Post-Traumatic Stress Disorder PTSD

1. Post-Traumatic Stress DisorderPTSD AAPPP EDUCATIONAL MATERIAL

2. What is PTSD? PTSD is a DISORDER. It results from TRAUMA. Either from a single event or a series of events in a person’s life. It’s not a WEAKNESS. It’s your body sending the message: “I don’t know how to deal with what’s happened to me.” Any one can suffer from PTSD.

3. PTSD is Not New There is historical precedent. "And now my life ebbs away; days of suffering grip me. Night pierces my bones; my gnawing pains never rest.” Job 30:16-17

4. Civil War Soldier’s Heart

5. World War I Shell Shock

6. World War II Combat Fatigue

7. Audie Murphy • Action Hollywood movie legend AudieMurphy, son of poor Texas sharecroppers, rose to national fame as the most decorated U.S. combat soldier of World War II. Among his 33 awards and decorations was the Medal of Honor. He also received every decoration for valor that his country had to offer, some of them more than once, including 5 decorations by France and Belgium. Credited with single-handedly killing over 240 of the enemy while wounding and capturing many others, he became a legend within the 3rd Infantry Division. Beginning his service as an Army Private, Audie Murphy quickly rose to the enlisted rank of Staff Sergeant, was given a "battle field" commission as 2nd Lieutenant. He was wounded three times, fought in 9 major campaigns across the European Theater, and survived the war. • Murphy suffered from PTSD and was plagued by insomnia and depression. During the mid-60's he became dependent for a time on sleeping pills. When he recognized that he had become addicted to this prescription drug, he locked himself in a motel room, stopped taking the sleeping pills and went through withdrawal symptoms for a week. Always an advocate for the needs of veterans, he broke the taboo about discussing war related mental problems after this experience. In a effort to draw attention to the problems of returning Korean and Vietnam War veterans, Audie Murphy spoke-out candidly about his personal problems with PTSD, then known as "Battle Fatigue". He publicly called for United States government to give more consideration and study to the emotional impact war has on veterans and to extend health care benefits to address PTSD and other mental health problems of returning war vets.

8. Korea Combat Fatigue

9. Viet Nam PTSD

10. PTSD What’s this got to do with me?

11. Suicide How many U.S. war veterans commit suicide each week?

12. Suicide 120

13. Video Here’s one family’s tribute to their son who committed suicide. Note: All the videos present stories of National Guard soldiers. If 16-18% of returning troops suffer from PTSD, then hundreds of National Guardsmen returning this winter will have PTSD. The difference between them and regular Army troops is significant. Regular army soldiers will return to military bases and be with other soldiers. Guardsmen will be DUMPED right back into the community. They may literally be standing in a war zone today and be back working at the 7-11 tomorrow. WHAT DOES PTSD LOOK LIKE? WHO SUFFERS FROM PTSD?

14. The Faces of PTSD War Veterans The vast majority of homeless are vets suffering from PTSD or other personality disorders.

15. The Faces of PTSD Rape Victims

16. The Faces of PTSD Victims of Natural Disasters INCLUDING 1ST RESPONDERS Research shows a lower incidence of PTSD in police and fire fighters than combat veterans Why? PTSD training before the event Education and information is important

17. The Faces of PTSD Accident Victims

18. The Faces of PTSD Kidnap Victims Jaycee Lee Dugard

19. The Faces of PTSD Assault Victims Especially child victims of physical and emotional abuse Anyone want to admit to being a victim?

20. The Faces of PTSD Sexual or Physical Abuse OFTEN SHOWS UP YEARS AFTER THE EVENT. IN MARRIAGE BREAK UPS CHILD ABUSE MENTAL ILLNESS SUBSTANCE ABUSE When will PTSD from the Middle East War have the greatest impact on our society? 10-20 years from now

21. The Faces of PTSD Medical Procedures (especially in kids)

22. PTSD is a Normal Response to an Abnormal Situation PTSD victims are NOT weak PTSD IS YOUR BODY TELLING YOU “I DON’T KNOW HOW TO PROCESS WHAT’S HAPPENED TO ME”

23. Symptoms of PTSD • Re-experiencing the traumatic event • FLASHBACKS • NIGHTMARES • TROUBLING MEMORIES (Memories are horribly inaccurate) • Note: Don’t correct memories. They often serve as a defensive measure. • PHYSICAL REACTIONS (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

24. The Story of “Doc” Dwyer • During the first week of the war in Iraq, a combat photographer captured the arresting image of Army Spc. Joseph Patrick “Doc” Dwyer as he raced through a battle zone clutching a tiny Iraqi boy named Ali. • The photo was hailed as a portrait of the heart behind the U.S. military machine, and “Doc” Dwyer’s concerned face graced the pages of newspapers across the country. • But rather than going on to enjoy the public affection for his act of heroism, Dwyer was haunted by the demons of combat stress he could not exorcise. For the medic who cared for the wounds of his combat buddies as they pushed toward Baghdad, the battle for his own health proved too much to bear. • On June 28, 2008, Joseph Patrick Dwyer, 31, died of a drug overdose in his home in Pinehurst, N.C., after years of struggling with PTSD. During that time, his marriage fell apart as he spiraled into substance abuse and depression. Too often this is a familiar ending to stories about PTSD…but it doesn’t have to be.

