Filed under: PTSD
Sometimes just understanding what’s going on can help the process of recovery. If you’re experiencing post-traumatic stress disorder (PTSD), it might help to have a better idea of how your brain functions and how the various parts are supposed to work. This also can help you understand the treatments used to help “rewire” your brain, so it can work properly again.
PTSD is a mental health condition stemming from traumas—experienced during combat, disasters, or violence—that impact brain functioning. The alarm system in your brain, that normally helps ensure your survival, malfunctions; it becomes triggered too easily. In turn, parts of your brain responsible for thinking and memory stop functioning properly. When this happens, you have difficulty comparing what’s happening now with safe events from the past. Read more...
There’s a promising therapy that uses virtual-reality simulation to help treat service members with post-traumatic stress disorder (PTSD). According to the National Center for PTSD, 10–18% of returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans experience PTSD. The good news is that treatments such as virtual-reality exposure therapy (VRET) might help them work through their challenges.
Trained therapists use VRET to re-create stressful events or situations such as combat scenarios in a virtual-reality environment. The patient wears a headset and interactively reacts to possible sights, smells, sounds, and vibrations that have been visually re-created. This makes the experience realistic for the patient as it provides a strong sense of “being there.” Veterans learn to work through emotions such as fear, tension, and anxiety in a safe environment.
Healthcare providers have successfully used virtual-reality simulation as a resilience-training tool too. It helps builds service members’ confidence and coping skills so they feel stronger and ready for what comes next.
Visit the National Center for PTSD to learn more about post-traumatic stress. Here’s what VRET looks like in action.
Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune in to emotional experiences rather than try to escape from them. It’s easy to be overcome by depression, anxiety, PTSD, addiction, or other mental health problems. And you can make it worse by trying to forget the cause. For example, a service member afflicted with PTSD desperately wants to avoid experiencing certain traumatic events. Ironically, the actual effort to forget can cause him to relive difficult events through dreams, flashbacks, or memories. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more. Read more here.
Not everyone is affected the same way by exposure to injury and death. Many who do experience psychological wounds, however, come out stronger as a consequence, and so can you. If you’ve experience a traumatic event or experiences, there can be an upside: It’s called “post-traumatic growth” or PTG. It’s about finding a “new normal” that is even better than how things used to be. PTG can mean better relationships, openness to new possibilities, personal strength, spiritual change, or heightened appreciation of life. In addition (and researchers are still trying to understand why), if you get PTSD, you’re actually more likely to experience PTG. Nobody wants to experience PTSD, but if it happens, you may have an amazing opportunity to come out the other side with some unique strengths.
Mindfulness can help you feel better equipped to handle difficult emotions. It’s a process geared to help you tune into emotional experiences rather than try to escape from them. People can feel overcome by depression, anxiety, PTSD, addiction, or other mental health problems, which, ironically, can be exacerbated by trying to forget the cause. For example, a Warfighter afflicted with PTSD often relives difficult events through dreams, flashbacks, or unwanted memories, because he/she desperately wants to avoid experiencing those events. To illustrate this idea, right now, try NOT to think of weapons. You probably thought about them that much more.
Practicing mindfulness mediation means focusing on whatever you are experiencing in the present moment. It can be a structured meditation activity, but because mindfulness is about being present, you can purposefully engage in mindfulness anytime, anywhere. A common meditative approach is to focus on a physical experience such as your breathing, noticing where your attention wanders, and gently guiding it back to your breath; it allows you to experience sadness, anger, fear, and other unpleasant emotions, letting them pass without clinging to the idea of making them go away.”
If you have ever “white-knuckled” your way through an amusement park ride (or ridden in a car with a driver you didn’t trust), you may remember thinking, “When will this be over? Please let it be over…” This shows that focusing on how long something lasts can make it feel like an eternity. By engaging in mindfulness, you will feel less threatened by certain emotions, and you will be less likely to engage in problematic forms of escape (such as drinking, drugs, or simply spacing out).
When people experience difficult emotions, they often cope by engaging the language center of the brain, using words internally to wrestle with the experience. But when people have difficulty re-evaluating why they feel the way they do, this leads to a circular internal debate (such as “I shouldn’t feel this way, but I do, but I shouldn’t…”), which can be pointless and can actually cause more distress. Emotions can be dealt with not just through words but also by tapping into their physical elements (noticing how you feel in your body). When people engage in regular mindfulness practice, the parts of their brains tuned into physical sensations are activated while they experience hard emotions. And people who regularly have this part of their brain activated tend to be more emotionally steady.
Unfortunately, it’s difficult to escape unwanted emotions. And more problems will probably pop up as you try to escape. But if you’re willing to face hard emotions, letting them come and go like waves on a beach, then mindfulness practice can help you have a different experience. Tune in to HPRC for more mindfulness resources, and take advantage of the fact that mindfulness is everywhere now, whether part of your martial arts or yoga class or filling the self-help shelves of your local bookstore. Become more mindful, and you can feel better equipped to handle tough emotions; your mind and body will engage them more productively.
PTSD was finally recognized as a medical condition when recent advances in neuroscience showed that the brain no longer works properly after trauma. Your brain has an alarm system to help ensure your survival; it’s useful as long as it works properly. When the alarm system malfunctions because traumatic events pushed it to its limits, the part of the brain responsible for thinking and memory can’t function properly. When this happens, a person with PTSD can’t compare what’s happening now with events in the past when they were safe. However, there are treatments to help “rewire” the brain, so it can work properly again. Learn more about this in “How post-traumatic stress affects your brain”.
