““FROM THE TRAUMAS OF FROM THE TRAUMAS OF COMBAT,RAPE,AND ABUSE COMBAT,RAPE,AND ABUSE

COME KNOWLEDGE” COME KNOWLEDGE”

UNDERSTANDING P.T.S.D. UNDERSTANDING P.T.S.D.

Vietnam 1968Vietnam 1968

Williams AFB Williams AFB Arizona 1981Arizona 1981

Guess Who?Guess Who?

Prescription For PTSDPrescription For PTSD

UNDERSTANDING PTSDUNDERSTANDING PTSD

Rape and combat are theRape and combat are the two traumas that have been studied two traumas that have been studied the most.the most.

Seventy five percent of Americans have had at least one Seventy five percent of Americans have had at least one psychological trauma in their life. psychological trauma in their life.

One in ten women and one in twenty men will have PTSD at One in ten women and one in twenty men will have PTSD at one point in their life. This is because of the high instance of one point in their life. This is because of the high instance of sexual assaults against women versus men. sexual assaults against women versus men.

Rape PTSD is likely to be a lifelong disorder. The fact that Rape PTSD is likely to be a lifelong disorder. The fact that PTSD from rape or sexual assault is so strong and lasting PTSD from rape or sexual assault is so strong and lasting should not be a surprise.should not be a surprise.

UNDERSTANDING PTSDUNDERSTANDING PTSD

Rape is a very personal attack. It is almost always a surprise to the Rape is a very personal attack. It is almost always a surprise to the victim. It is a very humiliating event, so much so that most rapes victim. It is a very humiliating event, so much so that most rapes are very under reported and never see the light of a statistic. are very under reported and never see the light of a statistic.

When rape occurs there is penetration of your personal space, of When rape occurs there is penetration of your personal space, of your actual body. It doesn’t get any more personal than that. your actual body. It doesn’t get any more personal than that.

Trauma is more severe if it is intentional, unexpected and Trauma is more severe if it is intentional, unexpected and physically harmful or life threatening. While all combat veterans physically harmful or life threatening. While all combat veterans experience a life threatening situation, the fact that they are experience a life threatening situation, the fact that they are soldiers and know that this is part of the job can actually help their soldiers and know that this is part of the job can actually help their resistance to PTSD. They also share a bond with others in their resistance to PTSD. They also share a bond with others in their same situation.same situation.

UNDERSTANDING PTSDUNDERSTANDING PTSD

Rape is almost always a one-on-one event. You are basically by Rape is almost always a one-on-one event. You are basically by yourself in your trauma, and feel that no one can ever know or yourself in your trauma, and feel that no one can ever know or relate to what you endured. relate to what you endured.

There is usually no one to “de-brief” with.There is usually no one to “de-brief” with. Two thirds of rape victims will get PTSD. Two thirds of rape victims will get PTSD. With rape, you relive it every time you have a sexual encounter, With rape, you relive it every time you have a sexual encounter,

even if desired. The act, although different in nature, is similar, if even if desired. The act, although different in nature, is similar, if only in the physical act itself.only in the physical act itself.

Difficult to avoidDifficult to avoid Natural disasters.Natural disasters.

““The only experts The only experts on PTSD are the on PTSD are the Survivors among Survivors among

Us”Us”

What Is PTSD?What Is PTSD?

Generally, it is an anxiety disorder that develops Generally, it is an anxiety disorder that develops after exposure to a terrifying event or ordeal in after exposure to a terrifying event or ordeal in which grave physical or emotional harm occurred which grave physical or emotional harm occurred or was threatened or was threatened

What causes PTSD?What causes PTSD?

Traumatic events that may trigger PTSD include Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused violent personal assaults, natural or human-caused disasters, accidents, and military combat. disasters, accidents, and military combat.

What is PTSD?What is PTSD?

PTSD is biologically and chemically related. PTSD is biologically and chemically related. It is not a thought-related disorder. It is not a thought-related disorder. F.M.R.I. (functional magnetic resonance imaging) F.M.R.I. (functional magnetic resonance imaging)

and P.E.T. (position emission tomography) scans and P.E.T. (position emission tomography) scans reveal that the brains of PTSD sufferers function reveal that the brains of PTSD sufferers function differently than normal brains due to differing differently than normal brains due to differing brain chemistry. brain chemistry.

What Triggers PTSD?What Triggers PTSD?

