ptsd Iom Ptsd Report

[Former Member]

http://vawatchdog.org/07/nf07/nfMAY07/nf050907-1.htm

Larry Scott doesn't have the actual report yet-but stated:

"This is the report the VA didn't want," said Larry Scott, founder of the group VAWatchdog.org, who applauded the conclusions. If the IOM's recommendations are implemented, he said, they will cost VA "billions of dollars -- more staff, more staff training, more data collection, more clinical evaluations and higher awards."

[Jay Johnson]

The findings were posted in another thread and were quite favorable for vets with PTSD. Every time the VA goes on a witch hunt for PTSD they get burned....one wonders when they'll learn to cut their loses whilst they're ahead:-)

[SLEDGE]

Has anyone seen the results of the study that connects higher than average hormone levels and above average intelligence with the propencity to develop PTSD?

In other words, are the troops most likely to develop PTSD the ones that are the most desirable for the armed forces to enlist in the first place?

Could some kind of anti-hormone therapy cut down on the number of cases of PTSD in the first place?

Could some kind of anti-hormone therapy be combined with other therapies to help reduce the effects of trauma, after the fact?

Should the government stop bitching about the number of PTSD cases and start working on a 'cure'?

sledge

[Pete53]

Sledge:

I don't have PTSD although I screen for it but I do have Panic Disorder sort of a relative of PTSD. I share a lot of the PTSD symptoms. Looking back my Dad had PTSD he served in WW2 and had purple heart and bronze star with valor.

Ok here is the point. To acquire PTSD something has to happen. It has to be triggered and once it is triggered and the patient has PTSD they got it for life. Meds and treatment can help. My experience is that you have to study and learn and than deal with it.

Is it caused by hormones and could you take a pill that would stop it from happening who knows. I believe in my heart I would not have acquired Panic Disorder if I was not drafted and torn away from my family.

My brother has raging PTSD. The VA knows it and he knows it but there is not a chance in hell he will ever get full benefits. He currently lives in Mexico on a pension for war time and is very happy with it.

I think that there is a link to family but it still takes a traumatic event to cross the wiring and start PTSD in my opinion.

[Jay Johnson]

I have a degree in this field and I'm working on a degree in psychology at the moment, so I'll tell you what I know:

Pete is right, to an extent. Hormones don't "cause" PTSD, nor do they continue symptoms (though they play a role). It's a very complex issue dealing with a lot of fancy terms like classic conditioning, autonomic nervous system, etc.. But, to simplify, something has to happen (as Pete stated), this, in turn, leads to a memory, but not of the ordinary variety. Memories associated with traumatic experiences are stronger (flash bulb memory) because hormones are stimulated at the moment of the trauma, which force a stronger imprint on the brain (think of a normal memory as a love tap and a PTSD memory as a punch in the face). These memories are coupled with autonomic response (fight or flight), which put the body in states of excitement (floods of hormones that amplify feeling/mood and cause severe anxiety).

Drugs like lexapro hinder serotonin, which negates some of this "excitement" and keeps you more "even", but it's like a bandaid on a broken arm; it doesn't really "fix" anything. Hallucinations, on the other hand, are linked to dopamine levels in the brain to which most antipsychotics level out as well, but, again, it's not a fix.

To "fix" PTSD one would need to unlearn the event, which is impossible. So, we instead try to reduce the impact of the event by therapy, drugs and, most importantly, time, but none of those are cures. To use the broken arm analogy again, it's like permanently putting the broken arm in a sling and giving the patient pain meds....it will make life much easier, but, unless you reset the arm and "fix" the problem, you'll always have that broken arm.

That's the short version of PTSD:-) The real key to PTSD is not hormones (that's more of a side effect); rather, it's in our learning process and how we adapt to situations (classic conditioning type stuff). A great example of this type of conditioning is when you touch a hot stove......we know to be extremely cautious around a hot stove, despite only being burned once; so, statistically speaking, why do we exercise caution evey time we touch a stove? Now, what if you were "burned" in combat (burned being loosely used for rape, death, shot, etc)? This would translate to a fear of people even though 99.9% of the people you meet are good, just as 99.9% of the stoves are cool, but our bodies still tell us to stay away and be cautious. This is compounded by an overreaction of chemicals in the brain that over-exaggerate the situation and leads us to want to "fight" (lash out, yell, etc) or "flight" (hide, retreat, suicide, etc).

Anyway, that's PTSD in a nut shell.....If I can clear it up further, please ask...it's kinda tough to break it down like this without specifics:-)

[SLEDGE]

OK Jay,

Let's take this to email or some kind of messaging.

I have an idea.

sledge twkelly4@yahoo.com

[Jay Johnson]

Not really much else to say, but if you want to discuss something you can email me at jay_1699@hotmail.com. But, this wasn't off topic, so I don't see why we couldn't discuss it here. You cited a study on PTSD and so I gave some medical background on PTSD in order to debunk it. "Research" in the field of psychology is limited at best, so it's better to educate oneself on what, exactly, PTSD is to better weed through what can often be very misleading evidence on psychological disorders.

