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PTSD and sleep disruption: Which to tackle when?

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Filed under: PTSD, Sleep
In this article, learn how to decide on the order in which to pursue treatment options when you’re experiencing both PTSD symptoms and sleep disruption.

PTSD and insomnia often are connected. And while there are effective treatments available for both, deciding the order in which to tackle them can feel like a challenge. Is it better to treat the PTSD first in the expectation that addressing the PTSD will improve your sleep? Or is it better to treat your sleep issues first to help with later treatment of PTSD? Or is it possible to do both at the same time? In this article, guest experts discuss these three options to inform your decision on how to seek treatment for PTSD and insomnia. Read more...

Mindfulness in military environments

Filed under: Mindfulness, PTSD
Find out how practicing mindfulness can be useful in combat and austere environments.

Mindfulness training, or the practice of training your mind to stay in the present moment, offers many benefits, particularly for Service Members. These vary from pain and stress management related to post-deployment and post-traumatic stress disorder (PTSD) to supporting improved emotional states and emotion regulation. Mindfulness training also can enhance your ability to perform optimally in military environments—in garrison, during training, or in theater.

Mindfulness training cultivates your ability to focus on what’s happening internally in your surroundings. Mind-wandering, worrying about what’s coming down the pipeline, or even trying to evaluate what happened in the past can keep you from attending to details critical for the present. A mindfulness practice also encourages you to experience a situation without judgment (thinking, “This is neither good nor bad”) and with acceptance (thinking, “This is what’s happening right now”). 

In garrison or during dwell times, mindfulness can help you cultivate stronger relationships with friends and family and make the most of your time to recover and restore energy. Warfighters lead busy lives, and time with loved ones can feel limited. Mindfulness helps you maximize those precious moments and cope with difficult emotions that can impede communication and intimacy.

Mindfulness during training

In training environments, mindfulness helps Warfighters stay safe while acquiring new skills and tactics. It also aids with their memory and recall on difficult tests and qualifications. For example, Warfighters need to be able to block out distractions and tune into their physiology to obtain optimal performance in shooting tasks for weapons qualifications. Managing your mind-and-body experience of performance anxiety during the evaluative stages is critical for being able to shoot a weapon with accuracy and consistency.

Mindfulness in theater

Your situational awareness is enhanced by mindfulness in a combat environment too. Mind-wandering and judging an experience can create unnecessary stimuli that interfere with your ability to connect with the internal and external resources you need to accomplish your task, avert disaster, or respond to crisis. Warfighters are less lethal and resourceful in combat when their minds wander and they’re unable to fully focus on the situation at hand. Some research shows that mindfulness training—even for relatively short periods of time (for example, 8 hours over 8 weeks)—improves focus in Service Members. That is, they’re able to keep their minds from wandering and have fewer lapses in performance during a given task.

Combat environments are often characterized as Volatile, Uncertain, Complex, and Ambiguous (VUCA), which can easily lead to sensory overload. You might feel overwhelmed too. Cultivating mindfulness can help increase your tolerance of these environments and impede thinking traps about uncertain outcomes, enabling you to hone your skills of attending to the right stimuli at the right time. Mindfulness training also has been found to be effective for managing and tolerating heat pain for both experienced and inexperienced meditators. In one pain-threshold study, some participants who used mindfulness training were able to tolerate higher temperatures before they reported feeling pain, and they were able to endure heat stimuli for longer durations.

Debrief

One of the first steps in mindfulness involves pausing, taking a deep breath, and bringing your attention inward for a moment. For more information on how to begin a mindfulness practice, read HPRC’s “A mindfulness meditation primer” and watch the video below.

Posted 21 June 2017

PTSD and sleep disruption: Available treatments

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Filed under: PTSD, Sleep
Highly effective behavioral treatments exist for both PTSD and sleep disruption. Learn more about the types of interventions available to resolve symptoms.