Traumatic events that may trigger Traumatic events that may trigger PTSD include violent personal assaults, PTSD include violent personal assaults, natural or human-caused disasters, natural or human-caused disasters, accidents, and military combat.accidents, and military combat.

What effect does it have on those What effect does it have on those around a PTSD sufferer?around a PTSD sufferer?

Family members or other individuals having Family members or other individuals having prolonged exposure to PTSD victims can also prolonged exposure to PTSD victims can also develop what appears to be a form of PTSD It develop what appears to be a form of PTSD It is often called “is often called “secondary PTSDsecondary PTSD” or “” or “vicarious vicarious traumatic stress disordertraumatic stress disorder,” V.T.S.D.,” V.T.S.D.

PTSD sufferers Are Most Generally PTSD sufferers Are Most Generally

Broken Into Three Groups Broken Into Three Groups

Combat VeteransCombat Veterans

Non-Combat VeteransNon-Combat Veterans

OthersOthers

These three category’s stem from treatment These three category’s stem from treatment availability, not the illness itself.availability, not the illness itself.

Combat VeteransCombat Veterans Survival instincts born through sheer terror.Survival instincts born through sheer terror. Survival instincts brought about by sensory Survival instincts brought about by sensory

images.images. Survival instincts brought about by geographic Survival instincts brought about by geographic

location.location. Veterans go from normal to an instant blind rage.Veterans go from normal to an instant blind rage. You do not think, argue, deliberate, negotiate, or You do not think, argue, deliberate, negotiate, or

discuss in a war.discuss in a war. You must react because the distance between life You must react because the distance between life

and death is measured in milliseconds and and death is measured in milliseconds and fractions of inches.fractions of inches.

Non-Combat VeteransNon-Combat Veterans For non-combat trauma veterans, response-For non-combat trauma veterans, response-

provoking triggers are as varied as the provoking triggers are as varied as the traumas leading to the illness.traumas leading to the illness.

A single trauma or long-term exposure to A single trauma or long-term exposure to repeated extreme stress or trauma can cause repeated extreme stress or trauma can cause PTSD PTSD

Law enforcement, medical services, Law enforcement, medical services, emergency responders, crisis management emergency responders, crisis management and graves registration are but a few and graves registration are but a few examples.examples.

OthersOthers Psychiatrists have studied which groups are more at risk Psychiatrists have studied which groups are more at risk

after a traumatic event. Having endured trauma in the after a traumatic event. Having endured trauma in the past will more likely result in PTSD in you experience past will more likely result in PTSD in you experience another trauma. another trauma.

People who have a loved one with a major mental People who have a loved one with a major mental illness or those who have a major mental illness are illness or those who have a major mental illness are more likely to develop PTSD. more likely to develop PTSD.

Being very young or very old increases your odds. This Being very young or very old increases your odds. This is because children haven’t developed coping skills to is because children haven’t developed coping skills to deal with trauma. The elderly may have lost those deal with trauma. The elderly may have lost those skills. skills.

Victims of violent crimes, victims and witnesses to Victims of violent crimes, victims and witnesses to natural and unnatural traumatic events.natural and unnatural traumatic events.

Victims of systematic and repeated emotional, sexual, Victims of systematic and repeated emotional, sexual, or physical abuse.or physical abuse.

What are the physical symptoms?What are the physical symptoms?

HeadachesHeadaches DizzinessDizziness Chest painChest pain Gastro-intestinal distressGastro-intestinal distress Immune systems problemsImmune systems problems Discomforts in other parts of the body are also Discomforts in other parts of the body are also

common in people with PTSDcommon in people with PTSD Bodily stress and tensionBodily stress and tension JumpinessJumpiness Lack of concentrationLack of concentration

What are the emotional What are the emotional symptoms?symptoms?

Flashback episodesFlashback episodes MemoriesMemories NightmaresNightmares Frightening (and intrusive) thoughts, Frightening (and intrusive) thoughts,

especially when they are exposed to events especially when they are exposed to events or objects reminiscent of the trauma.or objects reminiscent of the trauma.

Anniversaries of the event can also trigger Anniversaries of the event can also trigger symptoms.symptoms.

