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  • **DEPRESSION - SUICIDE/CRISIS INTERVENTION**
    • Suicide Help -- PLEASE READ THIS!! If you or someone you know are having thoughts about suicide, call 1-800-273-TALK (8255). Calls are connected to a certified crisis center nearest the caller's location
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  • DEPRESSION & ANXIETY MEDICATIONS - LOOKING FOR ANSWERS
    • Abilify (aripiprazole)
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    • Medications: Posting, asking and sharing
  • DEPRESSION & ANXIETY RELATED ILLNESSES
    • MNESN - Members Needing Extra Support Now!
    • DEPRESSION CENTRAL
    • Anxiety, Panic, Post Traumatic Stress Disorders (PTSD)
    • Attention Deficit Hyperactivity Disorder (ADHD/ADD)
    • Suicidal Ideation Forum
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    • The Relationship and Depression Forum
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    • Bullying: Emotional and Physical Abuse
    • Therapy
    • Mental illness and stigma: Coping with the ridicule
    • Psych Education 101
    • Clinical Trials Connection Plus More
  • DEPRESSION-ROAD TO RECOVERY
    • The DF Water Cooler
    • One Step At A Time
    • Mental health disability benefits (US/UK/CA) insurance, parity, etc.
    • Our Information Portal

Blogs

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  1. PTSD - Post-Traumatic Stress Disorder: It’s Not Just Veterans Sources: National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm Anxiety & Depression Association of America: http://www.adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd National Institute of Mental Health What is Post-traumatic Stress Disorder (PTSD)? When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger. PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes. Signs & Symptoms PTSD can cause many symptoms. These symptoms can be grouped into three categories: 1. Re-experiencing symptoms Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweatingBad dreamsFrightening thoughts. Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing. 2. Avoidance symptoms Staying away from places, events, or objects that are reminders of the experienceFeeling emotionally numbFeeling strong guilt, depression, or worryLosing interest in activities that were enjoyable in the pastHaving trouble remembering the dangerous event. Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car. 3. Hyperarousal symptoms Being easily startledFeeling tense or “on edge”Having difficulty sleeping, and/or having angry outbursts. Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating. It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. Who Is At Risk? PTSD can occur at any age, including childhood. Women are more likely to develop PTSD than men, and there is some evidence that susceptibility to the disorder may run in families. Anyone can get PTSD at any age. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events. Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or is harmed. The sudden, unexpected death of a loved one can also cause PTSD. Why do some people get PTSD and other people do not? It is important to remember that not everyone who lives through a dangerous event gets PTSD. In fact, most will not get the disorder. Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event. Risk factors for PTSD include: Living through dangerous events and traumasHaving a history of mental illnessGetting hurtSeeing people hurt or killedFeeling horror, helplessness, or extreme fearHaving little or no social support after the eventDealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.Resilience factors that may reduce the risk of PTSD include: Seeking out support from other people, such as friends and familyFinding a support group after a traumatic eventFeeling good about one’s own actions in the face of dangerHaving a coping strategy, or a way of getting through the bad event and learning from itBeing able to act and respond effectively despite feeling fear. Researchers are studying the importance of various risk and resilience factors. With more study, it may be possible someday to predict who is likely to get PTSD and prevent it. HelpGuide Getting help for post-traumatic stress disorder (PTSD) Recovering from PTSD involves helping your nervous system return to its pre-trauma state of balance. As discussed above, the best way to regulate your nervous system is through social engagement—interacting with another human being—be it a loved one, a friend, or a professional therapist. However, as someone with PTSD, you need to first become “unstuck” and move out of the immobilization stress response. While this process is easier with the guidance and support of an experienced therapist or doctor, you don’t need to wait for a medical appointment to start feeling better. There are plenty of things you can do now to help yourself cope with symptoms, reduce anxiety and fear, and take back control of your life. PTSD Self-Help Tips (See the website for more details) 1) Get moving. (spending time in nature) 2) Connect with others. 3) Challenge your sense of helplessness. 4) Take care of yourself. Helping someone with post-traumatic stress disorder (PTSD) If a loved one has post-traumatic stress disorder, it can take a heavy toll on your relationship and family life. It can be hard to understand why your loved one won’t open up to you—why he or she is less affectionate and more volatile. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems. Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to take care of your loved one, you first need to take care of yourself. It’s also helpful to learn all you can about PTSD. The more you know about the symptoms and treatment options, the better equipped you'll be to help your loved one and keep things in perspective. Tips for helping a loved one with PTSD Be patient and understanding. Getting better takes time so be patient with the pace of recovery and offer a sympathetic ear. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Try to anticipate and prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you’ll be in a better position to offer your support and help your loved one calm down. Don’t take the symptoms of PTSD personally. Common symptoms of post-traumatic stress disorder include emotional numbness, anger, and withdrawal. If your loved one seems distant, irritable, or closed off, remember that this may not have anything to do with you or your relationship. Don’t pressure your loved one into talking. It is often very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Never try to force your loved one to open up. Let the person know, however, that you’re there when and if he or she wants to talk.
  2. Non-Soldiers Suffer Post-Traumatic Stress August 15, 2005 GLENVILLE, N.Y. (AP) -- For hundreds of thousands of Americans, mental illness is just a drive down the road. Ask Beth Puglisi. The 45-year-old mother was out to fill her gas tank on a bitter-cold January day last year. She turned the wheel of her pickup, felt a wrenching jolt, and watched the roadway fly into a spin. "No!" she heard herself screech. The rubbery aroma of spilled antifreeze filled her nostrils. In the days after her crash with a car, she took to the couch, weeping -- but not over her fractured vertebra and dislocated shoulder. Her mind was staggering. "It felt like a death," she says. Her body was quickly tended, but it took months before doctors even put a name to her other injury: post-traumatic stress disorder. Once associated mainly with the horror of combat, PTSD has stretched to take in more frequent swerves along life's road -- car crashes, house fires, a sudden death or severe family illness, witnessing a disaster, or even learning of one. PTSD has broadened the model of mental illness to cover disturbances set off solely by external events, outside of the mind. Almost anyone can be vulnerable. Research suggests the disorder is now present in 5 percent of Americans, or more than 13 million, according to the PTSD Alliance, which unites professionals and advocates. It is expected to touch 8 percent of adults during their lives. By contrast, just over 3 percent of Americans have cancer. Puglisi had been in accidents before, but she never felt this way. She couldn't stop picking over this crash in her mind. It wasn't her fault; it just wasn't. So why did it have to happen? Why? Her family encouraged her to talk: "Each time I would tell someone about it, I could feel it and smell it -- the whole thing." In a kind of flashback typical of PTSD, she could still smell the antifreeze. As PTSD's debilitating anxiety took hold, Puglisi started to feel nervous, flushed, even lightheaded when she was driven to a doctor or physical therapist. She would tremble, and her chest would tighten: "Just thinking about it was making me crazy." When she tried driving again, she'd have to circle around to avoid making the same kind of turn as in the crash. She'd bypass where it happened. Ashamed, she asked her husband to drive the children to their activities. While television droned war news from Iraq, she felt trapped in her own combat zone: "When you're in the war, you have no idea if you're going to be alive or dead in 10 minutes. That's exactly the way I felt." Warring soldiers have carried home psychological scars for centuries. The ancient Greeks noticed it. In American wars, it has been called shell shock, combat fatigue and post-Vietnam syndrome. Though skeptics discounted some cases as shams meant to win compensation, other extreme cases were taken for schizophrenia. Medical authorities first accepted PTSD as a distinct psychiatric condition in 1980 at the urging of Vietnam veterans and their medical caretakers. In PTSD, stress hormones like adrenaline scorch a painful event deep into long-term memory, scientists believe. Lab studies show such hormones normally improve memory in animals. They seem to overshoot the mark in PTSD. People get very edgy and fearful, prone to nightmares or flashbacks. They desperately want to avoid reminders of their shock, even to the point of feeling numb. PTSD happens more often in women, in cases of multiple traumas (Puglisi had another road accident just a couple weeks earlier), and in people with depression. Once defined, the disease was soon embraced, and insurance coverage expanded. Here was a psychiatric condition touched off by concrete events, not something hidden in the mind's dim recesses. It could