Post-Traumatic Stress Disorder (PTSD) can tear apart your sense of what is safe and of what is good.
Part of the diagnosis of PTSD is exposure to a traumatic event: death, serious injury, sexual violence, or the threat of any of these. PTSD symptoms such as intrusive memories, avoidance of situations or feelings, problems in thinking or mood, and feeling overly amped up are common reactions to abnormal circumstances. Think of PTSD symptoms as self-preservation instincts gone haywire. One theory holds that, because you nearly died or experienced something awful or could picture it because it happened to someone close to you, your mind/body tries to sound the alarm bells to keep you safe. But the alarm bells sound at the wrong times and in the wrong ways.
However, PTSD symptoms can come from sources other than fear of bodily harm. They also can arise from inner conflict, when emotions trigger feelings such shame and guilt or when you question fundamental beliefs (such as “the world is basically good”). Witnessing or experiencing betrayal (especially by a leader in a high-stakes situation), within-ranks violence, extreme violence, and incidents involving civilians are some of what can disrupt your world view. It isn’t just an event but the interpretation of an event that causes Warfighters to experience “moral injury.”
If you suffer moral injury as part of PTSD, you start believing you live in an immoral world, or you view yourself as immoral, irredeemable, and defective. If you’re a Warfighter experiencing these feelings, you not only feel lousy, but you are more likely to isolate yourself just when you need others more than ever. Isolation can lead to self-handicapping or self-destructive behaviors.
So how do you save yourself from experiencing moral injury as a part of PTSD? Having a healthy sense of self-esteem can be one of your best protectors. There are no quick fixes. But forgiveness—of others and of yourself—can help you to let go of moral injury. With the help of a psychotherapist, you can begin to wrap your heart and mind around what happened. And pursuing positive interactions, such as getting involved with charitable groups, can give you opportunities to relearn that you are good and the other people in the world are generally good too. Last but not least, connecting with your spirituality—in whatever way is comfortable to you—can help you navigate this difficult journey.
Bad things happen. Unfortunately, you can count on experiencing different traumas, deaths, illnesses, and injuries. As a Warfighter (or military family), you can probably expect to face these kinds of situations more often than other people. That doesn’t make these experiences any more pleasant, and often it doesn’t make them any less surprising. After a major trauma, illness, or life-changing event, it is often necessary to adapt and create a “new normal.”
Studies of “post-traumatic growth” have found that trauma survivors can grow mentally, emotionally, and spiritually after horrendous experiences such as cancer, terrorism, sexual assault, plane crashes, and even combat. It’s common to react with an emotional roller coaster of denial, anger, bargaining, depression, and acceptance. Your natural instinct might be to run from these feelings. However, post-traumatic growth can be accomplished better by taking steps to approach them. The people who support you (including but not limited to therapists and family members) can do the following:
- Listen empathically, accepting and encouraging full expression of feelings.
- Avoid clichés and easy answers. Hearing “there will be brighter days” is not helpful.
- Be patient. Changing perspective won’t happen overnight.
- Offer a helpful relationship, recognizing there is no “magic technique” or “quick fix.”
You can also be an active agent in your own healing. One technique that can be useful to you is to tell and retell versions of your story in order to become more immune to the hard parts and to reach a point where you can find new meaning in it. People of any age, including Warfighters, can benefit from actively embracing a “new normal” through taking advantage of your relationships and developing a new twist on their story, even when this initially might seem far-fetched.
Virtual reality was first introduced as a therapy tool for people with anxiety disorders such as phobias, but it is now used for a wide range of conditions, from PTSD to childhood ADHD. In fact, it recently warranted its own symposium at Walter Reed National Military Medical Center, where experts exchanged ideas on the current state of research.
Virtual environments used in therapy sessions are created for the individual’s needs—for example, a noisy classroom for a child with ADHD, the re-creation of the 9/11 attacks for a firefighter or police officer, or “Virtual Iraq” for a soldier. “Virtual Afghanistan” is the newest creation and is already being used to help service members overcome PTSD. Active-duty men and women are gradually brought back to their traumatic event using the virtual world as the therapist provides verbal cues to facilitate the healing process.
With a view to mitigating future need for therapy, a series of episodes is currently being created to provide pre-deployment “Stress Resilience Training for Warfighters.” The goal is to help reduce the risk of PTSD and better prepare warriors for actual scenarios they will encounter in theater.
For more information about how to prevent and manage stress, visit HPRC’s Stress Management section.
The physical and emotional stress associated with post-traumatic stress disorder (PTSD) can raise your blood pressure and cholesterol and increase body mass index, all of which are risk factors for heart disease. Veterans suffering from PTSD are more than twice as likely to die from a heart attack than those without PTSD. While the exact relationship between PTSD and heart disease is not fully understood, we know that regular exercise can help prevent heart disease and other risk factors, which could be helpful for those with PTSD. Some types of exercise can be effective in reducing psychological symptoms associated with PTSD and also can play a role in reducing unhealthy behaviors such as smoking, being overweight, and physical inactivity—sometimes byproducts of trying to cope. If you think that exercise might help you or a loved one cope with PTSD, speak with your healthcare provider to assess how much and what kind of exercise is best!