Emotional symptomsEmotional symptoms

Emotional numbnessEmotional numbness Severe sleep disturbancesSevere sleep disturbances DepressionDepression Anxiety and irritabilityAnxiety and irritability Outbursts of angerOutbursts of anger Feelings of intense guiltFeelings of intense guilt

Physical and emotional problems Physical and emotional problems caused by PTSD.caused by PTSD.

FEARS (such as crowds, closed FEARS (such as crowds, closed spaces, etc.)spaces, etc.)

ANXIETY (such as restlessness, ANXIETY (such as restlessness, obsessive worries, etc)obsessive worries, etc)

PANIC (such as fear of losing PANIC (such as fear of losing control, going crazy)control, going crazy)

DEPRESSION (such as DEPRESSION (such as hopelessness, loss of interest, hopelessness, loss of interest, suicidal thoughts)suicidal thoughts)

RAGE (in the form of intense RAGE (in the form of intense violent emotions or actions) violent emotions or actions)

IRRITABILITY (such as feeling IRRITABILITY (such as feeling constantly annoyed, on edge, constantly annoyed, on edge, critical)critical)

INABILITY TO RELAX (always INABILITY TO RELAX (always on guard, everything is life or on guard, everything is life or death, attack or crisis)death, attack or crisis)

SHAME (feeling embarrassed, SHAME (feeling embarrassed, exposed, violated, like a misfit)exposed, violated, like a misfit)

GUILT (others should have lived, I GUILT (others should have lived, I should have died, etc.)should have died, etc.)

ISOLATION (physically ISOLATION (physically present/emotionally gone, talk to present/emotionally gone, talk to nobody)nobody)

EMOTIONLESS (1000 yard stare, no EMOTIONLESS (1000 yard stare, no feelings about anything)feelings about anything)

ALEINATION (I don’t fit in, don’t ALEINATION (I don’t fit in, don’t have anything in common with people have anything in common with people other then vets like myself )other then vets like myself )

OVER-CONTROLLING OVER-CONTROLLING ADDICTION (compulsive overuse of ADDICTION (compulsive overuse of

alcohol or drugs; addicted to danger; alcohol or drugs; addicted to danger; self medicating)self medicating)

TIME/SCHEDULING (difficulty TIME/SCHEDULING (difficulty doing or keeping a schedule) doing or keeping a schedule)

Public Perception?

The public perception of PTSD seems to be that it is a “relatively new” The public perception of PTSD seems to be that it is a “relatively new” and mostly “mysterious” mental illness. Many people, (psychiatrists and and mostly “mysterious” mental illness. Many people, (psychiatrists and psychologists included) doubt that it even exists.psychologists included) doubt that it even exists.

Nothing could be further from the truth. For the WWII (greatest generation) crowd, Nothing could be further from the truth. For the WWII (greatest generation) crowd, the question was, “what’s wrong with Uncle Ed?” The answer was “he was in the “Big War” the question was, “what’s wrong with Uncle Ed?” The answer was “he was in the “Big War” and has “shell shock”, stay away from him!” For the Vietnam Era, the question was the same, and has “shell shock”, stay away from him!” For the Vietnam Era, the question was the same, the answer was, “he has Vietnam Syndrome, don’t go near him!” In Korea it was “Battle the answer was, “he has Vietnam Syndrome, don’t go near him!” In Korea it was “Battle Fatigue”. In WWI it was “Soldiers Heart”. Every war had a name for it, the only thing that Fatigue”. In WWI it was “Soldiers Heart”. Every war had a name for it, the only thing that changes is the answer to the question, “What’s wrong with him/her?” Combat stress and war changes is the answer to the question, “What’s wrong with him/her?” Combat stress and war neurosis are two of the newer names for this age old disease.neurosis are two of the newer names for this age old disease.

PTSD is like everything else in our world, if something may have an unpleasant, PTSD is like everything else in our world, if something may have an unpleasant, disturbing, or even dangerous impact upon us, we tend to disturbing, or even dangerous impact upon us, we tend to avoidavoid and and ignoreignore it! Since most of the it! Since most of the unsettling symptoms of PTSD come about as a result of “reactions” to “triggers” in the unsettling symptoms of PTSD come about as a result of “reactions” to “triggers” in the environment, it’s easy to see why society prefers to let PTSD sufferers isolate themselves from environment, it’s easy to see why society prefers to let PTSD sufferers isolate themselves from us. It is easier for outsiders to ignore, than to acknowledge that PTSD is a “real” and serious us. It is easier for outsiders to ignore, than to acknowledge that PTSD is a “real” and serious disorder.disorder.