theoretically happen to anyone, even the hardiest and soundest of mind. It wasn't your fault. The federal government established the National Center for Post-Traumatic Stress Disorder. It began researching PTSD and treating hundreds of thousands of veterans. Survivors from rape and car crashes began to seek therapy in greater numbers too. In 1994, the sudden death of a relative, or even learning that one was hurt, joined the expanding list of PTSD traumas in the chief diagnostic manual for psychiatry. By the late 1990s, when Dr. Greenbrier Almond was working as a psychiatrist at a West Virginia veterans hospital, PTSD was already its leading diagnosis, above heart disease and diabetes, he says. Over the past five years, the number of cases among veterans -- mostly from combat -- has exploded nationally by almost 80 percent to 215,871 last year, according to the Department of Veterans Affairs. It is the agency's fastest-growing disability. No similar statistics are collected for civilians, but the numbers are clearly substantial. Dr. Almond, who has left the veterans hospital, now treats PTSD in abused children at a community health clinic. Research at Henry Ford Health System, Harvard and Georgia State has identified the two leading causes of PTSD as unexpected deaths of relatives and car crashes. Combat ranks far down on the list. Some bad diagnosticians and purveyors of pop culture have come to consider just about any of life's shocks -- divorcing, losing a job, even failing a test -- as triggers for PTSD. Though veterans officials say rising awareness has driven most of their growth, they are also reviewing whether some cases have been diagnosed too readily. "Anything that happens to you that's remotely icky now qualifies," says psychologist J. Gayle Beck, at the University at Buffalo-State University of New York. "It's been culturally overdiagnosed." This psychiatric illness has carried cultural baggage since its birth in the social turmoil over the Vietnam War. The new disorder tied to external events meshed with a Kafkaesque view of society inherited from the 1960s: Outside forces constantly threaten peace of mind. Since 2001, PTSD has tapped into another source of anxiety: terrorists who can inflict mass death in an instant. A survey found highly elevated rates of PTSD in the New York metropolitan area, where the smoking towers of the World Trade Center could be seen for miles. Afterward, some companies sent reassuring notices to workers listing PTSD symptoms and saying they were common responses. One compared them to a minor flu. "It speaks to dangerous times and threats, and that certainly defines our era," says Dr. Robert Jay Lifton, a Harvard University psychiatrist who helped define PTSD as a condition. "There is bound to be widespread PTSD and an awareness of it." Even so, many people with PTSD still do not come forward for help, caregivers say. And even experts may miss the signs. "My father dropped dead in front of my mother. She developed PTSD for two years, and I was completely unaware of it. I knew something was wrong, but I didn't know it was PTSD," says psychologist Terence Keane. Yet he is director of behavioral science at the federal PTSD center. The good news is this: Even untreated, PTSD goes away in about half of the cases within six months, research indicates. The bad news: When it doesn't, it can last for decades. Puglisi had never needed therapy before and didn't think of treating her embarrassing automotive anxiety. "I would say I'm all right," she recalls. But she wasn't. Her doctor told her she'd soon get over it, but her physical therapists knew better. After several months, they persuaded her to look for help. She found Edward Hickling, a former veterans psychologist who now specializes in road-accident PTSD. "I came to private practice, and I saw motor-vehicle accident victims that looked a lot like ... the post-traumatic stress responses I saw in the veterans hospital," says the therapist based in nearby Albany. Like many PTSD therapists, he relies on cognitive behavioral therapy. A common psychological treatment, it teaches how to replace negative mental monologues ("I could die on the way to work") with positive, rational ones ("I'll probably get there just fine, as usual"). It can be carried out one-on-one or in groups. Like many PTSD therapists, Hickling re-exposes participants to memories of the terrifying situation, while desensitizing them over a few months or longer. They start by telling what happened and graduate to driving back to the crash site. One woman was able to drive back and gaze at the place where her car plunged down a hill, trapping her for more than two hours. Later, she felt as though she had "removed a cloud from her brain," according to Hickling. The therapy can work in up to 75 percent of road-accident survivors with chronic PTSD, research suggests. Some patients, though, can't tolerate thoughts of their ordeal. "It's just too painful," says psychologist Charles Figley, at Florida State University. Lesser symptoms persist in many people. Psychiatrists often treat PTSD with drugs. The federal government has approved two depression medicines, Zoloft and Paxil, for PTSD. Research suggests they help at least a quarter of PTSD patients. Other researchers are experimenting with potential PTSD drugs like anti-adrenaline agents and the antibiotic D-cycloserine. In theory, they might disrupt the consolidation of long-term PTSD memories or help the brain forget them later. Psychological therapy alone conquered Puglisi's symptoms, though it took a year. She still hasn't gone back to work but doesn't feel so alone. Now she knows of many others like her: "The mind does this sometimes." What happened to her, she has learned, is normal. Copyright 2005 The Associated Press. All rights reserved.
  3. Different Ways (11) Therapists Control Their Holiday Stress Sometimes even the experts need a little help staying holly and jolly. Research shows holiday season stress can feel insurmountable. No one is immune. Mental health professionals, who are usually helping others manage emotions, put their own advice into practice as the year winds down. Wonder what their secrets are? Below are some ways the experts handle holiday stress: 1. Set aside a few minutes to meditate. “I manage holiday stress by engaging in the same self-care activities that I already do on a routine basis, particularly exercise and mindfulness meditation. I practice mindfulness during the day to help take one thing at a time and not worry about everything else on my plate.” ―Ricks Warren, clinical associate professor in the department of psychiatry at the University of Michigan 2. Tell yourself it’s OK to take a break from family. “They all come with stress, tension and a unique history all packed into small rooms for long hours during the holidays. To help with this stress, I try to be prepared, knowing who will be there and who triggers hot buttons in others and in me. Knowing I can leave the room or the conversation is good prevention planning.” ―Dan Reidenberg, executive director of Suicide Awareness Voices of Education and chair of the American Psychotherapy Association © Provided by The Huffington Post 3. Spend time unplugged. “Because of electronics ― email, patient portals, access to paging ― it is important that somehow clinicians ‘turn off’ some of the electronics and sign out so they can really have some time away. Easier said than done, though.” ―Michelle Riba, associate director at the University of Michigan Depression Center 4. Let go of perfection. “Also, it’s very important for my holiday stress management to accept imperfection, whether it has to do with how a party might go, how many people I get to see, what presents I buy or don’t buy, whether I meet others expectations or not, etc.” ―Ricks Warren 5. Plan ahead. “Time is always an issue during the holidays. I find that taking a day or two or three in the weeks prior to the holiday helps to reduce stress and time crunch related to all of the holiday events that hit the calendar.” ―Ken Yeager, director of the Stress, Trauma and Resilience program at The Ohio State UniversityWexner Medical Center © Provided by The Huffington Post 6. Pay attention to the signs you might be stressed. “I pay attention to when I begin snapping at the children or my husband, have trouble sleeping, or if I become overwhelmed. I proactively take time to figure out what I need to outsource.” ―Jennifer Gentile, psychologist at telemedicine app LiveHealth Online 7. Be realistic about what you can accomplish. “No, I’m not making six dozen cookies for the school bazaar. In reality, there just are some things that I choose not to do during the holiday season. Some gatherings are not attended. There will be enough to do without cramming in 67 holiday gatherings. I choose the ones that are less stressful and enjoy.” ―Ken Yeager 8. Make time for your regular routines. “It is helpful to try to maintain balance between keeping to usual daily routines ― including healthy eating, exercise and getting adequate sleep ― while relaxing a bit to enjoy the festivities. Also, balancing demands on time and attention from friends and family with need for self care is important.” ―Victor Schwartz, chief medical officer at The Jed Foundation © Provided by The Huffington Post 9. Set a comfortable budget for gifts. “It is so easy to fall into the ‘commercialized holidays’ and strive to buy the ‘perfect’ gift for everyone. To help reduce that stress, I set a spending limit on everyone that is really modest, usually $25 to $50, and I stick to it. It might take some more creativity to find something that they will enjoy, but it reduces my financial stress and it forces me to think, ‘What would they really appreciate?’ ― as opposed to just ‘What do they want?’” ―Dan Reidenberg 10. Enjoy the holiday treats. “I proactively take steps to ensure I am eating healthy foods but understand that I will NOT be perfect when it comes to my diet, especially over the holidays, and that is OK.” ―Jennifer Gentile 11. Schedule some alone time if it all becomes too much. “With so many people around the house and stores filled with people, I find it helpful to make sure I take some time to myself. This is not about being selfish, but being OK saying that I deserve some me time, too.” ―Dan Reidenberg Cheers to a merry and bright season ― and giving stress the boot. Quotes have been lightly edited for clarity and length. This article originally appeared on HuffPost.
