Tuesday, 15 March 2011

Veteran Affairs Launches New PSA on Suicide Prevention for Veterans

God Bless the U.S. Department of Veteran Affairs, who recently launched a 24/7 confidential crisis line for veterans.  Already 13,000 actively suicidal veterans have been rescued!

March 15, 2011

VA Launches New PSA on Suicide Prevention for Veterans
Confidential Crisis Line Provides 24/7 Access to Help
WASHINGTON – The Department of Veterans Affairs (VA) is reaching out to Veterans in crisis and their families in a new public service announcement to raise awareness about suicide prevention resources, such as the Veterans Crisis Line at 1-800-273-TALK (8255)
As more Veterans return from Iraq and Afghanistan, the critical need for mental health care is rising,” said Sonja V. Batten, assistant deputy chief patient care services officer for mental health.  “VA is increasing its efforts to reach out to Veterans in need and their families, to inform 
them about available services and programs.”

The new television spot encourages Veterans in crisis to call the crisis hotline number at 1-800-273-TALK (8255) and then push 1 on their telephone keypad to reach a trained VA mental health professional who can assist the Veteran 24 hours a day, seven days a week.  
Suicide is preventable,” said Batten. “Every Veteran suicide is tragic and regardless of the numbers or rates, one Veteran suicide is too many.  We feel the responsibility to continue to spread the word throughout the nation that suicide prevention is everyone’s business.”
So far, more than 379,000 people have called the hotline, and more than 200,000 of these callers have identified themselves as Veterans, family members or friends of Veterans. The hotline has led to more than 13,000 rescues of actively suicidal Veterans.

The hotline also operates an online Veterans Chat program, which provides Veterans, their families and friends with the ability to communicate anonymously online in real-time with a trained VA mental health professional.  Veterans Chat can be accessed through the National Suicide Prevention Lifeline’s web page athttp://suicidepreventionlifeline.org/Veterans/Default.aspx.
Through the hotline and Veterans Chat, VA can connect Veterans and their families with important services, including suicide prevention coordinators, as well as general inpatient and outpatient psychiatric services at VA medical centers and community-based outpatient clinics. 
The hotline, which is part of the National Suicide Prevention Lifeline, was started in 2007 as a partnership between VA and the Substance Abuse and Mental Health Services Administration (SAMHSA).  

Monday, 14 March 2011

Charlie Sheen and Post Traumatic Stress Disorder...

I promised myself I wouldn't follow the "Charlie Sheen Circus", but here I am, analyzing his behaviour in my unprofessional blonde manner - it's simple:  he shows the classic symptoms of ptsd.  Obviously, none of his former treatment has addressed his early traumatic experiences which is why he's still hooked on destructive outbursts and negative conduct.

Charlie, do yourself a flavour: and all those who love you and need you (kids): get help.  Call Dr. Phil, seriously Dude.

A Private Security Contractor: Just my Humble Opinion....

I am a combat veteran.
Everyday, I live, I breathe, and I think Iraq. I think of every aspect of that place. It is my life...more so than many of the so-called experts who rant and rave about it. I have walked the streets of downtown Baghdad, I have trudged through the darkness that so much of my life has seemed to become. And I am frustrated. It is hard to battle on behalf of the ungrateful, the misled and the uninformed.

The Iraqis and the rest of the World are just as guilty as the Americans in this. It infuriates me to no end to have tried so hard, to have put myself and the ones I have led into the line of fire in danger...and now know that I have been forsaken by the ones I am here to save. They turned their heads when I asked questions. They would say, "there are no terrorists and still no freedom". Unfortunately, the Iraqi people only responded to force, violence, dominance...it has been their life for so long. Our cultures and religions alone only widen the gap between our struggles over there.

Those of us who have stepped up to fight, are few...the Army and police there are small, and struggling to grow. They encouraged and endorsed Security Contractors, like myself, to do the job with them. We were the hope of a nation ever leaving our control. We were their saviors ..........all the way to their detriment.

But more than anyone, I sometimes see futility in my actions. I fight, I kill, I scar myself emotionally, psychologically, and in some ways physically...and as I lay in the dark at night, I wonder what it was all for. Fortunate or unfortunate, you decide. I was marked to see the face of satan during my tour. I wonder if the Iraqi people will ever get it together or if the country will collapse on itself whether I was there or not. It makes me angry, and a big part of me is content to let it fall apart. Part of me doesn't care what happened to that God-forsaken city after I left it.

