How can the effects ofPTSD be minimised in military veterans? EPQ- Introductiondraft 1: PTSD is a mentalhealth disorder caused by a traumatic, stressful, frightening or distressingevent. Within a war zone military personnel experience many life threateningand traumatic situations. These range from the death of friends, civilians oreven the enemy to the horrific sites of destruction leaving civilians livestorn apart. Some of these persons may re-experience these in months or possiblyyears time through flashbacks, nightmares or images. These sensations may comewith an immense reality and affect the daily life of a military person oncereturned from the war zone, leading to hyper arousal, depression and possiblysubstance abuse. The symptoms of PTSDare often categorized into:· Re-experiencing;a vivid reliving of the event, in the form of: flashbacks, nightmares,distressing images or sensations, or physical sensations.
· Avoidanceor emotional numbing. This involvestrying not to be reminded of the experience in any way. Often the person willavoid certain people, places or talking of the experience at all. Some peoplemay try to relieve this feeling through attempting to ‘feel nothing’ at all,this is known as emotional numbing. Emotional numbing will lead to the personbecoming isolated and withdrawn from society. · Hyperarousal, this is the feeling of being on edge. The person will constantly feelthe need to be aware of any possible threats.
This often leads to irritability,anger outbursts, concentration difficulty or sleeping problems. The symptoms will alsooften lead the person to develop depression, resort to alcohol or drug abuse toalleviate the suffering. Or become distanced from family and loved ones, whichmay break down relationships within their life further affecting thememotionally. Chapter 1: Causes ofPTSD There are manypossible experiences that may cause PTSD. Any event that is traumatic to aperson or that causes them to feel an extreme amount of anxiety and fear canlater develop into PTSD. What different individuals find traumatic varieslargely from person to person depending on their personality, personal beliefsor values and the individual’s previous experiences. Usually the event will bethreatening leaving helpless fear in the individual.
There is no clear anddefinite description as to why these events cause PTSD however there are somesuggested possible reasons. One of thesesuggestions is that it is a form of survival mechanism. This says that thesymptoms may be part of an instinctive mechanism that aims to help you survivepotential traumatic experiences that could occur in the future. The feeling ofhyperarousal may develop so that they can react quicker and respond faster inanother situation, which is similar to the first. This mechanism is supposed tohelp you be better prepared in this situation. However, in reality this is notso helpful, hyperarousal means that you cant move on and properly process thesituation, leaving you with more long-term emotional anxiety. Another possiblesuggestion is the high level of adrenaline produced by suffers of PTSD.
Duringa dangerous situation, like one which may cause PTSD, the body produces highlevels of adrenaline. This is known as the “fight or flight” reaction, whichhelps the body to deaden senses and reduce pain so they can escape danger.Research has shown that people with PTSD continue to produce these high levelsof adrenaline (“fight or flight” hormones) even when there is no possibledanger present.
This may be a possible reason for the symptoms that are shownby people who have PTSD. The final possiblereason as to why PTSD is triggered is changes in the brain. When people whohave PTSD have had brain scans, some of the parts of the brain involved inemotional processing appear different. An example of this is the hippocampusappears to be smaller. The hippocampus is responsible for memory and emotions.These changes could be a related to the fear and anxiety, memory problems andthe flashbacks experienced by people suffering from PTSD.
A further issue tothe malfunctioning hippocampus is that it can restrict the proper processing offlashbacks or nightmares, this means that the anxiety that is caused by thesedoes not reduce over time. Why does militarycombat cause PTSD?Veterans trauma oftenrelates to combat duties, any mission they may have undergone under stressfulconditions or being in the danger of a warzone. A lot of the time spent withina warzone the soldiers are under high levels of stress and fight in gruesomeand horrific combat, exposing many to traumatic and disturbing scenes. Manybelieve that veterans that may have caused harm to a civilian will have anincreased chance of developing PTSD from the specific event. Treatments for PTSDaim to allow the person to properly process the negative memories and feelings,these means that over time the flashbacks or nightmares should be reduced andthen eventually disappear. Chapter 2: maintreatments used for ptsd. There are manytreatments available for PTSD, with varying levels of research into differenttypes.
The most researched and medically supported treatment is trauma-focusedtherapy. These treatments focus on the memory itself or the meaning behindtheir flashbacks, with the aim to help the sufferer process the experience.Trauma-focused therapy can be split into 3 main forms.
The first is prolongedexposure. This will involve talking to a counsellor about the memory andprogressively getting the patient to restart doing things that they haveavoided doing since the event happened. By doing this it should teach thepatient to gain control and be able to face their negative feelings. The nextfrom of trauma-focused therapy is cognitive processing therapy. This also involvestalking to a counsellor about the incident, however, also will involve shortwriting assessments about the event and what they have talked about. This formof therapy aims to teach the patient to refrain from the negative thoughts thatthey have linked to the event. The third form of trauma-focused therapy iseye-movement desensitisation and reprocessing (EMDR). EMDR involves the patientrecalling the traumatic experience whilst receiving a bilateral sensory input(a visual or auditory stimuli occurring in a side to side motion).
Using thistreatment should help the patient learnt to process and remove the negativefeelings experienced whilst thinking about or being reminded of the experience. Another form oftreatment for PTSD with strong supporting evidence is the use of antidepressantmedication. Specifically SSRIs (selective serotonin reuptake inhibitors) orSNRIs (serotonin-norepinephrine reuptake inhibitors). Serotonin andnorepinephrine affect mood and act in response to stress.
These drugs stop thereuptake of serotonin and norepinephrine so therefore they remain incirculation around the brain for longer. This will reduce anxiety and improvemood. There are four medications recommended for the use for PTSD: Sertraline,Paroxetine, Fluoxetine and Venlafaxine.
These are the most effective andbeneficial to patients suffering from PTSD. There are some othertreatments that don’t directly focus on the event but instead, focus onmanaging the symptoms and reactions that the patient has to the event. However,research backing these treatments is less thorough, so therefore arguably maybe less effective. The first of these is stress inoculation training. This is acognitive-behavioural therapy, which teaches techniques or the skills that canallow the patient to manage their stress and reduce anxiety. The next type ofthis style of treatment is present-centred therapy. This therapy focuses on thecurrent life problems, which are related to PTSD, that the patient isexperiencing since the traumatic experience.
The final form of this therapy isinterpersonal psychotherapy. This focuses on how the trauma has affected thepersonal relationships that the patient has with others. It aims to help thepatient strengthen relationships which may have broken down and to help themreduce their social anxiety.
As well as thesetreatments people who have PTSD use some techniques to help them cope withtheir trauma. These can be helpful in different ways for different people. Someexamples of possible strategies are establishing a daily routine; this willhelp the person feel they have more control.
This can also be achieved throughsetting small and manageable goals. By doing this you can help to focus on andtackle obstacles that they face during their day-to-day life. Other copingstrategies include getting support from family and friends when you need it.
Sharing experiences with people close to you can help them to help themunderstand and support you better. Sharing your experiences with other peoplewho understand your situation is often helpful, you can do this by joining asupport group who focus on PTSD.