PTSD and Fireworks

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Written by: Rebecca McCoy

Rebecca McCoy lives in Florida with her husband who has military related PTSD, two children, and extended family. She writes about her experiences as a supportive spouse and shares her unique perspective and wants to help others who are living with PTSD. She shares her story at www.aspousesstoryptsd.com. and on her Facebook page: A Spouses Story PTSD.

Has anyone noticed that many with #PTSD are having additional symptoms or increased symptoms right now? Now, do you know why?

For those of you in the United States… What’s coming? Ah… the 4th of July! (There are certain anniversaries or such going on in other countries as well) Which means…

Fireworks…Crowds…Celebrations…Expectations! Oh fireworks!

Fireworks.

Many ask, “Why fireworks?”. Because they might resemble what someone, especially military/war related OR a natural disaster, went through, their trauma, which lead to PTSD.

Many that do understand believe it’s because of the sound they produce, which is very true however not the full truth to them. What about the vibration they give off, vibrations from fireworks can also effect one. Then you have the light produced from them, it can be another PTSD trigger as well.

So what if the one with PTSD might be able to manage through the lights, vibrations, sound but you can’t figure out why fireworks are still a trigger to their PTSD. But are you still missing something? What about the smell? Ah… you may not have thought about that one, the smell. Many that have experienced military trauma relate the smell of fireworks to combat.

In a situation where natural disaster was at hand, it may be more of the sound, lights, and vibration over the smell sense that trigger a person.

You have to keep in mind ALL of the body’s senses when it comes to PTSD. PTSD can react to or be triggered by anything that can be sensed that reminds them of what happened to them and was going on around them at the time of their trauma.

At times, those that are triggered by fireworks can find ways to cope through them, others may have a more difficult time doing so. It all depends on the person, their level of coping at that time, as well as if there is time to prepare for a possible trigger.

So what can you do?

* Some will face what is going on. Actually sit, watch, and focus on fireworks to try to help keep themselves grounded to present time and place.

* Some will stay inside to avoid the smells fireworks produce. Or to avoid the light they produce, also by keeping the curtains shut to block the light.

* The vibrations are a slight bit more tricky. There’s no avoiding those. If vibrations are a trigger you have to focus to keep yourself grounded. Prepare yourself to what you know is actually taking place or going to take place. Helicopters are another thing that is a huge trigger to many due to vibrations, which seem to fly more during the holiday weekend.

* If the sound is a trigger, sometimes playing music or something you like such as watching a movie can help drown them out. Ear buds or headphones/headsets are wonderful in these cases.

* Using coping techniques/skills can help. To name a few common ones… Breathing exercises, meditation (which there are many different types of meditation, mindfulness is one we use), grounding techniques including focusing on someone or something.

* Talk to someone through these times. Having someone to talk to and focus on can help, as well as help keep you grounded.

Whatever works for you or try different things until you find what’s best for you in each situation, just make sure you do something. Flashbacks and triggers are no joke and sure not a fun experience so do or try things that can help get you through these times.

PTSD does start showing more symptoms when one is getting closer to days like the 4th of July. Recognize that there is a cause for additional symptoms and they are not something that are just coming out of the blue. With PTSD, there is always a “something” to cause the flashbacks or triggers. When you learn to recognize the causes or reasons, it makes it a little easier to handle and learn to cope best as possible when those things come.

To those without PTSD…

Please take into consideration and understand that if one with PTSD cannot manage to join in holiday activities, it’s not that they don’t want to, it’s due to what is going on now that may be triggering their symptoms. They may be overwhelmed, feel pressured, experiencing higher anxiety and stress levels, and a good chance due to the fear of the unknown which is very common with PTSD. It will all depend on a person’s coping level/ability to what they can manage and what they cannot at this point, as well as any triggers which may occur.

So let those with PTSD set their own pace and be the one to push themselves if they are in a position they feel they can. It is perfectly okay to invite them and include them in holiday activities, it actually will make them feel good, but at the same time do not pressure them to do so.

Many may retreat away from others during this time, please understand that this should not be taken personally, when this happens normally it’s due to them needing space to cope and manage their symptoms, as well as not wanting others to see what they go through.

I hope everyone has a peaceful and relaxing holiday, please stay safe out there!

~Bec

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SFTT Service Dog Salute Photo Campaign

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‘Some dogs help people see, while others
help them forget what they’ve seen!’

Stand for the Troops (SFTT), the David Hackworth legacy foundation, is Saluting Service Dogs with a photo campaign launching on PTSD Awareness Day, June 27th, 2018. Veterans and their families are encouraged to submit candid or portrait photographs of themselves and their service dog companion along with a short narrative about WHY this canine relationship has reduced the symptoms of post-traumatic stress (PTSD). The campaign will conclude on September 6th, 2018 when one Veteran will be selected to receive a year’s supply of Dog food. The announcement will be made at the Frank J. Robotti Golf Classic luncheon and recipient does not need to be present.

While the US Department of Veteran Affairs (VA) acknowledges that owning a dog can “lift your mood” and that “All dog owners, including those who have post-traumatic stress disorder (PTSD) can experience these benefits,” the VA still doesn’t acknowledge the value, both psychological and monetary, of canine companionship to Veterans.

The good news? The Contemporary Clinical Trials has designed the first-ever study to quantify the palliative effects of service dogs for Veterans who suffer from PTSD.

But the SFTT Medical Task Force doesn’t need a trial to know how restorative the relationship between a transitioning serviceman or woman and his/her service dog can be. Whether you’re recently separated from active duty or you’ve been a civilian for many years, we recognize the impact these animals have had on your lives, which is why we fund service dog programs throughout the US.

SFTT’s Service Dog Salute Photo Campaign is about you and your service dog. We know that so many Veterans have experienced the therapeutic benefits of having a PTSD service dog and we want to hear about — and see — your unique relationship with your canine.

Submit your Story and High Resolution Digital Photo to info@SFTT.org and we’ll post both your story and photo.  Dog Food recipient will be notified by phone so be sure to include name, address, email and phone number with your submission.

By submitting your story (500 words or less) and a photo of your battle buddy, you agree that it can be posted in its entirety along with any images on SFTT social media streams and SFTT.org.

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The Endocannabinoid System & PTSD:  Could Hemp Oil Be The Missing Link?

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Written by Fatima Cook and Gregg Cook

Let us begin with the basics.

What Is The Endocannabinoid System?

First documented in the 1990s, this system is a relatively new discovery and is an internal (endo-) receptor for cannabidiol, serving as a modulator and communicator between all the other systems in the body.  These receptors are found in the brain and gut as well as the immune, cardiovascular, nervous and endocrine systems, and even in the nuclear membrane of cells. When this enormously important endocannabinoid system is properly primed with sufficient cannabinoids – which in optimal health, the body is able to self-produce – the body maintains homeostasis, or balance, and functions the way it is naturally designed to do. In this way, the body can heal itself. We now know that, aside from the endogenous cannabinoids the body produces, they can also be found in small concentrations in such foods as cacao, echinacea, and fish oil, and is even present in mother’s breast milk.  In its most concentrated form, cannabinoids are found in cannabidiol, or hemp oil, also commonly referred to as CBD.

Hemp oil is extracted from the cannabis sativa plant (or the marijuana plant) and is one of the plant’s two main active compounds – the other being delta-9-terahydrocannabinol, or THC, the one producing psychoactive effects – the well-known “high.”  It has shown powerful results as a treatment for a variety of formerly untreatable conditions, ranging from auto-immune and neuro-degenerative diseases, epileptic seizures, chronic pain, anxiety, insomnia and post-traumatic stress disorder (PTSD), often experienced by Veterans.

How Can Hemp Oil Treat PTSD?       

Hemp oil mitigates two defining characteristics of PTSD: the terror PTSD sufferers experience reliving past trauma and the anxiety that this terror can cause. The immense, unrelenting stress and fear which lead to the disorder cause significant dampening of the endocannabinoid system and the brain’s ability to regulate memories.  Hemp oil fills the gaps, priming the system to self-regulate and expedite the elimination of a conditioned fear. Hemp oil or CBD works synergistically with the body to quell anxiety, therefore allowing for a more restful night’s sleep without the disruption of flashback memories. The added benefit of hemp oil is that it works its magic without the psychoactive component of the hemp plant.

Not All Hemp Oils Are Created Equal

While there are many hemp products in the marketplace today, it is important to know which ones will provide relief and not empty the bank account. The first thing to know is that some CBD products are plant-based while others are lab-created.  Look for plant-based — nature usually does things better than chemicals. Specifically, search for a hemp oil that is derived from the whole plant, including stalks and stems, and pristinely grown without the use of pesticides.

Second, make sure the hemp oil is meticulously extracted so that the amount of remaining THC is undetectable.

Last, but of equal importance, is the bio-availability of the oil.  What we mean by this, is that most dietary supplements need to travel through the digestive tract in order to be processed and for its positive effects to take hold.  In the case of hemp oil, most of the beneficial compounds (upwards of 90%) are destroyed through the digestive process, turning it into a relatively useless, very expensive supplement.  An efficient and bioavailable hemp oil should have two distinct features:

  1. It should be delivered to the body through high-grade liposomes.  A liposome is a microscopic sphere made of phospholipids, the basic building blocks of cell membranes.
  2. Its particle size should be miniscule, ideally, nano-sized (1/100th the width of a single human hair).

When these two features are combined, the absorption of the oil into the body rapidly begins in the mouth.  Consumed regularly, a state of calm focus and restorative well-being can be easily attained.

Looking for more research?  There are thousands upon thousands of studies out there.  Have a look at pubmed.gov and projectcbd.org.

Please contact us at Deep Health Evolution with any questions or concerns about how hemp oil might help reduce the debilitating effects the “invisible wounds” of PTSD and traumatic brain injury (TBI) have on Veterans.

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PTSD: Current Status, Key Challenges and Promising Treatments

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Yuval NeriaPost-traumatic Stress Disorder (PTSD) frequently occurs after the experience of traumatic events such as wars, disasters, acute medical events, and domestic violence. It is known as the signature disorder of combat and disaster.  Lifetime prevalence PTSD is substantial, estimated as approximately 8% in the United States, with a prevalence of about 4% in any given year  Among U.S. military personnel, frequently exposed to traumatic events, PTSD rates are even higher ranging from 19% to 22%. Military personnel are at higher risk for experiencing traumatic events, including exposure to combat, injury, loss, captivity, and sexual abuse. Consequently, PTSD is a common syndrome among veterans, and is frequently associated with functional impairment. Veterans with PTSD often suffer from a wide range of additional psychiatric symptoms including depression and substance and alcohol abuse.

PTSD symptoms are often persistent and disabling unless there is a timely targeted intervention. Symptoms of PTSD are wide-ranging and can affect trauma-exposed people in a number of debilitating ways. They include re-experiencing of the traumatic event (including intrusive thoughts, nightmares and flashbacks), avoidance of thoughts of the traumatic event and people, places, or other stimuli that evokes the trauma, changes in cognitions such regarding the world and yourself, hypervigilance, hyperarousal (including irritability, concentration difficulties, and disrupted sleep), and increases in troubling thoughts and negative feelings. PTSD is commonly associated with functional impairment, substance abuse, suicidal ideation, and increased utilization of medical care.

While a number of psychotherapies and pharmacotherapies for PTSD have been developed, research has consistently shown that more than one-third of PTSD patients never fully remit, even if treated. Meta-analysis of psychotherapy for PTSD has found short-term improvements compared to baseline only in about 50% to 60% of patients, with the majority continuing to have substantial residual symptoms. The efficacy of medication in PTSD is also unclear, with a critical lack of advancement in the psychopharmacologic treatment of the disorder. Only 20–30% of PTSD patients experience a complete remission following pharmacotherapy. Importantly, research has shown that among military personnel with PTSD, treatment reach is low to moderate, with a high percentage of service members not accessing care or not receiving adequate treatment.

Researchers in the field have raised a call to action to validate novel interventions that will improve treatment engagement and retention among veterans and family members. Here I would like to highlight three promising treatments that may address some of the above problems.

Attention-Bias Modification Treatment for PTSD:  Emerging research has demonstrated a relationship between biased attention to threat and PTSD.  Attention-bias relates to how people focus their attention; research shows that people with high levels of anxiety tend to focus on negative information in their environment. This knowledge has motivated the development of a novel therapy, attention-bias modification treatment (ABMT), currently provided at Columbia Psychiatry thanks to the generous support of SFTT. ABMT is designed to modify patients’ threat bias, i.e., change their attentional habits, with the use of a computer program. Participants with PTSD and attention bias towards or away from threat (documented by the dot probe task) undergo a 4-week (8-sessions) course of ABMT or an inactive Attention Control Program. Findings from this study are about to be published in the near future.

Interpersonal Psychotherapy for PTSD: Interpersonal Psychotherapy (IPT) is a time-limited, evidence-based treatment, has previously shown efficacy in treating major depressive disorder and other psychiatric conditions. Rather than focusing on the trauma, as in exposure based treatments, IPT focuses on the patient’s current life events and social and interpersonal functioning for understanding and treating symptoms. This treatment currently provided at Columbia Veterans Center, is a novel use of IPT as treatment for PTSD. Evidence from studies conducted at Columbia Psychiatry suggests IPT may relieve PTSD symptoms without focusing on exposure to trauma reminders. Hence, IPT offers an alternative for patients who avoid or do not respond to exposure-based approaches. Interpersonal Psychotherapy focuses on two problem areas that specifically affect patients with PTSD: interpersonal difficulties and affect dysregulation. The treatment help the patient identify and address problematic affects and interpersonal functioning, and to monitor treatment response.

Equine Assisted Treatment for PTSD. Equine-Assisted Therapy for PTSD (EAT-TSD) is a unique, group treatment that might reduce symptoms of PTSD, particularly individuals who encounter difficulty in more traditional treatments. In EAT-PTSD, a mental health professional and an equine specialist work together to guide participants with PTSD through a series of structured activities with a horse. Presently this treatment is studied at Columbia Psychiatry as part of the Man O War Project . It is an eight-week study aimed to examine how well EAT-PTSD works for veterans with PTSD. Treatment groups consist of 4-6 veterans at a time. 90-minute EAT sessions take place at the Bergen Equestrian Center in Leonia, New Jersey. Columbia Psychiatry provides transportation to treatment sessions. Treatment does not include riding horses. Through various interactive exercises with the horses, the veterans learn how their actions, intentions, expectations, and tone have an impact on their relationship with the horses (and ultimately with the people in their lives). Over the course of treatment, the equine specialist and the mental health professional assist veterans in drawing connections between what the horses may be doing, thinking, or feeling, and their own PTSD symptoms, increasing emotional awareness and ability to regulate emotions and behaviors, and learning to more effectively interact with the horses, and by extension other people as well.

Contributed by Dr. Yuval Neria
Stand For The Troops Special Medical Advisor
Professor of Medical Psychology, Departments of Psychiatry and Epidemiology
Research Scientist, The New York State Psychiatric Institute
Director of Trauma and PTSD Program, The New York State Psychiatric Institute
Director of Columbia-NYP Military Family Wellness Center
College of Physicians and Surgeons
Columbia University Medical Center

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The Unknown Soldier

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Released in 1968 by the Doors, the Unknown Soldier was considered an antiwar song and banned on many radio stations. The song, however was more of dig at the American media and the way that the Vietnam conflict was televised into our homes and became a part of our daily lives. The lyrics “Breakfast where the news is read/ Television children fed/ Unborn living, living dead/ Bullets strike the helmet’s head” portrays how the news of the Vietnam War was being presented to ordinary people.

Jim Morrison sings about how in the late 60’s American families stared at violent television images, watching a world far away where the unknown soldier is shot, yet life at home went on as usual.  The entire scenario seems to normalize the war. People were numb and continued to live their normal lives while their soldiers were dying. The fact that the soldier has no identity is also a strong message to the ignorance and lack of emotion that people had towards the men who were fighting ‘for them.’ And as we all know, the soldier who had no name came home to an unwelcoming party.

Today, military conflicts continue to play out daily on our televisions, our cell phone news feed and throughout social media.  This time those who are called to duty are welcomed home but soon forgotten by an overwhelmed VA and by the very people they serve. Today our veterans are faced with homelessness, mental health issueseducational hurdles, long waits and scandalous policies at the VA, and a military suicide rate of 22 a day.

It’s true that today’s veterans have never been more respected, unlike those who returned from Vietnam. But unlike Vietnam veterans many Americans have no personal connection to anyone who has served or is serving in the Armed Forces.  Many organizations have hit the media and social outlets to drum up support for Veterans in need but again, America’s eyes have glazed over to the  issues faced by our Veterans.  Even when it was discovered that a nonprofit claiming to help veterans at risk was misappropriating funds, there was little or no public reaction. And so, it seems the numbness prevails.

Forty years later the unknown soldier is the one struggling with PTSD. The unknown soldier is the one whose life was a daily pill that is now an addiction.  The unknown soldier is homeless. The unknown soldier is the one who suffers in silence. The unknown soldier is one of 22 each day that takes his own life.

Perhaps it’s time the unknown soldier had a name and America a plan to support those who served.

