My therapist prescribed me to drink more alcohol. I had described symptoms of posttraumatic stress disorder (PTSD), yet once again, the diagnosis was completely missed. Even worse, this uniformed therapist suggested that I drink wine “medicinally,” beginning in the morning, to help cope with what he said was high anxiety. What makes this horrible advice even more dangerous is the fact that upward of fifty percent of those with PTSD also battle substance use disorder.
Trauma that arises from natural disasters—like the horrific flood that has devastated much of Louisiana this week—can have a heavy emotional toll on those who are directly affected, including survivors, rescue workers, volunteers, bystanders, and witnesses. Mild to moderate stress reactions are normal and expected for anyone involved. Although their reactions, emotions, and behaviors may seem extreme at the time, they generally don’t turn into chronic disorders.
For some, though, the trauma can be so overwhelming that it more or less “rewires” the person’s brain, putting them in a state of hypervigilance and/or helplessness for many months or years beyond the event leaving them with the symptoms of Post-Traumatic Stress Disorder (PTSD) or severe anxiety and depression.
Peter Levine, a renowned trauma expert and Senior Fellow at The Meadows, defines trauma not by the event, but by the person’s reactions to it and their symptoms. Earthquakes, floods, tornadoes, hurricanes, shootings, and massive violent attacks are events that typically come to mind when people think of traumatic events. Many might also include being involved in a serious accident, being a witness to a serious accident, or being the victim of or witness to a serious crime as “trauma.”
Some people will be more severely affected by a traumatic event and struggle for varying periods of time based on the nature of the event and their own temperament. Some of the warning signs that someone is experiencing levels of stress beyond what is normal and expected after a traumatic event and may be struggling with PTSD include…
Any of these symptoms indicate that the person likely needs help from a mental health professional or treatment program.
It’s not possible to predict when or if someone who has experienced a traumatic event will develop PTSD. Some people will seem fine at first—maybe even strangely fine—only to be overcome with the disorder some time later. In general survivors of natural disasters should see a therapist or mental help professional if acute stress symptoms don’t subside after a month, or if they feel that their thoughts and emotions, and their lives, are spiraling out of control.
If a treatment program is needed, it might be helpful to look for one that offers not only talk therapy but also EMDR, Somatic Experiencing©, and the latest neurofeedback techniques for treating trauma. A comprehensive, brain-based approach can help PTSD sufferers recover more fully and return to “normal” more quickly.
By Dr. Jon Caldwell, D.O., Ph.D. Chief of Psychiatry at The Meadows
Note: This post was originally published on TheGriffon108.com. The Meadows is proud to be a TRICARE Preferred Provider of behavioral health and addiction inpatient services in the West Region. Call us today at 800-244-4949.
Trauma is part of the human experience. Being alive comes with the inevitable risks of stress, injury, sickness, loss, and death. There’s no escaping it. Critically though, these threats to health and life are perhaps most pronounced for individuals who serve in the military. Few other circumstances in modern times make these threats more real than military service. Military service members are required to complete their mission while facing significant risk and threat.
Fortunately, humans are equipped with a highly functional nervous system that, under typical conditions, can successfully deal with most stressors and threats. For example, relatively common experiences like nearly running over a piece of garbage on the freeway, an argument between two people in a retail store, or being disappointed by a loved one are stressful and somewhat threatening situations that are usually managed effectively by most people’s nervous systems.
In circumstances like these, most people feel a temporary surge of adrenaline and hyper awareness to the potential threat; their nervous system prepares them for “fight or flight” and mobilizes the necessary resources to effectively deal with the situation. In relatively short order, the fight or flight reactivity usually subsides naturally, and they are able to return to the flow of their lives: driving, shopping, and social engagement.
However, under extreme or chronic conditions of stress and threat, as is common in military service, the nervous system can become overwhelmed. In fact, the chemical and physical make-up of the brain-body stress response system can be altered by experiences of extreme or chronic stress (i.e., trauma). For many service members, this can result in decreased “resiliency”, or the capacity to effectively manage everyday life circumstances. This shift in resiliency can occur immediately after the experience of trauma, but very often it can occur down the road, sometimes years later.