Many veterans ignore and deny that they Many veterans ignore and deny that they suffer from symptoms of this disease. Many suffer from symptoms of this disease. Many do so out of fear of being branded “crazy” or do so out of fear of being branded “crazy” or

“mentally ill,” and out of fear of being viewed “mentally ill,” and out of fear of being viewed as “weak.” Denial is one of the many serious as “weak.” Denial is one of the many serious symptoms of P.T.S.D. and is detrimental to symptoms of P.T.S.D. and is detrimental to

the health and welfare of the affected the health and welfare of the affected veterans.veterans.

  The V.A. estimates there are 299,320 The V.A. estimates there are 299,320

homeless veterans in America, on any given homeless veterans in America, on any given night. Of these statistics show that 98% are night. Of these statistics show that 98% are males, 45% suffer from mental illness, 68% males, 45% suffer from mental illness, 68% plus have substance abuse problems, 47% plus have substance abuse problems, 47% served during the Vietnam era, and 1/3 of served during the Vietnam era, and 1/3 of

those were stationed in a war zone.those were stationed in a war zone.

  Twice as many Vietnam veterans met death at Twice as many Vietnam veterans met death at

their own hands (suicide, suicide by cops, their own hands (suicide, suicide by cops, lone occupant single vehicle accidents, etc.) lone occupant single vehicle accidents, etc.)

than are on the “Wall” in D.C.? than are on the “Wall” in D.C.?

  67% of Vietnam veterans diagnosed with 67% of Vietnam veterans diagnosed with

P.T.S.D. received their diagnosis P.T.S.D. received their diagnosis afterafter being being released from prison or jail? released from prison or jail?

  

According to the Bureau of Justice Statistics, According to the Bureau of Justice Statistics, 20% of veterans in prison are combat 20% of veterans in prison are combat

veterans.veterans.

  30% were first-time offenders; and 70% had 30% were first-time offenders; and 70% had

been working full time before their arrest.been working full time before their arrest.The VA predicts that 25% to 30% of all The VA predicts that 25% to 30% of all current war returnees will suffer from current war returnees will suffer from

P.T.S.D.P.T.S.D.  

The National Independent Budget for the The National Independent Budget for the V.A. reports that more than 460,000 veterans V.A. reports that more than 460,000 veterans have a service-connected disability due to a have a service-connected disability due to a

mental illness. . Of great concern must be the mental illness. . Of great concern must be the estimated 117,000 veterans who are service-estimated 117,000 veterans who are service-connected for psychosis and the more than connected for psychosis and the more than

180,000 who are service-connected for post-180,000 who are service-connected for post-traumatic stress disorder. In 2002, more than traumatic stress disorder. In 2002, more than

750,000 veterans received mental health 750,000 veterans received mental health services from the V.A.services from the V.A.

  

NAMI (National Alliance for the Mentally Ill) NAMI (National Alliance for the Mentally Ill) is the largest national organization is the largest national organization

representing persons with serious brain representing persons with serious brain disorders and their families.disorders and their families.

  

NAMI maintains a membership of more than NAMI maintains a membership of more than 220,000. Through their 1,200 chapters and 220,000. Through their 1,200 chapters and

affiliates in all 50 states, they support affiliates in all 50 states, they support education, outreach, advocacy and research education, outreach, advocacy and research

on behalf of persons with serious brain on behalf of persons with serious brain disorders.disorders.

  

Currently, NAMI and similar organizations Currently, NAMI and similar organizations are actively seeking veteran’s organizations to are actively seeking veteran’s organizations to

join them in their fight against the stigma join them in their fight against the stigma attached to mental illness, and their battle to attached to mental illness, and their battle to

secure fair and equal access and treatment for secure fair and equal access and treatment for the mentally ill. the mentally ill.

  

Gerald LaFountain, Montana State Gerald LaFountain, Montana State Commander of the Military Order of the Commander of the Military Order of the Purple Heart and member of the National Purple Heart and member of the National NAMI Veterans Council and the National NAMI Veterans Council and the National

NAMI Veterans CommitteeNAMI Veterans Committee  

Eileen White, National NAMI Board Member, member of the National NAMI Veterans Council, National trainer for I.O.O.V. (In Our Own Voice) and Chairperson, Mental Health Advisory Council

of South Dakota..