ÿþ<HTML> <HEAD> <Author:Bill Baty"> <TITLE>POST TRAMATIC STRESS SYNDROM (PTSD)</TITLE> </HEAD> <BODY background="Swirl.jpg" BGPROPERTIES=FIXED> <BODY TEXT="#000000" LINK="#0000FF" VLINK="#551A8B" ALINK="#0000FF"> <center><H1><BOLD>POST TRAMATIC STRESS SYNDROM (PTSD)</center></H1> <p> What is crisis? <p> Crisis is an internal and external response that may occur following a stressful event which is perceived as a threat to the individual. A crisis response may be painful as powerful emotions are experienced. An unexpected death may move one to a point of crisis. Living through battle, life as a prisoner, life on a base in the states or abroad, or life on a ship or submarine would suggest some daily crisis of various magnitudes. You have lived through many crisis of various magnitudes. You have lived through many crises if you are reading this article. Some crisis responses are more difficult to overcome than others. Your individual response to crisis is unique to you and the training, or lack of it, in your life. <p>You may at times feel out of control with what may seem a small every-day crisis when compared to the crisis of combat or a training mission. Your pulse may race, face flush, head pound and feelings of panic ensue. Where you once commanded hundreds of troops you now are in crisis over picking up the kids on time! What is this all about? You suddenly feel vulnerable and out of control. <p>The Vet Center staff is uniquely qualified to help you review how the crisis you experienced while serving your country has affected you and now your family. The counselors will assist you with diagnosing PTSD after meeting with you. This service is free. When one has a diagnosis of PTSD your threshold for crisis is lower. You need support and communication with people who understand. You need support and communication with people who understand. <p>What can I do to cope with crisis? <p> You can learn to spot triggers to anxiety that cause you to become susceptible to a crisis response. You can learn positive coping skills to use when triggers occur such as rhythmic breathing and calling a specific support person. Once you have learned effective coping skills, problem solved to use them and have seen the positive results, you can better face any crisis. <p>The counselors at the Vet Center are trained to help veterans develop skills necessary to cope with crisis so that you can live without fear. You will develop a sense of hope and self-confidence in your ability to handle a crisis. You will learn to talk about how you respond to anxiety because of experiences of the past, and you will make a safety plan to use every day. An effective safety plan includes names and numbers of support people to call who will be there for you immediately should any crisis arise. If you are having thoughts of hurting yourself or others, this is a crisis. Do not wait. Use your safety plan! <p>Most of us who have attended one of the annual reunions can testify that being among veterans who shared the same experiences that you did, is a healing experience. My wife made the remark that "I became a person totally unknown to her. I talked, laughed, cried and other things that she seldom ever saw me do. I know that while in the midst of my comrades at reunions, I feel safer than anywhere else. Maybe this is the secret. We miss the safety we felt when we were in Nam and watching each others back or knowing that if we survived a wound there was going to be a medic there soon and a chopper to take us off the killing ground. Not all share these feelings. Some have come to soon. You have to want to meet and visit with your old friends and be ready to defeat the old memories and feelings that try to turn you into a different person. Like all veterans, when we get together at reunions, when we've finished with the formalities of catching up, the conversation usually turns to Vietnam memories. There will always be somebody at the reunions willing to help you thru these moments or If you prefer, excuse yourself and take a walk or hit the sack early. No one will insist that you stay and listen to something that makes you uncomfortable, especially battle stories. But, as you yourself know, most of us are only aware of our little piece of ground directly to our front during a battle, and we share so that we can fill in the gaps. Everyone will understand if you want to leave and it won't be held against you. Most of us have experienced the same thing to some degree at sometime or another. You may never be able to sit thru battle stories, but you shouldn't allow this to keep you from re-establishing bonds with your wartime buddies and enjoying the comradely present at the reunions. <p>WHAT ARE DELUSIONS?