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Drs. Paul Harch and David Cifu Spar over Hyperbaric Oxygen Therapy

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Well over a year ago, Dr. Paul Harch, one of the leading experts in Hyperbaric Oxygen Therapy (“HBOT”) published an authoritative report entitled “Hyperbaric oxygen in chronic traumatic brain injury:  oxygen, pressure and gene therapy” for the U.S. National Library of Medicine (Medical Gas Research).

In this report (a lengthy extract is printed below), Dr. Harch argues persuasively over the many benefits of using HBOT in treating brain injury:

Hyperbaric oxygen therapy is a treatment for wounds in any location and of any duration that has been misunderstood for 353 years. Since 2008 it has been applied to the persistent post-concussion syndrome of mild traumatic brain injury by civilian and later military researchers with apparent conflicting results. The civilian studies are positive and the military-funded studies are a mixture of misinterpreted positive data, indeterminate data, and negative data. This has confused the medical, academic, and lay communities. The source of the confusion is a fundamental misunderstanding of the definition, principles, and mechanisms of action of hyperbaric oxygen therapy. This article argues that the traditional definition of hyperbaric oxygen therapy is arbitrary. The article establishes a scientific definition of hyperbaric oxygen therapy as a wound-healing therapy of combined increased atmospheric pressure and pressure of oxygen over ambient atmospheric pressure and pressure of oxygen whose main mechanisms of action are gene-mediated. Hyperbaric oxygen therapy exerts its wound-healing effects by expression and suppression of thousands of genes. The dominant gene actions are upregulation of trophic and anti-inflammatory genes and down-regulation of pro-inflammatory and apoptotic genes. The combination of genes affected depends on the different combinations of total pressure and pressure of oxygen. Understanding that hyperbaric oxygen therapy is a pressure and oxygen dose-dependent gene therapy allows for reconciliation of the conflicting TBI study results as outcomes of different doses of pressure and oxygen.

Not surprisingly, Dr. David Cifu, Senior TBI Specialist in the Department of Veterans Affairs’ Veterans Health Administration, gave the standard stock answer from the spin doctors at the VA that:

There is no reason to believe that an intervention like HBOT that purports to decrease inflammation would have any meaningful effect on the persistence of symptoms after concussion. Three well-controlled, independent studies (funded by the Department of Defense and published in a range of peer reviewed journals) involving more than 200 active duty servicemen subjects have demonstrated no durable or clinically meaningful effects of HBOT on the persistent (>3 months) symptoms of individuals who have sustained one or more concussions. Despite these scientifically rigorous studies, the clinicians and lobbyists who make their livings using HBOT for a wide range of neurologic disorders (without scientific support) have continued to advocate the use of HBOT for concussion.

To Dr. David Cifu’s stock VA response, Dr. Harch responded as follows:

The charge is inconsistent with nearly three decades of basic science and clinical research and more consistent with the conflict of interest of VA researchers.  A final point: in no publication has the claim regarding effectiveness of HBOT in mTBI PPCS been predicated on an exclusive or even dominant anti-inflammatory effect of HBOT. Rather, the argument is based on the known micro-wounding of brain white matter in mTBI, and the known gene-modulatory, trophic wound-healing effects of HBOT in chronic wounding.  The preponderance of literature in HBOT-treated chronic wound conditions, is contrary to Dr. Cifu’s statement of HBOT as a “useless technology.”

As a layman, Dr. Harch’s detailed rebuttal (see FULL RESPONSE HERE) completely destroys Dr. Cifu’s “non-responsive” comment to the scientific points raised in Dr. Harch’s report.  In my view, it goes beyond the traditional “professional respect” shown by peers:  Dr. Harch was pissed off and, in my opinion, had every right to be.

Not surprisingly, Dr. Cifu has not responded to the irrefutable arguments presented by Dr. Harch.

The discussion of HBOT is not a subject of mild academic interest.  Specifically,  Veterans are being deprived of hyperbaric oxygen therapy because Dr. David Cifu and his cronies at the VA are misrepresenting the overwhelming evidence that suggests that HBOT restores brain function.

Why?  Indeed, that is the $64 question.

It is difficult to forecast how this academic drama will play out.  Nevertheless, I suspect that David Ciful will eventually be viewed by Veterans as performing a similar role within the VA as Alvin Young, aka “Dr. Orange.”

I hope and pray this is not the case.  On behalf of tens of thousands of Veterans who are denied HBOT treatment for PTSD and TBI by the clumsy and sloppy claims of Dr. Cifu and others within the VA, please “do the right thing” and lend your support to HBOT as a recommended VA therapy for treating brain injury.

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