I came away knowing one thing:  Freedom isn't free: You fight for it.  You must be prepared to die for it.  Everyday that we are over there in the stench, the chaos, the hell, we are there to show the meek, the mild, the children, the women, the oppressed, that we are there to liberate them. As is the motto of my old Special Forces Unit, the 19 SFG(ABN) : DE OPPRESSO LIBER ...look it up.

Symptoms of PTSD Following a Shooting or Explosion while in combat:

There are a number of traumatic situations and events that can lead to the development of Post Traumatic Stress Disorder or PTSD. However, exposure to a shooting or explosion may place someone at a particularly higher risk for developing symptoms of PTSD, then say a person watching a building burn down or a person seeing a fatal accident.
Exposure to an explosion and/or shootings, can be particularly difficult to cope with for a number of reasons:

  1. In combat, when the potential for traumatic devastation is eminent and explosions and shootings are expected and anticipated, they are however, unpredictable. 
    With that being said, situations that are perceived as unpredictable are much more likely to bring on high levels of helplessness, anxiety, and fear. 
  2. The more frequent the explosions and shootings are the more intense the symptoms will become. (I lived through 6 explosions in Iraq. Twice my vehicle rolled. Each time the panic and anxiety intensified ten-fold).
  3. In addition, situations like this may leave a person feeling as though there is nothing they can do to protect themselves in the future or that their security awareness zone increased as their personal safe space has decreased.
  4. During an explosion or shooting, there is an extreme threat to a Combat Veterans life. This can drastically change his or her outlook on life. Even though in combat one is trained to expect the unexpected, in terms or life and death situations, the human mind still clings to a commonly-held assumption that we are safe, or beliefs like "bad things won't happen to me."  It is then that the combat veteran's perception of the unexpected and anticipated become destroyed and questioned.
  5. In addition to feeling as though your own life is in danger, during an explosion or shooting, a Combat Veteran is more likely to be exposed to the death or injury of others. This may bring up feelings of horror, magnifying the impact of this type of traumatic event.
In the aftermathof a explosion or shooting, a combat veteran will usually experience a number of symptoms that would be considered part of an acute stress or PTSD. Some of these stressors or triggers may be: (Note: these are only some of the symptoms that may arise following an explosion or shooting . It is also not uncommon to experience symptoms of depression and worry.)
  • Frequent and intense nightmares about the event.
  • Intrusive thoughts or memories about the explosion or shooting that are easily triggered by things in your environment (for example, newspaper or television news articles, television shows and movies, conversations about combat or war).
  • Attempts to avoid triggers that remind you of the explosion or shooting . This may especially be the case for places where you feel you could be in danger of experiencing a similar event again (for example, unfamiliar places or crowded places, noisy places).
  • A high level of fear and anxiety upon hearing sounds that are similar to an explosion or shooting. (such as a car backfiring or fireworks.)
  • Feeling constantly on edge or always on guard, almost as if there is danger lurking around every corner.
  • Insomnia and having difficulty sleeping. (For example, you may feel overly alert, and as a result, wake up in response to even the slightest of sounds or smells.)Click Here!


My Safe Haven...a Poem for all veterans

What secret Heaven would it be
To lay my heavy head upon the 
Beautiful breast of a lady kind and warm
To let my  hot tears flow onto her chest
As she stroked her fingers on my  brow
And whispered that I was safe from harm

To know that no matter what I told her
Of the things I have had to do
She would love and comfort me
With a heart strong and true

I am not that person who pulled the trigger
And shot that little boy
Neither am I the being who polished my gun
And called it my favourite toy

I did what I was called to do 
In the name of Freedom and Glory
And now that it's over they tell me
Not to worry...

I am forever changed:  their faces 
Come to me at night and haunt me
I call to God for forgiveness and to the 
Devil not to taunt me

She kisses my forehead and tells me
To let it be
But I can't, it's in my veins, my thoughts
And everyone I see

So this is what I must live with
It is the price I must pay
To know that she and you are safe
In this world that winds away...

