeutic approaches to PTSD, the progression of the disorder in some veterans severely impaired their functional abilities and quality of life, as well as that of their family members and friends. The tragic nature of this disorder also had significant ramifications for the U.S. Veteranes Administration healthcare delivery system often leading to designations of lifelong service connected disability status. In mid-2004, the first systematic study of mental health problems due to the Iraq conflict revealed that ?@The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent)T (Hoge et al., 2004). With this history in mind, the USC Institute for Creative Technologies (ICT) has initiated a project that is creating an immersive virtual environment system for the treatment of Iraq War veterans diagnosed with combat-related PTSD. This project has now been funded as part of a larger multi-year effort by the U.S. Office of Naval Research that brings together the technical, clinical and creative forces of ICT, Virtually Better, Inc. and the Virtual Reality Medical Center. The VR treatment environment is based on a cost effective approach to recycling virtual graphic assets that were initially built for a combat tactical simulation scenario entitled Full Spectrum Command, which later inspired the creation of the commercially successful X-Box game, Full Spectrum Warrior. This paper will present the vision, rationale, technical specifications, clinical interface design, and development status of the Full Spectrum PTSD treatment system that is currently in progress at the ICT.

Download PDF file

, , ,

Leave a comment

[WEB SITE] Brain Training And The End Of The Prozac Generation

More than 20 percent of Americans regularly consume prescribed drugs related to mental health issues, earning contemporary America the nickname, “the Prozac Generation.”  However, developing safe, targeted, and effective drugs for mental illnesses has increasingly become a struggle for the pharmaceutical industry.

As a result, there’s been a gradual withdrawal of research dollars from this area, despite the fact that globally, the mental health pharmaceutical market is worth more than $80 billion.

According to the National Institute for Mental Health (NIMH), more than 57 million people, or 26 percent of the U.S. population suffer from some form of mental health problem. But despite the ongoing need, one can legitimately claim that research has not produced a novel neurological drug in the past 30 years.  Additionally, many drugs currently on the market have been increasingly identified with negative side effects and limited efficacy.

Until recently, most mood disorders were attributed to an imbalance in a single neurochemical, such as serotonin. Increasingly, scientists have come to acknowledge that this is an oversimplification that can lead to counterproductive treatment.

Due to the complexity of brain networks, these pharmaceutical compounds may work to alleviate some symptoms, but they may exacerbate others. They may even contribute to new problems, such as cognitive impairment, suicide, or diabetes. Because the diagnosis of many conditions is a highly subjective process based on patient self-reporting, identifying the appropriate course of treatment is frequently an exercise in trial and error.

High cost, negative press, and the lack of an efficacy model have resulted in the drying up of the drug pipeline for pharmaceutical treatment of mental illness.

Are we moving into a post-pharmaceutical age in the treatment of neurological and psychiatric illness? If the flurry of wearable sensors, brain-computer interfaces, and non-invasive brain stimulation research are any measure, then the answer is “yes.”

 Brain training and the end of the Prozac generation

Brain training can be used to treat problems related to cognition, behavior, and emotion. (Image Source: Evoke Neuroscience)

New technology and an increased focus on traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), have led to a greater understanding of the complexity of the brain. Instead of focusing on single chemical neurotransmitters affecting cognition and behavior, mental health research has evolved to address neurological “functions” through models of neural circuits known as “neural networks.”

Continue –> Brain Training And The End Of The Prozac Generation.

, , , , , , , , , ,

2 Comments

[WEB SITE] Emotional Problems After Traumatic Brain Injury

Brain injury and emotions

A brain injury can change the way people feel or express emotions. An individual with TBI can have several types of emotional problems.

Difficulty controlling emotions or “mood swings”

Some people may experience emotions very quickly and intensely but with very little lasting effect. For example, they may get angry easily but get over it quickly. Or they may seem to be “on an emotional roller coaster” in which they are happy one moment, sad the next and then angry. This is called emotional lability.

What causes this problem?

  • Mood swings and emotional lability are often caused by damage to the part of the brain that controls emotions and behavior.
  • Often there is no specific event that triggers a sudden emotional response. This may be confusing for family members who may think they accidently did something that upset the injured person.
  • In some cases the brain injury can cause sudden episodes of crying or laughing. These emotional expressions or outbursts may not have any relationship to the way the persons feels (in other words, they may cry without feeling sad or laugh without feeling happy). In some cases the emotional expression may not match the situation (such as laughing at a sad story). Usually the person cannot control these expressions of emotion.

What can be done about it?

  • Fortunately, this situation often improves in the first few months after injury, and people often return to a more normal emotional balance and expression.
  • If you are having problems controlling your emotions, it is important to talk to a physician or psychologist to find out the cause and get help with treatment.
  • Counseling for the family can be reassuring and allow them to cope better on a daily basis.
  • Several medications may help improve or stabilize mood. You should consult a physician familiar with the emotional problems caused by brain injury.

What family members and others can do:

  • Remain calm if an emotional outburst occurs, and avoid reacting emotionally yourself.
  • Take the person to a quiet area to help him or her calm down and regain control.
  • Acknowledge feelings and give the person a chance to talk about feelings.
  • Provide feedback gently and supportively after the person gains control.
  • Gently redirect attention to a different topic or activity.

more –> Emotional Problems After Traumatic Brain Injury.

, , , , , , , , ,

Leave a comment

%d bloggers like this: