Post Traumatic Stress Disorder (PTSD)


Because of my young age, I was wholly unaware of the political struggle that surrounded the Vietnam War (as it relates to the inclusion of PTSD).  I am confounded by the statement “PTSD was a normal response to an abnormal stressor that would evoke marked distress in nearly everyone, regardless of his or her preexisting vulnerabilities.”  (Blaney & Millon, 2009, p. 189)  The above statement is basically the reason it was included in the first place, and not 30 years later it has been refuted entirely.

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I was floored by the fact that “one epidemiological study of Michigan residents indicated that 89.6% of American adults now qualify as trauma survivors.”  (Blaney & Millon, 2009, p. 177)  I can’t believe that watching the evening news is considered trauma.  I could possibly comprehend assigning that status to someone who was directly involved in the 9-11 events, but if you had no connections (lost no immediate family members, etc) how can that be considered trauma?  Despite the fact that it is undoubtedly good for our profession (makes our market bigger), I can’t say I agree with this “bracket creep” that has been occurring.  To be quite honest, it’s approaching the “ridiculous.”

I am always drawn to the sex ratio comparisons for some reason, and I was especially drawn to the statement “men are exposed to traumatic events more often than women are, yet the rate of PTSD is twice as great in women as in men.”  (Blaney & Millon, 2009, p. 178)

The ongoing debate about the “definition of impairment” was really interesting since it had such a marked effect on the prevalence rates.  I really took this home as evidence that you really can “create the scenario you want to prove” if you manipulate the variables enough.

I can confirm the “reluctance to seek mental health care because of possible stigma” in the military community.

“The modal veteran in this cohort continued to deteriorate psychiatrically despite remaining in treatment, but then terminated treatment once 100% service-connected disability status had been achieved.”  All due respect to our veterans because they deserve that money in my opinion, but it’s the slightest bit amazing how much better $750/month can make me feel.  I am surprised that the VA Inspector General came to that conclusion; usually they sweep stuff like that “under the rug.”

Evidently it’s difficult to find someone who has pure PTSD, which I was wholly unaware of.  It’s not that it’s comorbid with that many different disorders (Major Depression, GAD, Alcohol/Substance Abuse), but it would appear that comorbidity is an issue in up to 84% of cases.  (Blaney & Millon, 2009, p. 181)  It really makes me question the validity of the diagnosis, given the current definition of “impairment,” and “trauma.”  While I am confident that this is a legitimate issue, I am inclined to align myself with the proponents of differential diagnosis on this one.

The Stroop Paradigm is ingenious.  I need to learn how to administer this test.  Is this commonly administered in private practice?

The suggestion that “being above average cognitively can protect you from the effects of PTSD” reminded me of my mother saying “your smarter than that” every time I got in trouble.  I called my mom tonight and told her she was right… she laughed.

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Reference

Blaney, P. H., & Millon, T. (2009). Oxford textbook of psychopathology (2nd ed.). New York, New York: Oxford University Press.

9 thoughts on “Post Traumatic Stress Disorder (PTSD)

  1. Reynaldo

    I know one thing about PTSD… it can be crippling.

    I had PTSD after Vietnam but it wasn’t diagnosed and treated until 2004.

    I also lost my wife to suicide upon my return home one day in 1975 (found her body) and then witnessed the murder of my 14 year old son to a previously convicted drunk driver in front of my home in Arizona in 1985.

    These traumas compounded with what I participated in during the Vietnam War…

    The VA has helped me immensely, BTW my Psychiatrist is now allowed to consider Medical Marijuana as a legitimate medicine.

    Regarding the disappearance of symptoms etc.. after receiving benefits.. my therapy has reduced dramatically, and yes my VA Pension helped ease a lot of my problems, but I still see a therapist, not as frequently but as needed (PRN), and they have me medicated with Celexa routinely and I use seroquel PRN so my need for therapy has been less.

    I do see my Psychiatrist every 6-8 weeks and my counselor as needed, group therapy for me with other combat veterans proved to be problematic reliving the experiences does not help me in any way.

    I also have available to me EMDR but that therapy while I am medicated isn’t necessary… if I start to have emotional reactions to memories I may undergo the EMDR…

    Otherwise I am happy to have a home and a life…I am very lucky compared to a lot of my brother and sister veterans…

    Reply
    1. brookskent Post author

      Rey,

      It’s really difficult to generalize about the entirety of the Vietnam War era vets… honestly, I think the great majority of them are in a similar situation to yourself… legitimate issues with PTSD… (Hyper-vigilant state, increased arousal, avoidance and emotional numbing flashbacks, nightmares, intense distress, intense physical reactions to memories, etc)

      As I said in the article above, I am 100% in favor of supporting our troops who come home with this terrible condition. The unfortunate truth is that a few bad apples are going to ruin the whole barrel we don’t find better ways to sort out legitimate cases from the people who claim to have PTSD because they watched the evening news.

      Rey – have you or did you ever experience a dissociative state? (i.e. time seems to be moving in slow motion, almost as though you are in a dream… maybe you felt like you were in a movie, or as if you were a robot. You may have had an out of body experience, like you were looking at yourself from above, like an observer, disconnected from your own body.

      Almost all the first hand accounts I have read incorporate some form of dissociative state into the experience, just curious…

      Reply
      1. brookskent Post author

        I just wanted to add, Rey, that I really appreciate you sharing your experience. Quite honestly, you made me cry sir. I think they are way too many people out there who suffer untreated. I hope people like us can make some headway into educating people about the trials of war and trauma.

  2. Reynaldo

    BTW there has been no valid research made available that I am aware of regarding how many veterans who’ve committed suicide may have lived had their PTSD been diagnosed and treated.

    Also I am leery of comments that this disorder can be faked, that would only work so far, I have had to undergo brain scans at the VA which I was led to believe were helpful in diagnosing the PTSD..

    Reply
    1. brookskent Post author

      Rey, I, too, lost a member of my family to PTSD, so I know how serious it is… that’s why it pains me to see people taking advantage of the diagnosis… because I know there are legitimate cases out there. I am not as familiar with the neurology aspect or the brain scans as I would like to be, but I am aware that they have recently begun to utilize MRI’s? to do that?

      Reply
  3. Reynaldo

    Sorry to post so often on this subject, but it strikes home with me for apparent reasons… I forgot to mention; 5% of PTSD sufferers also suffer from a dissociative disorder, this happens to me very rarely now but occasionally, they are currently training my new pet to ALERT when I do so…

    Reply
  4. brookskent Post author

    Oh, no need to be sorry Rey, I am glad you enjoyed the article. Funny you mention the dissociative disorder, I actually asked about that in another reply before I read this one… I’ve never heard of pets being trained to identify that state, but it sounds like Benny is good for more than companionship. Honestly, I never would have even considered it, but I think thats a fantastic ideal.

    I am going to go ahead and share a very personal narrative for your benefit Rey. It should be up shortly. I hope you enjoy it.

    Reply
  5. Reynaldo

    I don’t know if the study that suggested PTSD symptoms disappeared after receiving a check for $700 or so dollars a month. I think a couple things should be clarified about the process, once initially diagnosed, they will provide a rating % this determines how much money you receive in your pension… 100% Disability rating is rare for PTSD alone, few are awarded this rating, but regardless of the percentage…

    A pension is always TEMPORARY when awarded for PTSD for a minimum of four years, and you are evaluated by a therapist for the VA in addition to your own psychiatrist and therapist, then they decide if your % stands and if you still are disabled by PTSD, this is different then physical disabilities they are permanent when awarded.

    So if a Veteran fails to follow up with his therapy and fails to show for an evaluation their benefits (pension) are discontinued this I imagine to STOP or DETECT FRAUD…

    100% disability pension is $2673 per month currently… the VA is quite proficient these days at treating PTSD in it’s early stages, a lot of us older vets who’ve has this disorder for 30+ years they mostly seem to stabilize us with medication and therapy, but it is evident to me it will be necessary the remainder of my life.

    Reply

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