Sunday, 13 March 2011

General (Civilian) PTSD compared to Combat PTSD

It is imperative to respect and recognize the fundamental differences between General post-traumatic stress disorder (found in the civilian population) and Combat post-traumatic stress disorder. General PTSD is experienced by infants, children, adolescents and adults in civilian environments, while Combat PTSD is experienced by military personnelprivate military contractors, employees of NGOs, medical staff and administrative staff in combat environments or environments where armed conflict is prevalent.

Although both general PTSD and combat PTSD survivors experience trauma, the reactions, symptoms and responses differ according to the nature of the traumatic event experienced.

Post-traumatic stress disorder (PTSD) is an anxiety disorder which is triggered by a traumatic event. PTSD presents itself when a person has experienced or witnessed a life-threatening situation, extreme fear(terror), shock or horror. 
PTSD symptoms may present themselves most often within 3 months of the traumatic event. Some cases of PTSD only present themselves years or decades after the original event.

Traumatic Brain Injury and Combat PTSD

Traumatic Brain Injury (TBI), occurs from a sudden blow or jolt to the head.  Brain injury often occurs during some type of trauma, such as an accident, blast or a fall. Often when people refer to TBI, they are mistakenly talking about the symptoms that occur following TBI.  Traumatic Brain Injury is the injury, not the symptom.

How serious is my injury?
A TBI is basically the same thing as a concussion. A TBI can be mild, moderate, or severe. These terms tell you the nature of the injury itself. They do not tell you what symptoms you may have or how severe the symptoms will be.
A TBI can occur even when there is no direct contact to the head. For example, when a person suffers whiplash, the brain may be shaken within the skull. This damage can cause bleeding between the brain and skull. Bruises can form where the brain hits the skull. Like bruises on other parts of the body, for mild injuries these will heal with time.
About 80% of all TBI's in civilians are mild (mTBI). Most people who have a mTBI will be back to normal by 3 months without any special treatment. Even patients with moderate or severe TBI can make remarkable recoveries.
The length of time that a person is unconscious (knocked out) is one way to measure how severe the injury was. If you weren't knocked out at all or if you were out for less than 30 minutes, your TBI was most likely minor or mild. If you were knocked out for more than 30 minutes but less than 6 hours, your TBI was most likely moderate.
What are the common symptoms following a TBI?
Symptoms that result from TBI are known as post-concussion syndrome (PCS). Few people will have all of the symptoms, but even one or two of the symptoms can be unpleasant. PCS makes it hard to work, get along at home, or relax. In the days, weeks, and months following a TBI the most common symptoms are:
feeling dizzy
being tired
trouble sleeping
vision problems
feeling bothered by noise and light

Cognitive (Mental)
memory problems
trouble staying focused
poor judgment and acting without thinking
being slowed down
trouble putting thoughts into words

Emotional (Feelings)
anger outbursts and quick to anger
anxiety (fear, worry, or feeling nervous)
personality changes

These symptoms are part of the normal process of getting better. They are not signs of lasting brain damage. These symptoms are to be expected and are not a cause for concern or worry. More serious symptoms include severe forms of those listed above, decreased response to standard treatments, and seizures.

Do I have the symptoms that follow a TBI or PTSD - or both?
You may notice that many of the symptoms that follow a TBI overlap with the common reactions to trauma. Because TBI is caused by trauma and there is symptom overlap, it can be hard to tell what the underlying problem is. In addition, many people who get a TBI also develop PTSD.
It is important to be assessed because:

  • people with TBI should not use certain medications
  • no matter how mild or severe the injury itself was, the effects could be serious

