Category Archives: PTSD

PTSD brain

Following the Vietnam War the Post Traumatic Stress Disorder or PTSD is being given much attention. During World Wars I and II, the disorder was known as shell shock and thought to be caused by the immediate stress of battle.

The cure, at the time, was to let the men lie quietly in or just outside the medical tent away from the battle area, and rest until their nerves settled down.

Once the syndrome was described, it was discovered that perhaps 25% or more of persons who have never been in the military have experienced PTSD. It has been precipitated by such things as child abuse or other childhood trauma such as emotional abandonment by parents or parental surrogates. In adults it has been precipitated by serious car accidents, major surgery, rapes, muggings, and in general by any other event in which the person felt helpless during an event he/she perceived as life threatening.

Nine times more females than males are now known to experience PTSD, and up to 75% of persons suffering from fibromyalgia have PTSD either currently or in their background.

It is now known that PTSD represents a basic split off of parts of the brain in which the emotional trauma was recorded, so that the waking brain remains unaware of it. The problem is that the part of the brain storing the memory often reactivates during sleep and the event is recalled in very stressful nightmares. Also, during the day, any number of small stimuli that occur can reactivate that section of the brain, and a flashback occurs. Accompanying a nightmare or flashback, the entire sympathetic nervous system
is called into play and the resulting stress, both physical and emotional can be
overwhelming.

Because so many things can trigger a flashback, the person slowly but surely begins to close off ever more areas of his past experience in order to not provoke an episode. The brain actually becomes phobic of those activities that can act as triggers, and closes them off from its daily awareness. The person, as a result, remains in hyper aroused alert status, with an ever narrower life view and experience. To those looking on, the person become quieter, less sociable, and tends to limit activities in all areas of
his/her life more and more.

CES for PTSD Therapy

CES treatment in PTSD should have a pronounced effect in that PTSD symptoms always increase when the person is under stress of any kind. Also, the research with CES in phobic patients indicates that phobic fear can not be experienced while CES treatment is in progress, and at least for a time thereafter. It is the panic felt by patients when the phobic areas are roused, with the accompanying uncontrolled system-wide sympathetic physiological arousal, that gives them their greatest fear and dread. To have CES
available during those times of panic should be very immediately helpful, and contribute markedly to a longer term cure as those feelings of helplessness dissipate or habituate via the continuing use of CES.

For this reason, it has been suggested that the use of CES during desensitization therapy, a therapy found very effective in treating PTSD, should allow desensitization therapy proceed at a much more rapid rate, and possibly be much more effective if it reduced or eliminated the fear while the desensitization was in process..

If nothing more, CES should reduce or eliminate many phobic areas within the personality, allowing the person to come down from his hyper aroused state and begin interacting in more areas of his life’s normal experience once again. That would be a type of desensitization therapy process on its own.

Clinical experience has shown that PTSD patients initially never go out without their CES device handy for use at a moment’s notice. The presence of the device gives them a needed feeling of security they can not get in any other way.

How much treatment is required to produce these effects with CES? Patients respond to differing amounts of CES treatment, depending on which of their neurohormonal systems CES is intended to rebalance. While effects begin to be felt from the first treatment, almost all patients are expected to come back within normal homeostatic limits with 30 minutes to 1 hour of treatments every day for 14 to 21 days, depending on the availability of any required neurohormonal precursors in their diet, their level of activity and so on.6

References:
1. Jarzembski, W.B., S.J. Larson, and A. Sances Jr. (1970) “Eval
Following are key research abstracts that pertain to the prevalence of substance abuse in the US military and the need for non-drug therapies; conclusively proving that there now exist no conventional safe and effective alternatives; i.e. drugs for treating this condition:

Adler DA, Possemato K, Mavandadi S, Lerner D, Chang H, Klaus J, Tew JD, Barrett D, Ingram E, Oslin DW.
Psychiatric status and work performance of veterans of Operations Enduring Freedom and Iraqi Freedom. Psychiatr Serv. 2011 Jan;62(1):39-46.
Source: Department of Medicine, Tufts Medical Center, Boston, MA, USA.