25. Symptoms of PTSD • PTSD symptoms of avoidance and emotional numbing • AVOIDANCE - activities, places, thoughts, or feelings that remind you of the trauma • MEMORY LAPSE - Inability to remember important aspects of the trauma • LOSS OF INTEREST • DETACHMENT • PANIC ATTACKS – DIM VIEW OF FUTURE

26. Symptoms of PTSD • PTSD symptoms of increased arousal • INSOMNIA (Neurotransmitters) • Norepinephrine, adrenalin, dopamine, seritonin • SSRI (Selective Seratonin Reuptake Inhibitors) Celexa, Lexapro, Paxil, Prozac, Zoloft) Benzodiazapine (psychoactive drugs) Valium, Librium, Ambien • Irritability or outbursts of anger • Difficulty concentrating (Adult ADD a possibility) • Hyper vigilance (on constant “red alert”) • STARTLE REFLEX

27. Symptoms of PTSD • OTHER SYMPTOMS • Anger and irritability • Guilt, shame, or self-blame (child abuse) • Substance abuse (self-medication) (Must be addressed first – requires sobriety) • Depression and hopelessness • Suicidal thoughts and feelings • Feeling alienated and alone (NO ONE UNDERSTANDS) • Feelings of mistrust and betrayal • PHYSICAL MALADIES

28. Getting Help • PTSD MAY TAKE YEARS TO BECOME EVIDENT • KNOWING EARLY WARNING SIGNS IS IMPORTANT • SHE’S REALLY QUIET NOW • HE SPENDS A LOT OF TIME ALONE • HE’S DIFFERENT SINCE HE CAME BACK – NORMAL PEOPLE ARE NOT “DIFFERENT” • SHE’S BEEN DRINKING A LOT SINCE SHE CAME BACK • Early treatment is better. Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes. • PTSD symptoms can affect family life. • IRRITABILITY - MARITAL PROBLEMS – ANGER OUTBURSTS – MOOD SWINGS • DIVORCE – CHILD AND DOMESTIC ABUSE • PTSD can be related to other health problems. A • ANXIETY AND PERSONALITY DISORDERS – DO YOU THINK THE GUY ON THE BUS WAS ALWAYS LIKE THAT? • HEART PROBLEMS – STROKE RISKS

29. Types of Treatment • Types of treatments for post-traumatic stress disorder (PTSD) • COGNITIVE BEHAVIOR THERAPY (CBT) • TREATMENT PROCESS CENTERED ON BEHAVIOR AND ATTITUDE • MAY INVOLVE GRADUAL EXPOSURE TO THE TRAUMA • EMDR (Eye Movement Desensitization and Reprocessing) – INFORMATION PROCESSING THERAPY • EMDR uses CBT with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. UNFREEZES the brain and allows it to process the traumatic event. • Family therapy. Because PTSD affects the whole family – marriage counseling – family counseling. Most effective is EMOTIONALLY EFFECTIVE THERAPY (EFT) – deals with attachment and attachment theory. • Medication.Only treats symptoms not the underlying problem. • AA or NA – MUST FIRST GET SOBER • Group Therapy. PTSD lends itself well to groups. There’s comfort in being with people like you. Often times group members can help each other much more than a professional therapist can.

30. Self-help and Support for PTSD MAY START WITH YOU WATCH FOR SYMPTOMS BE AWARE OF TRIGGERS DON’T CHALLENGE MEMORIES LISTEN TO THE STORY – OVER AND OVER BE THERE WHEN THEY REACH OUT – LET YOUR FACE POP INTO THIR MINDS

31. You’re Not Alone“I will never leave you or forsake you.”Joshua 1:5 DON’T SELL THE VALUE OF FAITH SHORT WE ALL NEED SOMETHING TO HOLD ON TO MORAL COMPASS GUIDEBOOK BESIDES WHO CAN FIX THE PROBLEM BETTER THAN THE GUY WHO DESIGNED THE MACHINE

32. Helping a Someone with PTSD • BE PATIENT – BE EMPATHIC – NEVER SAY YOU UNDERSTAND UNLESS YOU DO • SHARE YOUR OWN STORY. • LISTEN – OVER AND OVER AND OVER • IT’S THE BODIES WAY OF TRYING TO PROCESS WHAT IT DOESN’T UNDERSTAND • WATCH FOR TRIGGERS • ANNIVERSARY DATES • PLACE PEOPLE AND THINGS – A PHONE CALL CAN WORK WONDERS • “HEY, I WAS THIKNING ABOUT YOU TODAY.” • DON’T TAKE IT PERSONAL • SOMEONE MAY UNLOAD ON YOU BECAUSE YOU’RE SAFE • CAUTIOUSLY TOLERATE ISOLATION – NOT TOO LONG • NO PRESSURE • NOT EVERYONE WANTS TO TALK . JUST BE THERE WHEN THEY’RE READY. NEVER CHALLENGE MEMORIES – IT’S THE BODY’S WAY OF PROTECTING ITSELF.

33. What do I say? • You’re not weak What’s happening to you is normal It’s partly physical It’s your body saying “I don’t know how to process this” • You’re not alone I’m here – God is here (Psalm 23) “Yea though I walk through the valley of the shadow of death, thou art with me…” The valley is not infinite You’ll come out on the other side You have to walk through it BUT NOT ALONE God walks right along with you – all the way to the other side • I care about you WHEN THEY REACH OUT – AND EVERYONE DOES (BUT NOT EVERYONE IS RECOGNIZED) LET YOUR FACE POP INTO THEIR MINDS WHAT CAN YOU DO? JUST CARE - JUST BE THERE – JUST WALK THROUGH THE VALLEY WITH THEM YOU’LL LEARN A LOT ABOUT YOURSELF IN THE PROCESS