  4. Here is a new idea--actually an old idea that has been around for decades--that works: Transcendental Meditation. By USA Col. Brian Rees (ret.), MD, MPH, David O'Connell, PhD, and David Leffler, PhD Primary treatments for post-traumatic stress disorder (PTSD) such as Prolonged Exposure Therapy and Cognitive Processing Therapy are not proving effective. That's the conclusion of a recent Journal of the American Medical Association (JAMA) article calling for new ideas. The reality, the article points out, is that some two-thirds of combat veterans with PTSD are unable to free themselves from PTSD symptoms despite undergoing conventional treatments. Here is a new idea--actually an old idea that has been around for decades--that works: Transcendental Meditation. Research has shown that the practice of Transcendental Meditation ™ generates significant reductions in PTSD symptoms and in a short period of time. Examples: In a 1985 study, American Vietnam-era veterans with PTSD who were taught TM experienced major reductions in anxiety, depression, and negative personality traits. Iraq and Afghanistan veterans, taught TM in 2011, had a 50 percent reduction in symptoms within a 3-month period. In a 2013 study of Congolese refugees who had been exposed to civil war, sexual abuse, torture, and/or the brutal slaying of loved ones, 90 percent of subjects improved into a "non-symptomatic" range within 30 days of learning TM and remained that way throughout the more than 4-month monitoring period. A follow-up 2014 study of Congolese refugees showed that major benefits occurred within a mere 10 days of learning TM. The benefits were determined to be larger than those seen with other behavioral and meditation, relaxation or stress management techniques. TM is a cost-effective, easily learned, and effortless mental technique derived from ancient practices in India. It is taught in a systematic, highly structured and standardized manner by highly trained teachers throughout the world. More than 350 peer-reviewed studies, showing positive effects on mental and physical health, have been published in research journals. Based on the science, the American Heart Association has described TM as the only behavioral technique that can be recommended for lowering hypertension. Moreover, research reviews have shown TM to be the most effective behavioral technique in reducing anxiety. Prolonged Exposure Therapy and Cognitive Processing Therapy, conventional treatments used for PTSD, have been described as uncomfortable by many patients because they explicitly address and attempt to help patients process traumatic events and accompanying negative emotions and memories. In contrast, TM is not a therapy per se. Practitioners regularly describe their experiences with it as being pleasant and restful. With TM, negative emotions, thoughts and memories of past trauma are not explicitly addressed. Rather, regular TM practice leads to deep rest and a kind of passive processing of trauma. TM dissolves the deep stresses incurred on the physiological level and lessens identification with the trauma on the mental level. Brain wave activity becomes highly coherent, indicating orderliness and brain integration. Stress hormones such as cortisol, epinephrine and nor-epinephrine, decrease. Measurements of relaxation and well-being, such as serotonin levels, galvanic skin resistance, and immune-modulatory effects, all increase. Although conventional approaches to PTSD can increase one's self-confidence and sense of mastery and provide better coping mechanisms, TM practice apparently goes deeper. It provides a broader spectrum of benefits, including increases in ego development, executive functioning, personality integration, creativity, problem-solving abilities and intelligence--improvements well beyond disorder-specific symptom reduction. Military personnel and veterans are often hesitant to seek PTSD treatment because it could be viewed as a sign of weakness. TM is a self-sufficient technique free from the possible stigma of mental health services. The U.S. Army's Comprehensive Soldier and Family Fitness Program manual recognizes the need for "spiritual fitness." The fundamental damage in PTSD can be seen as spiritual. The individual is faced (over and over again for those tormented by intrusive thoughts and memories) with what seems to be hopelessly discouraging experiences that are irreconcilable with optimism. The Department of Defense and the Veterans Administration have worked hard to address PTSD, but in the United States we have frequently medicalized what is essentially a moral/spiritual injury. Resolution may lie in the benefits generated by something simple and broadly effective such as TM, where individuals can find quick and easy access to inner calm, stress release, and even bliss. With regular practice of just 20 minutes twice a day, tormented souls get measurable psychological and physical benefits--and a real chance to become more peaceful, productive, and fulfilled, and to enjoy more of what life has to offer. Although more high quality research is needed to test TM as a stand-alone treatment as well as an adjunct to conventional and other novel PTSD approaches, we now know from existing studies that the practice works well. Very well. And our veterans should have access to it--and to any other programs that work well. They deserve it. Rees, a former VA doctor, is a graduate of the U.S. Army War College who served in the Army Reserve for 37 years, including five deployments to Iraq and Afghanistan. He was the lead author of the two studies on TM for PTSD in Congolese refugees. His most recent book, Detained: Emails and musings from a spiritual journey through Abu Ghraib, Kandahar and other garden spots, was published this month; O'Connell is an author and has been a clinical and forensic psychologist for over 35 years. He most recently edited Prescribing Health: Transcendental Meditation in Contemporary Medical Care (New York, London: Rowman & Littlefield; 2015); Leffler is the executive director at the Center for Advanced Military Science (CAMS). He served in the U.S. Air Force for nearly nine years and has published articles about TM in over 1,000 locations worldwide.
  5. P. T. S. D. – Veterans Sources: HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/ptsd-in-veterans.htm http://www.helpguide.org/articles/stress/stress-relief-in-the-moment.htm Veterans’ Administration: http://www.ptsd.va.gov/public/family/ptsd-and-relationships.asp HelpGuide PTSD in Military Veterans Symptoms, Treatment, and the Road to Recovery for Post-Traumatic Stress Disorder Are you having a hard time readjusting to life outside the military? Are you always on edge, always on the verge of panicking or exploding, or, on the flip side, do you feel emotionally numb and disconnected from your loved ones? Do you believe that you’ll never feel normal again? For all too many veterans, these are common experiences—lingering symptoms of post-traumatic stress disorder (PTSD). It’s hard living with untreated PTSD and, with long V.A. wait times, it’s easy to get discouraged. But you can feel better, and you can start today, even while you’re waiting for professional treatment. There are things you can do to help yourself overcome PTSD and come out the other side even stronger than before. What is PTSD? Post-traumatic stress disorder (PTSD), sometimes known as shell shock or combat stress, occurs after experiencing severe trauma or a life-threatening event. It’s normal for the mind and body to be in shock after such an event, but this normal response becomes PTSD when your nervous system gets “stuck.” The latest research into the brain shows that there are three ways of regulating the nervous system and responding to stressful events: Social engagement is the most evolved strategy for keeping yourself feeling calm and safe. Socially interacting with another person—making eye contact, listening in an attentive way, talking—can quickly calm you down and put the brakes on defensive responses like “fight-or-flight.”Mobilization, otherwise known as the fight-or-flight response, occurs when social engagement isn’t an appropriate response—such as in a combat situation—and you need to either defend yourself or escape the danger at hand. Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your strength and stamina, speed your reaction time, and enhance your focus. Once the danger has passed, your nervous system then calms the body, slowing heart rate, lowering blood pressure, and winding back down to its normal balance.Immobilization. Immobilization occurs when you’ve experienced a traumatic amount of stress—in combat, for example. The physical danger of war has passed but you find yourself “stuck,” your nervous system unable to return to its pre-stress state of balance. This is PTSD.Who is affected by PTSD? Many military veterans develop symptoms of PTSD. In fact, military service is the most common cause of PTSD in men. Close to 30 percent of Afghanistan and Iraq War veterans treated at V.A. hospitals and clinics have been diagnosed with PTSD. For veterans who saw combat, the numbers are even higher, up to 49%. The more tours you made and the more combat you experienced, the more likely it is that you’ll develop PTSD. But however isolated or emotionally cut off from others you feel, it’s important to know that you’re not alone and there are things you can do to help yourself. What are the symptoms of PTSD in veterans? Symptoms sometimes don’t surface for months or even years after returning from deployment. While PTSD develops differently from veteran to veteran, there are four symptom clusters: Recurrent, intrusive reminders of the traumatic event, including distressing thoughts, nightmares, and flashbacks where you feel like it’s happening again. Experiencing extreme emotional and physical reactions to reminders of the trauma (panic attacks, uncontrollable shaking, heart palpitations, etc.).Extreme avoidance of things that remind you of the traumatic event, including people, places, people, thoughts, or situations you associate with the bad memories. Withdrawing from friends and family and losing interest in everyday activities.Negative changes in thoughts and mood, such as exaggerated negative beliefs about yourself or the world and persistent feelings of fear, guilt, or shame. Diminished ability to experience positive emotions and feeling detached from others.Being on guard all the time, jumpy, and emotionally reactive, as indicated by irritability, angry outbursts, reckless behavior, difficulty sleeping, trouble concentrating, hypervigilance, and an exaggerated start response.Suicide prevention in veterans with PTSD Suicidal thoughts and feelings are common symptoms of PTSD among military veterans. Feeling suicidal is not a character defect, and it doesn't mean that you are crazy, weak, or flawed. If you are thinking about taking your own life, seek help immediately. Please read Suicide Help, talk to someone you trust, or call a suicide helpline: In the U.S., call 1-800-273-TALK (8255).In the UK, call 08457 90 90 90.In Australia, call 13 11 14. Or visit IASP to find a helpline in your country. Self-help for PTSD in veterans While it’s common for veterans with PTSD to have to endure long waits for treatment at the V.A., there are plenty of things you can do for yourself to start feeling better. The job of recovery is to transition out of the mental and emotional war zone you’re still living in and help your nervous system return to its pre-war state of balance. As discussed above, the best way to regulate your nervous system is through social engagement—interacting with another human being, be it a loved one, a family member or a professional therapist. However, as a veteran with PTSD, you need to first become “unstuck” and move out of the immobilization stress response. With these recovery steps, you’ll learn how to deal with your combat stress and also learn skills that can benefit the rest of your post-war life. You’ll learn how to feel calm again, reconnect with others, deal with nightmares and flashbacks, cope with feelings of depression, anxiety, or guilt, and restore your sense of control. And when you do get to see a doctor or therapist at the V.A., you’ll be in a better position to benefit from professional treatment as well. The Road to PTSD Recovery for Veterans, 7 Steps: 1) The road to PTSD recovery step 1: Get moving Getting regular exercise has always been important for veterans with PTSD. As well as helping to burn off adrenaline, exercise can release endorphins and make you feel better, both mentally and physically. However, new research suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and move out of the immobilization stress response. Any exercise that engages both your arms and legs—such as running, swimming, basketball, or even dancing—will work well if, instead of continuing to focus on your thoughts as you exercise, you focus on how your body feels instead. Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. Many veterans find rock climbing, boxing, or martial arts especially effective as these activities make it easier to focus on your body movements—after all, if you don’t, you could get seriously hurt. 2) The road to PTSD recovery step 2: Connect with others Social interaction with someone who cares about you is an effective way to calm your nervous system. For any veteran with PTSD, it’s important to find someone you can connect with face to face—someone you can talk to for an uninterrupted period of time, someone who will listen to you without judging, criticizing, or continually being distracted by the phone or other people. That person may be your significant other, a family member, one of your buddies from the service, or a civilian friend. You may feel like the civilians in your life can’t understand you since they don't know what it's like to be in the military or to have seen the things you have. But people don't have to have gone through the exact same experiences to understand and relate to painful emotions and be able to offer support. What matters is that the person you're turning to cares about you, is a good listener, and is able to be there for you as a source of strength and comfort. If you're not ready to open up about the details of what happened, that's perfectly okay. You can talk about how you feel without going into a blow-by-blow account of events. You can also tell the other person what you need or what they can do to help, whether it's just sitting with you, listening, or doing something practical. Comfort comes from someone else understanding your emotional experience. You’ll also find that people who care about you welcome the opportunity to help. Listening is not a burden for them but an opportunity. How PTSD can get in the way of connecting with others Many veterans find that PTSD can leave them feeling disconnected, withdrawn and, while their nervous system is still stuck, make it tough to connect with other people. No matter how close they are to the person, or how helpful that person tries to be, they just don’t feel any better after talking with them. If that describes you, there are some things you can do to help the process along. Before you’re due to sit down with a friend over a alcohol or coffee, for example, take some time to exercise, as described in step 1 above. As well as calming you when you’re feeling anxious, irritable or on edge, physical movement can also open your nervous system’s pathway to social engagement. Think of it as shaking loose all the blockages to connecting with people. If working out isn’t practical, find a quiet place and take a few minutes before you meet your friend to move around, jump up and down, swing your arms and legs—in other words, flail around like you did as a three year old. A few minutes of that and you’ll be breathing heavily, your head will feel clearer, and you’ll be in a better place to connect. It may sound weird, but vocal toning is also a great way to open up your nervous system to social engagement—even if you can’t sing or consider yourself “tone-deaf.” Again, find a quiet place before hooking up with a buddy and, with your lips together and teeth slightly apart, simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face. Practice for a few minutes and notice if the vibration spreads to your heart and stomach as well. Other ways to connect with others Many veterans find it helpful to join a PTSD support group or to connect with other veterans or trauma survivors. Listening to others' stories and struggles may help you feel less isolated. You can also volunteer in the community, which can help you feel more connected and useful, especially if you’re not currently working. 3) The road to PTSD recovery step 3: More ways to calm your nervous system Just as loud noises, certain smells, or the feel of sand in your clothes can instantly transport you back to the trauma of a combat zone, so too can sights, sounds, smells, and other sensory input quickly calm you down. The key is to find the sensory input that works for you. Think back to your time on deployment: what brought you comfort at the end of the day? Perhaps it was looking at photos of your family? Or maybe it was the taste of candy in a care package from home, or listening to a favorite song, or smelling a certain brand of soap or cologne? Or maybe petting an animal works quickly to make you feel calm and centered? Everyone responds to sensory input a little differently, so experiment to find what works best for you. 4) The road to PTSD recovery step 4: Take care of your body The symptoms of PTSD can be hard on your body so it’s important to put a priority on sleep, exercise, healthy food, and relaxing activities. You may find it very difficult to relax at first. It’s common for veterans to be drawn to behaviors that pump up adrenaline. After being in a combat zone, that’s what feels normal. Without the rush, you feel strange or even dead inside. Things you may turn to for that familiar adrenaline rush include energy drinks, coffee, drugs, cigarettes, violent video games, and daredevil sports. If you recognize these urges for what they are, you can make better choices that will calm and care for your body and mind. Healthy habits for veterans with PTSD Here are some active steps you can take to improve your PTSD symptoms: Take time to rest and restore your body’s balance. Relaxation techniques such as massage, meditation, yoga, and tai chi are powerful defensive weapons against the symptoms of PTSD.Avoid alcohol and drugs (including nicotine). It can be tempting to turn to drugs and alcohol to numb painful feelings and memories and get to sleep. But substance abuse can make the symptoms of PTSD worse and compound your problems. The same goes for cigarettes.Find safe ways to blow off steam. Pound on a punching bag, pummel a pillow, go for a hard run, sing along to loud music, head to the gym for a vigorous workout, go somewhere private where you can scream at the top of your lungs, or vent in your journal or to someone you trust.Support your body with a healthy diet. Eat plenty of complex carbohydrates, such as potatoes and whole grains, to support mental clarity and physical stamina. Limit processed sugars, which can exacerbate mood swings and energy fluctuations.Get plenty of sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as soothing as possible. Use curtains to block outside light and if noise is a problem, try using a sound machine. 5) The road to PTSD recovery step 5: Deal with flashbacks, nightmares, and intrusive thoughts Flashbacks usually involve visual and auditory memories of combat or other trauma you experienced. It feels as if it’s happening all over again so it’s vital for you to accept and reassure yourself that your traumatic experience is not occurring in the present. One effective technique is to state to yourself (either out loud or in your head) the reality that while you feel as if the trauma is currently happening, you can look around and recognize that you’re safe. Here’s a simple script you can use when you awaken from a nightmare or start to experience a flashback or intrusive thought: “I am feeling [panicked, overwhelmed, etc.] because I am remembering [traumatic event], but as I look around I can see that the event isn’t happening right now and I’m not actually in danger.” Other techniques that can be helpful in bringing you back to the present include tapping your arms or describing what you see when look around (name the place where you are, the current date, and three things you see when you look around). Tips for grounding yourself during a flashback If you’re starting to disassociate or experience a flashback, try using your senses to bring you back to the present and "ground" yourself. Experiment to find what works best for you. Movement: Move around vigorously (run in place, jump up and down, etc.); rub your hands together; shake your head Touch : Splash cold water on your face; grip a piece of ice; touch or grab on to a safe object; pinch yourself; play with worry beads or a stress ball Sight: Blink rapidly and firmly; look around and take inventory of what you see Sound : Turn on loud music; clap your hands or stomp your feet; talk to yourself (tell yourself you’re safe, that you’ll be okay) Smell: Smell something that links you to the present (coffee, mouthwash, your wife’s perfume) or a scent that has good memories Taste : Suck on a strong mint or chew a piece of gum; bite into something tart or spicy; drink a glass of cold water or juice 6) The road to PTSD recovery step 6: Work through survivor's guilt Feelings of guilt are very common among veterans with PTSD. You may have seen people injured or killed, often your friends and comrades. You may ask yourself questions such as: Why didn’t I get hurt?Why did I survive when others didn’t?Could I have done something differently to save them? You may end up blaming yourself for what happened and believing that your actions (or inability to act) led to someone else’s death. You may feel like others deserved to live more than you—that you’re the one who should have died. This is survivor’s guilt. Healing from survivor's guilt Healing doesn’t mean that you’ll forget what happened or those who died. And it doesn’t mean you’ll have no regrets. What it does mean is that you’ll look at your role more realistically. Remember, you are only human. The following questions can help you “reality test” your guilty feelings: Is the amount of responsibility you’re assuming reasonable?Could you really have prevented or stopped what happened? Could you really have reacted differently?Are you judging your decisions based on full information about the event, or just your emotions?Did you do your best at the time, under challenging circumstances?Do you truly believe that if you had died, someone else would have survived? Honestly assessing your responsibility and role can free you to move on and grieve your losses. Instead of punishing yourself, you can redirect your energy into honoring those you lost and finding ways to keep their memory alive. And in those cases where you truly believe you did something wrong, you can make amends. Even when you can’t make amends