This article provides an overview of evidence-based treatments for PTSD and insomnia. The first article in this 3-part guest-authored series—“A double whammy”—explored the potential interrelationship between these two conditions. Not only is sleep disruption a common symptom of PTSD, but the two can interact in a cycle that can make both worse and can be hard to break. Understanding your treatment options and having more knowledge about available treatments can help you engage in productive discussions with your healthcare providers and make informed choices about treatment. Read more...

PTSD and sleep disturbance: A double whammy

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Learn how post-traumatic stress disorder (PTSD) and insomnia work to create a vicious cycle.

Sleep problems and post-traumatic stress disorder (PTSD) are two common difficulties experienced by Service Members. They can share a complicated relationship, so for those experiencing or at risk for this double whammy, as well as for those treating patients, it’s important to understand how they can influence each other in a cycle. In a series of 3 articles, beginning with this one, guest experts explore the connection between PTSD and sleep, examine the different ways to approach treatment, and introduce evidence-based therapies available for both PTSD and insomnia. Read more...

How PTSD affects brain “circuitry”

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Filed under: Brain, PTSD
Learn how PTSD affects your brain “circuitry,” confusing symptoms of threat and safety.

If you’re experiencing post-traumatic stress disorder (PTSD), it’s important to understand how the different parts of your brain function. Post-traumatic stress is a normal response to traumatic events. However, PTSD is a more serious condition that impacts brain function, and it often results from traumas experienced during combat, disasters, or violence.

Your brain is equipped with an alarm system that normally helps ensure your survival. With PTSD, this system becomes overly sensitive and triggers easily. In turn, the parts of your brain responsible for thinking and memory stop functioning properly. When this occurs, it’s hard to separate safe events happening now from dangerous events that happened in the past. Read more...

Take responsible action for your mental health

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During Mental Health Awareness Month, HPRC takes a look at common barriers to seeking support for mental health concerns. Learn what you can do to get the help you need.

Warfighters lead stressful lives, so it’s important to seek support and resources to help you cope and stay ready for duty. While many wouldn’t hesitate to see their doctor about a physical ailment, asking for help to address psychological struggles can feel overwhelming.

Nearly 44 million adults in the U.S.—about 1 in 5—experience a mental illness every year. In the military population, those statistics are even higher. More than 1.6 million service members have deployed to Afghanistan and Iraq since 2001, and almost 19% have post-traumatic stress disorder (PTSD) or depression. And only half of those who need mental health support actually seek treatment.

There are many barriers that people encounter when seeking mental health support from outside sources. Here are examples of what the most common barriers sound like and some recommended courses of action (COA) you can take to start moving past whatever’s standing in your way. Read more...

Musical healing for TBI and PTSD

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Music therapy has gained acceptance as an evidence-based treatment for TBI and PTSD. Learn more and watch a video of music therapy in action.

Music therapy is an evidence-based therapeutic application for the treatment of brain and psychological injuries such as traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). TBI and PTSD can be life-changing events that cause physical, cognitive, sensory, and/or emotional impairments. However, a trained music therapist can use music to activate injured areas of the brain involved in the control of movement, cognition, speech and emotions.

Substantial scientific evidence supports how and why music therapy works, but it also can be understood intuitively. Music evokes emotions and influences mood, whether happy or sad, relaxed or pumped. Music also inspires movement: Think how a good beat can induce foot tapping or dancing.

Injured nerve pathways actually can be stimulated by music. Music also can be used to stimulate speech and facilitate cognitive function. In those with PTSD, music can arouse memories that need to be accessed and processed during the healing process. Music can help to promote movement affected by TBI. Watch this video from the National Endowment for the Arts (NEA) and DoD to see music (and other arts) therapy helping injured service members.

Music therapy is part of the rehabilitation process at places such as NICOE, Walter Reed National Military Medical Center, and VA centers around the U.S. The VA also sponsors the National Veterans Creative Arts Festival, where veterans showcase their work. This TBICreative Forces fact sheet describes the NEA Military Healing Arts Network and lists several creative arts therapy locations.