Psychiatric status and work performance of veterans of Operations Enduring Freedom and Iraqi Freedom

OBJECTIVE:

This cross-sectional study investigated the relationship between psychiatric diagnosis and impaired work functioning among American service members returning from Operation Iraqi Freedom-Operation Enduring Freedom (OEF-OIF).

METHODS:

Participants were 797 OEF-OIF veterans, of whom 473 were employed. They were referred for further psychiatric assessment by primary care providers at six Veterans Affairs medical centers and underwent a behavioral health interview that assessed psychiatric and health status and work impairment as measured by the Work Limitations Questionnaire (WLQ). The four WLQ subscales (mental-interpersonal demands, time management, output, and physical demands) and an aggregated measure of productivity loss were considered in the analysis. Associations between patient characteristics, psychiatric status, and work impairments were investigated with regression models.

RESULTS:

Major depressive disorder, posttraumatic stress disorder, and generalized anxiety or panic disorder were significantly associated with impairments in mental-interpersonal demands, time management, and output. Alcohol dependence and illicit drug use were associated with impairments in output and physical demands. On average these productivity losses were four times those found in a previous study of nonveteran employees with no psychiatric disorders.

CONCLUSIONS:

Veterans’ ability to maintain gainful employment is a major component of successful reintegration into civilian life, and psychiatric disorders have a negative impact on work performance. This study demonstrated that multiple dimensions of job performance are impaired by psychiatric illness among OEF-OIF veterans. Delivery of empirically supported interventions to treat psychiatric disorders and development of care models that focus on work-specific interventions are needed to help veterans return to civilian life.

Psychiatric status and work performance of veterans of Operations Enduring Freedom and Iraqi Freedom. Psychiatr Serv. 2011 Jan;62(1):39-46.
Source: Department of Medicine, Tufts Medical Center, Boston, MA, USA.

The Use of Cranial Electrotherapy Stimulation In the Treatment of Post Traumatic Stress Disorder

Post Traumatic Stress Disorder is known to be a very difficult syndrome to treat in that traumatic memories that are normally sequestered in a separate, sometimes amnesic part of the brain can appear in nightmares, or in sudden flashbacks during the waking state. These are accompanied by a very intense body-wide sympathetic neurological response during which the patient experiences a very strong and frightening state of panic. If these continue unabated, the syndrome can progress and become a much more difficult problem to treat.

Therapists are taught to avoid inciting these states of recall until and unless the patient can quickly be brought out of them if they threaten to get out of control. To do that, the patient is taught how to switch mentally into a “safe place,” or to concentrate intensely on specific items in the here and now, using whatever other stress reduction procedures he and the therapist have worked out in advance, such as meditation, deep breathing exercises, and the like. When a patient in therapy begins to experience a flashback that is becoming too intense, he is taught immediately to go to this safe place, and thus turn off the traumatic experience.

There is a published CES study in which it was found that phobic patients can not experience a fear response when CES is being applied, and usually for a time after cessation of the treatment.1 Thereby lies a potentially important use of CES in the treatment of PTSD.

The usual, non CES treatment involves slowly but surely bringing out parts of the traumatic memory as the patient can tolerate them, until the whole memory is back into awareness and can be integrated back into the personality. That process can go forward no faster than the patient can handle the memories called forth during the therapeutic process, sometimes requiring years of therapy. The use of CES during the therapeutic process might well block the patient’s fear and its attendant stress reaction in a manner that would allow the patient and therapist to bring forward elements of the memory at a much faster rate, and therefore shorten the time of therapy significantly, and with much less trauma to the patient.

In addition, having a personal CES unit in his home, and also even available at other times, could be seen by the patient as very emotionally supportive, and thus intensely therapeutic. Just knowing that it was available should reduce the patient’s stress significantly, since he would know that he always had a means at hand to stop or block the trauma when it was in the process of emerging from his subconscious in too great an intensity to handle by other means.

1Smith, Ray B., and Frank N. Shiromoto. (1992) The use of cranial electrotherapy stimulation to block fear perception in phobic patients. Current Therapeutic Research, 51(2):249-253.