<p> Delusions are false beliefs one experiences with some basis in reality. Delusional thinking may lead to feelings of anxiety and paranoia because of loss of touch with reality. The veteran may beel confused and unsafe if the delusions are frightening in nature. Delusions may seem completely real. Perhaps the veteran believes he is back in combat. The family's response to someone experiencing delusions is often on of fear depending on the severity of the delusion and supports in place with which to cope. Education is important for the veteran and family so everyone understands what is occurring when the veteran experiences a delusion. <p>There are multiple causes for delusions, medical and psychiatric. A correct diagnosis is important. You will need to see a primary care provider to rule out medical concerns. This is true with most of the symptoms described in this booklet. Your providers need to communicate with one another to provide you with the very best bio-psycho-social care. <p>Making a safety plan ahead of time is wise so everyone including the veteran knows what to do if a delusion is experienced. The Vet Center can help you with this. <p>Names and numbers of support people and places are important to list on your safety plan. When you feel a trigger to a delusion put the safety plan into action. With practice it will work for you! <p>WHAT CAN I DO TO COPE WITH DELUSIONS?<p> It is essential to learn to identify triggers to delusional thinking. You can learn to do this with education and encouragement. You will need a correct medical and psychiatric diagnosis. Those who suffer from PTSD may experience delusional thinking as well as the other symptoms listed and described in this series. The key is to learn to recognize the symptoms and their triggers, and to learn positive coping skills in which to better and more safely live with the symptoms. Some symptoms may vanish when you learn the new coping skills. Other symptoms may remain, but lessen, and be less intrusive to your improved quality of life. <p>The staff at the Vet Center will help you learn to function at the highest quality possible. Some veterans will learn to control delusions by using relaxation exercises, talking to someone in order to reconnect with reality, write their thoughts, art therapy, gently exercise or begin a hobby. It is important to avoid social isolation. Spending time with others can boost self esteem, allow a connection with reality and offer a check with the important safety plan the veteran will use should delusions occur <p>DENIAL<p> What is denial?<p> Denial is refusal to acknowledge the truth about something. Denial is a defense mechanism used to protect against anxiety or emotional pain. You may be using denial unconsciously to avoid dealing with painful memories. Denial is a coping skill to protect you from stress, but it can backfire and make you feel worse. Veterans may try to convince themselves that everything is fine and they do not need help! The truth may be their lives are in chaos and they are having a difficult time functioning. Often veterans have difficulty accepting reality because it may imply vulnerability. Their memories are shared and loyalties are deep. They may feel out of control and terrified. Sometimes denial is reality. This is when a family member may need to call the Vet Center for help. Support and encouragement are needed for the Veteran and family. <p>What can I do to avoid using denial as a defense mechanism? <p>Learning to discuss your feelings and emotions takes time for most people. Having experienced combat or traumatic service-related experiences makes it more difficult to express yourself. You will need to learn to problem-solve to lessen feelings of anxiety that can lead to using denial to defend yourself. Building trust takes time. It can be hard to ask for help. Getting to the Vet Center is a good first step for you and your family. Considering the possible negative outcome of not seeking help with the issues that are causing you to live in denial is a key to recovery. You will learn to identify fears, unrealistic threats, grief and loss issues and anxiety provoking triggers to denial. As you gain insight and learn to problem-solve effectively your self-esteem will grow. You will no longer need the defense mechanism of denial. You will live in reality and truth. <p>You will more easily face life realistically when you can think positively. Once you have used these newly-learned coping skills and have experienced the positive outcome, you will have renewed confidence. <p>Denial can magnify an existing problem. It is essential to develope the skills necessary to face life's situations openly, honestly and realistically. You can learn to master your life in the moment, one day at a time without the need to deny anything. When you know that you are supported by someone who understands, anything is possible <p>WHAT IS DEPENDENCE?