directly, there is always something you can do (such as volunteering for a cause that’s connected in some way to one of the friends you lost). The goal is to put your guilt to positive use, and thus transform tragedy, even in a small way, into something good. 7) The road to PTSD recovery step 7: Seek professional treatment Under the guidance of an experienced therapist or doctor, there are several different types of professional treatment for PTSD available. Cognitive-behavioral therapy or “counselling” involves carefully and gradually “exposing” yourself to thoughts and feelings that remind you of the event. Therapy also involves identifying distorted and irrational thoughts about the event—and replacing them with more balanced picture.Medication, such as antidepressants, is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These work by helping the nervous system become “unstuck.” Veterans’ Administration Relationships and PTSD How does trauma affect relationships? Trauma survivors with PTSD may have trouble with their close family relationships or friendships. The symptoms of PTSD can cause problems with trust, closeness, communication, and problem solving. These problems may affect the way the survivor acts with others. In turn, the way a loved one responds to him or her affects the trauma survivor. A circular pattern can develop that may sometimes harm relationships. How might trauma survivors react? In the first weeks and months following a trauma, survivors may feel angry, detached, tense or worried in their relationships. In time, most are able to resume their prior level of closeness in relationships. Yet the 5% to 10% of survivors who develop PTSD may have lasting relationship problems. Survivors with PTSD may feel distant from others and feel numb. They may have less interest in social or sexual activities. Because survivors feel irritable, on guard, jumpy, worried, or nervous, they may not be able to relax or be intimate. They may also feel an increased need to protect their loved ones. They may come across as tense or demanding. The trauma survivor may often have trauma memories or flashbacks. He or she might go to great lengths to avoid such memories. Survivors may avoid any activity that could trigger a memory. If the survivor has trouble sleeping or has nightmares, both the survivor and partner may not be able to get enough rest. This may make sleeping together harder. Survivors often struggle with intense anger and impulses. In order to suppress angry feelings and actions, they may avoid closeness. They may push away or find fault with loved ones and friends. Also, drinking and drug problems, which can be an attempt to cope with PTSD, can destroy intimacy and friendships. Verbal or physical violence can occur. In other cases, survivors may depend too much on their partners, family members, and friends. This could also include support persons such as health care providers or therapists. Dealing with these symptoms can take up a lot of the survivor's attention. He or she may not be able to focus on the partner. It may be hard to listen carefully and make decisions together with someone else. Partners may come to feel that talking together and working as a team are not possible. How might loved ones react? Partners, friends, or family members may feel hurt, cut off, or down because the survivor has not been able to get over the trauma. Loved ones may become angry or distant toward the survivor. They may feel pressured, tense, and controlled. The survivor's symptoms can make a loved one feel like he or she is living in a war zone or in constant threat of danger. Living with someone who has PTSD can sometimes lead the partner to have some of the same feelings of having been through trauma. In sum, a person who goes through a trauma may have certain common reactions. These reactions affect the people around the survivor. Family, friends, and others then react to how the survivor is behaving. This in turn comes back to affect the person who went through the trauma. Trauma types and relationships Certain types of "man-made" traumas can have a more severe effect on relationships. These traumas include: Childhood sexual and physical abuseRapeDomestic violenceCombatTerrorismGenocideTortureKidnappingPrisoner of war Survivors of man-made traumas often feel a lasting sense of terror, horror, endangerment, and betrayal. These feelings affect how they relate to others. They may feel like they are letting down their guard if they get close to someone else and trust them. This is not to say a survivor never feels a strong bond of love or friendship. However, a close relationship can also feel scary or dangerous to a trauma survivor. Do all trauma survivors have relationship problems? Many trauma survivors do not develop PTSD. Also, many people with PTSD do not have relationship problems. People with PTSD can create and maintain good relationships by: Building a personal support network to help cope with PTSD while working on family and friend relationshipsSharing feelings honestly and openly, with respect and compassionBuilding skills at problem solving and connecting with othersIncluding ways to play, be creative, relax, and enjoy others What can be done to help someone who has PTSD? Relations with others are very important for trauma survivors. Social support is one of the best things to protect against getting PTSD. Relationships can offset feelings of being alone. Relationships may also help the survivor's self-esteem. This may help reduce depression and guilt. A relationship can also give the survivor a way to help someone else. Helping others can reduce feelings of failure or feeling cut off from others. Lastly, relationships are a source of support when coping with stress. If you need to seek professional help, try to find a therapist who has skills in treating PTSD as well as working with couples or families. For resources, please see our Where to Get Help for PTSD page. Many treatment approaches may be helpful for dealing with relationship issues. Options include: One-to-one and group therapyAnger and stress managementAssertiveness trainingCouples counselingFamily education classesFamily therapy
  6. P. T. S. D. – Helping Your Child Cope With Traumatic Events Sources: Anxiety & Depression Association of America: http://www.adaa.org/living-with-anxiety/children-and-teens/tips-parents-and-caregivers/help-your-child-manage-traumatic- http://www.adaa.org/living-with-anxiety/children National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm KidsHealth: http://kidshealth.org/parent/emotions/feelings/ptsd.html Veterans’ Administration: http://www.ptsd.va.gov/public/family/ptsd-children-adolescents.asp http://www.ptsd.va.gov/public/family/very_young_trauma_survivors.asp Anxiety & Depression Association of America Help Your Child Manage Traumatic Events Since the terrorist attacks of 9/11, most adults have accepted that we live in a new era of trying times. Tornadoes, hurricanes, and other natural disasters, as well as explosions, and other traumatic events threaten our sense of safety and security, and they occur around the world on any given day. Adults often struggle with the effects of trauma, even though they understand them. But children react differently based on their personality, age, and circumstances. Children rely on the support of parents and teachers to help them deal with their emotions during and after traumatic events. Parents should decide how much information their children can handle. ADAA member Aureen Wagner, PhD, Director of The Anxiety Wellness Center in Cary, North Carolina, offers this recommendation for parents: “Remain as calm as possible; watch and listen to your child to understand how upset he or she is. Explain a traumatic event as accurately as possible, but don’t give graphic details. It’s best not to give more information than your child asks for. Let your child know that it is normal to feel upset, scared or angry. If older children or teenagers want to watch television or read news online about a traumatic event, be available to them, especially to discuss what they are seeing and reading.” These tips are important for children and adolescents of all ages: Reassure them that you’ll do everything you can to keep them and their loved ones safe.Encourage them to talk and ask questionsLet them know that they can be open about their feelings.Answer questions honestly.Protect them from what they don’t need to know.Avoid discussing worst-case scenarios.Limit excessive watching and listening to graphic replays of the traumatic eventStick to your daily routine as much as possible. Most children and teenagers will recover from their fear. But you can watch for these signs of ongoing distress: Difficulty sleepingChange in eating habitsClinginessRe-experiencing the event through nightmares, recollections, or playAvoidance anything reminiscent of the eventEmotional numbing or lack of feeling about the eventJumpinessPersistent fears about another disaster If after a month or so your child is still showing signs of distress, professional help may be indicated. Children who have trouble getting beyond their fears may be suffering from PTSD, or posttraumatic stress disorder. And that’s when it’s time to seek the assistance of a mental health professional. Many effective treatments are available for children and teens. Anxiety & Depression Association of America (Anxiety & Depression In) Children & Teens Anxiety and depression are treatable, but 80% of kids with a diagnosable anxiety disorder and 60% of kids with diagnosable depression are not getting treatment, according to the 2015 Child Mind Institute Children’s Mental Health Report. Anxiety is a normal part of childhood, and every child goes through phases. A phase is temporary and usually harmless. But children who suffer from an anxiety disorder experience fear, nervousness, and shyness, and they start to avoid places and activities. A child who sees a scary movie and then has trouble falling asleep or has a similar temporary fear can be reassured and comforted. But that is not enough to help a child with an anxiety disorder get past his or her fear and anxiety. Anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. Anxiety disorders often co-occur with depression as well as eating disorders, attention-deficit/hyperactivity disorder (ADHD), and others. With treatment and support, your child can learn how to successfully manage the symptoms of an anxiety disorder and depression and live a normal childhood. National Institute of Mental Health Do Children React Differently (To PTSD) Than Adults? Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include: Bedwetting, when they’d learned how to use the toilet beforeForgetting how or being unable to talkActing out the scary event during playtimeBeing unusually clingy with a parent or other adult. Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge. For more information, see the NIMH booklets on helping children cope with violence and disasters. HelpGuide Symptoms of PTSD In Children & Adolescents In children—especially those who are very young—the symptoms of PTSD can be different than those in adults. Symptoms in children include: Fear of being separated from parentLosing previously-acquired skills (such as toilet training)Sleep problems and nightmares without recognizable contentSomber, compulsive play in which themes or aspects of the trauma are repeatedNew phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)Acting out the trauma through play, stories, or drawingsAches and pains with no apparent causeIrritability and aggression Veterans’ Administration Very Young Trauma Survivors: The Role of Attachment Years ago, little was known about PTSD in infants and young children. Today, we know that trauma and abuse can have grave impact on the very young. We also know how much the attachment or bond between a child and parent matters as a young child grows. This can make a difference in how a child responds to trauma. Below we discuss rates of trauma-related problems in infants and young children, as well as treatment options. How many infants and young children are abused? In the United States, Child Protective Services receives reports on the abuse or neglect of about 5.5 million children in a year. Infants and young children have more risk of abuse than older children. Over one-third of proven reports to child protection services are for children under the age of five years. Further, children are most often hurt or killed from abuse when they are in the first year of life. Over three-quarters of children killed due to abuse are under the age of three years. How do trauma and neglect affect infants and young children? As with adults, following trauma, most children will have some symptoms. Young children may show a fear of strangers or be scared to leave their parent. They might also have sleep problems or bad dreams. Young children may also repeat themes of the trauma in their play. For example, a child who was sexually abused in her bed might play out "dark" bedroom scenes with dolls. They might also be more fussy, irritable, aggressive, or reckless. Young children may lose skills they once had, such as toilet training. They might go back to earlier habits, like sucking their thumb. Very young children may not show the same PTSD symptoms we see in adults. This may be because many of the symptoms of PTSD require that the child be able to talk about what happened. Early trauma affects the child's nervous system. The nervous system is shaped by the child's experiences. Stress over a period of time can lead to changes in the parts of the brain that control and manage feelings. That is to say, stress and trauma early in life can change the brain. This can have long-term effects on physical, mental, and emotional growth. What's more, the impact of early abuse often extends into later childhood, teen, and even adult years. Diagnosing PTSD in infants and young children Although most children have symptoms following trauma, only a few will go on to get PTSD. Diagnosing PTSD in children can be difficult. The definition of trauma that is used to diagnose PTSD is specific. It says that a person must feel fear, helplessness, or horror for an event to be a "trauma." It is hard to say if this happens for a very small child. Young children are often not able to describe in words the event or how they felt about it. For this reason, other ways of diagnosing PTSD have been created for use with children ages zero to three years. What is attachment? Attachment is the connection found in the main relationship in a child's life. Usually it is with his or her caregiver. Children and parents are meant to form attachments with each other. For example, your baby is born knowing how to cuddle and cry, and it causes you to respond. Also, infants like their caregiver's face and voice more than other sights and sounds. The type of attachment between a child and caregiver can affect how a child will relate to the people she or he comes across in life. Why is attachment important when dealing with trauma? A child's main attachment helps him learn to control his emotions and thoughts. When a caregiver's responses are in tune with a child's needs, the child feels secure. The child then uses this relationship pattern as practice to build coping skills. On the other hand, a child who gets confusing or inconsistent responses from the caregiver might be fussy, have a hard time calming down, withdraw from others, or have tantrums. Children also use their caregivers to guide how they should respond to events. Have you noticed how a child sometimes looks at his or her parent to know how to respond? When you stop your child from doing something unsafe, he in time learns to stop himself. So a parent's reaction to trauma affects the child. Through a relationship with their caregiver, children learn how to be in charge of feelings and behaviors, and how to act with other people. Here are some examples: If a caregiver often helps a child manage her feelings, the child can build coping skills. This could lead to better healing for children who go through trauma.A traumatic event might hurt the attachment between a caregiver and child due to strong feelings that get in the way of a good relationship. Sometimes a child can be angry toward her parent for not keeping her safe. Even very young children can have these feelings. Or, a parent might feel guilty about the event and this might affect the relationship.If the caregiver has her own trauma history, her symptoms (trying not to feel, always worried about danger) might get in the way of caring for her child. What kind of help is out there? Child health care settings, doctors, and other health care providers can give support, education, safety planning, and information about treatment.Child and family social services can help caregivers with many issues.In-home nurses and other providers can help new parents provide good care for their young children. They might help with feeding, sleep, safety, or illness.Therapy is needed if relationship problems or PTSD symptoms do not get better. Treatment that involves the caregiver and child together is best for cases with poor attachment and trauma. One such treatment is called child-parent psychotherapy (CPP). CPP helps caregivers understand their children, keep them safe, and give emotional help.For some children, treatment does not take place for many years. No matter the age, when trauma and PTSD are involved, evidence-based, effective treatment exists. Veterans’ Administration PTSD In Children & Teens What events cause PTSD in children? Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live. Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur: 65% neglect18% physical abuse10% sexual abuse7% psychological (mental) abuse Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.) How many children get PTSD? Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors. What are the risk factors for PTSD? Three factors have been shown to raise the chances that children will get PTSD. These factors are: How severe the trauma isHow the parents react to the traumaHow close or far away the child is from the trauma Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress. Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas. Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages. What does PTSD look like in children? School-aged children (ages 5-12) These children may not have flashbacks or problems remembering parts of the trauma, the way adults with PTSD often do. Children, though, might put the events of the trauma in the wrong order. They might also think there were signs that the trauma was going to happen. As a result, they think that they will see these signs again before another trauma happens. They think that if they pay attention, they can avoid future traumas. Children of this age might also show signs of PTSD in their play. They might keep repeating a part of the trauma. These games do not make their worry and distress go away. For example, a child might always want to play shooting games after he sees a school shooting. Children may also fit parts of the trauma into their daily lives. For example, a child might carry a gun to school after seeing a school shooting. Teens (ages 12-18) Teens are in between children and adults. Some PTSD symptoms in teens begin to look like those of adults. One difference is that teens are more likely than younger children or adults to show impulsive and aggressive behaviors. What are the other effects of trauma on children? Besides PTSD, children and teens that have gone through trauma often have other types of problems. Much of what we know about the effects of trauma on children comes from the research on child sexual abuse. This research shows that sexually abused children often have problems with Fear, worry, sadness, anger, feeling alone and apart from others, feeling as if people are looking down on them, low self-worth, and not being able to trust othersBehaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcoholHow is PTSD treated in children and teens? For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years if they do not get treatment. There are many treatment options, described below: Cognitive-Behavioral Therapy (CBT) CBT is the most effective approach for treating children. One type of CBT is called Trauma-Focused CBT (TF-CBT). In TF-CBT, the child may talk about his or her memory of the trauma. TF-CBT also includes techniques to help lower worry and stress. The child may learn how to assert himself or herself. The therapy may involve learning to change thoughts or beliefs about the trauma that are not correct or true. For example, after a trauma, a child may start thinking, "the world is totally unsafe." Some may question whether children should be asked to think about and remember events that scared them. However, this type of treatment approach is useful when children are distressed by memories of the trauma. The child can be taught at his or her own pace to relax while they are thinking about the trauma. That way, they learn that they do not have to be afraid of their memories. Research shows that TF-CBT is safe and effective for children with PTSD. CBT often uses training for parents and caregivers as well. It is important for caregivers to understand the effects of PTSD. Parents need to learn coping skills that will help them help their children. Psychological first aid/crisis management Psychological First Aid (PFA) has been used with school-aged children and teens that have been through violence where they live. PFA can be used in schools and traditional settings. It involves providing comfort and support, and letting children know their reactions are normal. PFA teaches calming and problem solving skills. PFA also helps caregivers deal with changes in the child's feelings and behavior. Children with more severe symptoms may be referred for added treatment. Eye movement desensitization and reprocessing (EMDR) EMDR combines cognitive therapy with directed eye movements. EMDR is effective in treating both children and adults with PTSD, yet studies indicate that the eye movements are not needed to make it work. Play therapy Play therapy can be used to treat young children with PTSD who are not able to deal with the trauma more directly. The therapist uses games, drawings, and other methods to help children process their traumatic memories. Other treatments Special treatments may be needed for children who show out-of-place sexual behaviors, extreme behavior problems, or problems with drugs or alcohol. What can you do to help? Reading this fact sheet is a first step toward helping your child. Learn about PTSD and pay attention to how your child is doing. Watch for signs such as sleep problems, anger, and avoidance of certain people or places. Also watch for changes in school performance and problems with friends. You may need to get professional help for your child. Find a mental health provider who has treated PTSD in children. Ask how the therapist treats PTSD, and choose someone who makes you and your child feel at ease. You, as a parent, might also get help from talking to a therapist on your own.
