Ptsd @ MindSay

I was a rape victim on December 15, 2006.  I was at work when it happened and I do not know who he was-he wore a mask, gloves, etc...  I just want to speak to others who have been through this humilating nightmare and hope to be able to help someone through it and them help me as well.  I have good days but when I have bad, they are really "bad".  The flashbacks are getting worse as I try so hard not to think or talk about it but my doctor tells me to join an organization and talk to others, I am just not willing to do it face to face.  I am still too hurt and embarrased to look at anyone or anyone look at me that "knows." 

By Navy Lt. Jennifer Cragg

Special to American Forces Press Service

May 23, 2008 - Reducing the stigma related to servicemembers seeking mental health assistance is a total team effort that involves educating peers to look out for each other and encouraging those who might be reluctant to receive care, a senior military medical official said yesterday.  "Commanders and noncommissioned officers really play a critical role in eliminating stigma, especially the junior-level noncommissioned officers who are with the troops on a day-to-basis. They play a key role in this goal of decreasing stigma," Col. (Dr.) C.J. Diebold, chief of the psychiatry department at Tripler Army Medical Center in Hawaii, said in an interview on the "Dot Mil Docs" program on BlogTalkRadio.com.

He added that improving one's overall behavioral health by eating sensibly, getting exercise, and practicing good hygiene are key factors when facing stressful situations. "Behavioral health is important to everyone, as it directly affects how a person feels and acts," Diebold said.

He added that keeping up overall mental health is especially crucial when deployed to a combat zone.

"When one is deployed in a place like a combat zone, one must really maintain a really healthy lifestyle and a positive attitude to be able maintain good behavioral health," Diebold said.

Encouraging servicemembers to learn more about maintaining overall mental health for not only themselves, but also for their families, is just one of the elements highlighted in May, which is Mental Health Month.

"It jogs people's consciousness to recognize the importance of mental health, and hopefully that will continue throughout the entire year," Diebold said.

Many lessons have been learned by looking at mental health issues year-round, he added.

"One of the lessons learned over the past few decades is the importance of a servicemember's psychological well-being in terms of being able to perform their mission, but also the psychological well-being of their families," Diebold said. He added that servicemembers who may need assistance either during or after their deployment have a lot of different options to choose from.

"A servicemember could go to their unit chaplain, and I have talked with servicemembers over the years, and this is really the first place that a lot of people will go to," he said. "The chaplains are a very good way to go and be able to talk through some of the issues that are going on."

Diebold said still other outlets include talking with primary care providers, behavioral health professionals, psychologists, psychiatrists, social workers, family therapists, and alcohol- and substance-abuse counselors.

"The important thing to remember is that if a person is concerned that they may have experienced a traumatic event in theater and some other environment, and it is really affecting them, to go in and talk to a counselor [or] their primary care manager and get evaluated and get treated if it is indicated," Diebold said. "The sooner it's recognized and the sooner it is evaluated and treatment, the better a person is going to feel, and [it decreases] the chance that they may have long-term effects."

Servicemembers may encounter post-traumatic stress disorder or combat and operational stress during or after deployments, Diebold said.

"I think that it is now the longest continuous combat operations of any war besides the Revolutionary War, and we have had servicemembers deploying multiple times now," he said. "The stress that servicemembers and the families [are experiencing] have been well recognized, and that is why these special programs and bolstering of helping services have been implemented to help out."

Some of the symptoms associated with PTSD are nightmares, nervousness, anxiety or flashbacks. In contrast to PTSD, combat and operational stress reactions are short reactions to stress from being in the combat zone. Usually, combat and operational stress symptoms will resolve with rest, short-term counseling or sometimes simply on their own, he explained, whereas symptoms of PTSD can last a few days, months or even years.

Diebold added that the Department of Veterans Affairs has been working to find treatments for PTSD. Usually, with treatment, a servicemember affected by PTSD can return to active duty. Mental health professionals are deployed in theater to aid servicemembers who may be dealing with PTSD or know someone who is, he noted.

"Our mental health professionals are out there among the troops, educating the troops that this is an expected reaction and here are some of the things that you can do to help decrease some of your stress.

"Commanders and soldiers are being educated and being encouraged to go in and seek mental health treatment," he continued, "and leaders are encouraged to allow their soldiers time away from work ... to get evaluated and treated."

(Navy Lt. Jennifer Cragg works in the New Media branch of the Defense Media Activity.)

