Frontline Psych with Doc Bender: What’s the Difference between PTS, PTSD?
Posted by Dr. James Bender, DCoE psychologist on September 27, 2011

Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1^st Cavalry Division’s 4^th Brigade Combat Team out of Fort Hood, Texas. During his deployment, he traveled through Southern Iraq, from Basra to Baghdad. He writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.

Hello. I was talking to our DCoE social media people a few weeks ago and they were saying that some people confuse post-traumatic stress disorder (PTSD) with post-traumatic stress. It’s an easy mistake to make, especially for people who don’t spend a lot of time studying the topic. However, there are significant differences between the two and it’s useful for our nation’s warriors and the people who support them to know about them.

Post-traumatic stress is a common, normal and often adaptive response to experiencing a traumatic or stressful event. If you’ve ever been a bit shocked or rattled after a car accident or had a close call with a physical injury (falling off a ladder, nearly drowning or being in a combat situation) you may have noticed your heart racing and maybe your hands shook for a while. You might find yourself leery about engaging in the activity that almost injured you. Being more careful in a potentially dangerous situation is one of the positive outcomes of post-traumatic stress. Other experiences, like avoiding the activity that almost got you hurt or feeling scared, will subside in time.

Post-traumatic stress disorder is a clinically-diagnosed condition. Anyone who has experienced or witnessed a situation involving the possibility of death or serious injury can develop PTSD (although many people who experience traumatic situations recover after a period of adjustment). PTSD symptoms include reliving the event through nightmares, flashbacks or constantly thinking about the incident. Other symptoms include avoiding situations or people that remind you of the event, trouble feeling positive emotions, and being constantly jittery, nervous, or “on edge.” These symptoms must be present for more than one month to qualify for a PTSD diagnoses.

Key differences:

§  Post-traumatic stress symptoms resolve on their own and improve within a month. PTSD symptoms are more severe, numerous and interfere with normal life

§  Post-traumatic stress is common and most people with post-traumatic stress do not develop PTSD

§  PTSD is a medically-diagnosed condition

Those with PTSD have many effective treatments available to them. There are medications that are FDA-approved to treat PTSD and therapy techniques, like exposure therapy and cognitive therapy. If you have, or think you may have PTSD, the best thing for you to do is to educate yourself, download the PTSD Coach mobile app, visit the Department of Veterans Affairs National Center for PTSD, or contact the DCoE Outreach Center for material.

Thanks for reading and for your service. Please respond to this post if you have any questions or comments. Stay safe.

Deal Reached On Veterans' Benefits

Class-action suit leads to better terms for those with condition

By Kimberly Hefling, Associated Press

From Dallas Morning News, July 30, 2011, Pg. 9

WASHINGTON -- More than a thousand Iraq and Afghanistan veterans with posttraumatic stress disorder would be given lifetime disability retirement benefits such as military health insurance under the terms of a settlement reached between the govern Attorneys for the veterans, the Justice Department and the military jointly filed a motion on Thursday that spelled out the terms. The settlement must be approved by a judge.

It also would affect a thousand more veterans who already had lifetime retirement benefits, who would receive a higher disability rating from the military. All of the veterans affected by the settlement would potentially receive new monthly disability compensation.

Mobile Applications for Mental Health

Posted by Dr. Julia E. Hoffman, National Center for Telehealth & Technology clinical psychologist on May 17, 2011

As has happened in every era, service members are returning from deployments with combat wounds that affect their mental and physical health. The impact of these problems goes far beyond the service members themselves. Deployment-related mental, behavioral and physical health problems can lead to challenges in military families and communities that last for months or even years. The good news is that there are a variety of treatments that work for post-deployment challenges, and these effective treatments are offered across the Departments of Defense (DoD) and Veterans Affairs (VA) treatment facilities.

However, many service members and families who need treatment will never seek care for a number of reasons like logistical problems getting to treatment because of location, transportation options, work schedules, etc. Others fear the negative perception of seeking help for psychological health concerns as a sign of weakness, and some don’t even realize that treatment would be helpful because they’re trained that reintegration stress is normal.

A General Speaks Out About His Battle With PTSD

Fayetteville (NC) Observer
November 14, 2010
By John Ramsey, Staff writer

While everyone else danced at a New Year's celebration to start 2008, Maj. Gen. David Blackledge couldn't stop picturing a suicide bomber blowing up the ballroom.

After nearly losing his life twice during consecutive deployments, Blackledge rarely felt safe.  He couldn't shake the nightmares. He couldn't control his temper. He couldn't focus.  "I started to think, well, this is just the way it's going to be," Blackledge said.But later that year, after his routine physical, he described his symptoms to a doctor.

Classic post traumatic stress disorder, the doctor said. He sent Blackledge to behavioral health, where he saw a psychiatrist and a psychologist.  They confirmed the diagnosis and told the general they could help.

Now Blackledge - commander of the Army's Civil Affairs and Psychological Operations Command - is speaking publicly about his invisible wounds to let other warriors know their reactions to combat are normal.

PTSD is one of the signature injuries of the wars in Iraq and Afghanistan. A 2008 Rand Corp. study estimated that as many as 300,000 veterans of those wars suffered from PTSD or depression.  Yet it remains difficult to persuade soldiers to get the help they need.

Feds Roll Out New PTSD Benefits For Veterans

By the CNN Wire Staff
July 12, 2010 12:28 p.m. EDT
STORY HIGHLIGHTS
New VA rule makes it easier for veterans to get PTSD benefits
Veterans are no longer required to documents specific events causing PTSD
VA acknowledging "inherently stressful nature ... of military service"
Over 400,000 veterans now receive PTSD benefits

Washington (CNN) -- The Department of Veterans Affairs unveiled new regulations Monday making it easier for men and women who served in the armed forces to receive benefits for post-traumatic stress disorder.