Although TBI screens are used, a screen is not used to diagnose TBI. Even if your TBI screen is positive, that does not mean that you have a TBI. It means that you should be assessed further.
Diagnosing a TBI is hard because there may not be any physical signs of injury. Details of the trauma may be hard to pin down. Sometimes right after the injury the effects are so brief that they are not noticed. You may go to the doctor some time later when details of the injury are not as clear. TBI can occur in confused times of crisis, such as combat. In the heat of events the injury may be ignored. Many of the symptoms that can result from a TBI are the same as the symptoms of PTSD. For these reasons, the best way to diagnose a TBI is an interview by a skilled clinician.
Are there effective treatments?
Many people recover from TBI without any formal treatment. Problems that linger may clear up in a few weeks. You may notice some problems more as you return to your normal routine. For example, you may not realize that you get tired more quickly until you return to your regular chores, work, or school. Even so, people usually get better after a head injury, not worse. Professional treatment for the symptoms that follow TBI usually involves rehabilitation to improve functioning.
To treat TBI and PTSD, the good news is that effective treatments for PTSD also work well for those who have suffered mTBI. This includes two forms of therapy: Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE).
What can I do to cope?
The best way to deal with symptoms following TBI:
  • go back slowly to your normal routine, a little at a time. How much time you spend at work, with family, with others, or exercising depends on what feels comfortable. 
  • Pace yourself, and be sure to get all the rest you need. 
  • Avoiding alcohol and not taking any unnecessary medications is a good idea, to help allow the brain to heal.
If your symptoms get worse, or if you notice new PCS symptoms, this is a sign that you are pushing yourself too hard. Ignoring your symptoms and trying to "tough it out" often make the symptoms worse. Symptoms are your body's way of giving you information. A broken bone or a torn muscle hurts so that you won't use it and it has time to heal. PCS symptoms are your brain's way of telling you that you need to rest it.
Research suggests that 1 week of relaxing at home and then a week of slowly doing more after leaving the hospital is best for most patients. Most patients who took this advice were back to normal at work or school in 3-4 weeks. Most patients who weren't told what to do took 5-12 weeks to get back to their normal routine. They also had more PCS symptoms than patients who returned slowly to their routines.
Accept and deal with the stress of the injury
Be aware that having a head injury adds more stress to your life, not just bumps and bruises to your head. The trauma itself, being in the hospital, and going back to work or school and normal routines are all things that add stress to most patients' lives. You may have some trouble with work or school at first, and even though it is normal, this may be stressful and frustrating.
Another main cause of stress after a TBI is worry about the symptoms you have. Thinking and worrying about your symptoms can make them seem worse. Doctors who treat TBI agree that the single most important factor in recovery is that you know what to expect and what to do about the symptoms. You should remember that the symptoms are a normal part of getting better. They will likely go away on their own.
Involve Family
Any level of TBI can disrupt families. Roles and responsibilities change when a family member is hurt. From the start, families needs to be involved and informed about TBI. By supporting the family, patient outcomes can be improved and burnout prevented.
Return to school or work slowly
Returning to school or work is often the biggest challenge after TBI. This is because PCS symptoms can get in the way of meeting your work and school demands. For example, trouble focusing and memory problems may make it harder to learn new things in school. Or fatigue may limit your being able to handle work demands. Keep in mind when trying to return to work or school that the process will be slow. Don't expect yourself to perform right away as you did before your TBI. Instead, you should slowly resume responsibilities as you are able. Slowly increase your workload and hours. Only increase them when you feel fully ready.
TBI and Veterans
The conflicts in Afghanistan and Iraq (OEF/OIF) have resulted in increased numbers of Veterans who have TBI. The main causes of TBI in OEF/OIF Veterans are blasts, motor vehicle accidents, and gunshot wounds. The Department of Defense and the Defense and Veteran's Brain Injury Center estimate that 22% of all OEF/OIF combat wounds are brain injuries. This is compared to TBI in 12% of combat wounds that occurred in Vietnam.
Veterans seem to have symptoms for longer than civilians. Some studies show most will still have symptoms 18-24 months after the TBI. Also, many Veterans have more than one medical problem, including: PTSD, chronic pain, or substance abuse. From 60-80% of service members who are hurt in other ways by a blast may have a TBI. These other problems make it harder to get better from any single problem. Veterans should remember, though, that their TBI symptoms are likely to last only a limited time. With proper treatment and healthy behaviors, they are likely to improve.

Veteran Affairs (VA) is working to make sure that TBI care is easy to access. VA is using a TBI screening tool to begin the assessment process. VA has put in place the Polytrauma System of Care to treat Veterans with TBI who also have other injuries. Veterans with the most severe wounds are being treated at one of the 4 Polytrauma Rehabilitation Centers or one of the 21 Polytrauma Network Sites. Patients with less severe wounds may get treatment at local VA Medical Centers. No matter where a Veteran goes first, there is no "wrong door" for treatment.