  7. I was going to sit home and read like always but my ex-boyfriend from my sophomore year in high school texted me We dated for three months back in 2006; we kept in touch, sort of,but we aren't close either so it was kind of surprising. I've been off my meds recently (taking a break from them) so not only is my sadness and irritation elevated but my anxiety has come back severely. He asked to come hang out in our old town, which is 40 minutes away from me now & for some stupid reason I agreed thinking I could actually handle this situation. So I got ready, then headed up there. As soon as I turn on the street doom struck me & I said to my self out loud "what the world am I doing here ." I passed the house, saw all the cars parked and people walking in and out, I parked down the street & had a panic attack; naturally. Thank god I had my brown paper bag, those things are friggin life savers! I texted him & lied & said I can't make it, so maybe next time. You guys don't understand how much I HATE lying, little fibs or any sort of lying, I feel sick to my stomach. But I couldn't do it....I couldn't go in there & face him, or all those people for that matter! I think what I was afraid of in the back of my mind is me coming to see him, he might get the wrong idea. Or I had an irrational fear of him doing something to me, out of spite....I have no idea why. I imagined myself walking down there and something really bad happening, no he never did anything to hurt me; physically at least. I'm sorry I had to write this but I feel so pathetic right now & low, I hate myself for it. If I could punch myself in the face right now, or have someone punch me in the face that would be awesome....I don't know why I'm taking this so hard right now. It's probably not even a big deal, I don't know why I'm so scared and angry right now. So many mixed emotions, but this is also why I can't keep friends or boyfriends because I'm so scared of this world. It's way too loud, big, and terrifying people scare me; genuinely freak me out. I hate leaving my room, especially my house....gahhh I feel so stupidddddd! (even for writing this; but I had to get it out) notice the rambling......
  8. Sorry for the non-capital "i" in the thread title. Edit wouldn't let me fix it. So here is my current situation: I moved recently for a job. I moved in November. On Halloween, I went to my first therapist appointment in my new city. She in turned me to my new/latest therapist. I see her tomorrow for my 2nd time, but we've been in contact over the phone since the last visit when I had a melt down and thought I wasn't going to make it through the night. I live in Michigan. The only successful med I have taken to date has been 5 mg of Zyprexa for sleep, 10 mg would zonk me out for 12-16 hours at a time. It kept me even for a several months, but as the stress grew I quit sleeping well on it and eventually became uneven on it. So for a few months I had a large supply of Zyprexa, I was prescribed 10 mg's on accident and when I went to return they told me to just cut them in half. Anyway, I work in a call center doing tax support. There are parts I really excel at, and there are parts I am horrible with. This is not acceptable where I work. Everything is performance-based. You're either good at what you do, or you get in trouble, it's literally that simple. Everybody watches you. The stress of the job is finally breaking me. What set me off today was all week I was excited because I was going to my old town on Saturday to hang out with a friend all day. Today they added me to the Saturday shift without telling me. That was it for me. I've had TWO days off in the past two weeks and I get about 3 hours to myself a day. I cannot handle this. This busy "season" lasts for at LEAST 3 damned months of the year. I cannot do this. I do not like what I do and I will not continue to sacrifice my happiness for it. I come home and am miserable. The one night I was so depressed I had to actually sit down and think about ending it all. I spent a while debating it, I decided not to. I told my therapist and my psychiatrist. Ideally, I will put my two weeks in and get the #### out so at least I can put them on the resume. I need to get out of this job. The only thing stopping me from quitting tomorrow is the fact that I can't get insured, or so that is what my mom originally told me. My mom told me money is not the issue here, which is comforting and embarrassing at the same time. I want to handle this on my own, but living paycheck to paycheck and getting no insurance if I quit, I feel forced into this just so I can go and visit my doc once a month and maybe tweak something. Anyway, I went and did research on it. Now, living in Michigan, I learned we do not have a high-risk pool. I learned I can apply to Blue Cross Blue Shield of Michigan, but there is an 180 day waiting period, which can be waived with proof. On the site, the insurance is around $220 a month. I would not be able to afford this working. thus leaving my mom stuck with the bill until I get working again. How god damned embarrassing, I'm 27. But I can tell you what I've learned: I spend money like crazy. Not even on stuff I need, stuff that will make me feel better temporarily. I think just short term, not for the future. Completely irrational and stupid, and again, highly embarrassing. I really miss having a girlfriend. But the one woman I've met up here, I've scared off because I had an episode when we first met due to work. I cannot and will not enter a relationship until I am stable again. I want to begin the rest of my life after college as a stable person. There is nothing more that I want than to live a normal life and not having to worry about losing it or freaking out to the point where I'm literally paralyzed with fear. Currently, I am on 5mg of Seroquil. Monday started off great, I felt so calm and so good that I went through the day and got home, still in a good mood. I rode the high to Tuesday. Yesterday was fine. Today was good, until I saw my schedule. Then I got so angry I literally wanted to fight someone. Then on the ride home I got so upset I started crying, feeling helpless and alone. The reason I'm so p***** was because tomorrow night I have therapy after work, so I wont get home until 9 at the earliest. I have to work Saturday, so I need to be up by 10. Now, the key here is that for several months I could not sleep. I would have no problems falling asleep, but staying asleep was a nightmare. I could never stay asleep for more than a few hours. It made me angry and extremely irritable. And I'm on the phone listening to old people who don't know a damned thing about computers all day. During this job I have discovered that I am far too excitable and even display inappropriate motions that make things awkward. The job...it's for a big tax company. I support software. It's very cut throat and the people there are so fake it makes me sick sometimes. They're rude. I come home and literally worry all night about how the hell I'm going to get up tomorrow and go through this for one more day. It's demoralizing, the people are too demanding. I took this job out of desperation for the pay and just to have a job, but it's been months now and it has become unbearable. I've called off twice this year already because I get so worried about getting ream out for not meeting their too-high standards. This is a very traumatic experience. I am extremely embarrassed about everything and I've told no one. I'm even more embarrassed to admit that at 27 I am so pathetic and screwed that my own mother offered to pay for the insurance. It's just embarrassing that I cannot stand on my own two feet. I feel so demoralized and dehumanized. Tonight I have been beyond nervous and I even started talking to myself. On the ride home I got so p***** I punched the steering wheel and began crying. Now with my first meeting with my psychiatrist we discussed some treatment options. The one I really liked the most was an intensive care program. In short she explained that I go to a hospital for a few weeks and get treated. We also talked about one where I just go in and check in with doctors once a day or whatever. Ideally, I want to get as much as I can sorted out as quickly as possible. Why? Because I want to start the rest of my life already. I'm 27, have a degree in computer engineering, and I have no savings, am living paycheck to paycheck, and am completely miserable, I'm embarrassed, and I feel worthless. The bipolar...it started when my dad died if I had to guess when I really noticed a change in myself. My cousin, who I am very close to, even told me the other day I have never been the same since my dad died. Another traumatic experience: I was in a detention home when I was 16. The local police tried to say I was going to pull a "Columbine". They arrested me and put me in a detention home for 30 days. They found no evidence of any such thing. The third day in the detention home my mom and dad come to visit me, my dad tells me has terminal cancer. I get out after 30 days of house arrest and finally get to be with my dad. He offers me a job working for him while I'm on house arrest. During that time we became extremely close. Roll forward some time. I became socially awkward. People avoid me. My mental health degrades severely. My third year in college on summer I go off my meds and get violent. Not