By Elaine Wilson

Special to American Forces Press Service

May 22, 2008 - The U.S. Army Institute of Surgical Research here has launched a program aimed at caring for a segment of the military population much more accustomed to administering care than receiving it. The program, called Care for the Caregivers, is designed to identify and treat a syndrome called "compassion fatigue" in military health care providers.

Compassion fatigue, also known as secondary traumatic stress disorder, is the emotional residue or strain of exposure of working with patients recovering from traumatic events.

The relatively new term, coined by Dr. Charles Figley in the 1990s, is becoming increasingly popular as caregivers are faced with the long-term care of trauma patients surviving the battlefield in greater numbers than ever before.

"We're starting to notice signs of compassion fatigue in caregivers of wounded warriors," said Army Col. Kathryn Gaylord, director of the Army Institute of Surgical Research's Care for the Caregivers program. "Caregivers are giving everything of themselves to care for patients, but there's a price sometimes associated with that."

Taxed by deployments of their own and the complicated care of severely wounded servicemembers, caregivers are beginning to exhibit signs of trauma normally reserved for patients. With symptoms such as heightened irritability, anxiety, depression and sleep disturbances, the syndrome bears a marked resemblance to post-traumatic stress disorder.

"Compassion fatigue is when caregivers have such deep empathy they develop symptoms of trauma similar to the patient," Gaylord explained.

While similar in nature, Gaylord pointed out the difference between compassion fatigue and "burnout," an emotional exhaustion many people experience due to increased workload and institutional stress. Unlike compassion fatigue, burnout does not contain a trauma element.

Over time, compassion fatigue can lead a caregiver to grow distant from patients or, on the flip side, too close. Both can be detrimental to the patients and families.

Caregivers at the burn center, for instance, treat the same patients for months or even years, which can lead to a strong connection, and a strong sense of failure, guilt and loss if a patient does not survive.

"We treat patients for many weeks to months, during which time they undergo many operations and procedures," Gaylord said. "A strong relationship develops with the patient's family; we get to know them very well."

Army Spc. Antonio Cevallos, a physical therapy technician at the institute, is familiar with the ongoing intensity of day-to-day care. He went from transferring patients wounded in Iraq via ground ambulance in Kuwait to treating wounded warriors in the burn center.

"I see a lot more here [at the institute]," he said. "Compared to minutes or hours of one-on-one contact, it's days and weeks. It has its ups and downs."

Cevallos said he grew close to several patients and was pained to see two patients deteriorate, then pass away.

"It's difficult at times," he said. "But what keeps me going is the fact that I'm helping other people. As long as I keep my purpose, it keeps me above water."

Caregivers are trained to be compassionate, but there is little training in the military on how to handle the stress of compassion, said Gaylord, who hopes to remedy the problem through the Care for the Caregivers program.

The doctor described the program as a combination of prevention training and treatment through the use of seminars and stress-management techniques.

"We have a series of world-renowned experts coming here to speak on topics such as grief, relaxation, nutrition and exercise," said Gaylord, who said the key to prevention is to find ways to manage and alleviate stress.

The seminars include education on the latest relaxation techniques, including "Alpha Stim," which is cranial electrical stimulation and vibration sounds that trigger the brain to relax.

In addition, Gaylord and her staff are building a respite room at the institute, which will serve as a peaceful haven caregivers can retreat to and regenerate. Wanting a state-of-the-art area, Gaylord contracted an architect who designed relaxation rooms for Nike and Hilton.

"The room will be very relaxing with a waterfall, music, massage chair, special motion chair and a video with headsets," she said.

Gaylord also plans to integrate group sessions and questionnaires that will help identify issues and track the impact of the program.

Cevallos said having a support system at work is beneficial.

"Sometimes you need to talk to someone or relax with a group," he said. "I've sat down in a session, and it was soothing. There's a sense of comfort from being with other people who are going through similar experiences."

Army Chaplain (Maj.) Philip Kochenburger, Brooke Army Medical Center chaplain, attended a compassion fatigue seminar on loss, grief and trauma May 9 and used an air travel safety briefing analogy to describe the importance of caring for caregivers.

"The flight attendants always tell you to put on your own oxygen mask first before you help others," he said. "The same is true of caregivers. They have to make sure they take care of themselves along with the patients."

Gaylord said the focus will remain on resiliency and mental well-being.

"We'd like to eventually delve into the research aspects of this so we can determine what makes some people more innately resilient than others."