And just to give you a reference point on why this type of research is sketchy at best: A "good" experiment typically involves what researchers call a "representative sample" of people. This sample is anywhere from 100 to a couple thousand strong and typically comes from a single community. Now, ask yourself this - If you were to ask 500 wealthy people from San Francisco a given question, do you think they would "represent" 500 poor people from a predominantly black neighborhood in Alabama? Not a chance! And this is in the same country.....think about asking a sample of Americans as compared to Iranians, Chinese, tribal Africa, etc..

Right off the bat I would question how this study you're talking about came to determine the IQ of its representative sample...do you know that some researchers believe there are several forms of IQ? How do hormones relate to sex characteristics? Are the results the same for females and males? Are the more intelligent service members just more likely to report their PTSD, or do they actually get PTSD more often; how could you even measure that if the lower IQ members aren't reporting their symptoms honestly? Was this research done using self-reporting statements (which many are and they are useless imo), or did they actually do field or clinical studies?

The point is that most studies are overly generalized, yet try to make specific claims and, from the sound of it, this is one of those pieces of research. This is not uncommon at all by the way....how much do we here on TV that obesity causes diabetes, heart disease, etc? Now, even a basic knowledge of physiology tells us that obesity has NOTHING to do with heart disease, diabetes, or any other disease...it is simply the act of taking in more calories than the body burns, thus depositing fat stores. However, how one becomes obese CAN **contribute** to various diseases (IE - if you got fat eating sugary donuts, you have an increased risk for diabetes), but, even in this case, it does NOT cause disease as many lead us to believe. So, having that basic knowledge of anatomy allows one to sift through the nonsense in order to get a real idea of how to eat healthy....this is why I listed the PTSD stuff; so people can look at a study and think, "this doesn't seem to make sense...it's overly generalized".

But, if it's emails you want, so be it:-)

Edited May 10, 2007 by Jay Johnson (see edit history)

[Pete53]

My experience with Anxiety is I learned a lot more form people who have it than I ever did from Doc's. In fact the so called experts are so busy talking that they rarely listen. This is a general observation and not a refutation of what Jay has to say.

I also learned in my experience that a lot of people think that they have it and don't. Its actually one thing to get a little nervous about going over a bridge and being petrified and drive 100 miles out of your way to avoid the bridge.

I have long since quit trying to explain what my syndrome is like. I find that people like me understand and people that are not afflicted have a hard time getting a grasp.

Jay I hope that you are able to finish up your studies and being empathetic to your wife is a big help.

One last question do you know of a cure for PTSD or is the best shot just a remission or low symptoms?

My cure and salvation has been Xanax. I am pretty sure that without it I would not be here.

[Pete53]

Sledge:

Going to email deprives a lot of people of a chance to learn or comment on a subject that may interest them.

Of course anyone who wants to can always avail themselves of using PM or email but I think that posts help a lot of people and email only helps one.

[Jay Johnson]

One last question do you know of a cure for PTSD or is the best shot just a remission or low symptoms?

My cure and salvation has been Xanax. I am pretty sure that without it I would not be here.

It really depends on your definition of "cure". One can get their symptoms to a point in which they have little or no impact on their lives, so I guess you could call that a cure; however, they typically still have nightmares, anxiety and other symptoms, but they've learned to control them better.

The problem with throwing around "cure" (and I don't mean this against you in any way..more of a VA tactic) is that it makes one think that the affliction is entirely gone. What I've noticed, even in the most improved of people with PTSD, is that any gains are largely dependent on their surroundings. A vet may be able to live a somewhat normal life, after being 100% PTSD, but that life usually doesn't include work (or, at least, the dependency of work). Once you place that veteran, or anyone else with PTSD, back into a high stress situation there's a fairly high chance for a relapse.

As for xanax - My wife just started on xanax about 8 months ago and has done quite well. She's on the slow release kind (1mg x4 day) and it seems to keep her more "even" than any other anxiety med she's tried (and she's tried them all). Also, it doesn't make her tired, which was a common side effect of previous drugs.

Right now, she's on a combo of Xanax, Lexapro and Serequil with ativan as a PRN med. This combination seems to be the most effective to date, which is great.

By the way, I'm not a huge fan of psych docs either; despite wanting to go into the field. If anything, the lack of good, caring psychs is WHY I want to learn more and pursue the field. The problem, as I see it, is that those docs feel a need to "make you better" and psychology simply doesn't work like that. They often set goals that are too high and down-play serious symptoms.

One of the better psychologists that my wife saw was in a VA hospital. They brought the psych in JUST for her from a city about 1 hr away (Baltimore). The psych specialized in sexual trauma and was quite candid with her. Rather than do the typical "we'll get you all better" nonsense, she told my wife that we should "shoot" for getting 10% better and ultimately hope for a slight increase in quality of life. There was no push for her to work, or rejoin society immediately. It was the first time my wife said, "someone finally understands".