with person, but just to the point where I couldn't be calmed down, similar to what happened today. Friends have been an issue lately. Since I moved a lot of my old friends don't keep in touch. I look through my texts and feel so pathetic, I only talk to a few people anymore. Growing up I've always had tons of friends, especially best friends who always hung out with me. This lasted until I moved in 2006, since then I have never had more than a few friends. I thought I had some good friends to count on, but they never make any attempt to come see me or get in touch with me really. So then I move away and have to start all over again. In the winter. I live in my apartment, it drives me nuts. If I'm here too long I get antsy. I often go out to eat just to get the hell out of the apartment. My healthcare history: nothing but s*** doctors. I have an extreme hatred for psychiatrists. My new therapist made me wait 30 minutes extra and I was p*****. I was quite an a****** to her, but towards the end I lightened up because she seemed like she wanted to help. I have never had steady monitoring. I was on a cocktail of meds in just a couple weeks and crashed hard and became suicidal. Good job doctors. That's when I saw my first psychiatrist, but she was on maternity leave and vacation so much I only saw her once in a while for meds. My therapist was worthless. I only went to her because she was hot and made me feel good, temporarily. We never solved a D*** thing and she never really helped. But she was my only option at that point. I do not like my current psychiatrist. Well, I think she is knowledgeable, and we've only had one visit so far, but she got on my nerves. She asked a ton of questions about dates, like I was supposed to recall every event like I have a photographic memory. That p***** me off. And she kept asking every little detail. Which I understand what she was doing, I just found it irritating. Now also, I don't know how I'm going to take time off from work to get meds. My boss made a comment today to me that really made me nervous. I've called off twice this year already from being too nervous to work, (I get points against me, so many points and I get written up, fired, whatever), I put in a request for a half day to go back but I've not yet seen a response to it and I know my boss doesn't like it. They expect my life to revolve around this job. How the hell can I do that when I can't even stand to be in the damned building?? I need out. I took my meds for the evening but I am so worried and so irritated that I just don't know what the #### I'm going to do. I am so screwed. To summarize: I'm 27, I've been labeled as "bipolar", I have a degree in computer engineering and a passion for IT, I think I'm a fairly smart person, I'm a quick learner, and there is no computer I can't fix. But that is just to get me in the door, I have dreams of being an IT director or some kind of management in IT, I want to be the guy in charge of stuff basically. I've even thought about going a Master's at some point just so I can get more experience with the technology I want to work in rather than waiting years to get promoted. Being a recent college graduate, I understand I can't have the world the way I want it, but I should not have to sacrifice my happiness (which in this case is being caused by 10 hour work days, plus a Saturday shift, in an extremely stressful work environment) In short I'm a good worker, if it wasn't for my wild mood swings, my paranoia, excitably. I just want to be a normal person. I cannot stay at this current job, the hours are too long, the job stresses me out daily and literally scares me, and I'm afraid to just be in the building. I am very serious about what I do, but this disorder is preventing me from doing what I love successfully. Help :( I need out but I have no one to ask, and my therapist doesn't always get back to me at the most critical times, like tonight. Sorry for the long winded post, but the more info, the better I guess. I don't know what else to really do at this point. I am not a religious man by any means, praying for me will not work. What I need is advice on what to do so I can start enjoying life again. I realize much easier said than done, but it's clear what needs to be done, I just don't know how to achieve it in the best possible manner. I know it will not be quick and it will not be easy, but I cannot keep living like this. This was OK for the time being, but it is not what I want to do with the rest of my life, let alone tomorrow. I'm smart enough and capable enough to be working, I just need to get everything under control with the help of a capable doctor, who I could of possibly met. But I want serious care, my career is everything to me right now and I'm more concerned with getting my mood swings and emotions under control, be calmed down, so I can do what I enjoy in life: working with computers and technology. I am so, so tired. I know people are sick of hearing it from me. But I can't sleep because I'm so stressed. I wake up early every day and dread work.
  9. I'm so scared of even posting this online in fear a co-worker-to-be/employer-to-be would find me. If they do.... dog, I hope they don't think it's me. ;_; This is a problem that's been growing worse and worse the last couple weeks. It will be long but I hope you can bare with me. I'm 20. I've been training at my future workplace. I'm training to work in a program right now. Another guy who is training sits next to me, but he was employed for a different position and is like ******* time learning the program with me (among others). Also, he has a friend beside him who knows the program that he can ask to. I have nobody next to me to ask tiny questions to which I am jealous of. (I wish I could just casually ask if I wasn't so freaking terrified of speaking to people...) So I end up having to ask the division lead. He said to bug him as much as I want with questions. But I kept asking the same questions over and over, him teaching me the same things over and over. I'm afraid he thinks I'm a scatter-brain. So for two days straight I didn't ask any questions. (He has to review work that everyone in the workplace has done, so he's busy anyway I tell myself) Then he says to me during lunch break that I should ask all the questions I can now than when my contract starts. So I gave him my list of questions and he sat down with me and answered them. One would think that would let me feel more comfortable with asking questions, but nooo my '****** paranoid brain tells me he(lead) thinks I'm dumber than ever now! I try to stay logical and tell me not to bully myself, that people don't hate me but I'm still terrified. So two weeks has gone by and I've made little to no progress. Progress I do not think is adequate for staying in the workplace 9.30hrs/day the entire week. I would have more done if it weren't for my insecurities and illogical way of thinking. Yesterday I went into the workplace trying to convince myself to ask questions, and not put it off in fear. Lest I end up putting it off until he comes back after leaving for a 4o'clock meeting. He asks me if he could attend to my question tomorrow (today). That. That was the feeling of failure to me. If I had asked the question in the morning WHEN I FIRST HAD IT, he wouldn't have had that look of "why do you ask me NOW when it's the end of the day??" sorta exasperated expression. All my failures came flooding back to me that night and I cried until my head hurt. I wanted to discuss this with my mom. I did once. But if I tell her any further she will shrug it off because she wants to believe that I don't have depression. (I'm saving that for another thread though, It'll be way too long) So I've had no one to consult to except myself, and we all know how well that goes. I had an outburst just now. I lost my dentist contact card among all the mess an my mom says "AGAIN??" I couldn't take it anymore.Just writing this was enough stress pent up inside and I couldn't hold back my tears anymore. She even told me to get a grip and stop crying all the time. Am I just a scatter-brain? I feel hopeless right now, despite all the books I've read on depression and how to cope with it. I am tempted to explain why I'm such a wreck at 20 over TINY things, but I'm sorry it just feels overwhelming to me right now. I'm sorry I didn't get depression for a good enough reason and I'm sorry you had to read through all of that. But if anybody at all can sympathize with me right now, would you help me?
  10. Hi all.. just wondering if anyone has any tips they've found out and about or from personal experience.. I've suffered with anxiety for 3 odd years now, panic attacks, not being able to leave the house, retreating from everyone, insomnia as a result of anxiety (an inability to sleep due to being in a permanent state of fear). I can do anything, or even contemplate doing anything, without my mind going into overdrive on the 'what ifs' of it. Essentially, I was wondering if anyone had any techniques or methods (excluding medication, I dislike to take mine, definitely don't want anymore) that they found had some combatting effect on anxiety...however small. I realise I'm not going to get 'better', but I would like to try and relieve a bit of the daily stress....key word being 'try'. Regards, Jigsaw Girl
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