For some service members, the trauma-related changes to the nervous system progresses to the point where he or she qualifies for the diagnosis of Post-Traumatic Stress Disorder (PTSD). The diagnosis of PTSD is made when a person was directly or indirectly exposed to an extremely stressful or threatening event or series of events that resulted in symptoms of intrusion (e.g., disturbing memories, nightmares, flashbacks), avoidance (e.g., avoidance of thoughts, people, places, and things associated with past trauma), negative alterations in thinking and mood (e.g., self-blame, guilt, shame, isolation, withdrawal, depression), and alterations in arousal and activity (e.g., insomnia, hypervigilance, irritability, anger, self-destructive behavior).
These trauma-related symptoms are very distressing. But, for a variety of reasons, many service members don’t seek help and, despite their best efforts, are unable to manage the symptoms on their own. Therefore, it is common for these individuals to cope with their symptoms by turning to addictive behaviors, like alcohol and drugs, pornography and sex, gambling, video games, and disordered eating. Of course, while these behaviors may temporarily modify unpleasant trauma-related symptoms, they frequently result in more distress and added functional limitations.
The everyday situations mentioned above will be used here to better understand the experience of PTSD. For many service members, a piece of garbage on the freeway would likely elicit thoughts, memories, or flashbacks about Improvised Explosive Devices (IEDs). This experience could easily result in driving-related stress and hypervigilance, intrusive memories or flashbacks, poor concentration while driving, fear and avoidance of driving, or anger and road-rage.
When encountering an argument between two people in a retail store, a service member who is affected by past trauma might experience a pronounced fight or flight response. If it is a fight response, he or she may experience intrusive memories or flashbacks of previous violent encounters and surges of adrenaline in preparation for defending oneself or attacking others. If the individual has a flight response, he or she may experience overwhelming urges to leave the store, avoid that store and similar retail stores, and retreat further from public places and crowds.
If a military service member who is affected by trauma is disappointed by a loved one, he or she may escalate quickly to irritability and anger, perhaps reacting by yelling, throwing things, or becoming violent. Alternatively, the anger might secretly fester into resentments that result in addictive acting out behaviors. On the other hand, being let down by a loved one might result in painful feelings of being misunderstood, guilt and shame, self-loathing, sadness, and depression.
As these vignettes illustrate, services members can have pronounced nervous system reactivity in response to everyday situations as a result of their history of traumatic experiences. This reactivity takes them out of the present moment flow of routine life and leaves them feeling uncomfortable in their own skin and disconnected from other people. In this state, they are more likely to resort to addictive and unhealthy behaviors. Sadly, many service members suffer in silence, and some don’t get help before it’s too late.
Fortunately, it’s never too late to get help, and there is hope! Appropriate treatment can help to identify past traumas, current symptoms, and unhealthy coping mechanisms. Additionally, treatment can help reduce nervous system reactivity and restore its natural capacity for self-regulation. Treatment can help affected service members to let go of shame and self-destructive behaviors. Restoration of resiliency means that service members will once again feel confident in their abilities to manage everyday life situations. Lastly, service members who receive appropriate treatment can reestablish safe connections to peers, loved ones, and the world around them – they are able once again to enter the flow of life and experience all that it has to offer!
The treatment of psychological and emotional trauma is at the heart of everything we do at our Meadows Behavioral Healthcare programs. (The Meadows, The Claudia Black Young Adult Center, Gentle Path at the Meadows, Remuda Ranch, The Meadows Outpatient Center and Rio Retreat Center.) We’re grateful to have Dr. Bessel van der Kolk, Dr. Peter Levine and Dr. Shelley Uram as Senior Fellows, who help guide our staff and ensure that we stay on the cutting edge of therapeutic inventions to help people fully recover from addiction, depression, anxiety, bipolar disorder, sex addiction, eating disorders and many other behavioral health issues.