(Elaine Wilson works in the Fort Sam Houston Public Information Office.)

I pray that the reading of this very personal account of war and its aftermath will benefit other combat veterans agonized by severe and chronic PTSD as it has been for me in the writing of it. The intention of this account is to help them, their friends and loved ones better understand this devastating “psychological, automatic, and natural response” to repeated, life threatening situations and to offer them hope and guidance in achieving a much brighter future. This publication will bring them to the realization that they are not alone in their sufferings and that professional help, understanding and comradeship, is as close as the nearest Veterans Administration Medical Center.

READ ON

 http://www.police-writers.com/articles/griffin_bugle_call.html

By Donna Miles

American Forces Press Service

May 1, 2008 - The Defense Department is working to reduce stress on the force and improve quality of life for the troops, Defense Secretary Robert M. Gates told soldiers at the Army Sergeants Major Academy here today. As part of that effort, Gates asked the senior leaders' help in getting troops who need it to seek combat-related mental health care.

"Our country, in recent years, has asked a tremendous amount of you and those who serve with and under you, and everyone has risen to the occasion," Gates told the senior noncommissioned officers, all attending the Army's top NCO school and bound for sergeant major and command sergeant major jobs in the force.

He conceded that "no one expected major combat operations in Iraq to go on this long" and cited the challenges: "multiple and sometimes extended deployments, the stresses of battle, the wounds of war, both seen and unseen."

"All of this has taken its toll on our troops and their families," Gates said. Yet, he noted, morale remains high, "testimony to the extraordinary honor, courage and resilience of those who serve, as well as the leadership and mentoring provided by the senior NCO corps."

But that high morale can't be taken for granted, Gates said. "I know I am preaching to the choir when I tell you that, as senior leaders, we must all be ever cognizant of stress on the force -- stress that has been greatly increased in recent years," he said.

Gates outlined measures being taken to reduce that stress and improve soldiers' quality of life.

Combat deployments are being reduced from 15 to 12 months in light of changes on the ground and gains made. Gates expressed hope that conditions on the ground will enable force levels in Iraq to reduce further by the year's end. A more sustainable deployment rotation will be adopted within the next year or so, with the active force serving two years at home after every one year overseas.

"From my perspective, we are trying to strike a balance: to reduce the tempo of deployment without compromising our strategic objectives or national security," Gates said.

The United States is growing its ground forces and will add 7,000 troops to the Army as part of a five-year, 65,000-troop expansion. The Marine Corps is getting larger too and will complete its 27,000-member expansion next year, two years ahead of schedule.

"With a larger pool of soldiers and forces available, individual soldiers and their units should be deployed less frequently, with more dwell time at home," Gates said.

The secretary cited vast improvements in emergency care on the front lines and in the Army medical system. Since last year's revelations of what he called "deplorable outpatient conditions" at Walter Reed Army Medical Center, Gates said, he has focused a lot of time and energy on the system of care for wounded warriors.

"We have made great strides, even though more remains to be done," he said.

New warriors-in-transition campuses are revolutionizing the way wounded warriors are getting medical treatment and rehabilitation, he said. With an NCO with them throughout the process, wounded troops get help navigating the full range of support available for their families.

Gone are the days, Gates said, when wounded warriors are considered "permanently broken."

"The reality is that these extraordinary young men and women are far from broken," he said.

The Defense Department also is emphasizing care for troops with post-traumatic stress disorder, Gates told the NCOs, but he admitted that not all are getting the treatment they need.

In addition to new screening procedures that will help ensure no one "slips through the cracks" of the care system, the department is actively working to eliminate the stigma associated with PTSD, he said.

As part of that effort, Gates announced earlier today that the Defense Department will no longer require people who have received treatment for combat-related stress to report it on Standard Form 86, the government security-clearance form.

"Mental health treatment in and of itself will not be a reason to revoke or deny a clearance," Gates told the soldiers. "We hope this will encourage more men and women in uniform to seek help."

Gates called on the NCOs, the "backbone of the military," for help in getting soldiers who may have hesitated in the past to step forward to now get the care they need.

"All of you have a special role in encouraging troops to seek help for the unseen scars of war -- to let them know that doing so is a sign of strength and maturity," Gates told the group. "I urge you all to talk with those below you to find out where we can continue to improve.

"Those who have sacrificed for our nation deserve the best care they can get," he continued. "As I have said before, there is no higher priority for the Department of Defense, after the war itself, than caring for our wounded warriors."