<p> Dependence is relying on someone else to much for near constant support or aid. This can lead to unhealthy need for physical contact, attention, help, approval or repeated praise from others. Dependency issues can cause difficulty and confusion in one's life due to resistance to treatment, which is common. Veterans who are overly dependent may resist caring for themselves, feel helpless, cling to others, express somatic complaints, demand extreme care and become angry patients in the inpatient setting. <p>Veterans who are dependent tend to require a great deal of attention, affection and approval from others. They have difficulty comforting themselves. They need to have complete acceptance from others, everyone they meet! Friend, family and caregivers become tired and sometimes stressed from attempting to meet all their needs. They may borrow a bit of a personality from someone close to them, perhaps a care giver, pastor or supervisor, having lost site of their own persona. This is dangerous when taken to the extreme and can be a treatment issue to discuss with the counselor. <p>Dependency issues are complicated and require skilled intervention. Intervention is worth the effort and treatment can work for the veteran and family. Independence means freedom for the future. <p>WHAT CAN I DO TO DEVELOP A BETTER SENSE OF INDEPENDENCE?<p> It is very difficult for a veteran to feel dependent and sometimes just as difficult for the veteran to regain independence when suffering from PTSD. Fighting for independence, however, is something at which veterans are pretty damned good! <p>There's every possibility you can regain more independence than you imagined with support and encouragement from the veteran community. The Vet Centers and service organization like MOPH make these printed words more than lip service. The computer makes communication with these organizations very doable. Please take advantage of the recourses at the end of this course. They are for you. Your quality of life will improve if you reach out and communicate with those who understand some of what you feel. <p>Learning to participate in your own life once again is like being set free~ Family and friends will welcome you back, healing will happen, hearts will open where you may have thought they were closed. It is important to develop positive coping skills to be able to communicate effectively, openly and honestly with those in your life now that you are rebuilding it. You will be making changes that will touch everyone around you, having been dependent for whatever reason. <p>The new communication skills you will learn will benefit you in every area of your life. You are never too old to begin again. Go for it! <p>WHAT IS DEPRESSION?<p> Depression is a common symptom of PTSD. It colors the way you feel, your attitude and belief about the world. Depression can look like sadness or the veteran may cover the depression with a smile making it difficult to detect. You will be sad when someone close to your dies. Depression lasts longer. Depression looks different in everyone, similar in most. Signs of depression may include moving more slowly than normal, or agitation, anxiety, fears, feelings of guilt, hopelessness, frequent crying, withdrawal, difficulty making decisions, low self-esteem, a negative view of the world, substance abuse, and thoughts of suicide or suicide attempts. It is very important to get help immediately if you or someone you know even mentions thoughts of suicide. Suicide is a leading cause of death and must be taken very seriously. Have a safety plan ready with a number to call of a friend or get to a local emergency room if you ever feel unsafe. <p>It is understandable that having experienced trauma in the service would lead to symptoms of depression. You no longer find interest in things or people you once enjoyed. There may be "survivor's guilt" because you came home and others did not. There is no shame in depression. It would be a shame not to seek treatment when depression is usually successfully treated. There is help and support for you. There is a listening ear for you. <p>WHAT CAN I DO ABOUT MY DEPRESSIVE SYMPTOMS?<p> Diagnosis and treatment will offer relief to the pain and isolation of depressive symptoms often associated with PTSD. Learning positive coping skills will help you to feel more control as you feel your mood lift. Once you feel well enough to begin to exercise, reach out to friends and family, begin a hobby you enjoy, learn relaxation skills to improve your quality of sleep and limit your bad habits such as anything that is destructive, you will notice a positive change in your mood. Your self confidence will grow. You may surprise yourself. Success builds upon itself. Regular counseling is important and can help you sustain your success. Depressive symptoms often respond well to medications. The Vet Center staff can make appropriate referrals. Keep asking questions until you get the answers you need and are feeling better! <p> <H4><center><a href="ptsd-2.htm">PTSD-2 Page "Education"</center></a> <p> <center><h4><a href="page1.htm">Return to the QuarterHorse Index Page</a></h4></center> <p> <HR> </BODY> </HTML>