That’s also why we’re proud to be sponsors of the 27th Annual International Trauma Conference, taking place in Boston, Massachusetts, June 1 – 4. This year’s theme is “Psychological Trauma: Neuroscience, Self-Identity and Therapeutic Interventions.”
The conference is being directed by Dr. van der Kolk, who is the author of The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Dr. Shelley Uram will lead a workshop on Friday afternoon called “Reclaiming Our Lives from ‘little t’ Trauma;” and, Dr. Peter Levine will give a keynote address on Somatic Experiencing on Saturday morning.
Early registration ends May 2. Continuing Education Credits are available for behavioral health professionals. Visit the conference website for more information.
For the past three decades, the International Trauma conference has examined how trauma affects psychological and biological processes, and how the damage caused by overwhelming life experiences can be reversed. This year, they will explore new frontiers in this work— frontiers that transcend old paradigms of talking, analyzing and administering drugs.
The study of psychological trauma has been accompanied by an explosion of knowledge about how experience shapes the central nervous system and the formation of the self. Developments in the neurosciences, developmental psychopathology, and information processing have contributed to our understanding of how brain function is shaped by experience and that life itself continually transforms perception and biology.
The study of trauma has probably been the single most fertile area in helping to develop a deeper understanding of the relationship among the emotional, cognitive, social and biological forces that shape human development.
Researchers have learned that most experience is automatically processed on a subcortical level, i.e., by “unconscious” interpretations that take place outside of awareness. Insight and understanding have only a limited influence on the operation of these subcortical processes. When addressing the problems of traumatized people who, in a myriad of ways, continue to react to current experience as a replay of the past, there is a need for therapeutic methods that do not depend exclusively on understanding and cognition.
Don’t miss this opportunity to learn from the industry’s top leaders in neurobehavioral health!
The 26th Annual International Trauma Conference, which focuses on psychological trauma: neuroscience, attachment, and therapeutic interventions, takes place May 27-30 and will feature a very special workshop to help soldiers rebuild trust, release pain and forge new bonds through song.
SongwritingWith:Soldiers (SW:S) uses songwriting as a catalyst for positive change. In SW:S retreat and workshop settings, service members are paired with professional songwriters to craft songs about their experiences, often about combat and their return home.
Bessel van der Kolk, MD, Conference Director, world-renowned trauma expert and Senior Fellow at The Meadows will present SongwritingWith:Soldiers work in the “Innovative Programs” session.
You can view the SongwritingWith:Soldiers video trailer here
For the past three decades the conference has examined how trauma affects psychological and biological processes, and how the damage caused by overwhelming life experiences can be reversed. This year the conference will explore new frontiers in this work, frontiers that transcend old paradigms of talking, analyzing and administering drugs.
The objective of this conference is to present current research findings on how people’s brains, minds, and bodies respond to traumatic experiences; how they regulate emotional and behavioral responses; and the role of relationships in protecting and restoring safety and regulation.
When: Wednesday, May 27, 2015 – Saturday, May 30, 2015
Where: Seaport World Trade Center, Boston, MA
Those who have experienced a traumatic event can benefit from seeking help. At The Meadows in Wickenburg, Arizona, clients are invited to recollect and share the emotions and sensations they experienced during the initial trauma or subsequent events.
At The Meadows, world renowned experts in treating psychological trauma guide each patient through a safe and effective process of uncovering and processing any issues related to unresolved trauma and PTSD.
We can help restore the sense of control and lessen the powerful hold of trauma. Contact an Intake Coordinator at 800-244-4949 and learn how The Meadows can help.
The Meadows has been selected to be part of the United Behavioral Health (UBH) Provider Network for the TRICARE Program. As a TRICARE Provider, The Meadows is honored to provide behavioral health and substance abuse inpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders, to active duty military members, retirees, and dependents.