Current department rules require veterans to document events like firefights or bomb explosions that could have caused the disorder. Such documentation was often time-consuming and difficult, and sometimes was impossible.

Under the new rules a veteran only needs to demonstrate that he or she served in a war and performed a job during which events could have happened that could cause the disorder.

The InTransition Program: Maintaining Continuity of Care through Transitions

DoD/VA Offers Resources to Help Guard and Reserve Members

DCoE in Action Vol 3, No 7    July 2010

Approximately 1.1 million members of the Guard and Reserve protect our nation. With ongoing high-operations tempo overseas, guardsmen and re­servists across all services will continue to deploy.

Since September 11, 2001, nearly 775,000 Guard and Reserve members have served or are currently deployed. These deployments bring increased exposure to conditions that may affect psychological health, such as post-traumatic stress disorder (PTSD). In 2009, there were 17,538 hospitalizations for psychological health issues through­out the military compared to 11,156 for physical injuries and battle wounds.

Military Reckons with the Mental Wounds of War

By Greg Jaffe
Washington Post Staff Writer
July 18, 2010

The 300-pound bomb blasted Marine Staff Sgt. James Ownbey's mine-resistant truck so high that it snapped power lines before it slammed to the dusty ground in western Iraq.

Ownbey, knocked briefly unconscious by the blast, awoke to suffocating black smoke and a swirling cloud of dirt. He felt for the vehicle's door, then stumbled into the sunlight where he was joined by the rest of his woozy, three-man crew. Their bodies were sore, but they looked fine.

A Marine general visiting from Washington heard about the blast and came to see the survivors. As Gen. James F. Amos laid a hand on Ownbey's neck, his aide snapped a picture, proof of the new vehicle's efficacy against insurgent bombs.

"I kind of felt separated from myself," Ownbey recalled of the aftermath of the 2007 blast. "It didn't feel like anything was real."

Two years after the explosion Amos and Ownbey met again, this time in a cramped room at the National Naval Medical Center in Bethesda. Ownbey had been overtaken by terrifying panic attacks, puzzling memory loss and strange rib-snapping coughing fits that left him hospitalized for weeks at a time. Doctors diagnosed post-traumatic stress disorder (PTSD) and traumatic brain injury, caused by battlefield concussions.

Harassment, Sexual Trauma Take Toll on Female Veterans

Fallout of military sexual trauma can’t be ignored

The Spokesman-Review

The Spokane, Washington-based Spokesman Review (7/11) reports on military sexual trauma, noting that a quarter of the "female Iraq and Afghanistan veterans receiving health care at Spokane Veterans Affairs Medical Center report experiencing some type of sexual trauma while serving in the military." The account also notes that veterans who say they were sexually assaulted or repeatedly harassed in the military "were much more likely to be diagnosed with depression, post-traumatic stress, anxiety and substance abuse, according to the VA, which screens every veteran it sees for military sexual trauma."

Some female veterans coming home from Iraq and Afghanistan are having trouble adjusting to civilian life because of the trauma they experienced in the military. Not all war wounds, they say, are inflicted by the enemy.

“For me and my family, the war didn’t stop for us,” said Melissa Kilgore, a former Army specialist who arrived in Iraq with the 501st Forward Support Battalion on Mother’s Day 2003, leaving her husband and three children in Germany, where her unit was based.

Treatment for Military Personnel and Families

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) Blog
Wed, 30 Jun 2010
Posted by Dan Bullis and Monica Valdiviez-Wiley, DCoE’s Deployment Health Clinical Center on June 30, 2010

In May we posted on the Deployment Health Clinical Center’s (DHCC) Track II program, which helps recent veterans who were deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom and experience operational stress, post-traumatic stress disorder (PTSD) or disabling symptoms associated with their recent combat deployment.

In addition to our Track II program, we offer the Specialized Care Program (SPC) Track I, an intensive treatment program designed to address medically unexplained and disabling physical symptoms experienced by service members following deployment or other military exposure. Referral by a doctor or designated provider is required.

The state-of-the-art programs align directly with DHCC’s mission to improve deployment-related health by providing caring assistance and medical advocacy for military members and families with deployment-related health concerns.

What is the Department of Veterans Affairs National Center for PTSD?

Although we provide no direct clinical care, our purpose is to improve the well-being and understanding of American Veterans.  We conduct cutting edge research and apply resultant findings to: “Advance the Science and Promote Understanding of Traumatic Stress.”

Studies Find Breakthrough in PTSD Treatment

Marine Corps Times
By Kelly Kennedy
Posted : Sunday Dec 27, 2009

Brain scans, blood tests may help predict condition

Two new studies seem to provide more evidence that post-traumatic stress disorder is a chemical change in the brain caused by trauma — and that it might be possible to diagnose, treat and predict which troops are most susceptible to it using brain scans or blood tests.

In one study, Christine Marx of the Duke University Medical Center and Durham Veterans Affairs Medical Center wondered why PTSD, depression and pain often occur together.

Researchers already knew that people with PTSD show changes in their neurosteroids, which are brain chemicals thought to play a role in how the body responds to stress.

Click here to download document PTSD Diagnostic Criteria from American Psychiatric Association DSM IV TR

Click here to download document Essential Features of PTSD and Short QUIZ from The American Psychiatric Association's Diagnostic and Statistical Manual for Classifying Mental Disorders