Tai Chi for post-traumatic stress

Filed under: Exercise, PTSD, Tai Chi
Learn how this Asian form of exercise can be used to reduce the symptoms of PTS.

Tai Chi is a form of exercise and mind-body practice that can provide many physical, psychological, and social benefits. It can also be used to reduce symptoms of post-traumatic stress (PTS, formerly referred to as PTS). Tai Chi involves slow, gentle movements and controlled breathing. It can improve sleep, pain management, strength, and flexibility for many individuals. Practicing Tai Chi can also reduce depression, stress, and anger, which are often symptoms of PTS. The mental focus, relaxation and breathing techniques, and physical health benefits associated with Tai Chi might explain this reduction in depression and improvement in overall mood.

This Chinese form of exercise promotes relaxation and enhances alertness and attentiveness. Hyperarousal (that is, increased heart rate, rapid breathing, tense muscles, and sweating) is a common symptom of PTS, and Tai Chi can help individuals regulate their arousal levels. Tai Chi and other mind-body practices such as yoga and mindfulness can help individuals cope with chronic pain and health ailments that commonly accompany symptoms of PTS.

You don’t have to be diagnosed with PTS to experience the benefits of Tai Chi, though. It is a low-impact workout for anyone who would like to sweat a little and relax the mind. Also, it is offered at many MWR facilities on military bases around the world. If you would like to try it first in the comfort of your own home, there are videos online you can watch to get an idea of the practice and what it involves. Look at your gym schedule to see if Tai Chi is available to try out too!

Dogs fighting depression and PTSD

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Service dogs and therapy dogs can help wounded and ill service members recover. Learn how these dogs can help in multiple ways.

The U.S. military supports the use of service dogs and therapy dogs to help wounded warriors obtain a higher level of independence, well-being, and purpose.

There’s an important distinction between service and therapy dogs. Service dogs are trained to do work or perform specific tasks for those with disabilities (as defined in the Americans with Disabilities Act). The dog becomes a full-time companion for the person it serves. Service dogs also can retrieve objects, turn on lights, or open doors for those with mobility issues. Guide dogs assist visually impaired individuals, and signal dogs alert those who are hearing-impaired.

Therapy dogs offer goal-directed emotional, psychological, and (sometimes) physical support. They’re trained to provide comfort, affection, and unconditional acceptance. They can complement treatment for depression and post-traumatic stress disorder (PTSD) too. A therapy dog usually belongs to its “handler,” who accompanies it on visits to patients. Such dogs also complete special training, but it’s less lengthy than that of service dogs.

The value of animal-assisted interventions (including service and therapy dogs) has become widely accepted. The range of benefits includes positive physical and psychological health effects. Just physically touching a dog can reduce blood pressure, anxiety, stress, and hopelessness. These dogs are helping injured and ill service members at military and veterans’ hospitals across the country.

A special program exists where the roles of dogs in service and therapy come together: Veterans with PTSD train service dogs for veterans with mobility issues. This is a win-win: Both the veteran-trainer and the mobility-impaired veteran benefit from the same dog. Veteran-trainers learn and use positive methods of shaping a dog’s behavior, and as they do so, regain control of their own emotions, focus their attention, improve their social competence, and gain a sense of meaningful purpose.

Learn more about training dogs for service. And watch the Military Health System’s video of therapy dogs at work.

Yoga for pain relief

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Learn more about how adding yoga to your pain management plan can help.

Adding yoga to your existing pain management plan can help ease pain from injury or illness. An integrative mind-body approach, it often combines meditation and breathing with exercise and stretching. It can be done home, either on your own or with the help of a video, or in a class with an instructor. Yoga and other mind-body practices are recognized by DoD as treatment strategies to help regulate and manage pain-related stress. In addition, yoga and meditation can help relieve symptoms of PTSD. Read the full article for more information... 

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